Two hundred consecutive cases up to 19 years of age admitted for confinement at The Nowrosjee Wadia Maternity Hospital, Bombay, were studied. Out of these 200 girls, 6 were unmarried, 51 were anaemic, 20 had toxaemia of pregnancy. Six girls (43%) in the age group 15-17 years delivered prematurely as compared to only 26 girls (14%) in the age group of 17-19 years. This difference is statistically significant. Also, only, 4 girls (29%) in the age group of 15-17 years had full term normal delivery as compared to 113 girls (61%) in the age group of 17-19 years signifying that the outcome of pregnancy becomes worst in girls below the age of 17 years. Ten babies (71%) of mothers in the age group of 15-17 years were LBW as compared to 75 babies (44%) of mothers in the age group of 17-19 years signifying that the incidence of LBW babies is inversely proportional to maternal age. Teenage pregnant girls needed more attention for prevention and treatment of preeclampsia eclampsia, anaemia, prematurity and LBW.

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One hundred and five consecutive patients who sustained liver trauma during the period from Jan 1986 to Dec 1988 are reviewed. Of these, 82 cases suffered from blunt abdominal injury while the rest had penetrating trauma. Simple hepatorrhaphy and use of topical hemostatic agents were the only modes of treatment for 76 cases, hepato-omentorrhaphy was used in 12 cases and hepatotomy with selective vascular ligation and resectional debridement were carried out in remaining 17 cases. Mortality was 36.2% (38/105), 30 patients died of shock in the perioperative period. Uncomplicated recovery occurred in 50 cases.

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Five male and 3 female runners who participated in 10,000 meter distance run in South Asian Federation (SAF) Games, 1987 were volunteered for this pilot study. The pulse rate at rest, 1 hour prior to competition and post-run for 30 min at 5 min intervals were recorded. It was observed that the runners who showed less rise of pulse prior to competition, performed better. This might be attributed to less pre-competition tension in them which helped the athletes to perform better.

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Four cases of CSF otorrhoea following surgery are presented. The etiopathology and its surgical management are discussed.

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Serum sialic acid values, estimated by thiobarbituric acid method of Warren as modified by Saifer and Gerstenfeld in 50 normal healthy persons of both sexes are reported. The average values were 68.47 +/- 4.85 mg% and 67.77 +/- 7.87 mg% for males and females respectively and for both sexes the value was 68.12 +/- 6.70 mg%. Age and sex have no influence on sialic acid levels in serum.

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A case of malignant melanoma of the nasal cavity is reported. The rarity of its occurrence warrants its mention.

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Eighty nine children were studied for retinol (vitamin A) estimation and its transport protein--retinol-Binding Protein (RBP). Serum levels of retinol, RBP and serum protein and albumin were found to be low in children with signs of vit. A deficiency irrespective of their nutritional status. Serum levels of retinol and RBP were risen significantly almost double, after the oral and parenteral administration of vitamin A. PEM interferes with hepatic synthesis of RBP and the release of RBP from the liver depends on vitamin A. Vitamin A is a limiting factor, the presence of which is required for the release of apo-RBP from the liver.

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Impedance plethysmographic observations have been compared with arteriographic findings in 216 patients with peripheral arterial occlusive diseases. Impedance plethysmographic diagnosis in these patients was obtained by Parulkar's method without apriori knowledge of arteriographic diagnosis. But for minor discrepancy in the anatomical location of the block in few patients, impedance plethysmographic observations correlated very well with arteriographic findings. Impedance plethysmographic diagnosis was found to be correct in 312, wrong in 53, false negative in 8 limbs respectively, yielding a sensitivity of 97.5% and specificity of 98.1% of this technique.

