One hundred and two pregnant women and their neonates were examined to evaluate the effect of maternal haemoglobin concentration (Hb. conc) and iron deficiency anaemia on the placental weight and the foetal outcome. Haematological and serum ferritin values were determined. It was observed that 34.3% of the pregnant women were anaemic. Maternal Hb conc. and serum ferritin showed a highly significant correlation (r = 0.40, p < 0.001) indicating that iron deficiency was the most important cause of anaemia amongst them. The maternal Hb conc. showed a significant correlation with placental weight (p < 0.05), birth weight (p < 0.01), Apgar score (p < 0.001) and birth asphyxia. Maternal serum ferritin also correlated positively with cord ferritin (p < 0.001). The study did not reveal any association between high Hb and adverse foetal outcome.

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A total of 106 renal biopsies were examined. Each biopsy was processed for routine paraffin sectioning and frozen sectioning. Direct immunofluorescence was done by the conventional method. The immunofluorescence patterns were correlated with histopathological changes and clinical presentation. Fourteen biopsies revealed weak to strong IgA staining and out of these, 11 seemed to fulfil the criteria of primary IgA nephropathy. These cases were diagnosed in a brief period of eleven months and there had not been any earlier published series from India.

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One hundred and four cases of Hodgkin's disease diagnosed between July 1981 and June 1991 have been analysed. There was a definite male preponderance. Majority of the patients (82.7%) were below the age of 50 years. Mixed cellularity was the most common type (57.7%). It was followed by both nodular sclerosis and lymphocyte predominant types (16.3% each). Lymphocyte depletion Hodgkin's disease, the most aggressive variant, was the least common (9.7%). The detailed observations, as compared to the previous studies in this region as well as in other parts of the world have been presented and discussed.

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Three cases of angiomatoid fibrous histiocytoma of the lower extremity are described. All the three patients were young and gave a history of swelling of 1-5 years duration. Histologically, the lesions were characterised by the presence of large blood filled spaces lacking endothelial lining, being surrounded and lined by sheets of proliferating histiocytes, many of which contained haemosiderin pigment.

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Bone marrow involvement was observed in 7 cases amongst a total of 75 cases of Hodgkin's disease encountered between January 1981 and June 1990; thus representing an incidence of 9.3 percent. Analysis of these 7 cases showed male preponderance. The age ranged from 26 to 74 years. All patients presented within seven months of onset of symptoms; and all had symptoms at presentation. Lymphadenopathy was found in all the cases, splenomegaly was present in six; and hepatomegaly in 4 cases. Mixed cellularity and lymphocytic depletion subtypes showed the highest frequency of marrow involvement (6 cases; 85.7 percent). Alkaline phosphatase was raised in 6 cases (85.7%). All cases received standard combination chemotherapy with or without local radiation therapy. Two years follow-up revealed an overall survival of 42.9%. Replace free survival at the end of two years was zero, as all the cases relapsed within seven months of initiation of treatment.

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Nongestational choriocarcinoma is an extremely rare malignant tumour of the ovary. It may be pure or combined with other germ cell tumours. A case of nongestational choriocarcinoma with mature cystic teratoma is presented herewith.

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The binding of biotinylated bauhinia purpurea (BPA) and pisum Sativum (PSA) lectins to paraffin-embedded tissue sections from 10 normal breast and 55 breast carcinoma has been investigated by applying avidin biotin peroxidase method (ABC). BPA showed very low affinity for normal breast epithelium and the binding was confined to the luminal surface. Eighty-seven percent carcinoma bound BPA, and the staining patterns varied depending on the histologic grade of tumors: luminal surface binding in grade 1 carcinomas; diffuse, granular cytoplasmic with para- or perinuclear deposits and staining along the plasma membrane in grade 2 and grade 3 carcinomas. PSA bound consistently to the luminal surface of all ducts and acinar cells of normal breast tissue. PSA was reactive with all carcinoma but the staining profiles were similar regardless of the tumor differentiation. It is concluded that the lectins used in this study have limited usefulness in routine diagnosis.

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Phagocytic activity of peripheral blood mononuclear cells (PBMC) was investigated in 30 patients with pulmonary tuberculosis. The test was done using neutral red. Higher percentages of phagocytic cells were detected with PBMC of tuberculosis patients as compared with controls. An inverse relationship was observed between neutral red positive cell counts vs. relative percentages of several proteins (IgG, C3 and C4) in PEG precipitates in tuberculosis patients. It was interpreted that phagocytes might have mopped up the CICs via their surface Fc receptors.

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Serum protein electrophoresis done on 1100 patients with various diseases in one year demonstrated M-band in 31 patients. Most (87%) had the classical features of plasma cell dyscrasia (PCD), however a few had unusual presentations which are highlighted. A 22-year-old male operated for a massive tumour of the scapula clinically diagnosed as chondrosarcoma revealed plasmacytoma with amyloid on histology. Another case of kala-azar presented with features akin to that of PCD and one case had dual malignancies. Such a high incidence of PCDs with varied picture in a short time is not usually seen in other parts of this country; a fact which may be due to lack of awareness.

