Breastfeeding practices of urban and rural mothers.

This longitudinal study was conducted to describe the prevalence of exclusive breastfeeding and factors influencing it in urban (tertiary care hospital of Delhi) and rural (First Referral Unit in Haryana) settings. The exclusive breastfeeding rates were 38%, 30%, 24%, 20%, 16% and 1% at discharge, 1.5, 2.5, 3.5, 4.5 and 6 months, respectively in the urban and; 57%, 16%, 9%, 6%, 5% and 0% at discharge, 1.5, 2.5, 3.5, 4.5 and 6 months, respectively in rural setting. Use of formula feeding was very high (55%) among the urban mothers during hospital stay. The factors associated with continuation of exclusive breastfeeding were mothers’ knowledge regarding breastfeeding and reinforcement by health professionals, whereas the factors associated with cessation were perceived insufficiency of milk, and cultural practices.

Benign tumors and tumor-like lesions of the calcaneum: A study of 12 cases.

Benign tumors of the calcaneum are rare. Cystic lesions such as simple bone cysts and aneurysmal bone cysts are commonly seen. Aims and Objectives: To evaluate tumors of the calcaneum, which were seen over a 12-year period. Materials and Methods: We analyzed noninfectious, noninflammatory, benign lesions of the calcaneum seen in the Orthopedic Out Patient Department from 1991 to 2003. Twelve such tumors were encountered. There were 11 males and one female and their ages varied from 18 to 53 years with a median of 31. Data was collected from the histopathology reports, radiographs, and inpatient and outpatient records. One of the coauthors reviewed the histopathologic findings of all the tumors. Results: Twelve benign lesions were seen in 12 patients. In our series, cysts predominated, with three aneurysmal bone cysts and five simple bone cysts. The other benign tumors were: one fibrous dysplasia, one vascular hamartoma, one osteoblastoma, and one chondromyxoid fibroma. The bone cysts were treated by curettage, with or without bone grafting, except for one large aneurysmal bone cyst, which was treated by excision of the calcaneum. The postoperative function in this patient was good, with modified footwear. Conclusion: The calcaneum is an uncommon site for most bone tumors, and in our series, bone cysts were the most common benign lesions. Curettage and bone grafting or the use of bone substitutes can be effectively used in the treatment of symptomatic bone cysts of the calcaneum.

Tyrosinemia type I: a clinico-laboratory case report.

Progressive hepatocellular dysfunction in a neonate, resulting in elevated serum alpha-fetoprotein together with raised blood levels of tyrosine and methionine, a generalized amino aciduria and the absence of urinary delta-aminolevulinic acid and succinylacetone, suggests a diagnosis of tyrosinemia type Ib. Classical tyrosinemia type I arises from a deficiency of fumarylacetoacetate hydrolase while the variant tyrosinemia type Ib results from a deficiency of maleylacetoacetate isomerase.

Hyperammonemia with citrullinemia.

Two cases of hyperammonemia with elevated citrulline are reported, one resulting from a deficiency of pyruvate carboxylase and the other from a partial deficiency of argininosuccinate synthetase. Diagnosis was based on clinical, biochemical and amino acid profiles. The utility of amino acid determinations in hyperammonemia suspected to underlie an inborn error of metabolism is emphasized.

Oxidative damage in intermediate syndrome of acute organophosphorous poisoning.

BACKGROUND & OBJECTIVES: The main cause of morbidity due to organophosphate poisoning is intermediate syndrome (Type II paralysis) that can occur 48-72 h after poisoning. Mechanisms that underlie the intermediate syndrome are not known. This study investigates the role of oxidative damage to muscles as a possible mechanism underlying the development of the intermediate syndrome. METHODS: Nineteen patients with acute organophosphate poisoning were evaluated from admission to discharge from intensive care for the severity of poisoning and the development and duration of the intermediate syndrome. Blood cholinesterases and parameters of oxidative stress were studied daily and their temporal profiles analysed according to the severity of poisoning and the development and duration of the intermediate syndrome. RESULTS: Fifteen patients had severe poisoning and 16 developed intermediate syndrome. There was a positive association between the severity of poisoning and the occurrence of intermediate syndrome. There was no association between the organophosphate ingested and the development of intermediate syndrome. Erythrocyte membrane acetylcholinesterase and serum butyrylcholinesterase levels at admission and over the course of poisoning were significantly (P < 0.001) reduced in patients compared to controls. There were significantly (P < 0.05) higher levels of lipid peroxidation, conjugated dienes and protein thiols in erythrocyte membranes of patients who developed the intermediate syndrome compared to healthy controls, in patients who developed intermediate syndrome compared to those who did not and in patients with long compared to short duration intermediate syndrome. INTERPRETATION & CONCLUSION: In acute organophosphate poisoning, severe and prolonged acetylcholinesterase inhibition is associated with oxidative stress, detected in erythrocyte membranes, that occurs early in the course of poisoning and may contribute to the development and severity of intermediate syndrome.

Rat brain membrane-bound delta opioid receptor: loss and reactivation of binding on dialysis and aging at low temperature.

A change in the environment of rat brain membranes by dialysis from phosphate buffered saline (PBS) to 10 mM potassium phosphate (pH 7.2) led to a 35% loss in delta opioid receptor binding, while alteration of membrane structure on freezing at -20 degrees C for 55 days led to 85% loss of receptor binding. The dialysate, 200 mM KCI and NaCl restored receptor binding lost on dialysis. This K+ and Na+ restabilization of the receptor can be through cation-pi bonding, interactions that are suited to the lipid bilayer. In membranes stored at -20 degrees C, the loss of binding is attributed to increased membrane fluidity by phospholipase A2 action on membrane phospholipids, resulting in an increase of free fatty acids. K+ but not Na+ restabilization of these membrane receptors may be due to the ability of K+ to decrease membrane fluidity.

