Neonatal conjunctivitis: a profile

Neonatal conjunctivitis is one of the commonest infections encountered in the newborn. A prospective study was conducted on all babies born over a period of one year. No prophylactic ocular medication was instilled routinely in newborns. Babies developing purulent eye discharge were diagnosed to have conjunctivitis. Eye Swab from the neonates and maternal vaginal/cervical swabs were sent for culture. Chloromycetin eye drops were used for treatment and in case of no response, changed as per sensitivity report or to gentamicin eye drops. Oral erthromycin was given for dacryocystitis or when there was no response to topical therapy. The incidence of conjunctivitis was 7.2%. Two seasonal peaks, namely, February and then May and June, were noted. In 91.6% of the babies, conjunctivitis developed within the first week. A prolonged rupture of membranes was associated with a significantly higher incidence of conjunctivitis (p < 0.01). The most common organism grown from conjunctival swab was Staph aureus (35.2%) followed by Enterococcus (4.3%), Klebsiella (3.5%) and E. coli (2.8%). From vaginal/cervical swabs, E. coli was the most common organism isolated. No concurrence of organisms was noted between eye swabs and vaginal/cervical swabs. A uniformly good response to chloromycetin eye drops was noted with only 3.5% requiring a change of therapy. It is concluded that neonatal conjunctivitis is commonly acquired postnatally and responds well to topical chloromycetin therapy. Oral erythromycin may be used in resistant cases which will cover the chlamydial infection also.

Effect of Escherichia coli enterotoxins on macromolecular absorption

Macromolecular absorption of gliadin, a wheat protein and alpha lactalbumin, a milk protein was evaluated in control and Escherichia coli enterotoxin (heat-stable, heat-labile, and both heat-stable and heat-labile enterotoxin) treated mice. The peak concentration of gliadin and lactalbumin was two hours and three hours after their ingestion, respectively. There was also a significant increase (p < 0.01) in the absorption of both the proteins in all the three toxin treated groups compared with the control group. These results suggest that intestinal permeability and macromolecular absorption changes after E coli infection.

Carcinoma associated mucins: molecular biology and clinical applications

Mucin is a viscous secretion of glycoproteins secreted by epithelial cells of normal and cancerous tissues. Excessive and abnormal mucin synthesis has been observed in a number of cancers. The conformation and configuration of the surface carbohydrates play a key role in generating multiple forms of mucins in different cancers. The epitopes on the surface of mucin are recognized by antibodies present in different cancer cells. The primary structure of some of the cancer-associated mucins has been determined by molecular cloning of their complementary DNAs. The detection methods for cancer-associated mucins and their clinical applications are discussed.

Refractive errors in preterm babies

Fifty preterm neonates were followed up at the age of 6 months and 1 year. In addition to developmental assessment, a complete ophthalmological examination was done on both visits. The largest (62%) gestational age group was of 34-36 weeks. At 6 months, none of the infants had normal vision. At 1 year of age, 64% of the babies had normal vision while incidence of myopia and hypermetropia was 16% and 20%, respectively. There was an inverse relationship noted between gestation and incidence of refractive errors. It was also noted that with decreasing weight, the incidence of myopia increased. Myopia was seen exclusively among infants of birth weight of 2000 g or less. Birth weight had a significant positive correlation with astigmatism. No correlation of asphyxia with refractive errors was observed. It is recommended that all preterm babies should have an ophthalmological examination at one year of age with follow up later on.

Neutrophil leukotriene generation increases after cardiopulmonary bypass

BACKGROUND

Leukotriene B4 has been shown to play a role in the systemic inflammatory response after cardiopulmonary bypass in experimental animal models; however, the importance of this mediator in human beings undergoing cardiac operations has not been established.

METHODS

The neutrophils of ten patients undergoing coronary artery bypass grafting with cardiopulmonary bypass were studied for their ability to generate leukotrienes at the time of the induction of anesthesia, the institution of cardiopulmonary bypass, the removal of the aortic crossclamp, at the end of the operation, on admission to the intensive care unit, and on postoperative days 1 and 2

RESULTS

After cardiopulmonary bypass, the generation of chemotactic leukotrienes rose significantly and remained elevated on the first postoperative day compared with prebypass values (prebypass 133.8 +/- 10.7 versus postbypass 192.7 +/- 19.2 [p < 0.05] and first postoperative day 196.6 +/- 13.8 [p < 0.05]). The increases in plasma complement and lactoferrin levels, although significant, were not sustained. In addition to the neutrophil count, the potential leukotriene and oxygen radical produced was significantly increased, and this increase was correlated with postoperative length of stay.

