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OBJECTIVES: Clinical biochemistry reference intervals (RIs) play a crucial role in interpreting patient test results and making informed clinical decisions. Using data from an ongoing Indian Council of Medical Research-National task force study on healthy women, normative ranges for commonly analyzed biochemical analytes were established. MATERIALS AND METHODS: A total of 13,181 women of reproductive age (18-40 years) were recruited from different urban and rural regions of the country, of which 9898 women signed an informed consent were included. Among these, women having features of hyperandrogenism, menstrual cycle irregularities, and comorbidities were excluded. RIs of 22 analytes were computed in the remaining 938 women controls. To estimate the 95% range of the reference distribution, the limits of the 2.5th percentile and the 97.5th percentile were used in the study. RESULTS: Mean ± standard deviation of age and body mass index of participants was 30.12 ± 6.32 years and 22.8 ± 3.36 kg/m2 respectively. Centiles (2.5th-97.5th) of liver function parameters, lipid parameters, glycaemic parameters, and renal parameters are presented. No significant difference in analytes was observed in relation to the area of residence, and age groups except in albumin (P = 0.03). The distribution of most of the parameters was consistent with the various RI studies conducted in India as well as other countries. CONCLUSION: This is the first study generating biochemical RIs data among a large representative sample of healthy reproductive-age women recruited using a robust design across the country. The resource may serve as a reference range for common biochemical analytes for future in this age group. [ABSTRACT FROM AUTHOR]

Objectives: Clinical biochemistry reference intervals (RIs) are essential benchmarks to interpret patient test results and make clinical decisions. In this study, data on healthy women collected in an ongoing ICMR-National task force study was used to establish normative ranges for common biochemical analytes. Methods: A total of 13,181 women of reproductive age (18-40 years) were recruited from different urban and rural regions of the country, of which 9,898 women who signed an informed consent were included. Among these, women having features of hyperandrogenism, menstrual cycle irregularities, and with comorbidities were excluded. RIs of 22 analytes were computed in remaining 938 women controls. The 95% of the reference distribution was estimated using 2.5th percentile and 97.5th percentile limits. Results: The mean ± SD of age and body mass index (BMI) of participants was 30.12 ± 6.32 years and 22.8 ± 3.36 kg/m2 respectively. The median and 2.5th -97.5th percentiles of liver function parameters, lipid parameters, glycaemic parameters, and renal parameters were computed. No significant difference in analytes were observed in relation to the area of residence, and age groups except in albumin (p = 0.03). The distributions for most of the parameters were consistent with the various reference interval studies conducted in India as well as other countries. Conclusion: This is the first study generating biochemical RIs data among a large representative sample of healthy reproductive age women recruited using a robust design across the country. The resource may serve as reference range for common biochemical analytes for future in this age group. [ABSTRACT FROM AUTHOR]

We present a rare case of an intraorbital dermoid which was associated with a small temporal region dermal sinus in a 3-year-old child. This got infected and the child presented with orbital cellulitis. Definitive surgery involved excision of all the dermal elements using a superficial and intraorbital approach. We stress the need to evaluate, apparently benign lateral facial dermal sinuses as they may be the pointers of the underlying pathological deep dermoid cysts to avoid complications. [ABSTRACT FROM AUTHOR]

Aims and Objective: To postulate a hypothesis to explain the embryogenesis of exstrophy bladder based on our clinical observations. Materials and Methods: In 27 cases of exstrophy, we measured the distance between the lowermost inguinal skin crease to the root of the penis (clitoris) (B) and the distance between the penis (clitoris) and the scrotum (labia majora) (C). These were compared with age, height and XP distance (distance between xiphisternum and symphysis pubis) matched control group of normal children. The distance between the lowermost inguinal skin crease and the penis (clitoris) (A) was measured in control group. Results: The observation was A = B + C. This implies that in exstrophy bladder, the position of the penis (clitoris) has moved cephalad from the lower border of A to the junction of B and C. Conclusion: Based on the observations, we postulate that abnormal origin of genital tubercle may be the cause of exstrophy bladder. The abnormal origin of primordia of the genital tubercle in more cephalad direction than normal causes wedge effect, which will interfere with the medial migration of the mesoderm as well as the midline approximation of mesodermal structures in the lower abdominal wall, thereby resulting in the exstrophy of bladder. [ABSTRACT FROM AUTHOR]

Aim: To improve the results of tubularized plate urethroplasty by adding de-epithelized flap. Patients and Methods: Twenty-five cases of hypospadias who underwent Snodgrass urethroplasty using deepithelialized flap were studied. The minimum period of follow-up in this series was 1 year. Results: The resultant neo-meatus was vertically oriented and slit like. Glans was conical which is cosmetically well accepted. Penile raphe was in the midline. None of the patient had residual chordee, penile torsion, or glans dehiscence. Excellent cosmetic results were observed in all cases. The complication rate in our series was 8% (two cases). Two patients developed fistula. Conclusion: De-epithelialized flap is a simple method to provide additional covering to the constructed neourethra after Snodgrass urethroplasty. It achieves our goal of noncrossing suture lines and providing maximum vascularity. [ABSTRACT FROM AUTHOR]

Williams-Campbell syndrome was first described in 1960 as a rare form of bronchiectasis. Its pathogenesis is characterized by the absence of or markedly diminished bronchial cartilage. We describe a case of a 4-yearold male child in whom respiratory symptoms developed in neonatal period and were found to have histopathological changes consistent with Williams-Campbell syndrome. A brief review of literature has been discussed. [ABSTRACT FROM AUTHOR]

The syndrome described by Zollinger and Ellison in 1955 is a rare clinical entity which is even rarer in children. This report describes a 12-year-old boy who presented with refractory peptic ulcer disease which was finally diagnosed to be due to a gastrinoma and was successfully treated. [ABSTRACT FROM AUTHOR]

A 7-year-old male presented with history of low-grade fever, epigastric pain and dysphagia. Ultrasound of abdomen and thorax revealed presence of paraesophageal lymphadenopathy. 'Barium swallow' and computerized tomography scan thorax with oral contrast suggested a provisional diagnosis of paraesophageal diverticulum. Esophagoscopy was normal. Endoscopic ultrasonography with biopsy confirmed tuberculosis. The patient was started on four-drug antitubercular treatment. [ABSTRACT FROM AUTHOR]

Most neonates with congenital diaphragmatic hernia (CDH) present with CDH symptoms within the first 24 h of life. However, the presentation may be delayed in 10-20% of the cases. The presenting symptoms are nonspecific and are usually gastrointestinal in nature. We report a case of a 9 day-old neonate presenting with abdominal distention. The investigation was suggestive of CDH with the possibility of perforation which was confirmed by emergency laparotomy. A review of literature revealed one similar case report. This case highlights the risk of bowel incarceration in delayed cases presenting with gastrointestinal symptoms. [ABSTRACT FROM AUTHOR]

We report a case where two distinct meningoceles (thoracic and lumbosacral) with a normal intervening spinal canal was encountered. It was successfully treated by operative intervention. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented about a male infant with extruded peritoneal end of Ventriculoperitoneal shunt through the mouth.

The article reviews the book "Balanche Aajar Va Shalyachikitsa," by Dr. Minakshi Nalbale Bhosale.