Age-related proximal femur bone mineral loss in South Indian women: a dual energy X-ray absorptiometry study.

OBJECTIVES: i) To collect normative data for proximal femur bone mineral density (BMD) in South Indian women using dual energy X-ray absorptiometry (DXA) and ii) to study the rate and significance of hip bone mineral loss with advancing age in this population. MATERIAL AND METHODS: Forty five women, whose age ranged from 16 to 84 years were studied. This sample was drawn randomly from general medical practice at KJ Hospital, Chennai, South India during November, 1997 to April, 1998. Of these 45 cases, 21 were pre-menopausal (mean +/- SD age = 30.9+/-8.8 years) and 24 post-menopausal (mean +/- SD age = 62.1+/-11.0 years). Subjects with secondary bone diseases were excluded. Also excluded were those taking any drugs known to affect calcium metabolism e.g., thiazide diuretics, oestrogen and calcium. Subjects were divided into seven decadal age groups from 15-24 years to 75-84 years. BMD of the right proximal femur was evaluated using a QDR-1000 DXA bone densitometer (Hologic Inc., Waltham, Massachusetts, USA). Data analysis was done with SPSS/PC statistical software package. RESULTS: Linear regression analysis showed significant (p < 0.001) negative correlations between all hip BMD variables at different regions of interest and patient's age. Relative to that at 30 years of age, rates of BMD loss in the neck of femur, trochanter, intertrochanter, total hip and Ward's triangle were 0.68%, 0.65%, 0.58%, 0.61% and 1.05% per annum respectively. Over the age of 65 years, the above mentioned regions BMD decreased by 0.91%, 0.84%, 0.72%, 0.78% and 1.66% per annum respectively. CONCLUSION: Normative data for proximal femur BMD in South India women have been evaluated and it may prove useful for diagnosing osteoporosis in the women of South India.

Cell mediated immunity to Plasmodium vivax infection: in vitro inhibition of parasite growth by monocyte derived macrophages.

OBJECTIVE: To study the ability of soluble blood stage or cell associated antigens of Plasmodium vivax to stimulate human peripheral blood mononuclear cells (PBMC) and produce factors capable of causing inhibition of parasite growth in vitro was the objective of this investigation. METHOD: A local isolate of P vivax was either synchronized by triple sorbitol lysis for antigen preparation or used as unsynchronized culture for parasite inhibition, employing a macrophage inhibition assay. The soluble or cell associated antigens of P vivax were added to human monocyte derived macrophages with P vivax parasitized red blood cells. The percent inhibition of parasite growth was examined after 72 hrs by microscopy of Giemsa stained smears of red blood cells from the experimental and control groups. RESULTS: The differences in parasite inhibition were compared using Wilcoxon rank sum test for paired differences. Unstimulated PBMC supernatants did not inhibit parasite growth. Significant inhibition of parasite growth (90%) was seen after incubating P vivax infected erythrocytes with PBMC supernatants resulting from stimulation with soluble antigens (T = 3; P < 0.05). However, the cell associated antigens of P vivax did not stimulate PBMC to activate macrophages for parasite killing in vitro (T = 14, P < 0.05). CONCLUSION: We conclude that the soluble blood stage antigens of P vivax can stimulate human PBMC to produce factors capable of activating macrophages to function as effector cells in P vivax malaria.

Detection of Mycobacterium tuberculosis by polymerase chain reaction in 301 biological samples--a comparative study.

A repetitive target sequences of Mycobacterium tuberculosis DNA was amplified by polymerase chain reaction (PCR) in a total of 301 clinical samples. Sputum, blood, pleural fluid, and bronchial lavage specimen were taken from clinically suspected causes of tuberculosis and processed for the diagnosis of tuberculosis using a simplified procedure of DNA extraction. PCR was positive in a total of 58 samples (58/301--19.3%). A significant number of smear and culture negative cases of tuberculosis were PCR positive (37/174--21.26%). This finding, combined with the absence of either false positive or false negative results reflects the greater usefulness of this technique.

A retrospective study of 1247 cases of intracranial tuberculomata diagnosed by computerized tomography.

Tuberculomata in the brain are a common feature of intracranial tuberculosis, especially in the sub-continent. With the advent of computerized tomography, a diagnosis can be made, in many instances. In this study, 1247 cases of CT diagnosed intracranial tuberculomata were analysed retrospectively with regard to the age, sex and symptoms of the patient as well as the number, site and distribution of the lesion within the brain. Tabulation with respect to age revealed that patients with ages ranging from 1-30 years accounted for 60% of the cases. The male to female ratio was approximately 60:40. The parietal hemisphere accounted for 46.75% of the cases. Left sided lesion were more common when compared with the right (statistically significant). We postulate that this increased occurrence of left sided lesions is due to the hematogenous mode of infection and increased blood flow to the dominant hemisphere.

Right ventricular mural infective endocarditis in a patient with burns.

An individual who had sustained 43% burns and then developed blood culture negative right ventricular infective endocarditis and right basal segmental pulmonary infarction is reported. Echocardiography detected vegetations in the mid right ventricle. The patient had a central venous catheter in situ during the initial stage of management of burns. Following therapy, he recovered uneventfully from his extremely toxic and febrile state.