Prevalence of major neurological disorders among geriatric population in the metropolitan city of Kolkata

Well-conducted neuroepidemiological studies for the geriatric population are rare in India. In view of the growing aging population, we planned to determine the prevalence of common neurological disorders among the elderly population in the city of Kolkata. This was a cross-sectional study of a stratified random sample of the city population and carried in two stages through house to house survey. Initially, trained non-medical workers screened the cases with a validated family questionnaire and then a neurologist examined all the screened positive cases. A validated neuropsychological screening test was also applied among the elderly population with cognitive complaints. Results showed prevalence rates (per 1000 elderly population--> or = 60 years) of following disorders in decreasing order: stroke--33.93, essential tremor--13.76, dementia--7.89, Parkinsonism--3.30 and epilepsy--2.57. Sex-specific prevalence showed that stroke was commoner among men and that of other disorders among women. Age-specific prevalence recorded progressive increase in the rates of all disorders among both genders, though not uniformly among women. Overall the crude prevalence of neurological disorders was 60.9 per 1000. The present study shows higher rate of stroke as compared to other neurological disorders among elderly population in India, which needs urgent attention.

Homozygous alpha-thalassemia in a growth retarded, non-hydropic premature newborn

A newborn with homozygous alpha-thalassemia presented with intrauterine growth retardation and presumed persistent pulmonary hypertension. He also had moderate anemia, hepatomegaly and hypospadias. Correlating the newborn's clinical presentation with an underlying cause of anemia was helpful for early diagnosis. Prenatal blood tests must include red cell indices and a mean corpuscular volume value below 80 fL should prompt thalassemia screening in an at-risk population.

Comparative growth behaviour and characterization of stem cells from human Wharton's jelly

Human embryonic stem cells (hESC) face ethical sensitivities and the problem of teratoma formation. Although Wharton's jelly stem cells (WJSC), also of embryonic origin, may not face such ethical concerns, it is not definitely known whether under hESC culture conditions they would be as pluripotent as hESC. WJSC grown on plastic showed two types of morphology (epithelioid and short fibroblastic) in primary culture depending on the culture medium used, and only fibroblastic morphology when passaged. When grown in the presence of hESC medium on mouse feeder cells, they produced atypical colonies containing hESC-like cells with high-nuclear cytoplasmic ratios and prominent nucleoli. They were positive for the hESC markers Tra-1-60, Tra-1-81, SSEA-1, SSEA-4, Oct-4 and alkaline phosphatase, negative for SSEA-3, showed normal karyotypes, developed embryoid body (EB)-like structures, did not produce teratomas in SCID mice and differentiated into neuronal derivatives. They were also positive for the mesenchymal CD markers (CD105, CD90, CD44), negative for CD34 and HLA, and although nine out of 10 embryonic stem cell genomic markers were detectable, these were expressed at low levels. WJSC are thus not as pluripotent as hESC but widely multipotent, and have the advantages of being able to be scaled up easily and not inducing teratomas.

Vitamin K1 versus vitamin K3 for prevention of subclinical vitamin deficiency: a randomized controlled trial

OBJECTIVE

To compare efficacy of intramuscular phytomenadione (fat soluble vitamin K or vitamin K1) with menadione (water soluble vitamin K or vitamin K3) in prevention of subclinical vitamin K deficiency.

DESIGN

A doubleblind randomized controlled trial.

SETTINGS

Tertiary care hospital.

METHODS

Healthy term neonates were randomized to receive 1 mg of either phytomenadione (Group I, n = 85) or menadione (Group II, n = 85) intramuscularly within 2 hours of birth. PIVKA-II, a sensitive and specific marker of vitamin K deficiency was measured by ELISA method (Diagnostica Stago, France). Plasma level > 2 ng/mL was labeled as detectable PIVKA-II.

