Nutritional status of pavement dweller children of Calcutta City

Pavement dwelling is likely to aggravate malnutrition among its residents due to extreme poverty, lack of dwelling and access to food and their exposure to polluted environment. Paucity of information about nutritional status of street children compared to that among urban slum dwellers, squatters or rural/tribal population is quite evident. The present study revealed the magnitude of Protein Energy Malnutrition (PEM) and few associated factors among a sample of 435 underfives belonging to pavement dweller families and selected randomly from clusters of such families, from each of the five geographical sectors of Calcutta city. Overall prevalence of PEM was found almost similar (about 70%) to that among other 'urban poor' children viz. slum dwellers etc., but about 16% of them were found severely undernourished (Grade III & V of IAP classification of PEM). About 35% and 70% of street dweller children had wasting and stunting respectively. Severe PEM (Grade III & IV) was more prevalent among 12-23 months old, girl child, those belonged to illiterate parents and housewife mothers rather than wage earners. It also did increase with increase of birth rate of decrease of birth interval.

Comparative mutagenic and genotoxic effects of three antimalarial drugs, chloroquine, primaquine and amodiaquine

Comparative mutagenic and genotoxic effects of three antimalarial drugs, chloroquine, primaquine and amodiaquine, were assessed in the Ames mutagenicity assay (in strains TA97a, TA100, TA102 and TA104) and in vivo sister chromatid exchange (SCE) and chromosome aberration (CA) assays in bone marrow cells of mice. These are the most commonly used antimalarial drugs available at present throughout the world. The results of the bacterial mutagenicity assays showed a very weak mutagenic effect of all three drugs in Salmonella strains TA97a and TA100 both with and without S9 mix and in TA104 only with S9 mix. The results of the in vivo SCE and CA assays indicate that these three drugs are genotoxic in bone marrow cells of mice.

[Local vascular complications after heart catheterization]

Vascular complications such as haematoma and pseudoaneurysm are a significant problem in patients undergoing arterial catheterization. Ultrasound-guided compression of the pseudoaneurysm is a non-invasive and efficient therapy. We describe two patients with rare complications. A 59-year old man died of multiple pulmonary embolism after diagnostic cardiac catheterization. A 71-year old female patient developed a deep inguinal skin necrosis after repeated local compression of a pseudoaneurysm formed after therapeutic catheterization.

Pseudoaneurysm of femoral artery after catheterisation: treatment by a mechanical compression device guided by colour Doppler ultrasound

BACKGROUND

Femoral artery pseudoaneurysm is a significant complication in patients undergoing diagnostic or therapeutic catheterisation. First choice treatment for pseudoaneurysm is freehand ultrasound guided compression repair, which is time consuming and uncomfortable for the patient and operator.

AIM

To explore a mechanical compression device (FemoStop) as an alternative treatment for iatrogenic femoral artery pseudoaneurysm.

METHODS

Fourteen patients with pseudoaneurysm were considered for treatment with FemoStop after a brief freehand ultrasound guided compression repair to confirm the compressibility of the lesion. The FemoStop compression was applied for 20 minutes. The result was controlled with colour Doppler ultrasound, and a second cycle of 20 minutes followed if necessary.

RESULTS

FemoStop compression was successful in 13 of the 14 patients. The mean compression time was 33 minutes (range, 20-60). The mean number of compression periods was 1.6 (range 1-3). FemoStop compression was successful in all 11 patients not taking anticoagulants and in two of three patients receiving anticoagulants. The mean compression time in patients given oral or intravenous anticoagulants was longer (50 v 27 minutes). Colour Doppler ultrasound 12 hours after the procedure indicated no recurrence of pseudoaneurysm in the 13 patients with initial success.

CONCLUSIONS

FemoStop compression for iatrogenic pseudoaneurysm is feasible, and as safe and effective as freehand ultrasound guided compression repair. It is more comfortable for the patient and operator, and probably more economical than freehand compression.

[Non-surgical closure of type-II atrial-septal defect and patent foramen ovale]

In the past the standard therapy for significant atrial septal defect was surgical closure. In the presence of a patent foramen ovale with otherwise unexplained (cryptogenic) cerebral embolism, the therapy was oral anticoagulation or antiplatelet therapy. Surgery was considered only in the event of recurrence. Percutaneous transcatheter occlusion of atrial septal defect and patent foramen ovale is a new and valuable alternative to surgical closure. This report presents current knowledge and our own experience of nonsurgical closure of atrial septal defects and patent foramen ovale.

