Fetal Femur Length in Assessment of Gestational Age in Third Trimester in Women of Northern India (Lucknow, UP) and a Comparative Study with Western and Other Asian Countries.

Introduction: Gestational age (GA) estimation is the most important part of obstetric practice and ultrasonic study plays an important role in its accurate estimation. Fetal femur length (FL) is one of the parameters used for estimation of GA along with biparietal diameter, head circumference and abdominal circumference (AC). Objective: This study is an attempt to correlate fetal FL with GA and to ascertain if fetal FL can be used as a parameter to calculate the GA in third trimester of pregnancy in Indian women with moderate accuracy. Findings have been compared with the work of sonologists from other countries. Material and methods: Pregnant women in the third trimester of pregnancy with single live fetus and having no other complication either in mother or fetus, were selected for the study, fetal FL along with other parameters was measured. The results were analyzed for accuracy in estimation of GA by FL and were compared with findings of other workers. Result: GA estimated from FL in 512 cases between 27-39 weeks of gestation showed that quadratic model has a good fit to the data and r2 = 0.785 with standard error + 8 days. There was a significant difference with Iranians and Bangladesh women in comparison to our findings. The paired t-test between Indian and Bangladesh, women was significant, (p < 0.001). The findings in our study were similar to the results of Western fetal FLs. Conclusion: The data can be useful in estimation of GA by FL. Our error was + 8 days. A bigger study involving same number of cases in each week of gestation in third trimester is necessary to get an accurate formula for assessment of GA by FL.

A rare cause of heart failure--primary hypoparathyroidism.

We report a patient who presented with congestive heart failure (ejection fraction 24.4%) and who had previous history of convulsions. Our investigations found him to be a case of primary hypoparathyroidism. He showed a dramatic response with the addition of calcium infusion therapy with almost full recovery of left ventricular function (67% ejection fraction after 16 days of the initial echo). We conclude that in a young patient a thorough investigation for heart failure is never complete without looking for endocrine and metabolic causes. The prognosis in these cases is much better, identification and treatment of the same will yield dramatic results.

The changing spectrum of severe falciparum malaria: a clinical study from Bikaner (northwest India).

BACKGROUND & OBJECTIVES: Recently there were reports from all over India about changing spectrum of clinical presentation of severe malaria. The present study was planned to study the same in the northwest India. METHODS: This prospective study was conducted on patients of severe malaria admitted in a classified malaria ward of a tertiary care hospital in Bikaner, Rajasthan (northwest India) during 1994 and 2001. It included adult patients of both sexes belonging to all age groups. The diagnosis of Plasmodium falciparum was confirmed by demonstrating asexual form of parasites in peripheral blood smear. All patients were treated with i.v./oral quinine. The specific complications were treated by standard WHO protocol. The data for individual complications for both the years were analysed by applying chi-square test. RESULTS: In a prospective study in 1994 the spectrum of complication was dominated by cerebral malaria (25.75%) followed by jaundice (11.47%), bleeding tendencies (9.59%), severe anaemia (5.83%), shock (5.26%), Acute respiratory distress syndrome-ARDS (3.01%), renal failure (2.07%) and hypoglycemia (2.07%) whereas in 2001 it was dominated by jaundice (58.85%) followed by severe anaemia (26.04%), bleeding tendencies (25.52%), shock (10.94%), cerebral malaria (10.94%), renal failure (6.25%), ARDS (2.08%) and hypoglycemia (1.56%). The sharp difference for presence of jaundice and severe anaemia in 2001 and cerebral malaria in 1994 was statistically significant. Similarly, the important cause of mortality in 2001 was multiple organ dysfunction syndrome (71.10%) with predominant presentation of jaundice and renal failure, whereas in 1994, it was cerebral malaria (77.96%). INTERPRETATION & CONCLUSION: The observation of changing spectrum of severe malaria in this study and a significant increase in presentation with jaundice as an important manifestation is highly essential for primary, secondary and tertiary level health care providers for proper diagnosis and management.

Comparative value of glutamic oxaloacetic transaminase and lactic dehydrogenase enzyme pattern in serum and cerebrospinal fluid in acute cerebrovascular accidents.

A study of glutamic oxaloacetic transaminase (GOT) and lactic dehydrogenase (LDH) enzymes in serum and cerebrospinal fluid (CSF) was carried out on 30 cases of acute cerebrovascular accident (CVA) to determine their role in precise diagnosis and prognosis of the cases. The CSF GOT and LDH activities were well correlated with the severity, mortality and peak and proper timing in relation to infarct, same is about serum GOT. A characteristic rise of GOT and LDH was observed in cerebral haemorrhage especially in fatal cases. However, in cerebral thrombosis and embolism specially in non-fatal cases, the enzyme change was not so marked. GOT and LDH enzyme pattern in CSF and serum may, therefore, serve as an early, relatively easy and widely available tool for differential diagnosis and prognosis of cases of acute CVA.

Intrinsic multiple antibiotic resistance markers for competitive and effectiveness studies with various strains of mung bean rhizobia.

Ten strains of Rhizobium sp. with multiple antibiotic resistance markers were used for competitive and efficiency studies with mung bean var. ML 5. All the strains showed significant increase in grain yield and so also for nitrogenase activity except MO 5. Nitrogenase activity correlated very well with grain yeild. The compatibility of strains varied from 17 to 50%. The intrinsic multiple antibiotic markers for strain identification were found to be stable after passing through soil and host conditions and could be used for ecological studies. It was further revealed that the overall efficiency of a strain is the combined effect of characters like compatability, competitiveness and inherent capacity to fix nitrogen.