RESULTS

Birth weight (2914 +/- 318 vs 2958 +/- 312 g), gestation (38.4 +/- 1.2 vs 38.4 +/- 1.0 wk) and other baseline variables were comparable between the two groups. 48.2% (41/85) neonates in Group I and 44.7%(38/85) neonates in Group II had detectable PIVKAII levels ([Relative Risk (95% confidence interval): 1.1 (0.8-1.5); P = 0.76]). Median PIVKA-II levels in Group I and Group II were 1.99 ng/mL and 1.97 ng/mL respectively (P = 0.26). At 72 +/- 12 h of age, mean packed cell volume and mean serum bilirubin levels were comparable in the two groups.

CONCLUSION

Comparable PIVKAII detection rate and PIVKAII levels in neonates receiving phytomenadione or menadione indicate their similar efficacy in prevention of vitamin K deficiency. However, high PIVKAII detection rate observed with both preparations indicates recent vitamin K deficiency and may be due to either inadequate dose of vitamin K or persistence of PIVKAII of fetal origin.

Alpha-crystallin assisted refolding of enzyme substrates: optimization of external parameters

alpha-Crystallin is known to act as a molecular chaperone by preventing the aggregation of partially unfolded substrate proteins. It is also known to assist the refolding of a number of denatured enzymes, but the activity yield is often less than 20%. In this paper, we have tried to tune the refolding ability of alpha-crystallin in vitro by optimizing various external parameters. We wanted to find out the best possible condition under which it can exhibit maximum refolding capacity. We found that under suitable condition in vitro alpha-crystallin can refold denatured malate dehydrogenase, carbonic anhydrase and lactate dehydrogenase to recover more than 40% activity. We also measured the effect of several external factors such as nucleotides, osmolytes, electrolytes, temperature etc. on the in vitro alpha-crystallin mediated reactivation of above stated enzymes. We found that nucleotides and electrolytes had little effect on the refolding ability of alpha-crystallin. However, in presence of different osmolytes, we found that its ability to reactivate denatured substrate proteins enhanced significantly. Refolding in presence of pre-incubated alpha-crystallin reveals that hydrophobicity had stronger influence on the refolding capacity of alpha-crystallin than its oligomeric size.

REP-PCR analysis of Pasteurella multocida isolates from wild and domestic animals in India

Repetitive extragenic palindromic sequence-based PCR (REP-PCR) was used to characterize 67 field isolates of Pasteurella multocida originating from different animal species and geographical regions of India. REP-PCR was found to be rapid and reproducible (three repeats were done). These isolates yielded different 23 profiles which were clustered into eight groups. The discrimination index was moderate (D value 0.83). Somatic and antigenic typing of the isolates did not reveal any correlation with REP-PCR profiles. There was no host-specific, type-specific, region-specific or pathenogenicity-specific pattern. The REP profiles of isolates obtained from wild animals were similar to those obtained from domestic animals. Two common bands were present in all the isolates irrespective of somatic or antigenic types. The results were not comparable with earlier findings, which had shown high discrimination index and correlation with disease presentation.

An epidemiologic study of mild cognitive impairment in Kolkata, India

OBJECTIVES

To estimate the prevalence of two types of mild cognitive impairment (MCI)-amnestic and multiple domain types-among nondemented and nondepressed elderly subjects aged 50 and older.

METHODS

The study was carried out in Kolkata, the eastern metropolis of India. A cross-sectional community screening was carried out, and 960 subjects were selected by systematic random sampling for the assessment of cognitive function with the help of a validated cognitive questionnaire battery administered through house-to-house survey. A case-control study was also undertaken to identify potential risk factors through univariate analysis.

RESULTS

Ultimately, full evaluation of cognitive function was possible in 745 of 960 subjects. An overall prevalence of MCI detected based on neuropsychological testing was 14.89% (95% CI: 12.19 to 17.95). Prevalence of the amnestic type was 6.04% (95% CI: 4.40 to 8.1) and that of the multiple domain type was 8.85% (95% CI: 6.81 to 11.32). Adjusted for age, education. and gender, the amnestic type was more common among men and the multiple domain type among women with advancement of age. Rates differed considerably with educational attainment. Hypertension and diabetes mellitus were the major risk factors for both types of MCI.