CONCLUSION

These observations support the laboratory data documenting that the rise in leukotriene generation after cardiopulmonary bypass includes human patients.

Obesity and hypertension in children

A study was conducted on two thousand five hundred and sixty school children to evaluate the prevalence of hypertension in apparently healthy school children of a prosperous, industrialized city of Punjab. The children belonged to 5-15 years age group of both sexes. The weight (kg) was taken by a standardized weighing machine while height was measured using a calibrated bar. For diagnosing obesity, the body mass index (BMI) was calculated by the formula: [formula: see text] A value of > or = 2.26 was considered as obesity. Blood pressure (BP) measurements were taken by a a mercury sphygmomanometer as per the recommendations of American Heart Association. Hypertension was diagnosed if blood pressure was more than 95th percentile for the age. Family history of hypertension was enquired from the parents of children. The BP of the hypertensive children was reassessed after six and nine months. The prevalence of hypertension was 2.8% at the first screening but decreased to 1.3% and 1.1% by 6 and 9 months, respectively. This fall was statistically significant (p < 0.01). There was no significant difference in the prevalence of hypertension between the two sexes. At the final screening, only children of 11 years or above were hypertensive. A statistically significant correlation with positive family history of hypertension was noted; 85.7% of hypertensive children had positive family history. The prevalence of hypertension was much higher in obese as compared to non-obese children (13.7% vs 0.4%). The correlation between obesity and hypertension was statistically significant (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Canine U2 snRNA gene: nucleotide sequence, characterization and implications in RNA processing and cancer biology

Abnormal RNA processing (splicing) may lead a cell to become cancerous. Transcription of a gene starts in the nucleus where genomic DNA is converted to precursor RNA by removing introns and joining exons. Splicing, mediated by small nuclear RNA (snRNA) and nuclear proteins, is tightly regulated during growth and development. U2 snRNAs are small, stable RNAs located in the nucleus of eukaryotic cells that recognize the branch point of the intron-exon junction. We describe here the organization of DNA sequences complementary to canine U2 snRNA. From a genomic library we isolated one recombinant containing the U2 gene. Southern analysis revealed that the canine species possesses only 3 to 5 U2 snRNA genes or very closely related sequences. The size of the U2 gene is 125 nt whereas in rat, Drosophila, trypanosome and yeast it is 189, 234, 141, and 192 nt respectively. The nucleotide sequence showed 82, 78, 72 and 95% homology with rat, Drosophila, yeast, and trypanosome U2 snRNA, respectively. The sensitivity of U2 snRNA towards alpha-amanitin suggests that it is transcribed by RNA polymerase II. The conserved nucleotide sequences which have been implicated in heterogeneous nuclear RNA splicing have been identified. The implications of the knowledge gained through above studies in cancer biology are discussed.

Safe motherhood: when to begin

Two thousand five hundred college girls were assessed for their knowledge and attitudes regarding sex, pregnancy and child rearing with the help of a pretested questionnaire. The site of menstruation was known to only 35.3% of the girls. The knowledge about the time and site of conception was 25.3% and 58.2%, respectively. Only 16.3% of the respondents knew the normal route of delivery although the duration of normal pregnancy was known to majority (87.7%). The girls were aware of the ideal timing of abortion (67.5%) but the safe method and legality were poorly known facts. Only 5% of the girls believed in pre-marital sex. More than half (54.9%) of the girls knew about some form of contraceptive, Copper-T being the best known. Nearly one fifth of the girls were either undecided or wished family members to decide about antenatal check-ups. The need for better diet and injections during pregnancy was well known although few (15.2%) were aware of the injections being tetanus toxoid. Only about 10% wanted a home delivery but one fourth felt that a Dai or a relative was suitable for conducting the delivery. An overwhelming majority of the students stated that knowledge about above facts was important and they would like to learn about them preferably during college education. It is recommended that 'Family life education' be provided during pre-adolescent and adolescent years to ensure a safe motherhood and a healthy child.