Proximal coronary artery stenosis: three-dimensional MRI with fat saturation and navigator echo

The purpose of this study was to compare the diagnostic value of MR angiography (MRA) with conventional contrast angiography in coronary artery disease. Thirty-five patients underwent MRA and coronary angiography within 4 hours. Of these, three patients were investigated twice: once before and once after balloon angioplasty. The pulse sequence was a cardiac-triggered, single-slab, three-dimensional gradient-echo sequence, employing a spin-echo navigator echo measurement to track the variation of the diaphragm during the scan. The following segments of the coronary arteries were included in this prospective study: left main coronary artery, proximal and middle left anterior descending, proximal and middle left circumflex, proximal and middle right coronary artery, and intermediate branch, if present. In total, 176 segments were classified as normal or having a stenosis of less than 50% and as having a stenosis of more than 50%. Five patients were excluded because of lack of cooperation. Over all, 45 of 54 stenoses were detected and interpretable by MRA. Sensitivity, specificity, and positive and negative predictive values of MRA for detecting significant stenoses were 83%, 94%, 87%, and 93%, respectively. MRA identified significant stenoses within the major coronary arteries with a high degree of accuracy. Sensitivity and specificity are higher compared with exercise tests or scintigraphy or top of the precise localization.

Major goat sperm 105 kDa maturation antigen: purification, characterization, and effect of its antiserum on acrosin activity

A ConA binding membrane glycoantigen of 105 kDa molecular mass was purified from mature goat sperm by ion exchange and gel filtration chromatography. Of the detergents examined, the anionic deoxycholate was found to be highly effective in maximum solubilization of this sperm membrane antigen (SMA2). The analysis of the saccharide components by gas liquid chromatography revealed that the 105 kDa antigen (SMA2) contained the highest amount of mannose, followed by galactose and glucose in a ratio of 4:3:1. One amino sugar, N-acetylglucosamine, was also found to be present in the polysaccharide branching of the SMA2 antigen. The internal sulfydryl linkage is essential for the maintenance of the protein backbone of 105 kDa antigen. The antigen selectively resides on the anterior head of goat sperm. The binding of anti-SMA2 antibody to the integrated mature goat spermatozoa inhibited the release of acrosin after the induction of spermatozoa with Ca-ionophore.

[Atrial septum defect and open foramen ovale. Diagnosis, clinical aspects and therapy using a catheter technique]

The purpose of this report is to describe the pathophysiology and clinical symptoms of atrial septal defects with emphasis on right ventricular failure and the risk of paradoxical embolism in the setting of a patent foramen ovale. The diagnosis of both the atrial septal defects and the patent foramen ovale, usually is made by echocardiography. Percutaneous transcatheter occlusion of an atrial septal defect and a patent foramen ovale has gained interest for some years as a treatment alternative to surgical closure. Preliminary results of different devices have been encouraging and the method appears to be a viable alternative to surgical closure.

Distribution of 105-kDa sperm unique antigen on goat epididymal mature spermatozoa

The sperm surface antigens are organized into topographic domains, specifically formed into the membrane during the sperm maturation in the epididymis. The present study was directed to determine the distribution of 105 KD sperm membrane antigen (SMA2) into the cell by affinity purified antibody, generated by 105 KD sperm antigen. The cytoimmunofluorescence study of the integrated sperm cell reveal that the antigen is localized in the anterior head overlying the acrosome. On immunoblotting of isolated head and flagellum polypeptides it has been demonstrated that this antigen is selectively present in the head membrane and absent in the flagellum. Because of its selective presence in the anterior head membrane overlying the region of acrosome on mature spermatozoa, the 105 KD sperm unique glyco-antigen may have a role in events leading to sperm-egg recognition. It is a first report of a high molecular mass membrane antigen being localized in the anterior head membrane of goat mature epididymal spermatozoa.

Cardiac metastasis of an esthesioneuroblastoma

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Unusual pseudoaneurysms after catheterization: successful treatment by ultrasound-guided compression

Postcatheterization pseudoaneurysms occur mostly in the femoral artery. Two patients (both women, aged 67 and 59 years) undergoing percutaneous transluminal angioplasty (PTA) at our institution presented pseudoaneurysms in unusual locations, one in the brachial and one in the popliteal artery. Because of good experiences with ultrasound-guided compression repair (UGCR) in the femoral artery, we also successfully performed this noninvasive treatment on the two patients. Follow-up at 28 and 12 months, respectively, after the procedure, showed no instances of recurrence. As with the excellent results of UGCR in the femoral artery, we believe that this new modality is also the treatment of choice in iatrogenic pseudoaneurysms of the arm and popliteal arteries.