CONCLUSION

In this first community-based study of mild cognitive impairment (MCI) from India, prevalence of the amnestic type is comparable with and that of the multiple domain type is less than the prevalence in developed countries. Variations in age, education, and gender specific prevalence of MCI of both types were encountered. The putative risk factors identified merit further study.

Radical-mediated cyclization reactions leading to spiro and [6,6]-fused heterocycles

Regiochemical study of nBu3SnH–AIBN-mediated aryl-radical cyclization of different 3-(2-bromophenyl sul fenylmethyl)coumarins, 3-(2-bromophenylsulfonyl-methyl)coumarins, and 6-[(2-bromophenoxy)methyl]-4-methoxypyran-2-ones have been investigated with the formation of different [6,6]-fused and spirocylic heterocycles. The sulfides and ethers were prepared from 3-chloromethyl coumarin and 6-(bromomethyl)-4-methoxy pyran-2-one with different 2-bromothiophenol and 2-bromophenols under classical alkylation condition. The corresponding sulfones were prepared by oxidation of the sulfides with m-CPBA.Key words: aryl-radical cyclization, coumarin and pyrone derivatives, 5-exo-trig, 5-endo-trig, nBu3SnH, sulfur heterocycles.

FastFISH: technique for ultrarapid fluorescence in situ hybridization on uncultured amniocytes yielding results within 2 h of amniocentesis

Rapid aneuploidy detection methods allow prenatal diagnosis results to be released within 48 h, but not on the same day as the invasive test. We aimed to develop a rapid fluorescence in situ hybridization (FISH) method (FastFISH) that releases accurate results on the same day as amniocentesis. FastFISH was optimized to be completed within 2 h of sample collection using CEP and LSI probes for chromosomes 13, 18, 21, X, Y and DiGeorge syndrome (DGS). The technique was tested on 100 consecutive amniotic fluid samples in a blinded study. It was also validated as a 1-day molecular genetic test on three representative fetal tissue samples: chorionic villus, amniotic fluid and fetal blood. In the blinded study, FastFISH results were ready within 2 h of sample collection. Of the 100 amniotic fluid samples, 49 male and 50 female fetuses were identified. One fetus was 47, XXY (Klinefelter syndrome). Three fetuses had trisomy 21. One fetus suspected of DGS by ultrasound was identified as normal. Results of FastFISH analyses in all 100 cases were concordant with their karyotypes (100% accuracy; lower 95% CI, 97.05%). In the 1-day test validation, all results were released on the same day and were concordant with their respective karyotypes. FastFISH allows results to be released on the same day as amniocentesis. It represents the necessary development for a 1-day prenatal diagnosis service.

Prenatal diagnosis of haemophilia A by chorionic villus sampling and cordocentesis: all India Institute of Medical Science experience

BACKGROUND AND OBJECTIVE

We looked at the two most commonly used methods for prenatal diagnosis, cordocentesis and chorionic villus sampling for prenatal diagnosis of haemophilia A in an Indian setting.

MATERIAL AND METHODS

The study sample included 16 families which reported to us for prenatal diagnosis of haemophilia A at All India Institute of Medical Science, New Delhi, India. Prenatal tests were done on chorionic villus samples or on cord blood (cordocentesis). Molecular work-up included the use of indirect mutation analysis in the form of linkage markers like CA-13, CA-22, Xba1 and Bcl1 as well as direct mutation analysis in the form of inversion 1 and 22 detection. Non-molecular work-up included primarily factor VIII assays.

RESULT

Chorionic villus sampling was performed in eight mothers. Of the other eight mothers, six underwent cord blood factor VIII assays because these had absence of family history and were negative for linkage and inversion 1 and 22. One patient had a female child and another had a fetus that showed congenital abnormalities.

