Formulation and Antimicrobial Evaluation of A Novel Anti-Acne Herbal Hydrogel

Objective: The present study evaluates anti-microbial effect of hydrogel formulated with the extracts of some indigenous drugs against Propionibacterium acne. Material and Method: Procured Manjishtha (Rubia Cordifolia L.), Shalmali (Salmalia malabarica (DC. Schott & Endl) Schott & Endl.), Daruharidra (Berberis aristate DC), Aloe vera (Aloe barbadensis Miller), Yashthimadhu (Glycyrrhiza glabra L). Extracts of all drugs except Aloe vera were collected by hydroalcoholic extraction using the Soxhlet apparatus. Aqueous extract of Aloe vera was collected by drying method. Two types of hydrogels were prepared with the extracts of these drugs, one with 5% extract and the other with 10% extract. Propionibacterium acne strains were collected from CSIR-Imtech Chandigarh. Culturing of bacteria was done by using nutrient broth. Nutrient agar was used for preparing the culture media. The antibacterial efficacy of the hydrogels was evaluated by comparing them with standard gentamycin. Result: The prepared hydrogel showed an anti-bacterial effect, but it is comparatively less when compared with the standard gentamycin. Conclusion: The prepared gel has anti-microbial activity. 10% hyrdogel showed better results than 5% hydrogel.

Leptin, Adiponectin and its Molar Ratio as a Biomarker in the Diagnosis of Metabolic Syndrome.

Background: In order to prevent the downstream effects of metabolic syndrome, it is essential to identify the disease in its early stage and to initiate early treatment. Objective: To analyze the relationship of the adipocyte-derived hormones (adiponectin and leptin) with indices of metabolic syndrome diagnosis in Gujarati adult population. Design and setting: In this cross-sectional study, total 87 consecutive patients (44 metabolic syndrome positive and 43 metabolic syndrome negative) were recruited. Clinical evaluation included anthropometry, blood pressure, serum insulin (by electrochemiluminescence), adiponectin (by ELISA), leptin (by ELISA), and related parameters such as blood pressure, lipids and fasting blood glucose. Presence of the metabolic syndrome was assessed according to the joint statementgiven by international groups (2009). Results: Of the enrolled participants (n: 87), individuals with metabolic syndrome (n: 44) had lower adiponectin, but higher leptin, insulin resistance index and insulin levels than participants with no metabolic syndrome (n: 43). On bivariate correlation analysis with Pearson’s correlation coefficient (r), leptin and adiponectin were positively and negatively linked, respectively, with waist circumference, BMI, triglyceride and fasting insulin. However, with respect to HDL-C, a strong negative and positive correlation (p<0.001) was found between leptin and adiponectin respectively. Leptin/Adiponectin ratio had a largest AUC (0.892) suggesting its better diagnostic utility with 91% sensitivity and 81% specificity in studied population compare to leptin (0.875) and adiponectin (0.684).

Influence of genetic variability at the ACE locus in intron 16 on Diabetic Nephropathy in T1DM patients.

Background: Diallelic [insertion/deletion (I/D)] polymorphism in the angiotensin-converting enzyme (ACE) gene has been reported inconsistently as being associated with risk of diabetic nephropathy (DN). Objective: To examine the three ACE poly-morphic variants in intron 16 for a possible role in modulating DN in T1DM patients from Kutch region, Gujarat. Design and setting: I/D polymorphism in intron 16 of the ACE gene was examined in a case-control group (280 participants with T1DM, case participants n=138; control participants n=142) for association with nephropathy. All recruited individuals were carefully phenotyped and genotyping was performed using polymerase chain reaction and gel electrophoresis methods. Suitable descriptive statistics was used for different variables. Results: No departure from Hardy-Weinberg equilibrium was observed in cases or controls. Genetic polymorphism at the ACE locus in intron 16 were significantly associated with nephropathy when analyzed either by genotype or allele frequencies and D/D variant were significantly (p=0.0002) associated with nephropathy at the 5% level. In multivariate analysis, D/D variant had an independent and strongest influence on the micro-albumin excretion (p=0.002, OR=2.11, 95% CI=1.26– 4.48). However, it did not independently change the odds of having macroalbuminuria versus microalbuminuria. Conclusion: Genotype-associated differences in ACE in intron 16, have functional consequences in genetic susceptibility to diabetic nephropathy in a population with T1DM, and thus represent a potential DN genetic susceptibility locus worthy of replication.

