Integration of biosorption and biodegradation in a fed-batch mode for the enhanced crude oil remediation.

Microbial bioremediation of oil-contaminated sites is still a challenge due to the slower rate and susceptibility of microbes to a higher concentration of oil. The poor bioavailability, hydrophobicity, and non-polar nature of oil slow down microbial biodegradation. In this study, biodegradation of crude oil is performed in fed-batch mode using an oil-degrader Pseudomonas aeruginosa to address the issue of substrate toxicity. The slower biodegradation was integrated with faster biosorption for effective oil remediation. Highly fibrous and porous sugarcane bagasse was surface modified with hydrophobic octyl groups to improve the surface-oil interactions. The microbe showed 2 folds enhanced oil degradation in the fed-batch study, which was further increased by 1·5 folds in the integrated biosorption coupled biodegradation approach. The biosorption-assisted biodegradation approach supported the microbial growth to 2 folds higher than the fed-batch study without biosorbent. The analysis of biosurfactant production indicated the 3 folds higher concentration in fed-batch modes as compared to batch study. In the integrated strategy, the concentration of contaminant (oil) reduces to quite a tolerable level to microbes, which improved effective metabolism and thus overall biodegradation. This study puts forward a promising strategy for improved degradation of hazardous hydrophobic contaminants in a sustainable, economic and eco-friendly manner.

Effect of TiO2 addition on adhesion and biological behavior of BCP-TiO2 composite films deposited by magnetron sputtering.

The present investigation focuses on the deposition of biphasic calcium phosphate (BCP) and titania (TiO2) composite films on Ti-6Al-4V substrates using radio frequency (RF) magnetron sputtering. Three different compositions such as 100% BCP, 25% TiO2-75% BCP and 50% TiO2-50% BCP films were fabricated, and the physical, mechanical and biological behaviors of the films were analyzed. Post deposition, the films were annealed at 700 °C for 2 h to induce the crystallinity and to study its effect on different properties. The wettability was found to be 95°(±3°) for 100% BCP, 73°(±2°) for 25% TiO2-75% BCP and 35°(±1°) for 50% TiO2-50% BCP films, indicating improvement in wettability with an increase of TiO2 weight percent in the composite films. The value of critical load (Lc2) for 100 BCP film improved from 8.7 N to 14.8 N (25 TiO2-BCP) and >19 N (50 TiO2-BCP film), indicating improvement in bonding strength with TiO2 addition. The fetal bovine serum (FBS) adsorption decreased from 7.11 ± 0.25 to 4.42 ± 0.17 µg/cm2 with TiO2 weight percent from 0 to 50%. Cell adhesion and proliferation significantly improved in 100% BCP, 25% TiO2-75% BCP and 50% TiO2-50% BCP films as compared to uncoated Ti-6Al-4V. The maximum cell proliferation was found on the surface of 50% TiO2-50% BCP film (210.1 ± 6.5%) after 6 days of incubation. However, after annealing all the films exhibited less cell adhesion and cytocompatibility presumably due to change in composition. Globular apatite structure was observed on all modified surfaces after 7 days immersion in simulated body fluid (SBF); however, the growth rate was higher for 50 TiO2-BCP films. All these results revealed that the addition of TiO2 in BCP film (without annealing) is advantageous for improving the bonding strength as well as the bioactivity of implants, which can be used for long-term dental and orthopedic applications.

Magnesium Aluminate Nanoparticles for Chemical Detoxification of Sarin and Soman.

The solutions of Mg(NO3)2, Al(NO3)3, and (NH4)2CO3 were mixed at pH 8 and then heated at 95 °C for 4 h, aged at room temperature for 16 h, and calcined at 650 °C for 4 h to obtain magnesium aluminate nanoparticles. The obtained materials exhibited spinel structure with the particle size being 6 to 26 nm. The nanoparticles demonstrated type IV nitrogen adsorption isotherm, typical of mesoporosity with a surface area of 325 m²/g. They were utilized for studies on chemical detoxification of deadly chemical warfare agents such as sarin and soman. Our results showed that the magnesium aluminate nanoparticles effectively decontaminated more than 99% of sarin and soman within 8-10 min when used at a ratio of 1:50-60% w/w.

Prevalence of Canine Monocytic Ehrlichiosis in Canine Population Across India.

