Anti-C1q antibody as a marker of disease activity in systemic lupus erythematosus.

The present study was conducted to examine the usefulness of anti-C1q antibody as a marker of disease activity in Indian patients with systemic lupus erythematosus (SLE). We standardized the assay for detection of IgG anti-C1q antibody using ELISA. The normal cut-off level was determined by testing 57 healthy, age and sex matched controls to be 53 units/m1 (mean +/- 2 SD). Patients with SEL (97 females and 13 males) were studied and the following parameters were obtained on all: SLE disease activity index (SLEDAI), anti-C1q, anti-ds DNA and C3. Correlations were tested between these parameters using Spearman's rank correlation coefficients. Anti-C1q was found positive in 66 (60%) patients while anti-ds DNA was found in 78 (71%). The positive predictive values of anti-C1q and anti-ds DNA for lupus nephritis were 59 and 61 per cent respectively. The titres of anti-C1q correlated positively with SLEDAI (P < 0.01) and anti-ds DNA (P < 0.01) and negatively with C3 levels (P < 0.001). No significant correlation was observed between anti-C1q positivity and any particular organ involvement. Similarly, no correlation was found between anti-C1q and proliferative lupus nephritis. Anti-C1q was found positive in 5 of 9 patients with moderate SLEDAI scores and negative for anti-ds DNA antibody. It is concluded that anti-C1q antibody can serve as a general marker for lupus activity, supplementing the currently used serum markers.

Relapse of Wegener's granulomatosis in the first trimester of pregnancy: a case report.

The association of Wegener's granulomatosis and pregnancy is rare and poses unique therapeutic challenges, particularly when active disease presents in early pregnancy. We describe a 22-yr-old woman who recovered successfully from her initial episode of Wegener's granulomatosis with a standard course of treatment with prednisolone and cyclophosphamide. Two and a half years later, she presented with relapse during the first trimester of pregnancy (primigravida). Since the clinical features suggested mild disease, she was started on prednisolone at a dose of 1 mg/kg/day, to which she seemed to respond very well for 3 months. Unfortunately, she had a spontaneous abortion at 5 months of gestation while on 25 mg/day of prednisolone. At this time, her disease flared further, with clinically manifest lung disease which was not part of her initial presentation. She was treated with another course of oral cyclophosphamide and prednisolone, and a remission was achieved in 4 months. There are no agreed guidelines on the treatment of Wegener's granulomatosis during pregnancy. In this report, the therapeutic issues are discussed against the background of the available literature.

Bone mineral content in normal and malnourished children.

Bone mineral content (BMC) was determined at the distal radius in 70 children aged 2-14 years; Group I comprising 34 normal healthy children and Group II 36 malnourished children by the method of single photon absorptiometry. The mean value of BMC in Group I was 0.3 +/- 0.04 g/cm in 2-5 year, 0.52 +/- 0.08 g/cm in 6-10 year and 0.77 +/- 0.88 g/cm in 11-14 year age groups. No significant difference in the BMC was seen between boys and girls. An increase of BMC corresponded to growth spurts in 2-5 year and 11-14 year age groups. There was a significant reduction of BMC in Group II and in grade III malnutrition in 2-5 year and 11-14 year age groups as compared to Group I children. The study provides normal BMC data for Indian children and suggests that this can help to detect undemineralization of bones in malnourished children during the growth periods.

Somatotype, physical growth, and sexual maturation in young male smokers.

One thousand school boys aged 8 to 16 were examined for their somatotype, physical growth, sexual maturation, and smoking habits. Fifty-two boys were found to be smokers, of whom 30 were regularly smoking between two and 20 bidis or cigarettes a day for a mean duration of 2.5 years. The mean height and weight of the smokers was significantly lower than that of the non-smokers at all ages, more so in regular than occasional smokers. Sixty-nine per cent of the smokers had mesomorphic type of body build; about 65% of the non-smokers had ectomorphic somatotype (P less than 0.001). Onset of puberty occurred significantly earlier among smokers compared with non-smokers, as was evident from the early appearance of genital stage 2, and an early and rapid increase in testicular size. Genital stage 2 appeared at a mean age of 11 years in smokers and 11.6 years in non-smokers. However, the appearance of pubic, axillary, and facial hair was delayed. The possible significance of this is discussed.

Use of compressed air in a continuous flow anaesthetic machine.

Anaesthesia was given from a Boyle's apparatus to 100 patients, using compressed air as the carrier gas.