Urinary Glycosaminoglycan Estimation as a Routine Clinical Service.

Mucopolysaccharidoses, a group of inherited disorders are associated with defects in glycosaminoglycan metabolism. Thus, assessment of urinary glycosaminoglycan is used as a screening test for mucopolysaccharidoses. The detection methods range from qualitative spot tests to quantification using metachromatic dyes. In our laboratory we optimized a spectrophotometric quantitative method using a metachromatic dye, dimethylmethylene blue. Heparan sulfate was used for quantification. The glycosaminoglycan-dye complex showed a marked shift in color with increase in concentration. The color complex was quantified at 520 nm. The method was linear from 10-89 mg/L. An age matched normal range was obtained in 177 healthy individuals, grouped in 8 different age groups from neonates to adults. Urinary glycosaminoglycan concentration varied distinctly amongst the study population wherein the lowest range in healthy neonates was more than 3 times the upper limit of healthy adults. Urine samples from 10 patients with mucopolysaccharidoses were also included in the study for clinical validation. The method qualified both analytical and clinical validation and was found to be simple, robust and ideal to be offered as a screening test for mucopplysaccharidoses in a routine clinical chemistry laboratory.

Impact of nutritional supplements on hematological profile of pregnant women.

Eighty one pregnant women (20 +/- 2 weeks of gestation) were assessed for their nutritional status. They were divided into three groups; Group I women (n = 30) were given 200 mg ferrous sulphate (FeSO4) tablet per day for 15 weeks, Group II women (n = 25) were given FeSO4 tablets along with 2,000,000 IU of vitamin A as single dose in beginning of study; and Group III women (n = 26) were not given any supplements and served as controls. To study impact of supplements on hematological profile of pregnant women, Hb, PCV, RBC, TS%, TIBC and serum levels of iron, zinc, copper, manganese and vitamin A were assessed at 20 +/- 2 weeks and 36 +/- 2 weeks of gestation by standard techniques. Pregnant women in Group I (Fe suppl) and group II (Fe + vitamin A suppl) had significantly (p < 0.01) higher Hb, PCV, RBC, TS% and serum iron levels than the controls. Group II had significantly (p < 0.05) higher values of these indices as compared to Group I. Levels of serum zinc, copper, manganese were not affected by supplements. Iron supplements improved the hematological profile of pregnant mothers but Fe + vitamin A supplements were more beneficial.

Drug-resistant tuberculosis in an urban population including patients at risk for human immunodeficiency virus infection.

In the past 5 yr, an increased incidence of tuberculosis has been noted in the United States. Simultaneously, the population infected with human immunodeficiency virus-type I (HIV-I) and the number of cases of acquired immunodeficiency syndrome (AIDS) have increased. Selected areas of the United States have also reported increases in the frequency of drug-resistant isolates of Mycobacterium tuberculosis. Because our institution serves a population in which tuberculosis, AIDS, and drug resistant isolates of M. tuberculosis are frequently encountered, we sought to better define interrelationships among these factors by retrospectively reviewing the demographic, clinical, bacteriologic, and radiologic data for all adult patients in whom M. tuberculosis was isolated from a culture of respiratory-tract secretions during a 1-year period (June 1, 1988 to May 31, 1989). Two hundred forty-six patients were thus identified; 66.5% were U.S. born blacks, and 62.6% were 17 to 40 yr of age. Risk factors for HIV infection were present in 106 patients. The overall resistance rate (one or more drugs) = 30.9%, with primary resistance = 22.6% (35 of 155) and secondary resistance = 49.2% (29 of 59). In addition, 12 resistant isolates were found in 32 patients whose prior treatment status was indeterminate. Of the resistant isolates, 56.6% (43 of 76) were multiply resistant. Isoniazid resistance was noted in 90.7% (69 of 76) and rifampin resistance was noted in 50% (38 of 76) of the resistant isolates. No significant differences in the overall frequency of resistance were noted in patients at risk for HIV infection compared with those without these risks.(ABSTRACT TRUNCATED AT 250 WORDS)