Canine ehrlichiosis is a very important emerging disease in India. This study is the first attempt screening a large number of canines in India for the detection of canine monocytic ehrlichiosis. In the present study, 510 blood samples of dogs were screened for the presence of Ehrlichia canis and other variants of Anaplasmataceae family by serological and molecular methods.Out of the 510 serum samples, 293 (57.5%) cases were found positive for the presence of E. canis antibodies through enzyme-linked immunosorbent assay (ELISA). Furthermore, and 45 (8.8%) and 1 (0.2%) specimens were positive for E. canis and A. platys, respectively, based on the polymerase chain reaction (PCR). In the clinical samples of E. canis, the minimum detection limit for PCR was9 ng. In the immunofluorescence assay (IFA), the positive blood samples showed comparable results with those obtained from the commercially available dot ELISA kit (giving equivalent IFA titer). The results of sequencing were compared with other reported isolates in various regions of the world, and a phylogenetic relationship was established. The 16S rRNA region that was amplified and sequenced for E. canis and A. platys was highly conserved and so was another Vir B9 region.

Mechano-tribological properties and in vitro bioactivity of biphasic calcium phosphate coating on Ti-6Al-4V.

Biphasic calcium phosphate (BCP) consists of hydroxyapatite (HA) and beta-tricalcium phosphate (ß-TCP). BCP is mainly used in artificial tooth and bone implants due to higher protein adsorption and osteoinductivity compared to HA alone. Although, many studies have been investigated on radio frequency (RF) magnetron sputtering of HA on Ti and its alloy, however, limited studies are available on BCP coating by this process and its bioactivity and adhesion behavior. Thus, in order to obtain a better understanding and applications of BCP films, RF magnetron sputtering is used to deposit BCP films on Ti-6Al-4V in the present study. The effect of film thickness on wettability, mechanical properties and in vitro bioactivity at a particular set of sputtering parameters are investigated. BCP film thickness of 400 nm, 700 nm and 1000 nm are obtained when sputtered for 4 h, 6 h and 8 h, respectively. Although the phase compositions are almost same for all films, the surface roughness values varies around 112-153 nm with rise in film thickness. This in turn enhances hydrophilicity in accordance to Wenzel relation as the contact angle decreases from 89.6 ±â€¯2° to 61.2 ±â€¯2°. It is found that the 1000 nm film possess highest micro-hardness and surface scratch resistance. No cracking of film up to scratch load of 2.3 N and no significant delamination up to load of 7.8 N are observed, indicating very good adhesion between BCP films and Ti-6Al-4V substrate. There is a great improvement in wt% apatite layer formation on all films when dipped in simulated body fluid (SBF) for 14 days. Among these, 1000 nm sputtered film results the highest increase in wt% apatite layer from 44.87% to 86.7%. The apatite layer possess small globular as well as elliptical structure are nucleated and grew on all the BCP films. Thus, sputtering of BCP films improves wettability, mechanical properties as well as bioactivity of Ti-6Al-4V, which can be applied for orthopedic implants.

The Role of p53 Gene in Cervical Carcinogenesis.

AIM: To investigate the role of p53 gene in cervical carcinogenesis. MATERIALS AND METHODS: A total 50 cases and controls were taken after setting exclusion criteria. Venous blood (3 ml) samples were collected in sterile EDTA sterile vials. Both punch biopsy of cervical growth in cases and biopsy from cervix after hysterectomy in controls were performed. Genomic DNA was extracted from tissue and blood using standard protocol of Miller et al. 1994 using chloroform-phenol method. Gene was amplified using specific forward and reverse primers and p53 gene expressions were studied. The present study of p53 gene regulation analyzed the expression of 279-bp bands on 1.5 agarose gel. OBSERVATIONS: Out of the total 50 samples of cases and controls, we were able to isolate DNA from 38 cases and 28 controls in blood and in 22 cases and 22 controls in tissue. In cases of carcinoma cervix, p53 expression is either downregulated or absent in 71.06 % of cases compared to 50 % of controls in blood and 72.73 % of cases compared to 59.09 % of controls in tissue, but these figures were not statistically significant (p = 0.67 and p = 0.167, respectively). p53 positivity rate was only in 27.78 % of squamous cell cancer and 50 % of adenocarcinoma. Three out of nine patients (33.3 %) with L.N. positive status have p53 gene positivity, whereas 23 % (3 out of 13) with L.N. negative status have p53 gene positivity, which is not significantly associated. In our study, p53 overexpression increases with the various stages of cervical cancer. CONCLUSION: In our study, we found that there is the increased frequency of upregulation or overexpression of p53 gene in control in both blood (50 %) and tissue (40.9 %), but this association is statistically nonsignificant. In the present study, there is a lack of relationship between p53 overexpression and prognosis in the cervical cancer patients. However, our study lacked larger sample size which otherwise would have been able to lend support to truly significant findings through much larger combined and comparative datasets.