CONCLUSION

We found that the choice of either technique, chorionic villus or cordocentesis, is not really an alternative, but rather dependent on the gestational age of presentation.

Persistently high HIV seroprevalence among adult tuberculosis patients at a tertiary care centre in Delhi

BACKGROUND & OBJECTIVE

This study was designed to estimate HIV seroprevalence among tuberculosis patients presenting to tertiary care centre in Delhi.

METHODS

Cross-sectional prevalence study among all patients presenting to the inpatient and outpatient departments of All India Institute of Medical Sciences (AIIMS), New Delhi, and receiving anti-tuberculosis treatment from May 2003 to April 2005.

RESULTS

Of the 448 patients who presented to the TB clinic during the study period, 23 (5.1%) were previously tested HIV-positive. An additional 21 patients (4.6%) refused testing, and 30 (6.7%) were lost to follow up. Of the remaining 374 patients who consented to testing, 31 (8.3%) were found to be HIV-positive. Risk factors for HIV seropositivity included high-risk sexual behaviours (48% in HIV-TB co-infected vs. 6% in TB infected patients, P<0.001) and history of blood transfusion (23% vs. 5%; P=0.002).

INTERPRETATION & CONCLUSION

Previous studies from the same hospital published in 2000 and 2003 reported HIV seroprevalence among TB patients to be 0.4 and 9.4 per cent respectively. The current study documents a persistently high seropositivity among TB patients. These results emphasize the acute need for improved detection and treatment for HIV among TB patients in northern India.

Relationship of cloacal gland with testes, testosterone and fertility in different lines of male Japanese quail

An attempt has been made to investigate the relationship of cloacal gland with testes, testosterone and fertility in different lines of Japanese quail (Coturnix coturnix japonica). For this study, three lines of healthy adult male Japanese quails (<12 weeks) viz., heavy body weight (HB), white breasted (WB), and white egg shell (WES) were taken. They were housed in individual cages under uniform husbandry conditions and were provided with normal quail breeder ration and water ad libitum, with 14 h light/day. The experimental birds were selected from each of these three lines and categorized into different groups (15 birds/group) based on the increasing order of the area of cloacal gland. At the end of this experiment (24 weeks) the data indicated that size of the cloacal gland was directly proportional to foam discharge, foam weight, testicular weight, fertility and testosterone concentration in plasma. From this study it may be concluded that area of cloacal gland in Japanese quail is positively correlated with testicular weight, level of testosterone in plasma and fertility. Visual examination of cloacal gland and cloacal foam may provide a valuable non-invasive tool for predicting the fertilizing ability of individual male bird.

Effect of dietary Vitamin E on the cloacal gland, foam and semen characteristics of male Japanese quail

This experiment was to investigate the effects of increasing the level of dietary Vitamin E (Vit. E) on cloacal gland size, foam production and semen characteristics of male Japanese quail (Coturnix coturnix Japonica). One hundred and eighty male Japanese quail chicks (day old) were randomly distributed to three dietary treatments for a period of 25 weeks. Each treatment comprised of three replicates each containing 20 chicks. The basal diet contained 15 IU Vit. E/kg and the two experimental diets were supplemented with 150 and 300 IU Vit. E/kg (diets T2 and T3, respectively). DL alpha-tocopherol acetate was used as the source of Vit. E. All chicks were provided feed and water ad libitum. Foam characteristics, in terms of frequency of foam discharge (24h), cloacal gland index and foam weight were significantly higher (P<0.05) in T2 group. Body weight, testes weight (left and right) and plasma testosterone concentrations did not differ significantly. Semen characteristics (semen volume, sperm motility, % live sperm, % hatchability and sperm concentrations) did not differ significantly (P>0.05). Percentages of abnormal and dead spermatozoa were significantly (P<0.05) lower and fertility was higher (P<0.05) in the T2 group. From this study, it can be concluded that moderate supplementation of dietary Vit. E may be beneficial for foam production, cloacal gland and improve the semen characteristics in male Japanese quail.