Utility of the cysticercus immunoblot in a patient with an atypical solitary cerebral cysticercus granuloma.

The value of the enzyme linked immunotransfer blot (EITB) assay in avoiding an invasive diagnostic procedure in a patient with an atypical solitary cerebral cysticercus granuloma is presented.

A molecular weight study of adenosine deaminase.

Adenosine deaminase exists in its smallest molecular form (ADA-S) of < 42 kDa in primate and rodent brain, intestine and liver, human erythrocytes, avian liver and in bovine spleen and intestine. The enzyme exhibits molecular heterogeneity in monkey and chicken liver and human erythrocytes. The large form of adenosine deaminase is seen in monkey liver and intermediary forms of the enzyme in chicken liver and human erythrocytes. Large forms of the enzyme predominate in rabbit intestine. Molecular weights of adenosine deaminase molecular forms were determined by gel filtration and by non denaturing gel electrophoresis with construction of Ferguson plots. Anomalous migration of the enzyme on SDS-PAGE possibly due to charge, disulfide bonds and proline content, did not allow for molecular weight determination on denaturing gels.

A molecular weight study of the rat brain delta opioid receptor.

The molecular weight of the rat brain delta opioid receptor, studied with antiidiotypic antibodies to anti-leucine enkephalin that mimic leucine enkephalin in binding to the receptor, was examined by molecular sieving and Western Blots under nondenaturing, denaturing and reducing conditions. The receptor appeared to be 55-65 kDa, which on solubilization may exist in equilibrium with receptor oligomers of 130-150 kDa and aggregates of > 200 kDa. These forms may also represent aggregation due to solubilization. A 38-43 kDa molecule was considered a minor form of the receptor in the brain.

Ontogeny, glycosylation and modulation by dialysis, sodium and nucleotides of the rat brain delta opioid receptor studied with anti-idiotypic antibodies to anti-leucine enkephalin.

Ontogeny of the rat brain delta opioid receptor in 1-60 days old animals has been studied with anti-idiotypic antibodies to anti-leucine enkephalin. It is found that delta opioid receptors are present in rats from birth and attain adult levels by 28 days and these receptors are glycosylated and inhibited by Na+, GTP, ATP and CTP at all ages. Adult membrane-bound and solubilized delta opioid receptors are inhibited to similar extents by Na+ (100 mM), GTP, ATP and CTP (50 microM). Dialysis of the adult membrane-bound receptor led to 81% loss in binding which was restored by 100 mM Na+, 50 microM GTP, ATP and CTP to 77, 72, 87 and 94% respectively and by 100 mM NH4+, Mg2+, Ca2+ and Mn2+ to 63, 43, 57 and 73% respectively. Dialysis of the solubilized receptor resulted in 23% loss in binding with Na+ (100 mM), GTP and ATP (50 microM) inhibiting receptor binding to 46, 62 and 54% respectively, while CTP (50 microM) restored binding to 88%. These studies indicate that the delta opioid receptor can be probed with anti-idiotypic antibodies to anti-leucine enkephalin, that functional, glycosylated receptors are present at birth in rats and that the adult membrane-bound and solubilized receptors are modulated differently by dialysis.

Immunohistochemical mapping of rat brain delta opioid receptor.

Delta opioid receptors were immunohistochemically mapped in the rat brain with anti-idiotypic antibodies to anti-leucine enkephalin specific for the receptor. Regions of highest receptor binding were in the cerebral cortex and caudate putamen Lower receptor binding was mapped to the hypothalamus and claustrum.

The rat brain delta opioid receptor studied with anti-idiotypic antibodies to anti-leucine enkephalin.

Anti-idiotypic antibodies to anti-leucine enkephalin raised in rabbits immunized with leucine enkephalin conjugated to BSA, were purified and characterized for their ability to mimic leucine enkephalin in binding to the rat brain delta opioid receptor. An ELISA was standardized to assay the delta opioid receptor using these antibodies. The rat brain receptor was purified to 308 fold with a yield of 1.5% using these antibodies for assay. The receptor, probed with these anti-idiotypic antibodies, was characterized with respect to binding parameters, molecular weight and effect of divalent cations.

Poor diagnostic value of adenosine deaminase in pleural, peritoneal & cerebrospinal fluids in tuberculosis.

Adenosine deaminase (ADA) was estimated in 84 pleural, 140 peritoneal and 136 cerebrospinal fluids to study its diagnostic usefulness as a routine test for tuberculosis. The sensitivity, specificity, positive and negative predictive values for diagnosing tuberculosis in pleural fluids (ADA > 30 U/l) was 67, 92, 78 and 87 per cent respectively, in peritoneal fluids (ADA > 15 U/1) it was 89, 81, 25 and 99 per cent respectively and in cerebrospinal fluids (ADA > 10 U/l) it was 50, 90 21 and 97 per cent respectively. The differences in mean ADA levels between tuberculous (28.0 and 19.5 U/1) and non-tuberculous (9.7 and 4.8 U/1) peritoneal and cerebrospinal fluids although statistically significant (P < 0.001), were of no practical clinical value. A wide scatter in ADA values was seen in both tuberculous and non-tuberculous fluids. ADA estimation in plasma, lymphocytes and cell fractions of fluids was also not diagnostically useful nor did it throw light on the source of elevated ADA in fluids.