Changing picture of acute kidney injury in pregnancy: Study of 259 cases over a period of 33 years.

The incidence of acute kidney injury (AKI) in pregnancy is declining in developing countries but still remains a major cause of maternal and fetal morbidity and mortality. The aim of the study was to analyze the changing trends in pregnancy related AKI (PR-AKI) over a period of thirty-three years. Clinical characteristics of PR-AKI with respect to incidence, etiology and fetal and maternal outcomes were compared in three study periods, namely 1982-1991,1992-2002 and 2003-2014. The incidence of PR-AKI decreased to 10.4% in 1992-2002, from 15.2% in 1982-1991, with declining trend continuing in 2003-2014 (4.68%).Postabortal AKI decreased to 1.49% in 2003-2014 from 9.4% in 1982-1991of total AKI cases. The AKI related to puerperal sepsis increased to 1.56% of all AKI cases in 2003-2014 from 1.4% in 1982-1991. Preeclampsia/eclampsia associated AKI decreased from 3.5% of total AKI cases in 1982-1991 to 0.54% in 2003-2014. Pregnancy associated - thrombotic microangiopathy and acute fatty liver of pregnancy were uncommon causes of AKI. Hyperemesis gravidarum associated AKI was not observed in our study. Incidence of renal cortical necrosis (RCN) decreased to 1.4% in 2003-2014 from 17% in 1982-1991.Maternal mortality reduced to 5.79% from initial high value 20% in 1982-1991. The progression of PR-AKI to ESRD decreased to1.4% in 2003-2014 from 6.15% in 1982-1991. The incidence of PR-AKI has decreased over last three decades, mainly due to decrease in incidence of postabortal AKI. Puerperal sepsis and obstetric hemorrhage were the major causes of PR-AKI followed by preeclampsia in late pregnancy. Maternal mortality and incidence and severity of RCN have significantly decreased in PR-AKI. The progression to CKD and ESRD has decreased in women with AKI in pregnancy in recent decade. However, the perinatal mortality did not change throughout study period.

Spectrum of VP1 region genetic variants in the foot-and-mouth disease virus serotype O populations derived from infected cattle tongue epithelium.

RNA virus population exists as a complex distribution of non-identical but closely related sequences known as viral quasispecies. Variant strains are selected from this quasispecies population in response to changing environment. The quasispecies dynamics of a virus existing within an infected host differs from that in a cell culture-adapted population. This study was carried out to explore the genetic variations present in the VP1 coding region of the foot-and-mouth disease (FMD) virus serotype O derived directly from infected cattle tongue epithelium. Molecular clonal populations of two serotype O strains belonging to lineages Ind2001 (IND 30/2011) and PanAsia2 (IND 5/2011) were sequenced at VP1 coding region. For IND 30/2011, 19 clones were sequenced and analysis showed variations at 12 nucleotide positions (nt) resulting in 8 amino acid (aa) replacements. Similarly, for IND 5/2011 virus, 18 clones were sequenced, of which six showed nt variations leading to 3 aa replacements. Most of the variable positions mapped to the surface-exposed loops and some of them were found in the neutralizing antigenic sites (position 81, 149, 169, 186 and 202 of IND 30/2011 and 141 of IND 5/2011), which potentially could be beneficial in rapid adaptive evolution of the virus by giving rise to antigenic variants to overcome neutralizing antibodies. These findings encourage further research into the landscape of the viral quasispecies population in vivo and its implication for viral ecology.

In human alleles specific variation of MTHFR C677T and A1298C associated "risk factor" for the development of ovarian cancer.