Clinical characterization and evaluation of DYT1 gene in Indian primary dystonia patients

OBJECTIVES

Dystonia is a common movement disorder. The purpose of this study is to examine the relative distribution of the primary dystonia subtypes and identify mutation (s) in the DYT1 gene in Indian patients.

MATERIALS AND METHODS

Primary dystonia patients (n = 178) and controls (n = 63), lacking any symptoms of the disease, were recruited for the study from eastern India. The nucleotide variants in the DYT1 gene were identified by carrying out polymerase chain reaction, single stranded conformation polymorphism, and DNA sequencing.

RESULTS

Unlike other reports, pain and/or tremor was more common in our sporadic patients than in familial cases. Three reported and two novel changes were identified in this gene. The homozygous genotype (G,G) for a missense variant (c.646G > C; Asp216His) was significantly over-represented in the patients compared with controls (P < 0.05). However, the commonly reported 3 bp deletion (904-906delGAG) was not detected.

CONCLUSION

Our results suggest that the DYT1 gene might have a limited role in causation of dystonia in the Indian population.

Effect of higher levels of dietary selenium on production performance and immune responses in growing Japanese quail

1. The effect of increasing dietary selenium (Se) on production performance and immune responses in growing (0 to 6 weeks) Japanese quail was investigated. 2. One-day-old chicks (240) were randomly selected and divided into 12 groups with 20 chicks in each group (3 dietary treatments x 4 replicates). The basal diet contained 0.2 mg Se/kg and the two experimental diets were supplemented with 0.5 and 1.0 mg Se/kg. 3. Body weight gain, food intake and food conversion ratio and mortality were not affected by Se supplementation. 4. On d 28, antibody responses to inoculated sheep red blood cells were determined. Antibody titres were significantly higher after feeding the two Se-supplemented diets. 5. During week 4, the response to intradermally injected phytohaemagglutinin, an index of the in vivo cell-mediated immune response, was shown to be increased in the groups fed on the Se-supplemented diets. 6. After 6 weeks, the relative weights of the bursa of Fabricius and thymus were greater in the chicks given the Se-supplemented diets but there was no effect on the relative weight of spleen and liver. 7. It is concluded that supplementing the diet with Se has a beneficial effect on immune responses but does not affect production performance in growing Japanese quail.

Radiotherapy plus concurrent irinotecan (CPT-11) and capecitabine (CAP) as preoperative downstaging treatment for locally advanced inoperable rectal cancer: A phase I/II study

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Background: Preoperative downstaging chemoradiation has become standard treatment for locally advanced unresectable rectal cancer. Oral CAP is potentially more convenient as a radiation sensitiser than infusional fluoropyrimidine regimes. This study evaluated the dose-limiting toxicity (DLT), maximum tolerated dose (MTD) and recommended dose (RD) of daily CAP plus weekly i.v. CPT-11 when used in combination with RT in locally advanced rectal cancer. Methods: Patients had an adenocarcinoma of the rectum (lower limit within 12 cm of the anal verge) which on MRI was T3 within 2 mm of the mesorectal outer edge, T4, or any T3 within 5 cm of the anal verge. There were no distant metastases on staging investigations. Patients received planned pelvic RT to 45 Gy in 25 daily fractions over five weeks, concurrent with oral CAP daily throughout RT (including weekends) and a 60 minute infusion of i.v. CPT-11 weeks 1, 2, 3 and 4. Doses of CAP and CPT-11 were gradually escalated in cohorts of three patients. Results: The most common DLT was diarrhoea. Initially dose level (D/L) 3 was chosen as the recommended dose for phase II. However, unacceptable toxicity was encountered in the first 12 patients treated at D/L 3 (see Table). Thus D/L 2 is now being expanded to 60 patients for phase II. 40 patients have thus far potentially been eligible for resection: 5 (13%) could not be resected (2 deteriorated, 2 developed metastases, 1 died during treatment), 32 (80%) had R0 and 3 (7%) R1 resection. 9 (25%) had a pathological complete response (pCR) and 7 (20%) ‘near’ pCR. 5 (9%) of 57 patients had a defunctioning stoma pre-RT. Conclusions: The RD for this regime is 60 mg/m2 i.v. CPT-11 weeks 1, 2, 3, 4 and 650 mg/m2 bd of oral CAP daily. This demonstrates promising signs of efficacy. The RD is currently being studied in an expanded phase II cohort of 60 patients. D=diarrhea; F=febrile neutropenia; A=anorexia; L=lethargy; N=nausea/vomiting. [Table: see text]

