Efficacy of oral L-arginine on amniotic fluid index in pregnant women with oligohydramnios attending antenatal clinic in a tertiary care hospital in Telangana, India

Background: Oligohydramnios leads to feto-maternal morbidity and mortality. Though there is no specific treatment for oligohydramnios, use of L-arginine seems to be promising. As a nitric oxide donor, it causes vasodilatation, increases placental perfusion and finally increases amniotic fluid. However, data on the use of L-arginine for oligohydramnios is scarce. Hence, this study was aimed to evaluate the efficacy of oral L-arginine on Amniotic Fluid Index (AFI) and to document the pregnancy outcomes in women with oligohydramnios.Methods: This was a prospective observational study conducted on pregnant women attending antenatal clinic (ANC) at Mediciti Institute of Medical Sciences (MIMS), Ghanpur, Telangana, India from 1st January 2018 to 30th June 2018.Results: A total of 50 participants were enrolled and 4 participants among them were lost to follow- up. Mean age (SD) of the women enrolled was 23.3 (3.49) years. Mean gestational age (SD) at the time of diagnosis was 34.61 (1.53) weeks. Mean AFI (SD) at the time of diagnosis and after treatment with L-arginine were 6.8 (1.3) cm and 9.4 (2.82) cm respectively. After a mean treatment duration (SD) of 3.23 (1.38) weeks, a mean (SD) increase of AFI by 2.6 (1.57) cm (P <0.0001) was observed. An increase of AFI was noted in 84.78% of cases (P <0.0001). Mean (SD) Gestational age at the time of delivery was 38.25 (1.48) weeks. Only 37% of participants required operational deliveries. Mean (SD) birth weight of the new borns was 2.54 (0.47) kg. Neonatal Intensive Care Unit (NICU) admissions were required in 32.6% of new borns.Conclusions: L-arginine is efficacious in improving AFI in oligohydramnios. AFI improvement could possibly lead to better neonatal outcomes by reducing preterm deliveries and operative interventions.

Genetic sensitivity to bitter taste of 6-n Propylthiouracil: A useful diagnostic aid to detect early childhood caries in pre-school children.

PURPOSE: Genetic factor to bitter taste perception appears to be largely mediated by the TAS2R38 gene. The insensitivity to bitter compounds like 6-n-propylthiouracil (PROP) is mediated by this gene. PROP, a pharmacological drug used in treatment of Graves’ disease, proved to be useful tool in determining the genetic sensitivity levels to bitter and sweet taste. The purpose of this study is to show much simpler PROP sensitivity technique for the clinical examiner and its application as a diagnostic aid in Early Childhood Caries (ECC) detection among preschool children. MATERIALS AND METHODS: A total of 119 children belonging to the age group of 36 to 71 months of both sexes, were recruited from A. J. Institute of Dental Sciences, Mangalore (Karnataka). PROP sensitivity test was carried out to determine the inherent genetic ability to taste a bitter or sweet substance. This study used simpler scaling method to find out genetic sensitivity to bitter taste; one who tasted bitter as taster and one who was not able to differentiate/tasted like paper as non-taster. A questionnaire was provided to evaluate their dietary habits and caries experience was recorded. Collected data were tabulated and subjected to statistical analysis. RESULTS: In the total of 119 children the mean dmfs was definitely higher in non-taster children compared to tasters. The tasters had a mean dmfs value of 9.5120 (S.D. 7.0543) and non-tasters had a value of 7.7250 (S.D. 8.33147), which was statistically significant. The results suggested that there was increase in caries experience among the group of non-tasters as compared to tasters. Tasters tended to be sweet dislikers and non-tasters tended to be sweet likers. On the whole, tasters had a bad dentition as compared to non tasters. CONCLUSION: The PROP sensitivity test (filter paper test) proved to be a useful diagnostic tool in determining the genetic sensitivity levels of bitter taste. The knowledge of a child's taste perception can help us in identifying the children who are at higher risk for ECC.

Need for specific & routine strategy for the diagnosis of genital chlamydial infection among patients with sexually transmitted diseases in India.

BACKGROUND & OBJECTIVES: With increasing burden of human immunodeficiency virus (HIV) infection acquired immunodeficiency syndrome (AIDS) in India, documentation on the epidemiology of genital chlamydial infections in high-risk patients with sexually transmitted diseases (STD) is of significant public health value. Specific diagnosis is essential to prevent the morbidity due to the chlamydial infection and to reduce the risk of acquiring HIV infection. The present study was undertaken to analyse the usefulness of culture and antigen detection by direct fluorescent antibody (DFA) test for assessing the rate of Chlamydia trachomatis infection in symptomatic patients and feasibility of these tests for routine adoption in Indian setting. METHODS: Clinically diagnosed patients of both sex (n=143) attending the Institute of Sexually Transmitted Diseases, Government General Hospital, Chennai who consented for the study, were enrolled. Clinical and demographic details were recorded on a stratified proforma. Genital swab specimens collected from them were subjected for culture using McCoy cell line and for antigen detection by DFA testing. RESULTS: C. trachomatis was isolated in 27 of the total 143 patients (18.9%). Culture positivity was seen in 11 of the 63 (17.5%) males and in 16 of 80 (20%) females. DFA detected C. trachomatis specific antigen in 35 patients (24.5%); 15 (23.8%) males and 20 (25%) females. The rate of C. trachomatis diagnosis increased to 25.2 per cent by adopting both the methods as against 18.9 per cent by culture only and 24.5 per cent by DFA only. No association of C. trachomatis infection with any predictable genitourinary symptom (s), was seen. INTERPRETATION & CONCLUSION: The findings show a high infection rate for C. trachomatis in symptomatic patients with STD. Clinical symptoms alone can be unreliable in specifically predicting infections with C. trachomatis. Specific diagnostic tests need to be recommended for routine inclusion in the STD diagnosis to facilitate risk reduction of HIV infection in STD patients.