Inhibition of neutrophil leukotriene generation by the 21-aminosteroid, U-74389F

The 21-aminosteroids are potent inhibitors of iron-dependent lipid peroxidation and more protective than methylprednisolone in models of trauma and reperfusion, but without glucocorticosteroid side effects. Histologically, animals treated with 21-aminosteroids have decreased neutrophil (PMN) infiltrates and diminished tissue destruction associated with trauma or reperfusion. Since PMN contribute to organ failure following ischemia-reperfusion, we assessed the effect of U-74389F (U7), on normal PMN function. Neutrophils from normal volunteers were incubated for 90 min with either vehicle, 15 microM U7 or 80 microM methylprednisolone (MP), in DMSO. Lactoferrin released and generation of leukotrienes to calcium ionophore A23187, also oxygen consumed to PMA and leukotriene B4 (LTB4) and chemotaxis to FMLP and LTB4, were determined for each group of PMN. Lactoferrin released to A23187 was significantly decreased in both steroid groups (7.29 +/- 0.82 micrograms vs 3.06 +/- 0.57 micrograms U7 and 2.88 +/- 0.62 micrograms MP, P < 0.01). PMN incubated with U7 or MP generated significantly less LTB4 (60.6 +/- 4.3 ng vs 47.7 +/- 2.4 ng U7 and 43.3 +/- 5.6 ng MP, P < 0.05). There were no differences noted in the ability of PMN incubated with either compound to consume oxygen or to respond to chemotactic stimuli. We conclude that the proven protective action of the 21-aminosteroids in models of ischemia-reperfusion is related to the ability of "steroids" to inhibit leukotriene generation and degranulation and may be related to the prevention of tissue lipid peroxidation by scavenging oxygen radicals.

Triazines as anti-inflammatory agents

5,6-Diphenyl 1,2,4-triazine-3-thiol (III) was synthesized from alpha-diketone benzyl (II); II in turn was synthesized from benzoin (I). III on reaction with 1-chloro-2,3-epoxy propane yielded 3-[(oxiranyl methyl)thio]-5,6-diphenyl 1,2,4-triazine (IV). IV was converted to 3-[5,6-diphenyl-1,2,4-triazine-3-yl thio]-3-substituted propanols (V) on reaction with aryl amines. These compounds were screened for their anti-inflammatory activity in albino rats with carrageenin induced paw oedema. Two compounds, Ve and Vl, exhibited significant anti-inflammatory activity compared to the standard, phenylbutazone, with high ALD50 values.

Mucin coding sequences are remarkably conserved

Mucins are complex glycoproteins expressed by glandular epithelia and the carcinoma which develop from these tissues. The core protein is aberrantly glycosylated in cancers, and some antibodies show specificity in their reactions with the cancer-associated mucins, which also contains epitopes recognized by T-cells from pancreatic and breast cancer patients. Based on the PCR amplification of the mucin coding sequences, hybridization analysis and determination of the sequence divergence we present the evidence that mucin coding sequences are conserved in a number of species. A broad series of organisms were examined for analogous sequences. Data show that mucin-type sequences are present in a variety of mammals, but less apparent in chicken and yeast. Divergence increased in the order human, monkey, rabbit/rat/cow, mouse; chicken and yeast exhibited minimal homology. Furthermore, nucleotide sequences not included in the tandem repeats, a common feature of mucin core structure, are more conserved than the flanking sequences which also suggests that the flanking sequences may be functionally significant while repeats are structurally important. The hybridization bands showed different restriction patterns (suggesting for the existence of the restriction fragment length polymorphism). Northern analysis indicates message polydispersity, commonly seen with this class of RNA. The major features of the protein appear broadly conserved in the different mammalian species examined. The evolutionary significance of the above studies has been discussed.

Communication skills in clinical practice fad or necessity?

Communication skills of 40 final year medical students were assessed using Objective Structured Clinical Examination. The scores obtained were significantly less than those obtained in clinical skills. There was no significant correlation between the two sets of scores. It is suggested that emphasis should be placed on developing and evaluating communication skills during undergraduate medical curriculum.

DNA sequences encoding enolase are remarkably conserved from yeast to mammals

Enolase (2-phospho-D-glycerate hydrolase, EC 4.2.1.11), particularly isoform neuron-specific enolase (NSE), is primarily localized in neurons and neuroendocrine cells and is a cancer diagnostic marker for brain tumors. Homology of enolase-coding DNA sequences from human, dog, cow, rat, mouse, rabbit, chicken, and yeast cells was investigated using hybridization techniques, percent sequence divergence, and amino acid analysis. Because enolase is a significant enzyme of the glycolytic pathway, enolase-coding DNA sequences have been found in all organisms tested so far. The human enzyme was found to be more like those of monkey and dog in structure than to those of chicken and yeast. The implications of the existence of the genetic conservation of enolase-coding DNA sequences in understanding concerted evolution as well as post-transcriptional regulation during differentiation are discussed. This is the first report is which sequence divergence in the coding region for enolase has been determined in a variety of organisms.