[Acute dyspnea]

A 75 year old patient was hospitalized because of acute dyspnea. For two weeks she suffered from a flu-like illness with low-grade fever, cough, and fatigue. On auscultation systolic and diastolic murmurs were found whose intensity changed depending on the position assumed by the patient. Transthoracic and transoesophageal echocardiography showed a tumor in the left atrium obstructing the left ventricular inflow tract. The tumor was removed surgically because of this obstruction and the imminent danger of embolism to the peripheral arteries. The diagnosis of an atrial myxoma was confirmed intraoperatively and by histology.

Ultrasound-guided compression repair for treatment of femoral artery pseudoaneurysm: acute and follow-up results

Femoral artery pseudoaneurysm is a significant problem in patients undergoing arterial diagnostic or therapeutic catheterization. The aim of this investigation was to report the incidence of pseudoaneurysm after arterial catheterization and the success rate of ultra-sound-guided compression repair. During a 3-year period (11/91-11/94) 9,051 patients underwent 7,312 cardiac catheterizations and 1,739 peripheral percutaneous transluminal coronary angioplasty procedures. Patients suspect of pseudoaneurysm were referred for a color Doppler ultrasound examination. All patients with pseudoaneurysm were considered for ultrasound-guided compression repair. Pseudoaneurysm occurred more frequently after interventional procedures with new devices (valvuloplasty 2.3%, stent 3.2%) than after conventional catheterization diagnostic cardiac catheterization 0.2%, electrophysiology 1.3%, percutaneous transluminal coronary angioplasty 0.2%). The incidence of pseudoaneurysm after peripheral percutaneous coronary transluminal angioplasty, including intra-arterial lysis and stent, was 1%. Ultrasound-guided compression repair was successfully performed in 37 of 41 cases with pseudoaneurysm (90%). Ultrasound-guided compression repair was successfully performed in 30 of 31 patients (97%) without anticoagulation and in 7 of 10 patients (70%) receiving anticoagulants (P < 0.05). There was no correlation between mean diameter of the pseudoaneurysm, age of the lesion, or antiplatelet therapy. Color Doppler ultrasound re-examination at up to 3 months indicated successful treatment in all patients. The use of complex interventional catheterization procedures leads to an increased frequency of pseudoaneurysms compared with conventional angiography and percutaneous transluminal coronary angioplasty. Ultrasound-guided compression repair is a non-invasive, efficient, safe and cost-effective therapy for post-catheterization pseudoaneurysm.

Recurrent bleeding of angiomyolipomas in tuberous sclerosis

The diagnostic and therapeutic problems of renal hamartomas are illustrated by a case of recurrence of bleeding angiomyolipomas associated with tuberous sclerosis. Ultrasound and computed tomography provide clear evidence of lipomatous formation while, in rare instances, angiography can demonstrate the existence of multiple vascular tumor compartments. In view of the risk of bleeding, multiple or very large angiomyolipomas should be treated by interventional radiology in the form of superselective tumor embolization or by the most conservative surgery possible.

Evidence for a weak angiogenic response to human colorectal cancers

Many previous qualitative studies have shown that tumours are less vascular in the centre, and that host tissues become more vascular in close proximity to tumours. However, quantitative findings presented here for human colorectal cancer reveal some significant differences. Sections from 20 colorectal carcinomas (ten moderately and ten poorly differentiated) were immunostained with the QB/end/10 monoclonal to demonstrate blood vessels. These were measured by interactive morphometry and vascular volume density, surface density (Sv) and length density were recorded. In poorly differentiated carcinomas, the tumour centre was significantly less vascular than the periphery for all three parameters (P = 0.008 for Sv). However, no significant difference was seen for moderately differentiated tumours, which constitute the majority of colorectal cancers. Surrounding host tissues did not show a general increase in vascular density close to tumours. Furthermore, when total viable tissue was considered, the vascular density of carcinomas was not markedly different from normal mucosa. In the centre of moderately differentiated carcinomas for example, the mean value for Sv was only 1.4 times higher than the mean value for normal mucosa. These findings suggest that colorectal cancers may elicit a relatively weak angiogenic response, consistent with their exceptionally slow growth rate.