Study of occupational exposure to insecticides while spraying in cotton farms.

Organophosphorus compounds (OPC) are commonly used in farms and agricultural fields as insecticides. This study deals with manifestations of exposure among 40 workers engaged in the spraying of cotton crops with these insecticides over a period of two months. The compounds used were mostly monocrotophos, acephate, chlorpyriphos, methyl parathion and propanophos. All patients were illiterate males in the range of 15 years to 50 years of age. They showed typical manifestations of OPC poisoning. All of them responded to conventional treatment for OPC poisoning. There was one death. During the course of the survey it was found that none of the farmers were using protective gear as mandated by chapter VIII of Insecticides Rules, 1971 (Insecticides Act, 1968). A few of these workers were exposed to the insecticide for as much as nine hours per day for three days. In practice, in some deaths associated with OPC poisoning, history of inhalation is given. It is important to note that this could change the manner of death from suicidal to accidental. Due precaution must therefore be exercised in such cases before opining on the manner of death. It is imperative that extensive and persistent farmer education is done with regard to the implementation of various provisions under the Insecticides Rules, 1971, especially safety issues.

Vitamin a status of pregnant women and effect of post partum vitamin a supplementation.

OBJECTIVE: To assess the Vitamin A status of pregnant women in their third trimester using maternal serum retinol levels as the indicator; and (ii) To assess the impact of postpartum Vitamin A supplementation on the Vitamin A status of exclusively breastfed infants. DESIGN: Prospective randomized single blind controlled study. SETTING: Teaching Hospital. SUBJECTS: 109 apparently healthy primi and second gravida women registered at the antenatal clinic were included in the study and followed up for three months postpartum. Serum retinol levels of pregnant mothers in their third trimester (35-37 weeks) and cord blood levels after delivery were estimated. Mothers were then assigned to two groups. The experimental group included 53 mothers who received a single dose of 2 lakh units of Vitamin A orally. The control group had 56 mothers who did not receive Vitamin A. Mothers and infants were followed up for three months. The serum retinol of infants and the breast milk retinol levels were estimated at the end of three months and the results were compared. The growth of the infants was also monitored. RESULTS: Subclinical Vitamin A deficiency was seen in 29.67% of pregnant women. At the end of three months, 69.6% of mothers in the control group had breast milk retinol levels below 30 mg/dl, as opposed to 36.1% in the experimental group. Forty five per cent of infants in the control group had subclinical vitamin A deficiency compared to none in the experimental group. There was no difference in the growth of infants in the two groups. However, the infant serum and the breast milk retinol levels were significantly higher in the supplemented group. CONCLUSION: There is a high prevalence of inapparent Vitamin A deficiency (29.7%) in pregnant women in their third trimester from lower socio-economic strata. Postpartum Vitamin A supplementation had a beneficial impact on the infant serum retional and the breast milk retinol level but no effect on infant growth.

Melioidosis--rare or overlooked?

The word melioidosis conjures images of a rare, exotic disease meant only for large textbooks of pediatrics, to be read only to be forgotten or even to be ignored completely. The following two cases of melioidosis from India will surely serve as an eye opener.

Total and free thyroid hormone levels in chronic renal failure.

The levels of serum total thyroxine (TT4), triiodothyronine (TT3), free T3, (FT3) free T4 (FT4) and thyrotropin (TSH) were measured in 127 clinically euthyroid patients with varying grades of chronic renal failure (CRF); and 97 healthy individuals. They were grouped as: Group I containing 93 patients on conservative management; Group II containing 34 patients on regular dialysis therapy; and Group III (normals). Group I patients showed significant decrease in TT3, TT4 and FT3 levels (p less than 0.001) as compared to Group III, whereas FT4 and TSH values in group I were not significantly altered. TT3, TT4 and FT3 levels reduced as the severity of renal damage increased. Variations in TT3, TT4, FT3, FT4 and TSH levels in Group II patients were similar to those in Group I, except for a decrease in TSH levels (p less than 0.05) as compared to normals. Several thyroid function tests are abnormal in CRF patients, however, finding of normal FT4 and TSH levels would indicate functional euthyroid status.

Detection of autoantibodies against 3,5,3'-triiodothyronine in a hyperthyroid patient (a case report).

A 35-year-old female patient was evaluated for thyroid function and was found to be hyperthyroid clinically and by laboratory tests. During the course of treatment with neomercazole, she developed a bizarre picture with consistently low T3 levels irrespective of her clinical thyroid status and other laboratory tests like serum T4 and TSH levels. The serum of the patient when analysed for the presence of autoantibodies was positive for those against T3. The presence of T3 autoantibodies was confirmed by other laboratory techniques like assessment of blank values in radioimmunoassay, binding of T3-125I to isolated gamma globulin and starch gel electrophoresis. Autoantibodies were found to be present only against T3 and not against. T4 The affinity constant of T3 antibodies was 4 x 10(9) lit. mol-1 as determined by Scatchard plot analysis while total binding capacity was 23 x 10(-11) mol/L.