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In human ontogeny recapitulating phylogeny, bones arrive late on the scene--long after neurogenesis, musculogenesis, organogenesis and so on are over--as islands of ossification in an ocean of collagen. This study confirms this developmental sequence by demonstrating, in cadavers, the rather independent nature of bone, to which nothing--muscle, tendon, ligament or articular cartilage--is attached. Bone is like the air in a tubeless tyre; it gives rigidity and shape to the tyre, and in return takes the shape of the tyre. The tibia, for example, is the bony tissue that is contained in tyre-like casing made of peritibial soft tissues whose inner limit is the periosteum, which continues proximally and distally as capsules of knee/ankle joint, and to which only are the articular cartilages of the knee and ankle attached, being clearly free from the bones. This study also exposes the truer nature of a joint wherein the articular cartilage assumes anatomic and physiologic significance hitherto unthought of.

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Impedance plethysmography (IPG) was carried out in one hundred and forty-one patients suspected of venous disorders using Parulkar's method. In these patients occlusive impedance phlebography (OIP) and venography were also carried out using standard procedures. Comparison of IPG and OIP observations with venographic findings revealed sensitivity of these methods to be 65% and 77.7% in the diagnosis of primary varicosity of veins and chronic deep vein thrombosis respectively with a specificity of 85%. Occlusive impedance phlebograms showing unilateral decrease in OIP parameters were observed to be sufficiently diagnostic. IPG observations in 5 patients with arterio-venous malformation were observed to be different from those in patients with deep vein thrombosis.

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Counterimmunoelectrophoresis (CIE) detection of antiamoebic antibodies in the patients' sera, has been carried out and correlated with the routine diagnostic microscopic examination of stool and pus samples. The clinically suspected amoebiasis cases were divided into two main groups, (i) proved positive for Entamoeba histolytica as detected by microscopic examination of samples, and (ii) negative for the parasite. A total 153 cases of intestinal amoebiasis were studied. CIE was positive in 27 of the 84 proved cases, and in 12 out of 69 unproved cases showing negative microscopy. A total of 59 cases of amoebic liver abscess (ALA) were studied, of which CIE was positive in 20 of the 30 proved cases of ALA and in 4 of the 29 unproved cases. Sera from patients with non-amoebic illness (n = 48) gave negative results with CIE. Similarly sera from normal healthy controls (NHC) (n = 100) and asymptomatic cyst passers (n = 75) were negative by CIE.

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The obstruction to the third part of duodenum due to appendicular abscess is reported here. The abscess had tracked behind the mesocolon and obstructed the duodenum. The case was treated by drainage of abscess and anterior gastrojejunostomy.

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Choledochoduodenal fistula complicating duodenal ulcer disease is a rare occurrence. The present paper describes 3 such cases which were incidentally picked up on upper gastro-intestinal (GI) radiographic study and endoscopy done for ulcer like symptoms. The relevant literature is reviewed.

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Forty patients with symptoms of neuro-vascular compression in the upper extremities were subjected to impedance plethysmographic study using Parulkar's method. Two patients recorded decreased blood flow (BFI) in supine position and were diagnosed as having partial occlusion at subclavian level. Sixteen of the patients recorded decreased BFI on 90 degrees abduction and hyper-abduction. Twelve of these patients had radiological evidence of anomalous cervicle ribs. In remaining four patients extrinsic impression on the subclavian artery due to fibrous deposits was confirmed by arteriography. Remaining 22 patients recorded normal impedance plethysmograms. Impedance plethysmography thus provided a non-invasive modality for confirmation of vascular compression in thoracic outlet syndrome.

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Of 935 faecal samples studied over a period of one year, V. cholerae 01 was isolated from 102 samples (10.9%). All the strains were found to be E1 Tor Ogawa. The strains belonging to the phage types 2 and 4 were encountered in our study, type 2 being the highest (76.5%). The sensitivity pattern of all strains to the commonly used antibiotics was determined. Strains sensitive to gentamicin (92.2%), nalidixic acid (85.3%), kanamycin (83.3%), cotrimoxazole (80.4%) and chloramphenicol (75.5%) were observed. Out of the total, 36.3%, 29.4% and 28.4% of V. cholerae strains were found to be resistant to ampicillin, streptomycin and tetracycline respectively. V. cholerae was isolated throughout the year indicating the endemicity of cholera in Bombay.

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