Screening for light-for-gestational age infants: a comparison of three simple measurements

Summary. Fundal height, abdominal girth and abdominal length were measured during routine examination in our antenatal clinic. Standard graphs of fundal height, abdominal girth and the ratio of fundal height to abdominal length were drawn using data from 250 consecutive women with uncomplicated pregnancies. These graphs were used to predict low-birthweight-for-gestation (LGA) in 150 high-risk and 208 low-risk pregnancies. Fundal height measurements had high sensitivity (78–84%) and specificity (84–88%) and were therefore most reliable in screening for LGA babies.     

Natural Cytotoxicity and Serum Blocking in Malignant Cervical Neoplasia

ABSTRACT: Peripheral blood lymphocytes from 100 patients with various stages and histological types of squamous cell carcinoma of the uterine cervix were assayed for natural killer (NK) cell activity against K562 cells using the single cell cytotoxicity assay in agarose. The effect of autologous serum on NK cell activity and a quantitation of soluble antigen-antibody complexes was also carried out. The cancer patients showed reduced NK activity compared with normal controls, the reduction increasing with tumor load. Another observation was that patients with poorly differentiated tumours showed lower levels of NK activity. Addition of autologous serum resulted in further depression of NK activity in all groups of patients. An increase in circulating immune complexes was also evident in all groups of patients. Here again increase in tumor load and poorly differentiated tumors showed the highest levels. The results point toward a possible disturbance in NK cell activity that could be further depressed by autologous serum factors.     

Indian student doctors'' attitudes towards primary health care, poverty and related issues

An attempt is made to study the attitudes of student physicians towards primary health care, poverty, and related social issues in India. The sample consisted of 464 men and 228 women final-year medical students (a total of 692) from 11 medical colleges in India. An open-ended questionnaire was used. Content analysis was performed on the responses. There were no statistically significant differences between the responses of the students belonging to different socio-economic groups. There were some differences in the responses of the men and women students, especially on the question of poverty and related social issues. The data presented here show that the student physicians do not have a clear understanding of the primary health care approach, or about the social issues that influence health. This study underlines the need for exposing student physicians to the essential aspects of poverty and its impact on health and the importance of the primary health care approach for providing health care to disadvantaged groups.     

Monoclonal Antibody Defined Phenotypes of Peripheral Blood Lymphocytes in Cancer of the Uterine Cervix

ABSTRACT: Immunological phenotypes of lymphocytes from peripheral blood of 100 patients with different stages and histologies of cancer of the uterine cervix were analyzed using monoclonal antibodies and F(ab)₂fragments of antihuman immunoglobulin. The T lymphocyte population was decreased in advanced cases of the cancer along with a rise in the B cell numbers. The OKT4+ cells generally showed a decrease in the cancer patients in contrast to the increase shown by the OKT8+ cells. The OKT4/OKT8 ratio was altered in this cancer except in patients with stages I and IIA. In terms of histology, the poorly differentiated tumors showed a higher imbalance of the cellular composition when compared to the well-differentiated and moderately differentiated tumor-bearing patients. These findings point toward a possible alteration in the immune effector cells of these cancer-bearing patients.     

Clinical and prognostic significance of concanavalin-Ainduced suppressor cell activity in malignant cervical neoplasia

Summary. Peripheral blood lymphocytes from patients with different stages of cancer of the uterine cervix were analysed for concanavalin-A induced suppressor cell activity. All cancer patients had high levels of suppressor activity, the increase corresponding to tumour load. Radiotherapy resulted in further increase of suppressor activity. About six months after radiotherapy, patients who remained disease free returned to pretreatment levels of suppressor cell activity and later showed even lewer levels of suppression. On the other hand, patients who developed recurrent disease maintained sustained high levels of suppression and for all stages they always had higher suppressor activity than the patients who remained disease free in the corresponding stage. These results stress the importance of a possible deranged immune system in these patients and also shows the clinical and prognostic significance of the assay.     

Gastric mucosal blood flow and hepatic perfusion index in patients with portal hypertensive gastropathy

Endoscopic laser Doppler velocimetry is a simple non-invasive method to measure gastric mucosal blood flow. The present study is an attempt to determine a correlation, if any, between gastric mucosal blood flow and the hepatic perfusion index in patients with portal hypertensive gastropathy and their relationship to the severity of liver disease. Thirty patients with portal hypertensive gastropathy due to cirrhosis of the liver (eight class A, 13 class B, nine class C, according to Child-Pugh Classification) and six normal subjects were recruited into the study. In all subjects, the gastric mucosal blood flow and venous vasomotor reflex response was measured at two sites: the lesser and greater curvature, using endosoopic laser Doppler velocimetry. The hepatic perfusion index was measured using dynamic liver scintigraphy. The hepatic perfusion index (ratio of arterial/portal venous perfusion) in normal subjects and patients with portal hypertensive gastropathy belonging to Child-Pugh class A, B and C were 0.36 ± 0.02, 0.53 ± 0.08, 0.62 ± 0.14 and 1.04 ± 0.28, respectively. The gastric mucosal blood flow was similar in Child's A, B and C cases, while the venous vasomotor reflex response was reduced according to the Child-Pugh score (Child's A 37.4 ± 5.4%, normal control 62.3 ± 10.9%, Child's B 38.3 ± 18.2%, Child's C 22.5 ± 15.2%) and was statistically significant. The gastric mucosal blood flow and hepatic perfusion index are inversely correlated. The hepatic perfusion index altered with grading of cirrhotic change. This study confirms that the severity of portal hypertensive gastropathy is correlated with Child-Pugh score.