A study of the branching pattern of aortic arch.

The purpose of the present study is the description of the aortic arch branches variation in order to offer useful data to anatomists, radiologists, vascular, neck and thorax surgeons. Methods: A total 46 Indian adult cadavers were used. The authors investigated anatomical variation of the aortic arch and its major branches. Results : The three major branches directly originate from the aortic arch in 38 (82.6 %) ; the 3 ( 6.5%) remaining aortic arch showed only two branches and 5 (10.9 %) aortic arch showed the direct arch origin of left vertebral artery. Interpretation & conclusion: Despite the fact that the variations in question are usually asymptomatic, they may cause dyspnoea, dysphasia, intermittent claudication, misinterpretation of radiology examinations and complications during neck and thorax surgery. This study would provide an anatomical basis to assist surgeons in performing safe vascular surgery involving the aortic arch and its branches.

Effect of active smoking on glucose tolerance and lipid profile.

Background: The acute effects of cigarette smoking in smokers include dyslipidemia and impaired insulin action that leads to abnormal glucose metabolism. Both dyslipidemia and insulin resistance are well-established major risk factor for cardiovascular disease. Aims & Objective: To ascertain the prevalence of several degrees of glucose abnormalities in smokers and to assess the impact of active tobacco smoking on lipids profile in adult male population. Material and Methods: A cross-sectional study was conducted with one hundred and fifty two active adult male smokers defined by persons smoking cigarettes over 2 pack years and fifty age and Body Mass Index (BMI) matched healthy control. Smokers were classified into mild to moderate (Group I) and severe (Group II) based on the number of pack years as 2 – 10 and more than 10 respectively. Glucose tolerance was assessed according to American Diabetes Association (ADA) guidelines and standard methods were adopted to check the lipid levels. Data analyses were performed with the SPSS 15.0 statistical software. Results: An abnormal glucose metabolism was diagnosed in 66% (95% confidence interval [CI], 61.4%-71.6%) of the smokers. The mean HOMA-IR (Homeostasis model assessment-insulin resistance) in smokers was 6.8 + 3.1. Decreasing glucose tolerance was associated with insulin resistance i.e. from normal glucose tolerance condition through IGT, IFG to diabetic, the HOMA IR progressively increased (4.9 + 2.1, 6.7 + 4.2, 7.4 + 3.1 and 8.9 + 3.7 respectively). Atherogenic index as indicated by total cholesterol/HDL cholesterol and LDL cholesterol/HDL cholesterol ratio was significantly elevated in both the smoker groups as compared to non-smokers. According to the Adult Treatment Program III criteria, the metabolic syndrome was diagnosed in 44.07% (95% CI, 35.9%-47.3%) of the smokers. In fact only 10 participants (6%, 95% CI, 5.4% - 7.1%) showed good control of cardiovascular risk factors. Conclusion: Abnormalities in lipid profile and glucose tolerance are directly correlated with smoking pack years in this study. Intense education program about adverse health events of smoking should be under taken through all means.

Diabetic nephropathy: progression and pathophysiology.

Diabetic nephropathy is the leading cause of kidney disease in patients starting renal replacement therapy and affects ~30% of type 1 and type 2 diabetic patients. This review focuses on the progression and pathophysiological aspects of the condition. The natural history of diabetic nephropathy is characterized by specific renal morphological and functional alterations. Features of early diabetic renal changes are microalbuminuria (30-300mg/day), glomerular hyperfiltration, glomerular and renal hypertrophy, increased basement membrane thickness, and mesangial expansion with the accumulation of extracellular matrix proteins such as collagen, fibronectin, and laminin. Advanced diabetic nephropathy is characterized by macroalbuminuria ( >300mg/day), a progressive decline in glomerular filtration rate, decreasing creatinine clearance, glomerulosclerosis, and interstitial fibrosis. Although poor glycemic control is an important risk factor, glycemia does not fully explain why only a subset of diabetic patients progress to end stage renal disease. Several decades of extensive research has elucidated various pathways to be implicated in the development of diabetic kidney disease such as systemic and glomerular hypertension, advanced glycation endproducts and the aldose reductase system. Furthermore, hemodynamic factors, the reninangiotensin system, the endothelin system, the intracellular signaling molecule protein kinase C, transforming growth factor-ß, growth hormone, insulin like growth factors, vascular endothelial growth factor, and platelet-derived growth factor are believed to be involved in the pathogenesis. Thus, there are clearly many points at which therapeutic approaches could be tried to provide renoprotection in diabetes. It is likely that due to its complexity, targeting multiple points in altered metabolism in the diabetic kidney will be more successful in attenuating the development of diabetic nephropathy, rather than a single approach.