No significant financial relationships to disclose.

Otocephaly, and pulmonary malformation association: two case reports

Otocephaly is a rare lethal malformation of the first and second branchial arches. We report two infants with otocephaly and failed resuscitation. Both infants had pulmonary malformations: pulmonary hypoplasia and two-lobed right lung. We report these rare associations with a brief review of the literature.

SnCl4–I2 mediated regioselective 6-endo- and 5-exo-cyclization of ortho-allylenols

3-Allyl-4-hydroxycoumarins and 4-allyl-3-hydroxycoumarins are obtained in 90%–92% yields by the thermal [3,3] sigmatropic rearrangement of the corresponding ethers. 3-Allyl-4-hydroxy-6-methylpyrone is obtained from the direct alkylation of 4-hydroxy-6-methylpyrone with allyl halide. These substrates on treatment with SnCl4–I2 at 25 °C give a mixture of both 5-exo- and 6-endo-cyclization products. However, regioselective formation of 5-exo products is observed when the reactions are conducted at lower temperatures (0–5 °C, kinetically controlled), while the reaction at a higher temperature (50 °C, thermodynamically controlled) affords regioselectively 6-endo cyclization products.Key words: stannic chloride, iodine, claisen rearrangement, 6-endocyclization, 5-exocyclization, kinetically controlled reaction, thermodynamically controlled reaction.

Third-trimester ultrasound dating algorithms derived from pregnancies conceived with artificial reproductive techniques

OBJECTIVE

To derive an accurate formula for ultrasound estimation of gestational age in late pregnancy.

METHODS

A database of 123 singleton pregnancies conceived by artificial reproductive techniques with third-trimester ultrasound measurements was studied. Biometry variables included the fetal head circumference (HC) and femur length (FL). The dataset was equally divided into a derivation sample and a target sample. To derive the equations of best fit, regression analysis was used, with true menstrual age as the dependent variable and fetal biometry measurements as independent variables. The formulae were tested on the target set and the menstrual age estimates were compared with the actual menstrual age. Clinical performance was estimated in terms of systematic and random errors, absolute errors and their 95% CI values.

RESULTS

The menstrual ages at time of scanning ranged from 26 to 41 weeks, with a mean of 33 weeks. The best performing derived formula was a combination of HC and FL. This had a random error of 7.5 days and prediction errors within a 95% confidence limit of -13 to +17 days. With FL only, the random error was 8.2 days, whereas using the HC only yielded a random error of 9.4 days.

CONCLUSIONS

Ultrasound estimation of gestational age in late pregnancy is better than indicated by older publications. It is more accurately estimated by combining the HC with the FL than by using the FL measurements alone.

Caesarean scar pregnancy: a diagnosis to consider carefully in patients with risk factors

INTRODUCTION

Caesarean scar pregnancy is rare. A high index of suspicion is necessary to make the right diagnosis early.

CLINICAL PICTURE

Two women, each with a history of 1 previous caesarean delivery, were initially diagnosed with spontaneous abortion in progress when ultrasonography scan revealed the gestational sac to be in the lower uterine cavity. Subsequent ultrasound scans showed that the gestational sac was actually in the anterior uterine wall at the level of the uterine isthmus.

TREATMENT

Both women were managed successfully with intrasac methotrexate injection.

