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This study was undertaken to determine the coagulation profile of women with pregnancy induced hypertension and to evaluate the changes in the level of AT-III in pre-eclampsia and eclampsia and its correlation with severity of disease in order to evaluate if it can be used as a marker for severity of PIH. 119 women with PIH in the third trimester of pregnancy constituted the study group. Age and parity matched 25 normal pregnant and 25 non-pregnant women were taken as control group. No significant difference between the coagulation profile of non-pregnant and normal pregnant women was seen. There is evidence of consumption coagulopathy in PIH patients and AT-III activity shows a gradual and almost linear reduction in various groups ranging from normal pregnant women to eclampsia. Reduction in AT-III activity has positive correlation with PIH and it can be a useful marker for severity of PIH.

HIV screening of all donated blood is mandatory in India. The program instituted has many inherent lacunac like arbitrary identification of centres, absence of a guardian quality control program, criterion for test kit selection and absence of standard guidelines. This study was undertaken to evaluate the effects of frequent change of testing laboratory, change of testing staff, change of reagent kits and time of blood donation. All the donations at blood bank Safdarjang Hospital, during the year 1993, were taken for study. HBsAg and VDRL positivity were used as control/check value for similarity of donor population. Tests done during this period in three different laboratories show that the change of laboratory, change of reagent kit and the experience and training of the testing laboratory staff affect the test results, causing an increase in the number of false positive tests. This leads to destruction of donated blood which would have been otherwise fit for transfusion. It is suggested that a proper policy plan may be made and implemented in order to make the blood screening more effective.

Agarose Gel Serum Electrophoresis is a simple, rapid and sensitive technique routinely used for diagnosis of Multiple Myeloma. Its effectiveness as a screening tool for detecting infraclinical cases of Multiple Myeloma is brought out in this study. 29 out of the 219 patients presenting with unexplained osteoporosis and pain are found to be positive for M proteins. These patients were earlier adjudged organic disease free after preliminary investigation and examination.

An investigative study was carried out in 340 cases of established pulmonary and presumed pleural tuberculosis for co-occurrence of HIV-1 infection in them. Confirmatory screening for HIV-1 was carried out with both ELISA (Vironostika) and Serodia commercial kits in all reactive samples on first screening. In all, 16 cases proved to be having HIV-1 coexistent infection with pulmonary tuberculosis. Their preliminary vital clinical observations and roentogenic finding are summarized and literature reviewed briefly.In Marathwada region of Maharashtra State, India, clinicians obtained blood samples from 340 pulmonary and presumed pleural tuberculosis (TB) patients at the TB Wing of the Government Medical College Hospital in Aurangabad to determine the HIV seropositivity rate of the cases. All samples testing positive for an ELISA would undergo another ELISA to confirm the first ELISA's results. The ELISA commercial kits were Serodia and Vironostika. 16 cases tested positive for HIV by both ELISA tests. The sexual preference of all 16 cases was heterosexual. Males and 20-39 year olds were the predominant groups (12 vs. 4 for both groups). No case was younger than 20 years old. Six HIV-positive male TB patients had had multiple partners. Three of them also had genital ulcer disease, a cofactor facilitating HIV transmission. Six HIV-positive TB patients had a history of receiving streptomycin injections and 2 of them had also had multiple partners. 25% of HIV-positive TB patients had pleural effusion. 12 cases had TB clinical features (lower zone infiltration, hilar/mediastinal adenopathy, and diffuse infiltration without cavitation) associated with greater impairment of cell mediated immunity.

The first AIDS case in India was identified in 1986. 307 full-blown cases of AIDS and 11,406 HIV-seropositive individuals have been reported since then from 32 states and union territories in the country. Although a seropositivity rate of 7.4 per 1000 has been calculated, several estimates of HIV prevalence in India suggest that 300,000-1,000,000 may be infected. The sharing of syringes and needles among IV drug users in northeastern India and multi-partner sex in the rest of the country are the two distinct patterns of HIV transmission in India. The World Health Organization (WHO) realizes the potential threat posed by HIV and the major role played in its transmission by blood and blood products. WHO has therefore through a Global Blood Safety initiative issued a consensus statement on accelerated strategies to reduce the risk of HIV transmission by blood transfusion. The organization argues that the risk of transmission can be controlled by establishing safe practices for blood transfusion services ensuring perfect quality assurance procedures. Such practices and procedures are of particular importance in India given the large number of people infected and the many people who sell their blood to institutions and blood banks. The authors present WHO recommendations and describe measures in India to ensure the safety of blood and blood products. Current national health policy is not stringent enough to provide a safe supply of blood to hospitals and also fails to initiate any legal action against those involved in blood trading. Professional blood sellers should be discouraged from providing blood, while volunteers should be encouraged to come forth. Furthermore, the high percentage of unnecessary and cosmetic transfusions should be avoided, and the proportion of planned transfusions maximized with emphasis given to teaching the masses to promote blood gifting.

This study was conducted on high risk pregnancies, between 6-40 weeks of gestation, to evaluate the difference in maternal serum alphafetoprotein (MSAFP) levels in normal and abnormal pregnancies. It's predictive value for pregnancy outcome was calculated. Age and parity matched, normal pregnant women with normal pregnancy outcome were taken as controls. It was determined that the overall sensitivity (75.6%) and specificity (83.7%) was not very good for diagnostic purposes. On the contrary in patients with neural tube defects, congenital anomalies, early pregnancy complications leading to fetal death, still birth, neonatal deaths, Rh incompatibility and preterm deliveries the specificity was (96%-100%), due to very few false positives but sensitivity was comparatively low (75%-89%) due to many false negatives. As a result the predictive value of a negative test in these conditions was very high (80%-100%), though that of a positive test was comparatively low (60%-89%). This establishes a diagnostic value of MSAFP, especially in high risk pregnancies as opposed to its use as a screening test for all pregnancies. This is of special value for a poor country like India, where it is not possible to screen total pregnant population due to economic and logistic reasons.

Cases of malaria are increasing day by day in the vicinity of Delhi. A large number of cases attends this department for screening of malarial parasites. Several thousand cases were screened since October 1976 and only 10 cases were detected who were resistant to chloroquine treatment. The peripheral blood smears on repeated examination even after chloroquine therapy given on more than 2 to 3 occasions showed heavy parasitisation ofP. vivax. Subsequent treatment with primaquine for 5 days was inadequate as persistence ofP. vivax was present. Primaquine therapy extended to 14 days showed complete disappearance ofP. vivax from the peripheral blood on subsequent repeated examinations.

Some of the urological complications of bilharziasis are discussed including clinical features, diagnosis and treatment.

A rare occurrence of primary cutaneous diphtheria in the region of nape of neck, in a 35 year old male is presented for the first time from this institution.