Etiopathology of tumor biology is highly complex and ovarian cancer is one of the important gynaecological neoplasia associated with high risk of mortality rate. Methlenetetrahydrofolate reductase (MTHFR) mutation are commonly linked to folate metabolism with increased risk factor for the development of neural tube defects, recurrent pregnancy loss and development of several type of cancer but genetic interaction between two alleles of MTHFR has been poorly defined in ovarian cancer in India. Hence, present study becomes imperative with the aim to assess the alleles frequency of MTHFR (C677T & A1298C) gene polymorphism using PCR based RFLP analysis. The O.R at 95% confidence interval (C.I.) was computed between cases and their respective controls to determine "risk factor". Interestingly, our findings reveals highly significant (p < 0.001) difference in heterozygous (CT) condition of C677T allele by computing odd ratio (0.12 at 95% C.I, 0.021-0.0428; P for trend = 0.001) in controls and (0.34 at 95% C.I, 0.074-1.530; P for trend = 0.198) cases, suggesting that three time increase the "risk factor" for genetic susceptibility of MTHFR "T" allele for the development of ovarian carcinoma.

Genetic diversity of stem cells and their functional impact on the development of neural tube defects in Eastern population of India.

Anencephaly and myelomeningocele are the 2 most common forms of neural tube defects (NTDs). During embryogenesis large numbers of extrinsic and intrinsic factors are responsible for the closing of the neural tube. "Stem cells" maintain the pluripotency during differentiation of 3 germ layers, including the neural ectoderm. We examined the role of Oct4, Nanog3, and Sox2 genes in the etiopathology of NTDs in an eastern Indian population using PCR-based DNA analysis. The highest frequency (16%) of complete loss of the Sox2 gene was found in NTDs. The highest frequency (48%) of overexpression (upregulation) was found for Nanog3, while 40% was observed for Oct4 and Sox2. The odds ratio for cases versus controls was from 0.132 at 95% confidence interval = 0.005-1.298 for Nanog3 to 2.316 (0.424-13.812) for Oct4. The highest frequency (77%) of overexpression for Nanog3 and Sox2 was observed in encephalocele and anencephalic patients, while in the comparison of regional variation, i.e., cephalic to caudal regions of NTDs, the highest frequency of downregulation (regression) of Nanog3 and Sox2 was found in lumbosacral myelomeningocele patients. However, cervical myelomeningocele patients had the highest frequency of overexpression in all 3 genes, suggesting that the mutational spectra of stem cells influence the cells of the neural crest in NTDs.

Prevalence of cystathionine beta synthase gene mutation 852Ins68 as a possible risk for neural tube defects in eastern India.

Cystathionine beta synthase gene (CßS) catalyzes the condensation of homocysteine with serine, forming cystathionine by the transsulfuration pathway. Disruption of CßS enzyme activity due to defective folic acid metabolism increases the risk factor for neural tube defects. We evaluated the CßS gene mutation in 25 children with neural tube defects (NTDs), including lumbosacral and thoracic myelomeningocele and open NTDs and mothers of cases, along with 25 healthy children and their mothers, serving as controls. Genomic DNA was isolated to assess the polymorphism of 852Ins68 in the CßS gene using PCR-RFLP analysis and nucleotide sequencing techniques. The 68-bp insertion was observed in one of the 25 NTD cases (lumbosacral myelomeningocele), and in two of the mothers of NTD cases. Statistical analysis was carried out using the Fischer exact probability test, which showed a lack of significance (P > 0.05), but the odds ratio of 2.08 with 95% confidence interval of 0.17-24.6 in NTDs mother was quite high because of the small sample size. However, the study was further extended to find out the involvement of specific nucleotide sequences, which again confirmed the 852Ins68 insertion and replacement of nucleotides (TCCAT to GGGG) in lumbosacral myelomeningocele (due to other category of NTDs), suggesting that it could be an independent risk factor for birth defects, including NTDs.

Analgesic, anti-inflammatory, antipyretic and toxicological evaluation of some newer 3-methyl pyrazolone derivatives.

