Human plasma contains inhibitors, which control the activity of proteolytic enzymes. Alpha-1-proteinase inhibitor and alpha-2-macroglobulin are two of them present in high concentration in human plasma, which inhibit action of trypsin among other proteinases. The trypsin inhibitory capacity (TIC) of human plasma is observed to be decreased in pathological conditions like diabetes mellitus. The mechanisms of decrease in TIC was due to nonenzymatic glycosylation of alpha-1-proteinase inhibitor (A1PI). A1PI was partially purified from normal human plasma by steps involving ammonium sulphate precipitation, DEAE Sepharose CL6B chromatography, Concanavalin A Sepharose Chromatography and Sephadex G-100 Gel filtration. Purified inhibitor was glycosylated in vitro by incubating it with varying glucose concentrations, under nitrogen for different periods of time in reducing conditions. After glycosylation, the molecular weight of inhibitor increased from 52 kDa to 57 KDa because of binding with glucose molecules. The percent free amino groups in the protein decreased with increasing glucose concentration and days of incubation. The TIC of such modified inhibitor decreased significantly. Decrease in TIC was dependent on the glucose concentration and period of incubation used during in-vitro glycosylation of native inhibitor.

The present prospective study was carried out in the Paediatric Intensive Care Unit (PICU) of a tertiary care teaching hospital in Mumbai. The objective was to determine the incidence, risk factors, mortality and organisms responsible for urinary catheter related infections (UCRI). Colonization and/or bacteriuria was labelled as urinary catheter related infection (UCRI). Forty-four patients with 51 urinary catheters were studied. Incidence of UCRI was 47.06%. Age, female sex and immunocompromised status did not increase the risk of UCRI. Duration of catheter in-situ and duration of stay in the PICU were associated with higher risk of UCRI. The mortality was not increased by UCRI. Commonest organism isolated in UCRI was E. coli, which had maximum susceptibility to nitrofurantoin and amikacin.

Childhood malignant neoplasms of the gut are extremely rare. The reported incidence of colorectal cancers in patients under 20 years of age is 1 in 10 million. The low index of suspicion for this tumour in children results in advanced disease at diagnosis and subsequently a poor prognosis. A rare case of a primary linitis plastica of the rectum occurring in a 13 year old boy is reported with review of pertinent literature.

A case of severe ankylosing spondylitis involving the entire spine was to be operated for lumbar osteotomy. She had fixed rigidity of the cervical spine with minimal rotational movement, inability to lie down supine and severe restrictive lung disease with hypoxemia (pO2 = 65 mmHg). An awake intubation was performed and the patient was operated under general anaesthesia in the prone position. Intraoperative "wake-up" test was performed to judge whether extent of straightening was excessive. Postoperatively, she was electively ventilated and extubated uneventfully after 24 hours.

Two cases of plasma cell leukaemia--a rare form of leukaemia are described. Both cases presented with anaemia and hepatosplenomegaly. Investigations revealed leucocytosis with increased plasma cells (> 20%). Skeletal survey revealed a few osteolytic lesions in both cases.

Poor insight in schizophrenia has been recently thought to be a reflection of prominent and enduring neurocognitive impairments. Reports supporting this theory have implicated prefrontal and parietal lobe functions, among other parameters. The results of other studies have negated the role of neuropsychological abnormalities in poor insight. The analogy between poor insight in schizophrenia and anosognosia in neurological illness as proposed by one set of workers has been elucidated in this review and it appears quite promising. However, the drawing of definite conclusions from all this work has been deferred by us, because of the need for more uniform and standardized methodologies for research on the subject. Nevertheless, attempts to improve the cognitive processes, which affect insight in schizophrenia, may be done to gain better treatment outcome in this disorder.