Increased prevalence of type II diabetes mellitus in hepatitis C virus infection in western India.

BACKGROUND: Type II diabetes mellitus (DM) has been shown as more common in patients with hepatitis C virus infection (HCV). Similar data from India is not available. METHODS: This 3-year prospective study included consecutive Indian patients with HCV to detect the DM. In all patients, the presence of DM, duration of DM, probable duration of HCV, genotype of HCV, presence of steatosis and presence of cirrhosis were noted. Comparable numbers of consecutive patients with hepatitis B virus infection (HBV) and irritable bowel syndrome (IBS) were analysed for the presence of DM. RESULTS: A total of 200 patients with HCV were analysed: mean age = 45.9 +/- 9.8 years; male:female=1.3:1; genotype distribution (in 80 patients which included 17 patients of DM)--genotype 3 in 47 (58%), genotype 1 in 31 (39%) and genotype 2 in 2(3%) patients; probable duration (unknown in 40 patients) of HCV = 12.8 +/- 8.2 years; steatosis in 55(27.5%) patients; cirrhosis in 88 (44%) patients. Of these 200 patients, DM was present in 44(22%) patients with mean duration of DM of 6.1 +/- 2.3 years. HCV preceded DM in 29 patients by 10.8 +/- 2.3 years. Among HCV with genotype 3, DM was present in 11(23.4%) patients and with genotype 1, DM was present in 6(19.3%) patients. In patients with DM, cirrhosis and steatosis were present in 28(63.6%) and 20(45.4%) patients, respectively, as compared to 60 (38.4%) and 35 (22.4%) patients without DM. There was significantly lower presence of DM, 24 (12%) and 19 (9.5%), in 200 patients of HBV and 200 patients of IBS, respectively. CONCLUSION: There is increased prevalence of DM in patients with HCV. HCV precedes the development of DM by a decade.

Hepatobiliary tuberculosis in western India.

Tuberculous involvement of liver as a part of disseminated tuberculosis is seen in up to 50-80% cases, but localized hepatobiliary tuberculosis (HBTB) is uncommonly described. During 6 years, a total of 280 consecutive patients with TB were evaluated prospectively for the presence and etiology of liver involvement. Cases with miliary TB or immunosuppression and cases receiving anti-tuberculosis drugs prior to presentation to our unit were excluded (38 cases). Details of clinical, biochemical and imaging findings and histology/microbiology were noted. Of 242 included cases, 38 patients (15.7%; age 38.1 +/- 12.5 years; sex ratio 2.5:1) had HBTB, whereas 20 patients (9%; age 39.3 +/- 16.3 years; sex ratio 2.1:1) had other liver diseases. Diagnosis of HBTB was based on caseating granuloma on histology (18/23 procedures), positive smear/culture for acid-fast bacilli (21/39 procedures) and positive polymerase chain reaction for Mycobacterium tuberculosis (28/29 procedures) when diagnostic procedures were guided by imaging results. Thirty-eight cases with HBTB were classified as follows [patients (n), (%)]: (A) hepatic TB [20 (52.6%)]: (1) granulomatous hepatitis - 10 (26.3%), (2) liver abscesses or pseudotumors - 10 (26.3%) and (3) calcified hepatic granuloma - 0 (0%); (B) biliary TB [15 (39.4%)]: (1) biliary strictures - 2 (5.2%), (2) gall bladder involvement - 1 (2.6%) and (3) biliary obstruction due to lymph node masses - 12 (31.5%); (C) mixed variety [3 (7.8%)]: (1) simultaneous granulomatous hepatitis and biliary stricture - 1 (2.6%) and (2) simultaneous lymph node involvement and calcified hepatic granuloma - 2 (5.2%). All the cases responded well to standard anti-tuberculosis therapy. HBTB forms an important subgroup in TB cases. It requires a combination of imaging, histological and microbiological procedures to define the diagnosis. HBTB responds well to treatment.

Do different hepatitis C virus genotypes behave differently?

