Effect of hypovitaminosis D and its related factors in pregnant women and their newborns

Background: Maternal and fetal vitamin D deficiency has nowadays emerged as a frequent morbidity. Adequate vitamin D concentrations during pregnancy are necessary to maintain neonatal calcium homeostasis, bone maturation and mineralization. Objectives of this study were to evaluate serum vitamin D concentration in mothers and its correlation with neonatal cord blood vitamin D at the time of delivery and to study the impact of hypovitaminosis on neonatal anthropometry. Effect of related factors like calcium (Ca), alkaline phosphatase (ALP) and parathyroid hormone (PTH) on maternal vitamin D levels were to be evaluated.Methods: Cross sectional study was done on a total of 220 healthy uncomplicated antenatal females with singleton pregnancy attending labor room at the time of delivery. Maternal and neonatal cord blood samples were drawn in the delivery room and analyzed. Neonatal anthropometry was recorded. Correlations among various maternal and neonatal factors were studied.Results: Widespread vitamin D deficiency was observed in expectant subjects and neonates with 70.91% having deficient levels which were also reflected in newborns (71.82%). Maternal ALP (r= -0.5503, p=0.000) bears a weak negative correlation (p<0.05), maternal serum Ca positive correlation (r = 0.7486, p=0.000) and plasma PTH levels a negative correlation (r = -2.084, p=0.000) with hypovitaminosis. No significant correlation was observed between neonatal anthropometry and vitamin D levels.Conclusions: High prevalence of hypovitaminosis was observed among pregnant women and their neonates in this study. A positive linear relationship was seen between maternal and cord blood vitamin D (r 0.974, p 0.0001)

Adenosine deaminase and interferon-gamma in diagnosis of tubercular pleural effusion

Background: Pleural effusion is a common extrapulmonary manifestation of tuberculosis (TB). The conventional culture suffers from lack of sensitivity. Many pleural fluid markers have been evaluated to diagnose tubercular pleural fluid but none has proved to be an ideal. We have studied Adenosine deaminase (ADA), Interferon gamma (IFN) and their combination for diagnosis of tubercular pleural effusion.Methods: All consecutive patients with pleural effusion were subjected to thoracentesis and segregated into transudative and exudative using Light`s criteria. Patients with exudative pleural effusion were enrolled and divided into two groups. Group-I comprised of patients with tubercular etiology, Group-II- non-tubercular etiology. 45 patients were selected for each group. ADA and IFN in pleural fluid of these patients were measured. The sensitivity, specificity and predictive values were calculated.Results: The  sensitivity, specificity, positive predictive value, negative predictive value of ADA and IFN were 88.89%, 99.85%, 86.96%, 99.87%; 97.78%, 97.78%, 97.78%, 97.78% respectively. Combination of ADA and IFN didn’t improve the sensitivity or specificity compared to IFN alone.Conclusions: Pleural fluid ADA, IFN were found to be useful in differentiating tubercular from non-tubercular patients. Combination of ADA and IFN doesn’t give additional benefit over IFN alone

Otorhinolaryngological myiasis: the problem and its presentations in the weak and forgotten

Introduction: Myiasis is common in tropical regions, but now increasing incidence is seen in the west due to international travel. Otorhinolaryngological myiasis is uncommon and is seen in diabetics, alcoholics or patients unable in self-care.Objectives: To study presentations of otorhinolaryngological myiasis, identify associated risk factors and species of flies causing myiasis.Methods: Clinical findings and co-morbidities of 67 myiasis cases were noted. Maggots were identified, manually removed, and patients were managed with topical treatment, systemic ivermectin and antibiotics.Findings: Thirty-three nasal myiasis, 13 aural myiasis and 5 patients with oral myiasis were noted. Seven patients with head neck wounds myiasis and nine patients of tracheostome myiasis were recorded.Discussion: Warm humid climate of tropical regions is a major concern along with co-existing conditions like poor sanitation, alcoholism, psychiatric diseases and neuropathies. Hesitancy is seen in attendants and health care professionals to deal with myiasis.Conclusion: Awareness about risk factors is important in avoiding myiasis along with prompt treatment which reduces morbidity. Tracheostome myiasis is an under-documented entity rather than a rare presentation.Keywords: Myiasis, Ivermectin, screwworm, Chrysomya bezziana, Musca domestica, Lucilia sericata.Funding: Non

Adenosine deaminase and interferon-gamma in diagnosis of tubercular pleural effusion

Background: Pleural effusion is a common extrapulmonary manifestation of tuberculosis (TB). The conventional culture suffers from lack of sensitivity. Many pleural fluid markers have been evaluated to diagnose tubercular pleural fluid but none has proved to be an ideal. We have studied Adenosine deaminase (ADA), Interferon gamma (IFN) and their combination for diagnosis of tubercular pleural effusion.Methods: All consecutive patients with pleural effusion were subjected to thoracentesis and segregated into transudative and exudative using Light`s criteria. Patients with exudative pleural effusion were enrolled and divided into two groups. Group-I comprised of patients with tubercular etiology, Group-II- non-tubercular etiology. 45 patients were selected for each group. ADA and IFN in pleural fluid of these patients were measured. The sensitivity, specificity and predictive values were calculated.Results: The  sensitivity, specificity, positive predictive value, negative predictive value of ADA and IFN were 88.89%, 99.85%, 86.96%, 99.87%; 97.78%, 97.78%, 97.78%, 97.78% respectively. Combination of ADA and IFN didn’t improve the sensitivity or specificity compared to IFN alone.Conclusions: Pleural fluid ADA, IFN were found to be useful in differentiating tubercular from non-tubercular patients. Combination of ADA and IFN doesn’t give additional benefit over IFN alone