Physicians must not help parents decide the gender of their unborn child: the case against preconception gender selection.

India has amongst the worst gender ratios in the world. Preconception gender selection can aggravate this situation. This procedure is costly and has a moderate success rate. No moral theory supports this procedure. It demeans human beings and commodifies gender. The medical profession should not invest resources in this procedure and the government should ban the import of this technology.

Changing pattern of antibiotic sensitivity of Salmonella typhi.

BACKGROUND: The emergence of multidrug-resistant Salmonella typhi led to the use of quinolones as the first-line drug in the treatment of adult patients with typhoid fever. However, over the last few years there has been an impression that patients on ciprofloxacin tended to take longer to defervesce. We studied the response and antibiotic sensitivity patterns during 2 time periods to assess the changes that may have occurred. METHODS: A retrospective analysis was done of blood culture-positive patients with Salmonella typhi infection during 1991 and 1996-97. The mode of presentation treatment history, antibiotic sensitivity pattern, antibiotics administered, response to therapy and the complications that ensued were studied. RESULTS: In vitro sensitivity to ciprofloxacin was found to be 100% in both the study groups. It was found that a greater number of patients were sensitive to ampicillin (80%), chloramphenicol (80%) and co-trimoxazole (80%) during 1996-97 as compared to 1991, when sensitivity to ampicillin was 63%, chloramphenicol 65% and co-trimoxazole 65%. The mean (SD) defervescence period in 1991 was 6 (2.3) days and in 1996-97 was 6 (2) days (p > 0.05). CONCLUSION: In vitro sensitivity of Salmonella typhi to ciprofloxacin remains 100%. There was an increase in the sensitivity to ampicillin, chloramphenicol and co-trimoxazole which have been rarely used over the past few years. There was no significant difference in the time taken to defervesce between the two study periods.

Urinary IgG antibody capture particles adherence test for detecting HIV antibodies: a preliminary report.

It is known that antibodies to HIV are secreted in urine and saliva. IgG antibody capture particle adherence test (GACPAT) has been shown to provide accurate results for antibodies in urine. The aim of the study was to study the sensitivity and specificity of this test in our settings. 114 urine samples were collected from both HIV positive and HIV negative patients and were analysed using GACPAT. The test has a sensitivity of 92.3% and specificity of 100%. We feel that this test has a definite role in our country especially for surveillance purposes.

Teaching medical ethics in a medical college in India.

To the best of our knowledge, medical ethics is not taught as a separate subject in Indian medical colleges. St John's Medical College has a programme for teaching medical ethics to its undergraduate students. We describe here the structure of our programme, the syllabus and the teaching methodology. We feel that we have an effective way of teaching medical ethics at our medical college and would encourage other medical colleges to introduce the subject in their curriculum.

Cryptococcal meningitis in AIDS--need for early diagnosis.

Cryptococcal meningitis is the most common opportunistic fungal infection in patients with Acquired Immunodeficiency Syndrome (AIDS) contributing to the increased morbidity and mortality. This important infection in AIDS seems to be under diagnosed in India. We discuss the clinical features, laboratory diagnosis and therapy of seven cases of cryptococcal meningitis detected in our hospital. Diagnosis was established in all cases by identification of the fungus in cerebrospinal fluid (CSF) by India Ink preparation and positive fungal culture in CSF and/or Blood. Six patients were treated with Amphotericin B and Flucytosine. Two were cured and have not relapsed on suppressive therapy. Two died during treatment. Two were lost to follow up. All the three patients who died had positive fungal culture in blood and CSF. Presence of Cryptococcemia in Cryptococcal meningitis is an indicator of poor prognosis. A high index of clinical suspicion and routine mycological surveillance essential to identify this infection.