Post-menopausal osteoporosis is associated with estrogen deficiency and rapid bone loss. The mechanism by which estrogen deficiency results in bone loss has not been fully explained. Studies in mice rendered acutely estrogen deficient by ovariectomy have suggested that estrogen deficiency results in an activated T-lymphocyte phenotype and increased production of pro-osteoclastic cytokines. The aim of this study was to translate these findings from mouse models that suggest that the T-lymphocyte plays an important role in the etiology of post-menopausal osteoporosis. We recruited pre-menopausal women who underwent ovariectomy (OVX) for benign gynecologic conditions or for prophylaxis against ovarian cancer and a group of matched control women without OVX. Subjects provided blood samples to characterize T-lymphocyte phenotype by Fluorescence-activated cell sorting (FACS) and for T-lymphocyte culture and collection of conditioned media. Bone mineral density at the lumbar spine and left femoral neck was performed annually for two years and volumetric measurements by computed tomography (CT) of the thymus were obtained during the first 6 months. We enrolled 6 OVX and 13 control women. The OVX subjects had a significant loss of bone mineral density at the lumbar spine and left femoral neck. The volumetric thymus measurements suggested an increase in thymus size in the OVX subjects but did not reach statistical significance due to the small sample size. The T-lymphocyte phenotype in the OVX subjects demonstrated increased T-lymphocyte activation by FACS compared to the control subjects. Our preliminary findings support the hypothesis that estrogen deficiency leads to an activated T-lymphocyte phenotype which may contribute to the bone loss seen in estrogen deficiency. Larger clinical studies are necessary to confirm these findings.

Background: Thalassemia major is a hereditary anemia which is caused by defective synthesis of hemoglobin, ineffective erythropoiesis and rapid erythrocyte breakdown. Transfusions in beta thalassemia major are necessary for survival of these patients. Frequent blood transfusions and inadequate iron chelation therapy can result in iron overload which may lead to various endocrine complication such as thyroid dysfunction, cardiomyopathy, diabetes mellitus, hypogonadism. Objectives: To study the frequency of hypothyroidism in thalassemia and to study the correlation between iron overload as measured by serum ferritin levels and incidence of thyroid dysfunction, in children with thalassemia major on regular transfusion therapy. Methods: This is a single center prospective study including 100 children attending thalassemia day care center and on regular blood transfusion therapy for a minimum of 2 years and whose ferritin level is above 1000 μgm/dl. Detailed history and examination were recorded in the proforma. Blood was drawn for thyroid function tests and most recent ferritin value obtained from patients record was used for analysis. Results: Subclinical hypothyroidism was found in 24% patients and 2% had overt hypothyroidism. There was no correlation between serum ferritin levels and thyroid dysfunction. Conclusion: Hypothyroidism was found to be a complication of thalassemia in around 26% children in our study. Detection of hypothyroidism is important as effective replacement therapy is available. Therefore, thyroid function should be followed periodically, particularly when other iron overload-associated complications occur. Early recognition and hence prevention of these complications might help improve the quality of life of these patients.

OBJECTIVES:To analyze adherence of prescribers to treatment guidelines by W.H.O for childhood diarrhea and to assess the cost of various treatment modalities in diarrhea. MATERIAL AND METHODS: A cross sectional study was carried out between April 2012 to December 2012 and 547 prescriptions of acute diarrhea of children up to five years of age were collected randomly from main pharmacy outlets and OPDs of pediatric departments of government tertiary care, private tertiary care, government secondary care and private pediatric hospitals in Amritsar, Punjab. Data collected were tabulated and analyzed; also a structured proforma was prepared to assess the knowledge of 22 pediatricians working in various sectors. RESULT: It was seen that adherence of government tertiary care hospital to WHO guidelines was 83% while private tertiary care, government secondary care and private care hospitals were not adherent to the guidelines as all these are prescribing probiotics in 100 % of prescriptions and antibiotics in 25%, 78% and 97% of prescriptions. Knowledge of pediatricians regarding acute diarrhea and WHO recommendations for it's management was excellent, but there is a dichotomy between knowledge and attitude/practice in treating acute diarrhea in children. CONCLUSION: This study showed that there is a clear-cut mismatch between recommendations and practical care in treating children with acute diarrhea that warrants interventional strategies.

Birth weight is an indicator of both neonatal morbidity and mortality, maternal health, nutrition and quality of antenatal services. OBJECTIVE: To find out important anthropometric parameter(s) in the newborn as related to birth weight so that newborns with low birth weight can be identified. MATERIAL AND METHODS: A prospective cross sectional, analytical, hospital based study was conducted at Amritsar on 200 term low birth weight newborn babies(<2.5 kg) born during a period of 10 months and their various anthropometric measurements (HC, CC, MAC, TC, CFC) were taken according to standard techniques. RESULTS: The study showed a strong correlation (p <0.001) between mid-arm circumference (r=0.834) and birth weight, followed by head circumference (r=0.816) and birth weight. Other parameters were also strongly correlated (p < 0.001). A value of <9.2 cm and <7.6 cm for mid-arm circumference showed highest validity for picking up newborns weighing <2500 gm and <2000 gm respectively. CONCLUSION: Measurement of arm circumference is easier, convenient and statistically superior to other anthropometrical parameters in detection of low birth weight newborn babies. The researchers recommend designing of a simple 'Tri-colored tape' for early detection of 'At Risk' LBW newborns in rural communities for their timely management.