Socioeconomic status and prevalence of toxoplasmosis during pregnancy.

Two hundred and thirty-six women with previous bad obstetric history (BOH), belonging to different socio-economic groups were investigated for the presence of Toxoplasma specific antibodies (IgG/IgM) using commercial diagnostic kits. The study showed a higher percentage of IgG seropositivity in women of low socioeconomic group (LSG) compared to those of high socioeconomic group (HSG). Specific IgM positivity indicative of possible acute infection, was higher in women of HSG, emphasizing the need for educating pregnant mothers on preventive measures. However, there is a need to undertake in-depth studies to understand the significance of the presence of IgM in women with BOH.

A new approach to differentiate recent vs chronic toxoplasma infection: Avidity elisa in toxoplasma serology.

The diagnosis of toxoplamosis during pregnancy is based on maternal serology, due to the asymptomatic nature of the disease. Detection of specific IgM although is the method used all over the world to detect acute infection, persistence of IgM for long periods poses problems in distinguishing acute from chronic infection, which is of crucial importance in pregnancy. Avidity ELISA is a method recently developed to distinguish IgG antibodies developed at an early stage of infection from those that reflect past immunity. The avidity assay uses protein-denaturing agents and is a modification of an ELISA. The usefulness of this technique was tested on sera of 113 pregnant women screened for Toxoplasma specific IgG/IgM antibodies. Nine of the sixteen sera positive for IgM/IgG antibodies and three sera positive for IgG alone were subjected to avidity ELISA. Only three sera were positive for low avidity IgG indicative of recent infection. All the three sera positive for IgG alone showed high avidity.

Prevalence of specific IGM due to toxoplasma, rubella, CMV and c.trachomatis infections during pregnancy.

One hundred and seventy five apparently normal asymptomatic pregnant women were studied prospectively and 247 women with different complications of pregnancy were screened at the time of delivery for infections like Chlamydia trachomatis, Toxoplasma, Rubella and cytomegalovirus (CMV). One hundred and forty two women with normal outcome of pregnancy served as controls. Specific IgM due to these agents were determined in the sera using commercial diagnostic kits. Results of the study showed that chlamydial infection was the most prevalent (29.8%) followed by Toxoplasmosis (13.1), Rubella (6.5%) and CMV (5.8%). Adverse outcome was seen among those seropositive for Chlamydia, Toxoplasmosis and Rubella. CMV showed no association with adverse outcome of pregnancy. Since Chlamydia and Toxoplasmosis are amenable to treatment with antibiotics, screening for these infections and appropriate treatment would improve outcome of pregnancy.

Effect of pyridoxine or riboflavin supplementation on plasma homocysteine levels in women with oral lesions.

BACKGROUND: A moderate increase in plasma homocysteine level has been reported to be involved in neural tube defects, which can be prevented with folic acid supplementation. Folic acid, vitamins B6- and B12-dependent enzymes are required to metabolize homocysteine. A study in rats showed higher tissue homocysteine levels in riboflavin as well as pyridoxine deficiency. We studied the effect of treatment with pyridoxine or riboflavin on plasma total homocysteine concentration in women with clinical and biochemical deficiencies of riboflavin and pyridoxine. METHODS: Plasma total homocysteine concentrations were measured in 20 women with glossitis and angular stomatitis before and after supplementation with pyridoxine or riboflavin. RESULTS: Pyridoxine treatment significantly reduced plasma homocysteine concentration while riboflavin treatment did not have a significant effect. CONCLUSIONS: Plasma total homocysteine levels tended to be higher in women with clinical and biochemical deficiency of vitamin B6 and therapy with pyridoxine reduced its level significantly. Riboflavin supplementation did not have a significant impact on plasma homocysteine concentration in women with glossitis and angular stomatitis.

Antithrombin III levels in pregnancy induced hypertension.

