Perception towards breast feeding amongst working women teachers of a public school in Delhi.

A declining trend of breast feeding (BF) was noticed in the early 1970s, but a decade of intensive campaigning by national and international agencies for BF has reversed this. The objective of the present study was to assess the knowledge and attitude amongst teachers before launching an orientation course in maternal and child health care for them. A structured questionnaire was administered to 62 married women teachers of middle socioeconomic background and education. 98% of mothers knew that breast milk was the nutrition of choice up to 4-5 months of age, and 94% mentioned that BF should be started immediately after birth. 94% of subjects knew that colostrum should be given, 95% were aware that protective substances were present in breast milk. 61% were cognizant of the need to continue BF as long as possible. 92% of the subject knew about improved mother-infant bonding owing to BF. Only 60% knew that lactation provided complete protection against pregnancy during the first 4 months. 615 of the mothers deemed BF in public embarrassing. All subjects were aware that unhygienic bottle feeding caused diarrhea, whereas BF offered protection. Many of them felt that BF should be stopped when the mother had tuberculosis (16%), malaria (55%), and diarrhea (60%). 65% of mothers had misconceptions that diluted top milk should be given even after 4 months of age, while 35% were mistaken that commercial preparations of milk were more nutritious than breast milk. 76% had the erroneous knowledge that high consumption of almonds, cashew nuts and other dried fruits increased the volume of breast milk. 94% of the teachers knew that the child should get colostrum, and almost 37% felt that bottle feeding should be entirely avoided. These results point to the urgent need of starting nutrition education programs for working mothers.     

Combination of ABO blood group incompatibility and glucose-6-phosphate dehydrogenase deficiency: effect on hemolysis and neonatal hyperbilirubinemia

The incidence (%) of hyperbilirubinemia (serum bilirubin ≥257 μmol/l) was similar in neonates with a combination of ABO incompatibility and glucose-6-phosphate dehydrogenase (G-6-PD) deficiency (45%), with ABO incompatibility (54%) or G-6-PD deficiency (37%), alone (ns). Carboxyhemoglobin values, corrected for inspired CO, were similarly elevated in all three groups (0.87 ± 0.32%, 0.82 ± 0.29%, 0.76 ± 0.18%, respectively, ns), but correlated with bilirubin only in those with ABO incompatibility alone. ABO-incompatible/G-6-PD-deficient neonates, compared with those with either condition alone, are not at increased risk for hemolysis or hyperbilirubinemia.     

DC‐SIGN and DC‐SIGNR polymorphic variants in Northern Asian Indians

Dendritic cell‐specific intercellular adhesion molecule‐grabbing nonintegrin‐related protein (DC‐SIGNR), along with DC‐SIGN, is suggested to facilitate HIV infection of T cells in trans through binding with HIV gp120. We studied the repeat region polymorphisms in DC‐SIGN and DC‐SIGNR in 100 healthy HIV‐1 seronegative individuals among Northern Asian Indians. Each variant polymorphism obtained by polymerase chain reaction (PCR) was confirmed by cloning and sequencing. Fifty‐four per cent of the healthy seronegative individuals were homozygous for the DC‐SIGNR 7/7 repeat. The heterozygous 7/5 variant was found in 25%, while the 5/5 homozygous genotype was found in 17% of the subjects. Allele 8 was rare and accounted for 4% of the heterozygous genotype (8/7) in the sample population. DC‐SIGN polymorphism was rare, and the genotype 7/7 was most frequent in this study population. Further studies are warranted in a large sample size including high‐risk and seropositive HIV patients to confirm the association of DC‐SIGNR polymorphisms with HIV‐1 susceptibility.     

Kaposi's sarcoma of spleen with unusual clinical and histologic features

We report a case of Kaposi's sarcoma in a young woman who presented with unusual clinical and histologic features. The unusual clinical features were the absence of cutaneous lesions; the presence of a splenic mass; and extensive involvement of the peritoneum, resulting in massive ascites and intestinal and ureteral obstruction. We postulate that the spleen was the primary site of the tumor. The unusual histologic features were the presence of both sclerotic and cavernous hemangioma variants in the same tumor and extensive areas of calcium deposits in the tumor. Such atypical clinical and histologic features can pose diagnostic difficulties for both clinicians and pathologists.     

Endoscopic retrograde cholangiopancreatography in postcholecystectomy syndrome

The study was aimed to determine the role of endoscopic retrograde cholangiopancreatography (ERCP) in patients with postcholecystectomy symptoms in respect to interval of presentation following cholecystectomy. 170 patients with postcholecystectomy symptoms and negative upper gastrointestinal endoscopy were evaluated using ERCP. One hundred and seventeen (75%) out of 156 patients with successful ERCP had one or more abnormalities seen at ERCP. Bile duct stones (55 patients), benign strictures of bile duct (27 patients) were the common lesions detected. A significantly higher (p < 0.001) positive diagnosis was possible at ERCP in patients presenting with jaundice (100%) as compared to those without jaundice (61.8%). Spectrum of causes among patients presenting in early post-operative period (< 1 month) was somewhat different from those presenting later. Bile duct ligature and biliary fistula were the predominant causes in the former group, while stones and benign strictures were commoner in the patients presenting late. Endoscopic sphincterotomy and stone removal was performed successfully in 25 out of 30 patients in whom it was attempted. ERCP was found to be a very useful procedure in the management of postcholecystectomy symptoms. Spectrum of underlying disease was different in patients presenting before 1 month following cholecystectomy as compared to those presenting later.