BACKGROUND: The natural history of hepatitis C genotype III infection, the predominant form in India, is not wholly understood. This study attempted to compare the natural history of diseases due to genotypes III and I. METHODS: This 10-year prospective follow-up study (mean follow-up period = 3.6 +/- 1.4, range = 1-10 years) included 108 patients of hepatitis C. Group 1 comprised 65 patients with hepatitis C genotype III infection (mean age = 46.1 +/- 11.3 years, male: female = 1.8 : 1) and group 2 comprised 43 patients with hepatitis C genotype I infection (mean age = 44.2 +/- 8.2 years, male: female = 2.1 : 1). Demographic features, clinical presentation and course, response to treatment (either interferon-ribavirin or peginterferon-ribavirin combination) and complications were noted for all patients. Data were analysed using the chi-square test and Student's t-test. RESULTS: The number of steatosis cases was larger in group 1 (32.3%, 21/65 patients) than in group 2 (18.6%, 8/43 patients) although statistically not significant. There was no significant difference in the mode of infection, presence of diabetes, obesity or alcoholism, clinical presentation, extra-hepatic manifestations, stage of liver disease, complications like decompensation or hepatocellular carcinoma and mortality. Overall, the sustained treatment response was significantly greater in group 1 patients [(87.5%, 21/24 treated patients vs. 56.2%, 9/16 treated patients in group 2; p = 0.0001)]. CONCLUSION: HCV with genotype III was associated with better treatment response. Although statistically not significant, more number of patients in genotype III had steatosis.

Primary mesenteric venous thrombosis: a study from western India.

INTRODUCTION: The prevalence and clinical spectrum of mesenteric venous thrombosis (MVT) in India is largely unknown. METHODS: We retrospectively re-viewed the case records of patients with primary mesenteric venous thrombosis seen over a 10-year period and retrieved information on clinical picture, underlying hypercoagulable states and outcome. RESULTS: The 28 cases (mean age 41.2 [SD 10.2] years; 19 male) included 13 with acute MVT, 10 with subacute MVT and 5 with chronic MVT. Ten patients had past thromboembolic events (multiple events in five); four patients had isolated superior mesenteric vein involvement and 14 had multiple vessel involvement. Hypercoagulable state was identified in 17 patients, with multiple etiologies in 7 patients. Pre-operative diagnosis was made in all patients. Ten patients needed surgical management; the rest were managed medically initially, but 2 required surgery on follow up. Seven patients died during a follow up of up to 10 years, with in-hospital mortality during index admission in six. CONCLUSIONS: Most of the patients with MVT have multiple intra-abdominal vessel involvement and underlying hypercoagulable state. The policy of early treatment with anticoagulation in all and surgical treatment as per need, achieves low mortality.

Monotherapy with peginterferon alpha-2b {12 kDa} for chronic hepatitis C infection in patients undergoing haemodialysis.

BACKGROUND: A combination of Peginterferon and Ribavirin is the standard treatment for patients with chronic hepatitis C viral infection (HCV). Ribavirin is contraindicated in patients with chronic renal failure (CRF). Conventional Interferon monotherapy is effective in around 30% of such patients. There is scanty data on the use of Peginterferon monotherapy in them. METHODS: We describe our preliminary experience of monotherapy with Peginterferon alpha- 2b {12 kDa} (Peg-IFN) for HCV patients undergoing haemodialysis for CRF. They were treated with Peg-IFN 1 microg/kg body weight subcutaneously once a week for 24 weeks. In all patients, clinical (age, sex, mode of acquiring HCV, pattern of haemodialysis) and virological (HCV RNA quantitative-PCR and genotype) profile was noted at baseline. Early virological response at 12 weeks (EVR), end-of-treatment virological response at 24 weeks (ETVR) and sustained virological response after 6 months of stopping treatment (SVR) were noted during the follow-up period. RESULTS: The clinical and virological characteristics of patients were as follows: Of a total number of 6 patients, 5 were male and 1 was female with an age range of 35 to 62 years. The duration of haemodialysis was from between 5 and 12 months before the start of treatment and its frequency lay between 1 and 3 times a week. The mode of acquiring HCV was blood transfusion (100%). All 6 cases suffered from chronic hepatitis. The genotype distribution was genotype 3 in 3 (50%), genotype 1 in 1 (16.7%) and genotype none of 6 in 2 (33.3%) patients. All the patients (100%) completed treatment. EVR was seen in all 6 patients (100%). ETVR was seen in 5 of 6 patients (83.3%). A follow-up period of more than 1 year was available in 4 patients. 3 of these 4 patients (75%) had SVR. A virological response was maintained in all 3 (100%) patients with SVR even after 6 months of renal transplantation. CONCLUSION: Peg-IFN monotherapy is safe and effective in patients with HCV who are on haemodialysis for CRF.

