Obstructive jaundice in neonates.

The causes of jaundice in the first few weeks of life may be categorised into hematologic, enzymatic/metabolic, infectious and obstructive. Obstructive jaundice results from an interruption in the drainage of bile in the biliary system. Surgical causes of jaundice in neonates are biliary atresia, inspissated bile syndrome, intrahepatic hypoplasia, choledochal cyst, Caroli’s disease and spontaneous perforation of the bile duct. Pediatricians should be aware of the pernicious consequences of unresolved biliary obstruction and should thus refer neonates or infants with inexplicable jaundice for surgical exploration at an earlier age.

Rising trend in the prevalence of HIV infection among blood donors.

The prevalence of HIV infection among blood donors was analysed, for the five year period from April 1988 to March 1993. All donors were patients' relatives or volunteers; no paid/commercial donors were accepted. Each year between 14,084 and 15,544 donor blood samples were screened by ELISA and those found reactive were tested by Western blot. Western blot positive samples were considered to be infected with HIV. The prevalence rates were 1.5 per 1000 (1988-89), 1.1 per 1000 (1989-90 and 1990-91) 1.9 per 1000 (1991-92) and 3.1 per 1000 (1992-93). When the mean prevalence rate over the first three years [1.3 per 1000 (1988-89 to 1990-91)] was compared to the prevalence in 1991-92 (1.9/1000), increase was statistically significant (P < 0.05). The prevalence rate in 1992-93 (3/1000) was significantly higher than that of the previous year (P < 0.01). These data suggest that the prevalence of HIV infection in blood donors is increasing and this could be a reflection of the rising prevalence of HIV infection in the general population.

Prevalence of HIV infection in pregnant women in Vellore region.

All pregnant women attending the antenatal clinic of a large hospital in Vellore, India (Christian Medical College Hospital) were screened for HIV infection between October 1987 and June 1992. A total of 36,953 blood samples were thus screened and 20 infected women were identified. Among these 18 women had acquired HIV infection from their husbands, who were also detected to be HIV infected. While these 18 women were monogamous, all the husbands had multiple sex partners. Two of the 20 women in this series were commercial sex workers. Among the 20, 17 (85%) women belonged to low socio-economic status, while three were from well-to-do families, with the husbands being businessmen or teachers. As the overall prevalence (0.054%) of HIV infection among pregnant women was relatively high and equal to or higher than many States in the USA and in areas outside London in the UK, the authors recommend that strict universal precautions be instituted in all obstetric practice in India.