Evaluation of serum paraoxonase, 1 and its association with serum cholinesterase as a cause of congenital anomalies

Background: Birth defects are conditions of prenatal origin that are present at birth, potentially impacting an infant's health, development, and/or survival. Several environmental toxins affect the growth of the fetus during the intrauterine period by affecting various cellular components. Pesticides and industrial chemicals are known toxins that can hinder the developmental process. In this study, authors are evaluating the relation of cholinesterase and paraoxonase-1 with visible congenital anomalies.Methods: Sixty babies delivered in the labor room were selected for the study. They were divided into two groups. Thirty newborns with visible congenital anomalies were included in Group I. Only babies with visible congenital anomalies were taken as inclusion criteria for this group. This group was compared with Group II, which were taken as controls and consisted of 30 healthy newborns without any congenital anomalies. Serum cholinesterase and serum paraoxonase-1 were estimated and statistical tests were applied.Results: Serum cholinesterase and serum paraoxonase-1 were significantly low in the babies with visible congenital anomalies. Serum cholinesterase levels showed a statistically significant positive correlation with serum paraoxonase 1 level in both the groups.Conclusions: Decrease in acetylcholinesterase by various environmental toxins and the associated decrease in serum paraoxonase level imposes significant oxidant stress and the resultant risk of developing congenital anomalies.

Single Stage Cementless Bilateral Total Hip Replacement Surgery: Case Report And Review Of Literature

Two staged bilateral total hip replacement (THR) is commonly performed for bilateral hip end stage arthritis and is preferred as THR is a complex planned surgery and performing both sides simultaneously may be fraught with risks and complications. However, many studies now indicate that in carefully selected patients , single stage or simultaneous bilateral THR can be performed with successful and cost effective results. We report a case of one-stage bilateral THR performed in a 22 year old with bilateral severe arthritis due to ankylosing spondylitis. Patient was severely disabled due to pain and was only ambulating on wheelchair. After a successful single stage bilateral THR, patient recovered fully and after 6 weeks was walking independently without any pain, with full function of both hips and performing his occupation normally. The surgical costs to the patient and hospital were both economical. We conclude that single stage bilateral THR is a better surgical option for young and fit patients with bilateral hip arthritis.