Unilateral palatal palsy with viral hepatitis

Isolated unilateral palatal (velopalatopharyngeal) palsy is a clinical rarity. This usually presents in a child as acute onset rhinolalia, unilateral absent palatal reflex and pharyngeal asymmetry with a benign self-resolving course. Etiology remains controversial. We report association of this entity in a male child with viral hepatitis A.

Efficacy of Nebulised Epinephrine versus Salbutamol in Hospitalised Children with Bronchiolitis

BACKGROUND

The use of bronchodilators in bronchiolitis lacks consensus. The efficacy of nebulised epinephrine versus salbutamol in bronchiolitis and the safety profile of the bronchodilators was studied.

METHODS

Effects of nebulised epinephrine and salbutamol were compared in children with moderate to severe acute bronchiolitis. Thirty children between 2 to 24 months of age were recruited, 15 in each treatment group. Children received periodic (0,30,60 minutes followed by 4 hourly) doses of either 1:1000 laevo- epinephrine (0.5ml/kg subject to a maximum of 2.5ml with 3ml saline) or salbutamol (0.15mg/kg with 3ml saline) via nebuliser with oxygen. Changes in heart rate (HR), respiratory rate (RR), respiratory distress assessment instrument (RDAI), oxygen saturation (SpO2), oxygen requirement, duration of hospital stay and the side effects were studied.

RESULTS

The respiratory status was better with significant improvement in RR, RDAI score and SpO2, decreased oxygen requirement and shorter hospital stay in the epinephrine group. There were no significant side effects in either group.

CONCLUSION

Nebulised epinephrine is a useful and safe drug for moderate/severe bronchiolitis and is superior to salbutamol.

An outbreak of dengue fever in Veerannapet village, Cherial Mandal, of Warangal district, Andhra Pradesh

An epidemiological and entomological investigation was carried out in Veerannapet village, Cherial Mandal of Warangal district, Andhra Pradesh. The study showed that all age groups and both the sexes were affected with the disease. Fever and bodyache was the first presenting feature, which was self-limiting and lasted for 4-5 days. Of the 19 Serum Samples tested, 17 showed high titre to Dengue antigen with 10 showing diagnostic titre. Five samples were positive for IgM antibodies to dengue virus. Larval surveys indicates high Breteau index (30.40%), House index (23.20%) and Container index (9.17%). The clinico-epidemiological and entomological investigation indicates present episode of fever outbreak is due to dengue fever. Strengthening and intensification of surveillance along with educating the community is recommended for prevention of outbreak.

Breeding habitats and larval indices of Aedes aegypti (L) in residential areas of Rajahmundry town, Andhra Pradesh

Entomological studies on relative prevalence and distribution of adults and immatures of Aedes aegypti were conducted in Rajahmundry town of Andhra Pradesh from December 1998 to November 1999. Adults and immature stages of Aedes aegypti were found in all the 22 localities viz; posh area (8), mixed area (8) and slum area (6) of the town. Larval indices were found to be higher in slum areas as compared to mixed or posh areas of the town. However, the larval habitats were observed to be similar in all localities. The larval indices were highest during monsoon and post-monsoon months. The breeding preference ratio (BPR) was highest for cement tubs followed by discarded tyres and barrels. The high larval indices of Aedes aegypti in these areas warrant intensification of vector surveillance activities along with source reduction and health education.

Community studies on hepatitis B in Rajahmundry town of Andhra Pradesh, India, 1997-8: unnecessary therapeutic injections are a major risk factor

In Rajahmundry town in India, 234 community cases of jaundice were interviewed for risk factors of viral hepatitis B and tested for markers of hepatitis A-E. About 41% and 1.7% of them were positive for anti-HBc and anti-HCV respectively. Of 83 cases who were tested within 3 months of onset of jaundice, 5 (6%), 11 (13.3%), 1 (1.2%), 5 (6%) and 16 (19.3%) were found to have acute viral hepatitis A-E, respectively. The aetiology of the remaining 60% (50/83) of cases of jaundice could not be established. Thirty-one percent (26/83) were already positive for anti-HBc before they developed jaundice. History of therapeutic injections before the onset of jaundice was significantly higher in cases of hepatitis B (P = 0.01) or B-D (P = 0.04) than in cases of hepatitis A and E together. Other potential risk factors of hepatitis B transmission were equally prevalent in two groups. Subsequent studies showed that the majority of injections given were unnecessary (74%, 95% CI 66-82%) and were administered by both qualified and unqualified doctors.

alpha(1,3)fucosyltransferases expressed by the gain-of-function Chinese hamster ovary glycosylation mutants LEC12, LEC29, and LEC30