Antiviral therapy of decompensated cirrhosis due to hepatitis C viral infection.

BACKGROUND: For decompensated HCV cirrhosis, liver transplantation is the only available treatment. Only a few studies in world literature have used antiviral therapy in this situation. METHODS: During a 4-year period, we gave closely monitored antiviral therapy to all consecutive patients of HCV-related cirrhosis with episodes of decompensation. Patients who were excluded from the standard Interferon trials were treated. Patients were started on low dose Interferon alpha-2b (1 MIU tiw) and Ribavirin (800 mg/day) combination therapy or low-dose Interferon alpha- 2b (1 MIJ tiw) monotherapy (in the presence of renal failure) for 6 months to 1 year. Dose of Interferon was escalated gradually to a maximum dose of 3 MIU tiw according to clinical follow-up. RESULTS: A total of 18 patients (mean age = 51.6 +/- 9.8 years; male: female ratio= 10: 8) were treated. At baseline, mean Child-Pugh score was 9.4 +/- 0.8 (range = 7-12). Interferon monotherapy was given to 4 (22.2%) and combination therapy to 14 (77.8%) patients after clinical recovery from an episode of decompensation. Though 16 (88.9%) patients noticed some adverse events, 15 (83.3%) patients completed the treatment schedule. Premature discontinuation was warranted in 3 (16.7%) patients. Out of the 15 patients who completed the treatment schedule, mean maximum tolerated dose of Interferon was 1.73 +/- 0.6 MIU tiw, 10 patients had genotype II or III and 2 patients had genotype I. Of these, end-of-treatment virological response was seen in 11 (73.3 %) and sustained virological response (at 6 months) in 7 (46.6 %) patients. All these patients were followed up for a mean duration of 1.3 +/- 0.6 years (6 month to 3.5 years). During follow up, 7 non-responders had further episodes of decompensation, of whom 4 died. CONCLUSION: Although there is high intolerance to the treatment, closely-monitored low dose escalating Interferon and/ or Ribavirin therapy achieves good results.

Randomised, double-blind, comparative study to evaluate the efficacy and safety of ganaton (itopride hydrochloride) and mosapride citrate in the management of functional dyspepsia.

Prokinetic agents like itopride hydrochloride and mosapride citrate are commonly used in the management of functional dyspepsia. However, in a recently conducted international, multicentric study, efficacy of 3 different regimens of mosapride was shown to be comparable to placebo. The objective of this phase 4 randomised, double blind, prospective study was to compare the efficacy and safety of ganaton (itopride hydrochloride) and mosapride citrate in the management of functional dyspepsia among patients attending the gastroenterology outpatient department of a tertiary care hospital. Ganaton 50 mg or mosapride citrate 5 mg three times daily before meals for a period of 2 weeks was administered orally. Thirty functional dyspepsia patients in each group (total = 60) were randomised to receive itopride hydrochloride or mosapride citrate treatment for 2 weeks. In itopride versus mosapride groups, global efficacy as judged by patients was excellent in 17 versus 9 (p < 0.05) and poor in 0 versus 3 (p < 0.05). In itopride versus mosapride group global efficacy as judged by physician was excellent in 24 (80%) versus 15 (50%) and poor in 0 (0%) versus 3 (10%) patients respectively. The global efficacy was rated as excellent to good in significantly (p < 0.05) more number of patients in itopride (93.3%) group as compared to mosapride (63.33 %) group. None of the patients reported any adverse events with itopride treatment. In the mosapride group 5 patients (16.7%) reported adverse events. Two patients (6.7%) were withdrawn from mosapride treatment due to adverse events. The physician rated global tolerability ofitopride versus mosapride treatment as excellent in 23 (76.7%) versus 8 (26.7%) (p < 0.05) and poor in 0 (0%) versus 6 (20%) patients respectively. It may be concluded that ganaton (itopride hydrochloride) is superior in efficacy and safety over mosapride citrate in the management of functional dyspepsia.

