In carcinoma of the esophagus, response to in vivo sensitization with recall antigens and DNCB was markedly depressed with 13% and 16% positivity respectively. Similarly, the number of T-cells was found to be significantly low (24 +/- 14) as compared to normal control (61 +/- 23). Blastogenesis index with PHA was only 1.75 +/- 1.04 in contrast to normal of 6.79 +/- 2.57. This depression was independent of serum albumin level and body weight. Cell-mediated immunity was further depressed following radiotherapy and did not improve following enteral alimentation for 3 weeks. In untreated patients, there was a significant rise in levels of IgA (298 +/- 184 mg/100 ml) as compared to normal (154 +/- 54 mg/100 ml). Levels of IgA did show a downward trend following enteral hyperalimentation. Circulating immune complexes and serum CEA level were elevated in almost 50% of patients. These data confirm the influence of tumor-related impairment of cell-mediated immunity while nutrition appears to affect IgA levels.

5 patients developed acute nonlymphocytic leukemia (ANLL) 2–4 years following the use of various cytotoxic agents for other primary disease. Alkylating agents were responsible for development of ANLL in 3 patients while mitomycin-C and methotrexate appear to be linked with leukemia transformation in the remaining 2 patients. 3 patients had a prolonged preleukemic phase preceding ANLL. Pancytopenia observed in 4 of 5 patients favors drug-induced stem cell damage leading to relatively resistant leukemia. Although the incidence of secondary leukemia is not very high, careful use of cytotoxic agents is needed to minimize therapy-linked neoplasms.

Antenatal intake of low dose aspirin is advised for prevention of pregnancy induced hypertension, intrauterine growth retardation and pre-term labour. Aspirin has an anticoagulant effect due to its action on Cyclo-oxygenase and vitamin K dependent coagulation factors. It can readily cross the placental barrier and be a potential cause for bleeding tendency in the fetus. Fetal intracranial hemorrhage, following low dose aspirin administration in a mother and subsequent effect after delivery is being reported.

Introduction:Neonatal jaundice or hyperbilirubinemia is a cause of concern for parents and pediatricians, with more than 60% being affected by this condition in the first few weeks. Prediction of high risk neonates for hyperbilirubinemia will help in developing appropriate follow-up programs for managing the condition. It will also help in reducing duration of hospital stay for low-risk neonates. Objective: To estimate the predictive value of umbilical cord blood bilirubin level for the development of significant hyperbilirubinemia in healthy, full term neonates. Methodology:A prospective study on 450 healthy full tem newborns was undertaken in the postnatal care ward of a tertiary level teaching hospital. The study focused on predictive ability of cord blood bilirubin levels and subsequent development of hyperbilirubinemia. Results:Clinically significant hyperbilirubinemia was detected in 254 out of 450 newborns (56%) neonates. Majority of participants had cord blood bilirubin levels ranging from 1.5-2.4mg/dl. Only 1.3% (3 neonates) had levels ≥3 mg/dl. Majority of newborns in our study (60%) had an intermediate risk of developing hyperbilirubinemia, and only 1.3% (31) belonged to the high risk category on stratifying risks. Cord bilirubin cut off value of 1.9 mg/dl predicted subsequent hyperbilirubinemia with sensitivity of 91.8% and specificity of 52.4%. Conclusion: Study highlights that risk stratification is an excellent method of tracking newborns with hyperbilirubinemia as newborns with hour-specific bilirubin value in low risk zone have reduced risk of developing subsequent significant hyperbilirubinemia. The probability of developing this condition in neonates was not significantly different in males and females.

Anemia due to lack of iron is the most important hematological disorder of infancy and childhood. According to India's third National Family Health Survey (NFHS-3) of 2005-6, 70 % of children between 6 months and 59 months are anemic. So it is very important to screen children for anemia early. The first 2 years of life is a critical window of opportunity to intervene in children since anemia can impair psychomotor development. A cross sectional study involving 260 apparently healthy children between 6 months and 15 months of age, showed the prevalence of anemia to be 60.7%. Only 9.2% of them were having Protein Energy Malnutrition. Introduction of animal milk at an early age and the amount of animal milk consumed were found to be the two important risk factors significantly associated with anemia.