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2006| January-April | Volume 12 | Issue 1
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Prevalence of congenital heart diseases in Mysore
R Smitha, SC Karat, D Narayanappa, B Krishnamurthy, SN Prasanth, NB Ramachandra
January-April 2006, 12(1):11-16
Prevalence studies on Congenital heart Diseases (CHDs) have been done several times world wide and such studies are very limited in Indian populations. A few earlier studies in India have reported an increased prevalence of CHDs ranging from 2.25 to 50.89 per 1000 live births.
Aims and Objective:
To study the prevalence of congenital heart diseases in Indian population.
Materials and Methods:
Data on the prevalence of CHDs were collected and analyzed from the three major hospitals of Mysore, Cheluvamba Hospital, CSI Holdsworth Memorial Hospital and J.S.S Hospital from the year 2000 to 2004.
The prevalence of CHDs for five years in Mysore hospitals ranges from 6.6 to 13.06 per 1000 live births. The most frequent type of CHD was found to be VSD (40.47%) followed by ASD (19.06%), TOF (13.38%) and PDA (9.53%). It is clear that the maximum CHDs were detected in the first year of life when compared to the later years of life. The prevalence of CHDs in Mysore is increasing from 2000 to 2004 which might be due to the improvement of diagnosis, attention or awareness among the medical authorities on the disease.
The prevalence of CHDs in Mysore is not very high as reported in other parts of the country, however; it is an important disease which needs an immediate medical attention.
Stem cells: A new paradigm
Sachin Kumar, NP Singh
January-April 2006, 12(1):4-10
Stem cell therapy is emerging as a potentially revolutionary new way to treat disease and injury, with wide-ranging medical benefits. It aims to repair damaged and diseased body-parts with healthy new cells provided by stem cell transplants. Disease and disorders with no therapies or at best, partially effective ones, are the lure of the pursuit of stem cell research. Recently a plethora of work has been done in this field in world around including India. However, Stem cell research presents many ethical and scientific questions as well as future challenges. Nevertheless, stem cell therapy, a prologue to an era of medical discovery of cell-based therapies that will one day restore function to those whose lives are now challenged every day, is still at the beginning of the road.
Epidemiology and genetics of hypertrophic cardiomyopathy
Reena R Tanjore, Bhavesh Thakkar, Annapurna D Sikindlapuram, Calambur Narasimhan, Prafulla G Kerkar, Haragopal V Vajjha, Pratibha Nallari
January-April 2006, 12(1):26-33
Hypertrophic cardiomyopathy (HCM) is a heart muscle disorder and is known to be inherited as an autosomal dominant trait. Mutations in several sarcomeric, cytoskeletal and mitochondrial genes have been reported in HCM. Though many cases of HCM are being identified, there is limited data regarding the epidemiology and genetics of HCM in India.
Therefore the present study is envisaged at identifying the epidemiological variables in HCM and fitting a probability model assuming dominant mode of inheritance in HCM, which may in turn shed light on the heterogeneity of this complex disorder.
Materials AND Methods:
The 127 HCM cases were divided into subtypes based on pattern of hypertrophy. Chi square analysis, odds ratio, probability, relative frequency, penetrance and heritability estimates were calculated apart from epidemiological variables.
The HCM subtypes revealed the heterogeneous nature of the condition suggesting that the genes/mutations involved in their pathogenesis are different and this is supported by distinctive differences observed in their probability, heritability and penetrance estimates apart from epidemiological variables. An increased male preponderance was observed with the sex ratio being 3.7:1. The age at onset was found to be more than a decade early in familial cases (30 ± 10 yrs) compared to non familial cases (44 ± 14 yrs).
Chi square analysis revealed obstructive HCM to be following autosomal dominant mode of inheritance where as non-obstructive HCM was significantly deviating. The level of deviation was significantly high for the middle onset group compared to early and late onset groups, therefore this group may be considered as an admixture wherein genes/gene modifiers and environmental variables may be contributing to the heterogeneity and this is further supported by odds ratio.
The study thus brings out the complexity of HCM and suggests that modes of inheritance other than autosomal dominant may be encountered in a subset of HCM especially in asymmetric septal hypertrophy, apical, concentric and mid cavity obstruction subsets and hence a mixed model of inheritance is the best fit for such complex disorders.
