Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

INTRODUCTION

The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures.

METHODS

In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025.

FINDINGS

Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2-6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5-5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4-10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32-4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23-11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation.

INTERPRETATION

After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification.

FUNDING

UK Research and Innovation and National Institute for Health Research.

Role of therapeutic plasma exchange in rat killer (yellow phosphorous) poisoning

CONTEXT

Yellow phosphorus (YP) 3% is one of the rodenticides available, which is a potent hepatotoxin and it is fatal. Management of YP poisoning is difficult since there is no antidote available; only definitive management is liver transplantation. Therapeutic plasma exchange (TPE) helps the YP poisoning patients by removing the poison or its metabolite or the inflammatory mediators released in the body in response to toxin.

AIMS

To determine the role of TPE in rat killer (YP) poisoning.

SETTINGS AND DESIGN

This was a descriptive period study conducted from November 2018 to September 2020.

SUBJECTS AND METHODS

Sixteen consecutive YP poisoning patients were included in the study (n = 16). A total of 48 sessions of TPE were carried out. Liver function tests such as serum glutamic-oxaloacetic transaminase, SGPT, total bilirubin, and direct bilirubin as well as coagulation profile such as prothrombin time, activated partial thromboplastin time, and international normalized ratio were analyzed at the time of admission, after each TPE session, and at the time of discharge.

STATISTICAL ANALYSIS USED

The results were recorded, and it was analyzed statistically by SPSS version 17.

RESULTS

Liver function tests improved significantly from the time of admission and after each TPE and at the time of discharge (P < 0.05). Coagulation profile improved statistically (P < 0.05). Thirteen patients were improved in their clinical status, and three patients left the hospital citing personal reasons.

CONCLUSIONS

TPE could potentially bridge the gap between medical management and liver transplantation in cases of YP poisoning.

A rare case of hepatic sinusoidal occlusive syndrome in a premature neonate with trisomy 21

Trisomy 21 (Down Syndrome) may lead to multiple hematological and hepatobiliary manifestations including the development of transient abnormal myelopoiesis. While many cases resolve, transient abnormal myelopoiesis may lead to significant morbidity and mortality in a small percentage of patients. This condition may present a diagnostic challenge for physicians and currently there is only limited data on effective treatments, particularly with low blast percent transient abnormal myelopoiesis. We present a case of a neonate with trisomy 21 and multiple congenital anomalies who consequently developed hepatic failure with evidence of non-cirrhotic portal hypertension likely due to transient abnormal myelopoiesis. This clinical scenario highlights the need for additional evaluation for transient abnormal myelopoiesis associated hepatic disorder and possibly hepatic sinusoidal occlusive syndrome among trisomy 21 neonates particularly with low blast percentage.

Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study

BACKGROUND

No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge.

METHODS

The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing.

FINDINGS

2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters.

INTERPRETATION

The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials.

FUNDING

UK Research and Innovation and National Institute for Health Research.

Assessment of noncompliance in self-disclosure of deferrable risk behaviors among blood donors

BACKGROUND

Blood transfusion services work to ensure universal accessibility of safe and effective blood products for transfusion to recipients. Failure of blood donors to disclose complete truthful information before blood donation is termed as noncompliance. Noncompliance in disclosing high-risk behaviors could compromise blood safety. This study aimed to assess the prevalence rate of noncompliance and assess the predictive factors and reasons for noncompliance.

MATERIALS AND METHODS

Blood donors were asked to fill a postdonation anonymous questionnaire after obtaining consent and the responses were tabulated and analyzed. Prevalence of noncompliance for both high-risk and nonhigh-risk behaviors are evaluated. Variables associated with noncompliance are analyzed by univariate analysis and logistic regression.

RESULTS

Total number of participants was 3001, 2850 participants gave valid responses and included in the study. There were 94 (3.30%) responses revealing noncompliance for nonhigh-risk behavior and 30 (1.05%) responses revealing noncompliance for high-risk behavior. The predictor variables for noncompliance in reporting high-risk behavior were education and adultery. The predictor variables for noncompliance in nonhigh-risk behavior reporting were presence of comorbidity and adultery.

CONCLUSION

Noncompliance in disclosure of high-risk behavior compromises blood safety. Blood donors must be ensured sufficient privacy while filling predonation questionnaire and while eliciting history any deferrable behaviors during blood donor medical examination. Privacy and confidence of the donors must be ensured either to share any postdonation information directly or anonymously to facilitate confidential unit exclusion.

