Seroepidemiological study of human metapneumovirus in New Delhi, India.

Purpose: There are a few seroepidemiological studies reported on human metapneumovirus (hMPV) as hMPV was only discovered in the year 2001. This respiratory virus has been reported to be ubiquitous and associated with respiratory tract infections in all age groups. The present study aimed at determining the prevalence of antibodies to hMPV in children and adults of 1 month to 55 years of age. Materials and Methods: Serum samples from 100 study subjects were tested for hMPV antibody by an in-house ELISA system that used hMPV-infected cell lysate antigen. Result: The prevalence of antibody to hMPV was lowest in children less than 5 years of age (60%) and increased throughout age to > 80%. Similarly, geometric mean titres were 1:180 in children less than 5 years of age and reached a peak of 1:419 in adults over 35 years of age. Conclusion: The results show that hMPV infection is acquired early in life and re-infection in later life may maintain the seroprevalence and antibody levels in adult population.

Comparison of perioperative morbidity in patients with ovarian malignancy undergoing radical cancer surgery with or without prior chemotherapy.

Evaluation was undertaken of the effect of chemotherapeutic drugs on the perioperative morbidity of patients with ovarian malignancy undergoing radical surgery. Twenty patients who had received cytotoxic drugs pre-operatively (group I) were compared with 11 patients in whom radical surgery was the first line of treatment (group II). Pre and post-operative cardiac, pulmonary, renal, hepatic and coagulation functions were compared in both groups, as well as the critical intra- and post-operative events like cardiac pump failure, respiratory dysfunction, rhythm disturbances, blood loss, etc. Demographic data, ASA status, biochemical and haematological parameters and cardiac ejection fractions were comparable in the two groups but patients in group I had significantly higher left ventricular end diastolic dimensions (P < 0.01). A higher number of patients in group I had pre-operative respiratory and coagulation factor abnormalities but critical intra- and post-operative events in both groups were comparable. The surgical time was significantly (P < 0.01) longer in group I (5.5 +/- 2.5 h) as compared to group II (4.5 +/- 1.5 h). One patient with extensive tumour spread and pre-operatively deranged coagulation profile (group I) died of disseminated intravascular coagulation in the post-operative period. It is concluded that patients with advanced ovarian malignancy, treated with cytotoxic drugs are more likely to have pre-operative cardiac, respiratory and coagulation abnormalities, which should be managed by thorough pre-operative evaluation and intensive intra- and post-operative monitoring.

Biparietal diameter: a useful measure for determining gestational age of human abortuses.

BACKGROUND: The crown-rump length is conventionally used to determine the age of human abortuses. However, it is not reliable as it is dependent on the positioning of the conceptus. We compared this with the biparietal diameter and foot length for determining the gestational age. METHODS: Different measurements, commonly used to assess gestational age, were measured in 146 human abortuses for which an accurate obstetric history could not be elicited. Measurements taken were crown-rump length, biparietal diameter and foot length. These were correlated with the observations at antenatal examinations before finalizing the approximate age. RESULTS: Multiple regression analysis of the data indicated that of the three measurements, the biparietal diameter was the most reliable for determining foetal gestational age between 8 and 26 weeks. The age determined with the biparietal diameter correlated well with that of abortuses with an accurate obstetric history. CONCLUSION: The biparietal diameter of a human foetus may be used to determine its age if the obstetric history regarding the period of gestation is vague or not available.

Non-linear law-like relationship between weight & height of infants & pre-school children.

A non-linear equation of the type log w - 0.008 h = a - be-kl for weight (w) and height (h) of 1177 infants and pre-school children from the Rural Health Centre area in Ballabhgarh was fitted by modified Guass-Newton Method using BMDP 03R program. On applying the non-linear model to the data of the present study it was found that the curve was a good fit in both sexes and also in all nutritional groups. The value of 'a' (the nutritional index) was almost the same in boys and girls but it was higher in case of children with normal nutrition (0.37) and lower in children with malnutrition (0.34 in Grade I, 0.32 in Grade II and 0.28 in Grades III & IV). The exponential term 'k' (index of maturation) was higher in boys compared to that of girls and higher in those with normal nutrition than with malnutrition. It was found that the rate of decay of the exponential term was slower in those with malnutrition compared to those with normal nutrition. While no difference was observed in the asymptotic value i.e., the rate at which infants reach the shape of older children, between boys and girls with normal nutrition (19 and 20 months respectively), it was delayed by 5 to 8 months in girls compared to boys with malnutrition. In the total sample, the Ehrenberg's index attained the asymptotic value at 20 months in boys and at 35 months in girls and at 27 months in the combined sample.

Law-like relationship between height and weight of school children.

Ehrenberg's Law-like relationship between height and weight [log (w) = ah + b] was applied to a group of public school and Govt. school children in New Delhi. It was found that the model log (w) = 0.8 h + 0.4 was comparatively a good fit for public school children and the model log (w) 0.8 h + 0.35 for Govt. school children. On fitting the model to the sample data it was found that the value of 'a' was 0.8, with some minor variation in the second decimal point and the value of 'b' was 0.39 & 0.36 respectively for public school boys and girls and 0.32 & 0.29 respectively for Govt. school boys & girls. These results corroborates with the findings of the earlier studies that the intercept constant 'b' in the Law-like relationship equation is influenced by the nutrition of children. This model is recommended because of its simplicity and practical usefulness using only already available information.

Intermittent intravenous pulse cyclophosphamide treatment in systemic lupus erythematosus.

To determine the efficacy and safety of intermittent intravenous pulse cyclophosphamide in patients of severe systemic lupus erythematosus (SLE), 50 patients having severe/refractory lupus nephritis, vasculitis or neuropsychiatric manifestations were treated with 3 weekly pulses of cyclophosphamide for 6 such pulses. This treatment was found to be associated with significant and sustained improvement during a 2 yr follow up with respect to the mean renal activity score, individual renal parameters (proteinuria, erythrocyturia, and serum creatinine levels), focal neurological manifestations, vasculitic lesions, antinuclear antibody titers, complement component C3, anti-dsDNA antibodies levels and ESR. There was a sustained decrease in the overall mean disease activity score, and the mean daily dose of prednisolone (pretreatment 32.62 mg daily to 3.75 mg daily after 24 months). There was a significant decline in the percentage and absolute B cell count after 7, 14 and 21 days of this treatment. Effect on other lymphocyte subsets (CD3+, CD4+ and CD8+) was not marked. Pulse cyclophosphamide could therefore be an effective and less toxic form of treatment in patients with SLE having severe lupus nephritis, focal neurological lesions or vasculitis.