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The infant autopsies were scrutinised to find the incidence, etiology & significance in terms of fatality of urinary tract anomalies. On analysing 1329 infant autopsies, 24 cases (1.8%) of significant urinary tract anomalies were found. There was marked male predominance. Intrauterine obstruction of urinary tract was the main etiological factor leading to dysplastic changes in the renal tissue. Dysplasia is severe in extent and may be associated with persistent blastemal zones when the obstruction is complete & bilateral in nature.

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This study was undertaken to determine the coagulation profile of women with pregnancy induced hypertension and to evaluate the changes in the level of AT-III in pre-eclampsia and eclampsia and its correlation with severity of disease in order to evaluate if it can be used as a marker for severity of PIH. 119 women with PIH in the third trimester of pregnancy constituted the study group. Age and parity matched 25 normal pregnant and 25 non-pregnant women were taken as control group. No significant difference between the coagulation profile of non-pregnant and normal pregnant women was seen. There is evidence of consumption coagulopathy in PIH patients and AT-III activity shows a gradual and almost linear reduction in various groups ranging from normal pregnant women to eclampsia. Reduction in AT-III activity has positive correlation with PIH and it can be a useful marker for severity of PIH.

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Coagulation parameters and platelet count were studied in 30 neonates of mothers with pregnancy induced hypertension (PIH). 30 neonates born to normotensive mothers were taken as controls. The test group was further subdivided as neonates born to mothers with gestational hypertension, pre-eclamptic toxemia and eclampsia. The values of Prothrombin Time, Partial Thromboplastin Time with Kaolin, Thrombin Time, Fibrinogen Degradation Products were significantly raised and Fibrinogen and Platelet count were reduced significantly in both term and preterm test groups as compared to controls. The derangement in coagulation parameters was more marked with increasing severity of PIH.

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The effect of sub-lethal concentrations of isoniazid, ethambutol, rifampicin and pyrazinamide on the growth in vitro and the production of both exochelins and mycobactins by the high virulent and the South Indian low virulent strains of M. tuberculosis was examined under iron-deficient and iron-rich conditions. There was a marked decrease in the growth of both strains in the presence of increasing concentrations of all four drugs, the inhibition being total in the presence of minimal inhibitory concentrations of the drugs. It was also observed that the growth-inhibitory effect of all four drugs was slightly reversed in the presence of high concentration of iron in the medium. A significant increase was observed in the concentrations of both siderophores in the presence of all four drugs, under both iron-deficient (or) iron-rich conditions.

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Iron deficiency occurs when the rate of loss of utilization exceeds its assimilation. Treatment is based on iron supplementation but due to side effects compliance to iron therapy is poor. A double blind comparative study was done using a novel time release preparation of ferrous sulphate (Code A) v.s. sustained release ferrous sulphate preparation (Code B) on 60 pregnant women in mid or late pregnancy with anaemia. The amount of ferrous sulphate in Code A was less than half of Code B. The patients were sequentially randomised as Code A or Code B recipient. The non compliance rate was 33%, and for both Code A & Code B. The mean improvement in hemoglobin after 4 weeks of therapy was 2.01 gm% for Code A and 2.3 gm% for Code B. Iron absorption as evidenced by improvement in S. Iron, TIBC and ferritin levels was better with Code A. The improvement in subjective symptoms of anaemia was better than average in Code B preparation. Code A group had comparatively more side effects both major and minor, this may have been the reason for a slightly higher drop out rate in this group. In conclusion the timed release preparation has a comparable haematological response and better absorption with significantly lower doses as compared to the sustained release preparation.

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Antibodies to two mycobacterial antigens viz - culture filtrate antigen (CFA) and Mycobacterium tuberculosis antigen 5 were raised in rabbits. Enzyme-linked immuno sorbent assay (ELISA) and immunoblot methods were used for the evaluation of the specificity of the rabbit antibodies to M. tuberculosis. Immunoblot method is more sensitive than ELISA for the detection of antibodies to M. tuberculosis in the rabbit sera. It is being emphasised that characterisation of the mycobacterial antigens and evaluation of the specificity of the antimycobacterial antibodies are essential prior to their applications as an adjunct in the laboratory diagnosis of human mycobacterial disease.

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Twenty spleens of steroid resistant cases of idiopathic thrombocytopenic purpuras were studied by light and electron microscopy. Weights of the spleen were within normal range and were unremarkable grossly. On light microscopy reactive lymphoid follicles were seen in the five of the cases. Prominent and dirty looking sinusal histiocytes contain phagocytosed materials. Prominence of plasma cells were seen in the red pulp and also in the marginal zone. The three cases which failed to respond to splenectomy did not show any morphological variation from the others who had responded.

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