Target-receptive structural switching of ssDNA as selective and sensitive biosensor for subsequent detection of toxic Pb2+ and organophosphorus pesticide

A structural switching in Single-stranded DNA (ssDNA) fluorescence biosensor for quick turn-on/off detection of Pb²⁺ ions and pesticide was reported. The design strategy of Hex-labelled ssDNA consists of two types of aptamer probe, G-rich base pair sequence forms G-quadruplex confirmation with Pb²⁺ ions. While other part of base pair sequence exhibits affinity to fold isocarbophos pesticide. MoS₂ nanosheets were identified as quick quencher of Hex fluorescence intensity via Vander-Waals interaction and its significance was compared with other nanomaterials. This sensing mechanism proposes a specific affinity of GA-rich ssDNA with Pb²⁺ to form G-quadruplex via G-Pb²⁺-G sequences. Consequently, ssDNA relived from MoS₂ nanosheets to restore the fluorescence intensity (turn-on). Subsequent addition of pesticide shows stronger affinity towards unfolded aptamer probe to form a random coil like structure. This causes Hex-labelled 5' end closer to the G-quadruplex connected at the 3' end of ssDNA resulting in a remarkable fluorescence quenching (turn-off) owing to PET process. Moreover, the sensing probe (Hex-labelled GA-rich ssDNA) was recycled by introducing acetylcholinesterase enzyme and thiocoline into the reaction mixture. The detection limits of Pb²⁺ and isocarbophos pesticide was estimated to be 0.6 nM and 0.018 μg/L respectively. Moreover, this study reveals a high sensitivity and selectivity towards target molecules in environmental samples.

Baseline distributions and sources of polycyclic aromatic hydrocarbons (PAHs) in reef-associated sediments of Vembar group of Islands, Gulf of Mannar, India

The study aims to investigate the source and concentration of PAH fractions in the reef sediments of the Vembar group of Islands, Gulf of Mannar, India. The concentration of PAHs ranged from 0.36 to 15.98 ng/g. The reef environment was less contaminated with low-molecular-weight PAH fractions. The accumulation of the LMW-PAH fraction was very less, whereas the HMW fraction was derived from pyrolytic sources. The level of low and high molecular weight PAHs was lower than the level of Effective Range Median (ERM) and Effective Range Low (ERL).The calculated total TEQ value ranged from ND to 10.24 ng/g in the reef sediments.

Characterization and distribution of microplastics in estuarine surface sediments, Kayamkulam estuary, southwest coast of India

The present study aims to formulate the characterization and distribution of microplastic in the estuarine surface sediments of Kayamkulam estuary, southwest coast of India. The sediments were dominated by fibre and film shaped microplastic substances. The surface sediments were dominated by <1000 μm microplastics. The composition of microplastics in descending order was as follows: polyester > polypropylene > polyethylene. The distribution of microplastics was significantly higher than that observed in the other study regions, except for Pearl river estuary and Guanabara Bay. The distribution of microplastics was chiefly controlled by estuarine inundating water and the distance of the sampling site from the open sea.

Posttransfusion purpura sans purpura: A novel presentation

Posttransfusion purpura (PTP) is a rare condition that develops 5–10 days after transfusion of platelet containing blood component. Temporal relationship to blood transfusion, thrombocytopenia, and purpuric rashes with or without bleeding manifestation, supported by the serological presence of antiplatelet antibodies, are characteristic of PTP. We, herein, report a case of posttransfusion thrombocytopenia without purpuric rashes or bleeding symptoms, which is a rare presentation. A 44-year-old multiparous female, being treated for menorrhagia, who was transfused with three packed red blood cell units developed significant thrombocytopenia on day 8 after transfusion of the first unit. Her coagulation profile was normal. No purpuric rashes or bleeding manifestation was seen. Serum revealed the presence of antiplatelet antibodies on performing platelet antibody screen. Her platelet count improved from day 9 and reached above 50,000/μ l on day 10. She was managed conservatively with frequent monitoring for bleeding manifestations and blood counts.

A baseline study on elemental concentration and potential ecological risk status of the surface sediments of Ashtamudi Lake, south west coast of India

Element concentration (Fe, Mn, Pb, Zn, Cu, Cr, Ni and Co) in the surface sediments of Ashtamudi estuary, Southwest coast of India, has been analyzed to understand the spatial variation and potential ecological risk status. The sediment pollution index and Potential Ecological Risk index suggest that the northeastern part of the estuary exhibits low to moderate polluted sediments with moderate ecological risk. The results of correlation analysis indicate that the natural weathering process and river input play an important role in the distribution of the elements in the surface sediments of the estuary. The extracted factor results indicate that the fine sediment fractions supporting for accumulation of the trace elements, whereas the enriched level of Fe and Mn is chiefly controlled by the riverine process, and other elements are contributed by anthropogenic influences.