Clinical spectrum and natural history of non-alcoholic steatohepatitis with normal alanine aminotransferase values.

Non-alcoholic fatty liver disease (NAFLD) including nonalcoholic steatohepatitis (NASH) is a well-established cause for chronic liver disease. In most studies on NASH, elevation in alanine aminotransferase (ALT) is taken as one of the diagnostic criteria. However, the clinical and histological spectrum and natural history of NAFLD with normal ALT are not well explored. This study was planned to define the clinical spectrum and natural history of patients with NAFLD with normal ALT, and to compare them with NAFLD with abnormal ALT. A prospective study including 81 consecutive patients with ahistological diagnosis ofNAFLD was planned during the period from 1999 to 2003. Consecutive (n=81) patients with the histological diagnosis of NAFLD were included in the study. In all the patients, clinical, anthropometric, laboratory, histological and imaging features were noted at the baseline. All these patients were followed up regularly at 6-month intervals. Of the 81 cases, 25 patients (including 60% cirrhotics) had persistently normal enzyme, whereas 56 (including 23% cirrhotics) had abnormal ALT. Both the groups were comparable with respect to distribution of age, gender, ethnicity, clinical features, imaging features, histological severity and laboratory features; except a higher incidence of diabetes and higher occurrence of advanced liver disease at baseline in NAFLD with normal ALT. Natural history of NAFLD was better in patients without cirrhosis irrespective of baseline ALT levels than in patients with cirrhosis; except for a higher incidence of decompensation in cirrhotics with normal ALT. The entire clinical and histological spectrum of NAFLD is seen in patients with normal ALT and is not different from patients with abnormal ALT. In patients with diabetes and hepatomegaly in the absence of other obvious liver diseases, even normal ALT may not rule out advanced liver disease, and liver biopsy may be necessary to identify the severity of liver disease.

Prevalence of metabolic syndrome in non-diabetic and non-cirrhotic patients with non-alcoholic steatohepatitis.

Recently, insulin resistance (IR) was proposed as a primary pathogenic mechanism in non-alcoholic steatohepatitis (NASH). The prevalence of IR and metabolic syndrome remains largely unstudied in patients with NASH and without diabetes and cirrhosis, both being conditions associated with IR. During a 1-year period, all non-diabetic and noncirrhotic patients seen in our institute with a diagnosis of NASH were subjected to anthropometric measurements, clinical examination, lipid profile and glucose tolerance test to define metabolic syndrome. All the patients underwent test for fasting glucose and insulin levels to define the insulin resistance by HOMA-R (homeostasis model assessment) method. Of the 25 patients with NASH, the metabolic syndrome was present in 17 (68%) and at least one criterion for the metabolic syndrome was present in all the patients. IR was present in 20 patients (80%). All the patients were either overweight (8%) or obese (92%). Because of the high prevalence of the metabolic syndrome and IR in patients with NASH, it is pertinent to test for IR and metabolic abnormalities in all patients with NASH. Also, all patients with metabolic syndrome should undergo liver function tests and, in the presence of abnormal transaminases, a liver biopsy to define NASH.

Clinical experience with the use of Fluorescence in Situ Hybridization on uncultured cells for prenatal diagnosis.

The aim of the study was to prospectively evaluate the usefulness and limitations of Fluorescence In Situ Hybridization (FISH) on uncultured cells for prenatal diagnosis of numeric aneuploidies of chromosomes 13, 18, 21, X and Y. Hundred prospectively selected pregnant women that were at high risk of giving birth to an abnormal child were offered prenatal diagnosis by FISH after appropriate counseling. Fetal tissue was obtained by chorionic villus sampling (n=26), amniocentesis (n=62) and or fetal blood sampling (n=12) and processed for FISH using commercial probes. Six cases were excluded initially owing to maternal blood contamination or inadequate sample. FISH results were available in 98% of cases, in 2% of cases there was FISH failure. Of the remaining 92 cases, chromosome aneuploidy was detected in eleven cases. FISH was found extremely valuable in cases presenting with fetal abnormalities detected on ultrasonography and also for rapid screening of aneuploidies in cases of abnormal triple marker test. But as the diagnosis is limited to only a small number of chromosomes, appropriate evaluation of the cases with counseling regarding the limitations of FISH is mandatory before offering this test for prenatal diagnosis.