OUTCOME

We report 2 cases of caesarean scar pregnancies mistaken for spontaneous abortions by experienced ultrasonographers.

CONCLUSION

This highlights the difficulty in differentiating between these 2 diagnoses and the importance of having a high index of suspicion in women with risk factors.

Origin of the anomalous low temperature upturn in the resistivity of the electron-doped cuprate superconductors

The temperature, doping, and field dependences of the magnetoresistance (MR) in Pr2-xCexCuO4-delta films are reported. We distinguish between orbital MR, found when the magnetic field is applied perpendicular to the ab planes, and the nearly isotropic spin MR. The latter, the major MR effect in the superconducting samples, appears in the region of the doping-temperature phase diagram where drho/dT<0, or an upturn in the resistivity appears. We conclude that the upturn originates from spin scattering processes.

Characterization of a small supernumerary marker chromosome as r(8) at prenatal diagnosis by MFISH

OBJECTIVE

To identify the mosaic marker chromosome detected in amniotic fluid cells of a 26-year-old woman, with raised triple test values and an ultrasound scan, which showed a fetus with echogenic bowels.

METHODS

Routine karyotyping with G- and C-banding was carried out for both, amniotic fluid at 18 weeks of gestation as well as fetal blood at 22(+6) weeks. Peripheral blood of both parents was karytoyped. MFISH and the all centromeric human probe were used on fetal lymphocytes to identify the marker chromosome.

RESULTS

Both parents had a normal karyotype. Amniotic fluid culture showed a de novo supernumerary marker chromosome (SMC) in 14 of the 30 colonies from four different cover slip cultures. The marker was confirmed in 50% of the fetal lymphocytes. G- and C-banding provided little information except that the marker had some heterochromatic material. The all centromeric human probe also showed the presence of a centromere along with a rim of euchromatic material. MFISH identified this ring marker to be belonging to chromosome 8.

CONCLUSIONS

SMCs with chromosome 8 have been shown to be variable phenotypes. Presence of only heterochromatic material seems to have no discernable phenotypic effects, but, with the presence of euchromatic material, mental and physical developmental delay has been reported. The parents opted to go ahead with the pregnancy and an apparently normal female baby was born at 40 weeks with no complications.

Adaptive biased-coin designs for skewing the allocation proportion in clinical trials with normal responses

Response adaptive designs are used in phase III clinical trial for skewing the allocation pattern towards the better treatments. We use optimum design theory to derive adaptive designs when the responses are normally distributed. The performance of the designs is studied with respect to the loss and the proportion of allocation to different treatments. The adaptive design does not affect inference.

Structural Changes of ?-Lactoglobulin during Thermal Unfolding and Refolding ? An FT-IR and Circular Dichroism Study

We have quantitatively characterized by FT-IR spectroscopy the contents of secondary structure of beta-lactoglobulin during thermal unfolding and subsequent refolding. Our data clearly indicate that considerable amount of secondary structure, particularly beta-sheet, still remained intact even at 90 degrees C. Noticeable changes in secondary structure of beta-lactoglobulin were observed only above 70 degrees C. The refolded protein regained, within limits of experimental error, all of the secondary structure lost during thermal unfolding. The data also indicate that the refolding mechanism operating at pH 7.0 and 2.0 are the same. Identical secondary structure of native and refolded beta-lactoglobulin was also indicated by far-UV circular dichroic spectra of the two forms of protein. Near UV circular dichroic spectra of the same two forms showed considerable differences indicating less tertiary structure of refolded beta-lactoglobulin. The combined CD and FT-IR data indicated that refolded form of beta-lactoglobulin could be characterized as a molten globule state as it had native-like secondary structure and compromised tertiary structure.