In this paper, we described the pharmacological and toxicological studies of three pyrazolone derivatives namely PYZ1: 4-[4-N dimethylamino benzylidine]-3-methyl pyrazolin-5(4H)-one, PYZ2: 4-[2-chlorobenzylidine]-3-methylpyrazolin-5(4H)-one and PYZ3: 4-[benzylidine]-3-methylpyrazolin-5(4H)-one derivatives. Analgesic, anti-inflammatory and antipyretic studies of 3-methyl pyrazolone derivatives at 400 mg/kg, p.o. have shown significant activity as compared to control. Amongst three pyrazolone derivatives, PYZ2 was found to be more active. Based on the result of pharmacological studies, PYZ2 was selected for toxicological studies. Acute toxicity studies revealed that methyl pyrazolone derivatives are non-toxic in rats up to 5000 mg/kg, p.o. The subacute toxicity study of PYZ2 showed that decrease in Hb content, RBC and WBC count. In biochemical analysis level of blood glucose and bilirubin reduced where as AST, ALT and alkaline phosphatase level elevated. Histopathological studies revealed that there was mild toxicity on liver and kidney at 1000 mg/kg, p.o.

Serological evidence of foot-and-mouth disease virus infection in randomly surveyed goat population of Orissa, India.

India is endemic for foot-and-mouth disease (FMD), and goats constitute the second largest susceptible population of domestic livestock. FMD surveillance and control strategies in the country largely ignore small ruminants, known to be critical in the epidemiology of the disease. Here, serological investigations were carried out to generate estimates of antibody prevalence in goats of Orissa state to both non-structural (NSP-Ab) and structural proteins (SP-Ab) of FMD. The apparent overall NSP-Ab and SP-Ab seroprevalences were 38% and 20.7%, respectively, which signifies a very high level of FMD virus circulation in the goat population despite the lack of clinical signs in this species. The apparent prevalence of NSP-Ab and SP-Ab was positively correlated in the sampling areas. Interestingly, the values found for NSP-Ab prevalence were almost consistently higher than those found for SP-Ab prevalence. This could have been attributable to either issues related to sensitivity and specificity of the test systems employed or differences in the post-infection kinetics of NSP- and SP-Ab. The pattern that emerged from SP-Ab analysis indicated goats being infected with all three prevalent serotypes (O, A and Asia 1) and reinforces the concept that non-vaccinated goats can be exploited as tracer animals for detecting serotypes involved in outbreaks. The results underscore the requirement to bring caprine species under comprehensive surveillance and vaccination campaigns to check silent amplification, excretion and transmission of the virus.

Loss of the AZFc region due to a human Y-chromosome microdeletion in infertile male patients.

Infertility is a major reproductive health threat; the frequency of male infertility due to Y-chromosome microdeletions is 13-18% in the human population; these microdeletions involve recurrent loss of three non-overlapping regions designated as AZFa, AZFb and AZFc, associated with spermatogenic failure. Several contradictory reports have been published regarding deletion frequency based on sequence-tagged site markers and genotype-phenotype correlation. We examined the prevalence of Yq- deletion in 64 clinically diagnosed infertile male patients. We found a 3% frequency of microdeletion of the AZFc region; hormone profiles (FSH, LH and testosterone) showed significantly (P < 0.001) elevated levels compared to controls. No mutations were observed in the AZFa and AZFb regions, perhaps due to the selective use of sequence-tagged site markers.

Spectrum of kidney diseases in patients with preeclampsia-eclampsia.

AIM: The aim of this study was to analyse the clinical spectrum of renal manifestation of preeclampsia in pregnant women. METHOD: Diagnosis of preeclampsia was made using two cardinal feature of the disease after 20th weeks of gestation in previously normotensive and nonproteinuric women: (1) Blood pressure > 140/90 mm Hg and (2) urinary protein excretion of > 300 mg/24 hour. The patients with renal manifestations were followed up to 12 weeks postpartum or till death whichever was earlier. RESULT: Of 1805 pregnant women, preeclampsia was diagnosed in 106 (5.87%) patients. Primiparity constitutes 53.77% of total patients. Hypertension and proteinuria were observed in all patients. Hyperuricemia was observed in 93.65% of cases. Acute renal failure occurred in 22 patients. Dialysis support was needed in only four cases of ARF with complete recovery of renal function in 82% of cases. HELLP syndrome was seen in 16 (preeclampsia 5; eclampsia 11) patients. Sixty six patients (Death 13 and lost to follow up 27) were followed for 12 weeks. The renal parameters (Hypertension, Proteinuria and renal function) returned to normal in all except in two patients. Renal biopsy in these two cases revealed FSGS and MPGN in one each. CONCLUSION: The incidence of preeclampsia was 5.87%. Nephrotic syndrome was observed in 11.32% of patients. Acute renal failure occurred in 20.8% of patients. Hypertension, proteinuria and renal function resolved to normal over a average period of 35.8 days in all survivors. The overall mortality was 12%. Neurological complication, pulmonary edema and multiple organ failure were the causes of death.

