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Comments on cystic fibrosis in India

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Article
Summary One hundred and five children suffering from chronic diarrhoea were investigated for the type of anaemia and marrow morphology. Anaemia was mild in 30%, moderate in 65% and severe in 5% patients. Red cell morphology showed evidence of iron deficiency in 55% children and macrocytosis in 25%. The erythropoiesis was normoblastic, purely iron deficient and frankly megaloblastic in about an equal number of patients. Dimorphic anaemia was seen in 18 patients. The relationship between the type of deficiency anaemia observed and the aetiological factor is discussed.
Article
Cystic fibrosis (CF) is one of the common life limiting inherited diseases in Caucasian population. Recent reports suggest that the diagnosis of cystic fibrosis in Indian children is missed or delayed due to low index of suspicion. The diagnosis of cystic fibrosis is suspected by the typical clinical features and should be confirmed by doing sweat chloride estimation. If sweat test is not available, ancillary tests including blood electrolyte and acid base balance, airway microbiology, tests to identify pancreatic insufficiency and semen analysis for obstructive azoospermia in post pubertal boys should be carried out. Positive results of these tests make the suspicion very strong. A strongly suspected case should be treated as cystic fibrosis, but for giving a diagnosis of CF, sweat test should be done from the nearest centre where it is available. In the presence of typical clinical features with borderline sweat chloride values sweat test should be repeated 2-3 times and the child should be investigated for alternative diagnosis. In the absence of alternative diagnosis with consistently high or borderline sweat chloride values an attempt should be made to get tests for mutations.
The Short Textbook of Pediatrics
  • S Gupte
  • Pem
  • Diarrhea
Gupte S. PEM and diarrhea. In : Gupte S, ed. The Short Textbook of Pediatrics, 8th edn., New Delhi; Jaypee Brothers, 1998; 114-115.
Tropical malabsorption: Experience in north Indian children
  • S Gupte
  • Bns Walia
  • S Mehta
Gupte S, Walia BNS, Mehta S. Tropical malabsorption: Experience in north Indian children. In: Gupta S, ed. Newer Horizons in Tropical Pediatrics, 1st edn., New Delhi;
Cystic fibrosis in Indian Subcontinent. Yes or no?
  • S Gupte
  • M Pal
Gupte S, Pal M. Cystic fibrosis in Indian Subcontinent. Yes or no? Eur Chron Gastroenterol 1981; 3 : 412-13.
Chronic diarrhea and malabsorption in tropical settings
  • S Gupte
Gupte S. Chronic diarrhea and malabsorption in tropical settings. In : William AE, ed. Trends in Pediatric Problems in Developing Countries, 3rd edn., London; Smith and Smith, 1990; 332-347.
Diagnosis of cystic fibrosis: Indian perspective "~ was to review the information on diagnostic tests available and how effectively these can
Reply We are thankful to Dr. Gupte for highlighting the problem of cystic fibrosis (CF) in India by reporting his experience. The aim of our article, "Diagnosis of cystic fibrosis: Indian perspective "~ was to review the information on diagnostic tests available and how effectively these can Indian Joumal of Pediatrics, 2000; 67 (6) : 475