Occurrence and seasonal variation of bacterial indicators of faecal pollution along Thoothukudi Coast, Tamil Nadu.

Theprevalence and seasonal variation of bacterial indicators of faecal pollution such as total coliform bacteria, faecal coliform bacteria, Escherichia coli and faecal streptococci were investigated in samples of water and beach sand from the four fish landing centres of Thoothukudi. Further the samples were screened for Salmonella to study the reliability of faecal indicator bacteria as an index of human pathogenic bacteria. Total coliform bacteria, faecal coliform bacteria and Escherichia coli were isolated from all four landing centres from undetectable to the maximum detectable level of over Most Probable Number 140 throughout the year with no obvious seasonal variation. Faecal streptococci were also detected in most samples. There was no discernable relationship between faecal indicators and physical parameters. The relationship between faecal indicators and Salmonella was not significant (p > 0.05). The results showed that the coastal waters along Thoothukudi is polluted and presents a potential risk to public for recreational and fishing activities.

Juvenile hyperthyroidism: an experience.

OBJECTIVE: To analyze the clinical profile of juvenile hyperthyroidism at presentation, their treatment outcome; predictors of remission and relapse. METHODS: Retrospective analysis of medical records of 56 patients with juvenile hyperthyroidism seen over a period of 16 years. A cohort of 38 females and 18 males with mean (+/-SD) age of 14.9 +/- 3.4 years (range 3 to 18 years) was analyzed. RESULTS: Majority of patients was in the age group of 12-16 years. Common symptoms observed at presentation were weight loss (82.1%), excessive sweating (78.6%), heat intolerance (76.8%), increased appetite (73.2%) and diarrhea in 48.2%. In addition, accelerated linear growth was observed in 7.1% of patients. Goiter was present in 98.2% of children; 94.5% of which was diffuse and 4.8% was multinodular. The mean ((+/-SD) T3 was 4.8 +/- 3.4 ng/mL (N, 0.6-1.6), T4 was 218 +/- 98 ng/mL (N, 60-155) and TSH was 0.44 +/- 0.36 (N, 0.5-5.5 microIU/mL). TMA positivity seen in 36.9% of patients. All patients were treated with carbimazole; subsequently 4 patients required thyroidectomy and one required radioactive iodine ablation. Mean (+/-SD) duration of follow-up in our patients was 4.9 +/- 3 years, ranging between 1.6 to 16 years and mean (+/-SD) duration of treatment was 34.4 +/- 22.6 months (range 12 to 120 months). Mean (+/-SD) duration to achieve euthyroidism was 5.2 +/- 4.7 months, ranging between 1-33 months. On intention to treat analysis, remission with carbimazole was achieved in 47.6%, remaining patients failed to achieve remission with drug treatment. CONCLUSION: Graves disease is the commonest cause of juvenile hyperthyroidism. Carbimazole is safe, effective, cheap, and easily available form of therapy. It is occasionally associated with serious side effects but requires prolonged follow up.

Vitamin D deficiency masquerading as pseudohypoparathyroidism type 2.

A case of antiepileptic-induced vitamin D deficiency, who presented with hypocalcemia, hyperphosphatemia with increased tubular reabsorption of phosphate mimicking pseudohypoparathyroidism type 2, is reported. He showed remarkable improvement with calcium and vitamin D treatment with normalisation of serum calcium and phosphate with reestablishment of phosphaturic response.