Phylogenetic analysis of 3C protease (3C(pro)) coding region of Foot-and-mouth disease virus type A.

Nucleotide sequence analysis of the 3C protease (3C(pro)) region of Foot-and-mouth disease virus type A (FMDV-A) isolates from India has revealed incongruous phylogenetic grouping between 3C(pro) and VP1 region possibly due to the genetic recombination or independent evolution of non-structural and structural protein coding regions. Similar to the VP1 region, the emerging VP3(59)-deletion group maintained its genetic distinctiveness at 3C(pro) region and was found to be diverging with time. Two lineage specific signature aa residues were detected for the deletion group in proof of lineage specific drift or selection events. 3C(pro) region exhibited high degree of conservation as evident from low dN/dS ratio (0.036) and percentage of variable aa positions (20%). A transmembrane domain from aa 27 to 44 could be predicted that possibly anchors 3C to intracellular membranes for better interaction with RNA replication complex. On the basis of sequence conservation, the likelihood that the region aa 121-150 was carrying a vaccine exploitable T-cell epitope was very high.

Decreasing incidence of renal cortical necrosis in patients with acute renal failure in developing countries: a single-centre experience of 22 years from Eastern India.

BACKGROUND: Renal cortical necrosis (RCN) accounts for 2% of all cases of acute renal failure (ARF) in adults and 15-20% of ARF during the third trimester of pregnancy in developed nations. However, RCN incidence is higher in developing countries ranging from 6-7% of all cases of acute renal failure. The present study describes changing trends in the clinical spectrum of RCN in patients with ARF in Eastern India. METHODS: Patients with ARF suspected to have RCN on clinical grounds underwent percutaneous renal biopsy. Patients showing cortical necrosis on histology were included in the present study. Diffuse and patchy cortical necrosis was classified based on standard histological criteria. The patients with cortical necrosis were studied over a period of 22 years; from July 1984 to December 2005. The results of our observation were compared with respect to etiology, incidence, prognosis and outcome of renal cortical necrosis in two study periods; namely, 1984-1994 and 1995-2005. RESULTS: The incidence of RCN was 3.12% of all cases of ARF of diverse etiology. RCN was observed in 57 patients; obstetric 32 (56.2%); non-obstetric 25 (43.8%). Diffuse cortical necrosis was the dominant lesion in 41 (71.9%) patients and the remaining 16 (28%) patients had patchy cortical necrosis. The overall incidence of RCN in obstetric ARF was 15.2%; the incidence being higher (11.9%) in the post-abortal group in comparison to 3.3% in late pregnancy. RCN had occurred complicating abruptio placentae, puerperal sepsis and postpartum haemorrhage (PPH) in late pregnancy, while septic abortion was the sole cause of RCN in early pregnancy. Haemolytic uraemic syndrome (HUS) was the major (31.5%) cause of RCN in the non-obstetric group and miscellaneous factors were responsible in seven (12.3%) patients. Partial recovery of renal function was observed in 11 (19.2%), and 16 (28%) patients had progressed to ESRD. The incidence of RCN decreased from 6.7% in 1984-1994 to 1.6% in 1995-2005 of total ARF cases. RCN following obstetrical complication decreased significantly; 4.7% in the 1990s to 0.5% of the total ARF cases, in the 2000s. The mortality decreased to 19% in 1995-2005 from the initial high mortality of 72% in 1984-1994. The renal prognosis improved as a result of the decreased mortality of patients. CONCLUSION: We observed a decreasing trend in the incidence of RCN in patients with ARF in recent years, which is associated with increased patient survival and better renal prognosis. This improvement was mainly due to declining incidence and severity of RCN in obstetrical ARF.

Hypertension in pregnancy: hospital based study.