Fragile X screening for FRAXA and FRAXE mutations using PCR based studies: Results of a five year study
Madhumita Roy Chowdhury, Madhulika Kabra, Deepti Sharma, Deepika Singh, Anjali Dabral, BK Thelma, Veena Kalra
January-April 2006, 12(1):17-22
Fragile X syndrome is the most common cause of inherited X-linked mental retardation. It is due to a mutation in a gene on X chromosome leading to hyper-expansion of a trinucleotide repeat sequence. The two most common Fragile sites with clinical significance are FRAXA at Xq27.3 comprising CGG repeat and a more distal FRAXE associated with amplification of a GCC repeat, located at Xq28. The frequency of occurrence of Fragile X syndrome is estimated to be 1/4000 male births. Screening of referrals for the mutations associated with the Fragile X syndrome constitutes a significant workload in many genetic laboratories.
The aim of the present study was to establish the use of PCR based simple and rapid method of initial screening of samples, so that only a minority of samples tested positive with the above methods need to be screened by Southern blotting which is more time consuming and involves use of radioactive material.
materials and Methods:
Study includes 294 patients with mental retardation. DNA extracted from blood was used for simultaneous amplification of the triplet repeat sequences at the FRAXA and FRAXE loci. Secondly samples from females were analyzed for heterozygosity of normal FRAXA allele. For confirmation of the presence of an expanded FRAXA allele in all the male positive cases, Southern blot hybridization was carried out. PCR based assay was done to detect methylation of the CpG island upstream of the FMR-1 gene.
Out of the 294 cases 23 (7.8%) were found to be having full mutation (FM) for FRAXA (21 males, 1 female & 1 male with mosaic FM/PM) and 13 females as having premutation (PM). All these 36 cases were confirmed by Southern blotting using appropriate probes. Among the females the heterozygosity for FRAXA allele was found to be 46%.
Non-radioactive PCR methods are efficient and rapid test for intial screening of samples for the presence of FRAXA and FRAXE mutations. Since a large majority of referrals do not have Fragile X, this economical and reliable method reduces the number of samples needing Southern blotting.
Capillaroscopy in Fabry disease: Study of a family
Monica Lopez-Rodriguez, Francisco Javier Barbado-Hernandez, Antonio Torrijos Eslava, Julia Garcia-Consuegra, Natividad Arias-Martinez, Jorge Gomez-Cerezo, Barbara Pagan-Munoz, Juan Jose Vazquez-Rodriguez
January-April 2006, 12(1):23-25
Nail bed capillaroscopy represents a simple and innocuous diagnosis method, used in vasculitis or collagen diseases. In Fabry disease (FD), there is a vasculopathy due to the storage of globotriaosylceramide. This is the first series that studies capillaroscopy in FD.
To describe and evaluate the capillary findings in Fabry patients.
Materials and Methods:
Eight Fabry patients were selected; five were under enzyme replacement therapy (ERT) with agalsidase-A.
In three patients (under ERT), the capillaroscopy showed no abnormalities; two patients had absence of some capillaries (one with ERT); in three (one with ERT) the capillaroscopy revealed ramification of capillaries. Patients with normal capillaroscopy had no symptom of acroparesthesia for more than a year.
Capillaroscopy is a good method to evaluate small vessels in FD and seems to have a correlation with ERT benefits, clinical manifestations and capillary findings. We purpose to use the capillaroscopy in the study of Fabry patients.
Nithyananda K Chowta, Mukta N Chowta
January-April 2006, 12(1):39-40
CGA codons multiplex PCR in rapid diagnosis of retinoblastoma
Gandra Mamatha, Biju Joseph, Mahesh Palanivelu Shanmugam, Govindasamy Kumaramanickavel
January-April 2006, 12(1):34-38
Multiplex polymerase chain reaction allows amplification of multiple target sequences of a genome under identical conditions in a single tube. This "one-shot" polymerase chain reaction detection is time and cost effective when large or multiple genes, with many target fragments are investigated. This is applicable for retinoblastoma susceptibility gene having 27 exons with recurrent mutations reported at most of the 12 CGA codons.
Materials and Methods:
Multiplex polymerase chain reaction assay for the amplification of 12 CGA codons, which constitutes about 50 % of retinoblastoma susceptibility gene mutations has been designed. The time and cost (includes only reagent cost) involved in both multiplex and uniplex polymerase chain reaction was also calculated.
Twelve CGA codons were multiplexed in 5 instead of 12 uniplex polymerase chain reactions, which took 36 hours and 9.78 US$ whereas multiplex polymerase chain reaction took 15 hours and 6.88 US$. Multiplex polymerase chain reaction method saved 58.3% of time and 29.6% of cost over uniplex polymerase chain reaction.
Saving time by more than half and cost by nearly a third would help clinicians and geneticists while counseling retinoblastoma patients.
PCR - From diagnostics to gene expression profiling
Roshan B Colah
January-April 2006, 12(1):3-3
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