Antibiotic Sensitivity Patterns among Indian Strains of Avian Pasteurella multocida

An investigation was carried out to study the antibiotic sensitivity of avian strains of Pasteurella multocida and to select an effective antimicrobial agent for control of avian pasteurellosis in India. A total of 123 strains of P. multocida recently isolated from different avian species (chicken, duck, turkey, quail, and goose), from different regions of India were subjected to antibiotic sensitivity tests using 20 different antibiotics. Absolute resistance was observed against sulfadiazine. The studies indicated that the strains were most sensitive to chloramphenicol (73.98%), followed by enrofloxacin (71.54%), lincomycin (64.23%), norfloxacin (61.79%) and doxycycline-HCl (56.91%). The majority of the strains were found to exhibit intermediate sensitivity. Chloramphenicol was selected and suggested for treatment. Antibiogram studies also revealed the emergence of multidrug-resistant strains of P. multocida among Indian poultry.

Prevalent Serotypes of Pasteurella multocida Isolated from Different Animal and Avian Species in India

Identification and estimation of the prevalence of Pasteurella multocida organisms in different animal and avian species in India during November 2000 to July 2003 was carried out. Out of 418 samples collected from different outbreaks suspected to be caused by P. multocida, a total of 206 bacterial cultures were identified as P. multocida on the basis of cultural, morphological and biochemical characteristics. All the 206 cultures were isolated from different domestic animal species (cattle, buffalo, sheep, goat, pig and rabbit), avian species (chicken, duck, quail, turkey, goose) and wild animals such as leopard and deer. Serotyping of P. multocida cultures revealed the presence of various serotypes (A:1, A:3, A:1,3, A:4, B:2, D:1 and -:1) among the livestock population. P. multocida polymerase chain reaction (PCR) assay applied on different forms of bacterial cultures (bacterial culture lysate, direct bacterial colony and mixed bacterial culture lysate) yielded an amplified product of approximately 460 bp specific for P. multocida. The results of PCR assay correlated well with conventional methods of identification. The present investigation revealed the presence of varied serotypes among livestock and PCR assay was found to be useful for rapid, sensitive and specific diagnosis of pasteurellosis in animals and avian species.

Multiple brain haemorrhages in falciparum malaria

A young male with multiple intracerebral haemorrhages with presence of P. falciparum in peripheral smear and normal coagulation profile without features of encephalopathy managed successfully with antimalarial has been reported. The rarity of the clinical presentation has been highlighted and its possible pathogenesis discussed.

Henoch-Schonlein purpura with intracerebral haemorrhage

Henoch-Schonlein purpura is a leucocytoclastic vasculitis commonly seen among children and young adults. Neurological complications, though rare, include focal cerebral deficit, coma, convulsion, subarachnoid hemorrhage and chorea. We are reporting a 12 years boy with Henoch-Schonlein purpura who developed a large intracerebral hematoma in right occipital lobe. He made an uneventful recovery with conservative treatment and one year follow up revealed no major neurological sequelae.

Molecular variability among strains of Pasteurella multocida isolated from an outbreak of haemorrhagic septicaemia in India

The applicability of conventional and molecular methods for rapid detection and differentiation of Pasteurella multocida serogroup B isolates involved in an outbreak of haemorrhagic septicaemia affecting Indian buffaloes, was studied. Five isolates were obtained and were subjected to phenotypic and genotypic characterization. None of the five isolates could be differentiated on the basis of cultural, biochemical, pathogenicity and antimicrobial sensitivity patterns. Polymerase chain reaction (PCR)-based techniques were found to be specific and sensitive for rapid detection and differentiation of isolates. Repetitive extragenic palindromic (REP-) PCR, enterobacterial repetitive intergenic consensus (ERIC-) PCR and single-primer PCR differentiated all the five isolates into different profiles. All the isolates involved in the outbreak were found to have a genetic profile different from standard P. multocida strain (P52). However, three isolates had similar profiles, whereas each of the remaining two had a different profile. The study indicates the involvement of multiple strains of P. multocida in a single outbreak of haemorrhagic septicaemia in buffaloes. The results also indicate that molecular methods of detection and typing are superior to conventional methods for rapid epidemiological investigations of haemorrhagic septicaemia.