BACKGROUND. Antithrombin III deficiency is common as well as severe in both consumptive coagulopathy and conditions such as pregnancy induced hypertension. We determined antithrombin III levels in women suffering from pregnancy induced hypertension to determine its usefulness in assessing severity of the disease and outcome. METHODS. Forty-five pregnant women with mild and severe forms of pregnancy induced hypertension and 18 women with normal pregnancies matched for gestational age formed the study population. Fasting blood samples were collected and the plasma separated. Antithrombin III levels were estimated by the kinetic Berichrom antithrombin III method. RESULTS. The mean (SD) antithrombin III levels [0.76 (0.233) IU/ml] were significantly lower in pregnancy induced hypertension compared to the control group [0.97 (0.234) IU/ml]. Low antithrombin III and high diastolic blood pressure (> 110 mmHg) were related to poor pregnancy outcome in primigravidae. CONCLUSION. Mean antithrombin III levels were lower in pregnancy induced hypertension compared to a control group of women especially those who were primigravidae and had a diastolic blood pressure > 110 mmHg. Since low antithrombin III levels and a high diastolic blood pressure result in adverse pregnancy outcome monitoring of antithrombin III levels in pregnancy induced hypertension may help in assessing foetal jeopardy.

Iron nutritional status of preschool children.

Low hemoglobin and low MCHC levels were indicative of high incidence of iron deficiency in preschool children. The extent of iron deficiency as assessed by serum ferritin and free erythrocyte protoporphyrin showed a different trend. While FEP levels were highly suggestive of extensive iron deficiency (in 40-45% of children below the age of 5 years), low serum ferritin was seen in only 16-20% of children. The discrepant finding of high serum ferritin, and high erythrocyte protoporphyrin despite low MCHC in the present study, possibly reflects iron deficiency status along with chronic infection resulting in hyperferritinemia and hyperprotoporphyrinemia. It may be also due to associated folate deficiency resulting in non utilization of iron leading to the elevated levels of protoporphyrin.

Need for protection against rubella in India.

Reports from different parts of India highlight the existence of Rubella leading to fetal malformations and wastage. However, the need for routine immunization to control rubella has not been duly recognized. In the present study the prevalence of rubella was determined in different age groups of the population by estimating IgG antibodies to rubella virus using ELISA kit obtained from Diamedix. Two hundred and seventy four pairs of maternal blood samples were collected. Samples were also obtained from one hundred and thirty nine children aged 1-15 years and assayed for rubella antibodies. The sample was read as positive if the Elisa unit/ml was 15 EU/ml. The results showed that 94.9% of mothers and 94.1% of cord blood samples showed seropositivity. Children between 1 and 5 years showed the lowest seropositivity of 69.2% which gradually increased to reach near 95% levels by 15 years. These observations indicate the prevalence of rubella in children and thus suggest the need to protect susceptible women of reproductive age group.

Pharmacokinetics of norethisterone from two different combination contraceptive pills in Indian women.

In view of our previous studies that the plasma elimination of norethisterone (NET) from mini pill is faster in low socio-economic group Indian women, the present studies were contemplated to find the least effective dosage of NET from combination pills. Pharmacokinetics of NET were evaluated in a total of twenty women of low socio-economic group taking pills containing NET-acetate (500 micrograms or 1 mg) and ethinyl estradiol (30 or 50 micrograms respectively) on empty stomach. Blood samples were drawn at different time intervals from 0.5 to 24 hr and plasma NET was estimated by a specific radio-immunoassay. In the women taking 1 mg NET-acetate containing pills peak plasma levels ranging from 6.2 to 20.8 ng/ml were observed at 1 hr whereas with 500 micrograms pill they ranged from 2.0 to 6.5 ng/ml and the peak was noted at 4 hr. Pharmacokinetic parameters of NET were more or less comparable between the two pills. The results suggest that pills containing 500 micrograms NET-acetate and 30 micrograms ethinyl estradiol provide adequate levels of NET even in low-socio-economic group women.