Eighteen hundred two pregnant women consisting of 750 primigravida and 1,052 multigravida were screened for hypertension between July 2000 to June 2002. Hypertension was noted in 97 (5.38%) patients. Twenty five patients were lost to follow up and only 72 patients were included in the final study. The age of the patients ranged between 19 to 32 (mean +/- SD = 24.75 +/- 3.36) years. The majority of patients 41 (57%) were primigravida and 31 (43%) were multigravida. Of 31 multigravida, vast majority (84%) of patients were found to be hypertensive in the third trimester. Only 5 (16%) patient had hypertension in the first trimester. Stage I, II and III hypertension were noted in 18%, 50% and 32% of patients respectively as per JNC-VI criteria. Preeclampsia (PE) was seen in 44.44% (n=32), eclampsia in 40.28% (n=29), HELLP syndrome in 6.94% (n=5), chronic hypertension (HTN) with superimposed PE in 6.94% (n=5) and chronic HTN in 1.38% (n=1). Of the 6 patients with chronic hypertension 50% (3) had essential HTN. Acute renal failure (S. creat > 3 mg/dl) was seen in 7 patients and 4 required dialytic support. Maternal mortality was 5.55% (4) and perinatal death occurred in 37.5% (27) of deliveries. Low birth weight was seen in 66.66% (48) of births. Hypertension complicated 5.38% of all pregnancies in our study. Preeclampsia-eclampsia and its variants remain the major cause of hypertension in pregnant women. Hypertension during pregnancy is responsible for high fetal mortality and low birth weight.

Acute renal failure in pregnancy in a developing country: twenty years of experience.

UNLABELLED: Acute renal failure (ARF) has become a rare complication of pregnancy in developed countries. The aim of this study was to describe changing trends in pregnancy-related acute renal failure (PR-ARF) in two successive periods; 1982-1991 and 1992-2002. From July 1982 to December 2002, 190 cases of PR-ARF were observed in Eastern India (11.6% of total number of ARF needing dialysis). Obstetrical complications were causative factors for ARF in 15% (65/426) and 10% (125/1201) of patients in the two periods, respectively. The incidence of PR-ARF fell from 15% in 1982-1991 to 10% in 1992-2002, with respect to the total number of acute renal failure cases. Post-abortal ARF showed a declining trend, 9% in the 1980s to 7% in the 2000s, of the total number of ARF cases. Preeclampsia-eclampsia was the cause of obstetrical ARF in 23% (1982-1991) and 14.4% (1992-2002) of cases in these two periods. The percentage of total ARF due to eclampsia declined from 3.5% during the period 1982-1991 to 1.4% in 1992-2002. Puerperal sepsis contributed to 0.8% of total ARF in recent years, compared to 2.4% in the earlier period. The incidence of cortical necrosis decreased significantly (p < 0.001) from 17% in 1982-1991 to 2.4% in the 2000s. The maternal mortality reduced to 6.4% in 1992-2002 from initial high mortality of 20% in the period of 1982-1991. CONCLUSION: PR-ARF which remained high in the initial period has decreased in recent years. This is associated with a declining trend in

MTHFR C677T and A1298C polymorphisms are risk factors for Down's syndrome in Indian mothers.

Down's syndrome (DS), a chromosomal disorder due to trisomy 21, results mostly from nondisjunction in maternal meiosis. The present case-control study examined the association of genetic polymorphisms with predisposition to nondisjunction. Two common polymorphisms (SNPs), C677T and A1298C, in the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene involved in folate metabolism, are known to lower the activity of this enzyme. Three hundred and fourteen mothers (with DS children and controls), mostly from the eastern states of India, were genotyped for the two above-mentioned SNPs. Significant association with both of these SNPs were detected, more specifically, in the mothers of DS children homozygous for the polymorphic alleles 677 T and 1298 C. The relative risk of T (C677T) and C (A1298C) homozygosity in mothers for DS-affected pregnancy was 7 (OR 7.67, 95% CI 1.67-35.08, P=0.003) and 4 (OR 4.40, 95% CI 1.45-13.26, P=0.008), respectively. Moreover, all 677TT mothers studied were less than 31 years of age, whereas no correlation with maternal age was observed for A1298C genotypes. Interestingly, all of the young 677TT mothers had either a first- or secondborn child with DS. Thus, this study reports that young Indian mothers with TT genotypes are genetically predisposed to nondisjunction due to abnormal folate metabolism.