Gain-of-function glycosylation mutants provide access to glycosylation pathways, glycosylation genes, and mechanisms that regulate expression of a glycotype. Previous studies have shown that the gain-of-function Chinese hamster ovary (CHO) mutants LEC12, LEC29, and LEC30 express an N-ethylmaleimide-resistant alpha(1, 3)fucosyltransferase (alpha(1,3)Fuc-T) activity that is not detected in CHO cells and that generates the Lewis(X) but not the sialyl-Lewis(X) determinant. The three mutants differ, however, in lectin resistance properties, expression of fucosylated antigens, and in vitro alpha(1,3)Fuc-T activities. In this paper we show that each mutant expresses Fuc-TIX, but only LEC30 cells express Fuc-TIV. Using genomic PCR and reverse-transcriptase (RT)-PCR strategies, we isolated coding portions of the CHO Fut4 and Fut9 genes. Each gene is present in a single copy in the CHO and mutant genomes. The Fut4 gene is expressed only in LEC30 cells, while all three mutants express the Fut9 gene. Interestingly, the fucosylation phenotypes of LEC12 and LEC29 cells do not correlate with the relative abundance of their Fut9 gene transcripts (LEC29 >> LEC12). Compared to LEC29 cells, LEC12 cells have an approximately 40-fold higher in vitro alpha(1,3)Fuc-T activity and bind the VIM-2 monoclonal antibody, whereas LEC29 cells do not bind VIM-2. Mixing experiments did not detect Fuc-TIX inhibitory activity in LEC29 cell extracts, and CHO cells expressing a transfected Fut9 gene behaved like LEC12 cells. Therefore, it seems that LEC29 cells may not translate their more abundant Fut9 gene transcripts efficiently or may not synthesize appropriate acceptors for internal alpha(1,3)fucosylation. Alternatively, LEC12 cells may possess, in addition to Fuc-TIX, a novel alpha(1,3)Fuc-T activity.

Community studies on prevalence of HBsAg in two urban populations of southern India

OBJECTIVE

To find out prevalence of HBsAg in general population, especially in under-five children.

SETTING

Bangalore and Rajahmundry towns in southern India.

METHODS

Localities were chosen as the sampling units in each town. About 10-20 households were randomly selected from each locality. Only the youngest but apparently healthy person present in the household was interviewed for age, sex and history of jaundice any time in life. Mothers were interviewed to collect data for children below 15 years of age. Blood samples were collected from these persons on filter paper strips (18-mm diameter disc, Whatman filter paper No. 3) by finger prick method. The samples were tested for HBsAg by Micro ELISA (Ortho-Clinical Diagnostics).

RESULTS

Overall, 3.3% (95% CI, 2.0-4.5) of 737 persons in Rajahmundry and 4.2% (95% CI, 2.8-5.5) of 816 persons in Bangalore were found carriers of HBsAg. Age-specific or sex specific carrier rates were similar in Rajahmundry as well as in Bangalore. Most of the carriers (96%) denied having jaundice ever in life.

CONCLUSIONS

The results from this community based study are in agreement with the historical data from hospital based studies that about 3-5% of persons may be carriers of HBsAg and that the pool of chronic carriers of hepatitis B virus in India is built up in childhood and is then maintained in older children and adults. The results highlight the need of completing hepatitis B immunization during the infancy.

Some aspects of the bionomics of Culex quinquefasciatus (Diptera: Culicidae) in Rajahmundry town, Andhra Pradesh

From January 1991 to December 1992 the adult and immature populations of Culex quinquefasciatus were monitored in selected localities of Rajahmundry town. The larval density per dip ranged from 1.1 in September to 25.3 in October and the pupal density from 1.2 to 8.4 in October. Two high peaks of adult density in a year were observed during the study. Infective mosquitoes were recorded only in November 1991 and August 1992. Cx. quinquefasciatus landing on human bait was maximum between 2200 to 2400 hours and they preferred to land on body site followed by legs, hands and face in that order. The anthropophilic index was 79.5 per cent. Ratio of Female: Male mosquitoes was 5:1.

Effect of covalent attachment of polyethylene glycol on some properties of rat liver soluble alanine aminotransferase

Soluble alanine aminotransferase from rat liver was modified with 2,4-bis(O-methoxypolyethylene glycol)-6-chloro-s-triazine which was synthesized from monomethoxypolyethylene glycol and cyanuric chloride. The modified enzyme exhibited relative stability against extreme conditions of pH and temperature and also resistivity against tryptic digestion as compared to the native enzyme.

Acute respiratory infection in children--a survey in East Godavari district of Andhra Pradesh

A survey was carried out in East Godavari district of Andhra Pradesh to determine the magnitude of the problem of Acute Respiratory Infection (ARI) in children below five years of age. ARI associated mortality rates were found to be 15 times higher in infants than in the 1-4 year age group. However, overall ARI associated mortality was only 2.01 per thousand with an estimated case fatality ratio of 0.4 per thousand. A reverse trend in morbidity was noted in which 2-week incidence of ARI was more in 1-4 years age group than in infants. There is a need to standardize diagnosis and treatment of ARI disease in the district in order to eliminate wasteful use of antibiotics.