Frequency-dependent alterations in enolase activity in Escherichia coli caused by exposure to electric and magnetic fields

Some neurochemical effects of low-intensity electric and magnetic fields have been shown to be nonlinear functions of exposure parameters. These effects occurred within narrow ranges of frequency and intensity. Previous studies on membrane-associated endpoints in cell culture preparations demonstrated changes in calcium efflux and in acetylcholinesterase activity following exposure to radiofrequency radiation, amplitude modulated (AM) at 16 and at 60 Hz, at a specific absorption rate of 0.05 W/kg. In this study, these modulation frequencies were tested for their influence on the activity of a cytoplasmic enzyme, enolase, which is being tested clinically for detection of neoplasia. Escherichia coli cultures containing a plasmid with a mammalian gene for enolase were exposed for 30 min, and cell extracts were assayed for enolase activity by measuring absorbance at 240 nm. The enolase activity in exposed cultures was compared to the activity in paired control cultures. Exposure to 147 MHz carrier waves at 0.05 W/kg, AM at 16 Hz showed enolase activity enhanced by 62%, and AM at 60 Hz showed enolase activity reduced by 28%. Similarly, exposure to 16 Hz fields alone, at 21.2 V/mrms (electric) and 97 nTrms (magnetic), showed enhancement in enolase activity by 59%, whereas exposure to 60 Hz fields alone, at 14.1 V/mrms (electric) and 65 nTrms (magnetic), showed reduction in activity by 24%. Sham exposures as well as exposure to continuous-wave 147 MHz radiation at 0.05 W/kg showed no change in enolase activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Developing and standardizing a scale for measuring attitudes towards infant feeding

A Likert type scale was designed to assess the attitudes of urban college girls towards infant feeding. The scale was administered to a sample population of 50 girls and the scores thus obtained were used to calculate the internal consistency of the scale. The scale had a reliability of 0.82 (p < 0.01 at df 48).

Attitudes of medical students towards Objective Structured Clinical Examination (OSCE) in pediatrics

A standardized Likert type scale containing 10 items was administered to 40 Fourth year medical students to assess their attitudes towards Objective Structured Clinical Examination (OSCE). The overall attitudes were favorable. However, on certain aspects, a near neutral attitude was observed. Remedial changes in the teaching methodology have been undertaken to mould the attitudes favorably as well as to make pediatric teaching more effective.

Evaluation of commercially available antacid tablets

Antacids are commonly used for the treatment of acid peptic disease. There is a need to study the relative merits of various brands of antacids available commercially. Twenty three brands of antacid tablet preparations were evaluated with regard to their composition, cost, dispersion time, pH, neutralising capacity and time taken for neutralisation. The cost of various tablets ranged from Rs 0.13 to Rs. 1.48 per tablet and the dispersion time from 20 to 90 minutes. The pH of the dispersed tablet solution ranged from 5.7 to 9.5. The neutralising capacity varied between 8 to 169 meq/tablet and the neutralizing time between 20 and 45 minutes. The cost: neutralizing ratio was calculated and ranged from 102 to 9867 x 10(-3) Rs/meq. A scoring system with a maximum score of 12 has been devised. The study provides a guide for choosing a more potent, quick neutralising and low cost antacid preparation.

Antipyrine congeners as antidepressant agents

1-(N-Antipyrinylglycyl)-3-arylideneamino)-2-thiobarbituric acids (III) were synthesized from 1-arylidene-4-(N-antipyrinyl glycyl)-3-thiosemicarbazones (II). Compounds II in turn were prepared from 4-amino antipyrine. Compounds III were finally converted into 1-(N-antipyrinylglycyl)-3-[(3'-chloro-4-aryl)azitidinyl]-2-t hiobarbituric acids (IV). 4-Aminoantipyrine was also treated with different N-protected amino acids in the presence of N,N'-dicyclohexylcarbodiimide to yield N-(antipyrinylcarbamoyl) substituted alkyl benzamides (V); their debenzoylation yielded 2-(amino-N-antipyrinyl) substituted acetamides (VI). The compounds were screened for their antidepressant activity. Compounds IIId, Va and Vb exhibited activity better than imipramine with less toxicity (ALD50 > 1000 mg/kg).

Microwave induced alteration in the neuron specific enolase gene expression

Exposure of pNGE7, a recombinant clone containing the coding and regulatory sequences for the expression of neuron specific enolase gene, cells to electromagnetic radiations (915 MHz, 16 Hz AM, SAR 0.05 mW/kg) resulted in the elevation of neuron specific enolase (NSE), a diagnostic marker for neuron and lung cancer. Using ion-exchange chromatography we separated the neuron specific enolase activity from the non-neuronal enolase (NNE) activity and observed an alteration in the expression of neuron specific enolase and non-neuronal enolase. The clinical applications of the present studies have been discussed.