Autologous umbilical cord blood for red cell concentrate transfusion in preterm infants in the era of delayed cord clamping: An uncontrolled clinical trial

OBJECTIVE

To assess the utility of autologous umbilical cord blood (UCB) for red cell concentrate (RCC) transfusion in preterm infants.

METHODS

We recruited preterm infants born at ≤30 weeks' gestation or have an estimated fetal weight <1,200 g. We intended to perform delayed cord clamping (DCC) and to collect UCB following DCC. The quality parameters used included blood culture performed once, and biochemical and haematological parameters assessed weekly.

RESULTS

Of the 46 recruited neonates, DCC could be performed for 1 minute in 11 (23.9%) and for 30-59 seconds in 10 (21.7%) infants. The success rate of UCB collection was significantly lower in infants who underwent DCC for 1 minute (27%) compared to those who underwent DCC for 30-59 seconds (70%) or immediate cord clamping (72%) (p value 0.031). Twenty-five UCBs were stored after eliminating three that had positive culture. UCB had satisfactory quality for transfusion from day 3 (when blood culture report was available) to 14 (after which pH decreased to <6.5). Thirteen infants required 27 RCC transfusions. Autologous UCB could be used for only five (18.5%) transfusions.

CONCLUSION

The success rate of UCB collection after DCC for 1 minute is low. Autologous UCB meets less than one-fifth of transfusion requirements. Hence, autologous UCB transfusion is not a workable option in preterm infants.

Execution of julolidine based derivative as bifunctional chemosensor for Zn2+ and Cu2+ ions: Applications in bio-imaging and molecular logic gate

A simple julolidine based chemosensor (JT) was designed and synthesized by single condensation step. JT displayed excellent selectivity and sensitivity with on-off responses towards Zn²⁺ and Cu²⁺ over other biologically relevant metal ions in aqueous media. Upon addition of Zn²⁺ ions, JT exhibited a significant blue shift in emission followed by turn-on enhancement while with Cu²⁺, the fluorescence intensity of JT was completely vanished. The 1:1 binding affinity between JT and Zn²⁺/Cu²⁺ was proposed by Job's plot analysis. The detection limit for Zn²⁺ and Cu²⁺ ions reached at 3.5 × 10^-8 M and 1.46 × 10^-6 M, respectively. The sensing mechanism of JT with Zn²⁺/Cu²⁺ was supported by DFT calculations. Based on photophysical studies and its reversibility environment with EDTA, molecular logic gates were fabricated. Furthermore, JT was successfully established to detect intracellular Zn²⁺ ions in live cells by turn-on response.

Rhodium(III)-Catalyzed C–H Activation/Alkylation of Diazabicyclic Olefins with Aryl Ketones: Facile Synthesis of Functionalized Cyclopentenes

A facile synthesis of biologically important trans-functionalized cyclopentenes by a mild Rh(III)-catalyzed alkylation of strained ­diazabicyclic olefins with aryl ketones in the presence of ammonium ­acetate has been developed. The reaction proceeds through C–H bond activation of the aryl ketone groups by transforming them in to an ­autocleavable directing group, such as in situ-formed imine.

Elemental concentration and potential ecological risk assessment of reef associated surface sediments of Appa Island, Gulf of Mannar Biosphere Reserve, Southeast coast of India

Thirty three surface sediments were collected for the present study to assess the elemental concentration and its associated ecological risk in the reef associated surface sediments, Appa Island, Gulf of Mannar Biosphere Reserve, South east coast of India. The distribution of calcium carbonate in the reef sediments is controlled by coral debris and shell fragments whereas the Organic matter (OM) content are chiefly derived from mangroves and sea grasses. The circulation of trace elements and Fe, Mn are controlled by the fluvial process and re-suspended sediments. The concentration of Pb was primarily controlled by migration of pollutants through long shore sediment transport process. The main source of Pb in the study area is from coal incinerating power plants and coal handling operations from harbors.

A Facile Access to trans-3-Styryl-4-hydrazinocyclopentenes via Palladium­-Catalyzed Ring Opening of Diazanorbornenes with (Z)-β-Bromostyrenes/2,3-Dibromohydrocinnamic Acids

trans-3-Styryl-4-hydrazinocyclopentenes have been synthesized via palladium-catalyzed desymmetrization of diazanorbornenes with (Z)-β-bromostyrenes. The reaction also works well with (Z)-β-bromostyrenes generated in situ from 2,3-dibromohydrocinnamic acids. The synthesized hydrazinocyclopentenes provide an easy route towards synthetic intermediates of many scaffolds of biological potential.

Green synthesis of surface-passivated carbon dots from the prickly pear cactus as a fluorescent probe for the dual detection of arsenic(iii) and hypochlorite ions from drinking water

Efforts were made to develop a simple new approach for the green synthesis of surface-passivated carbon dots from edible prickly pear cactus fruit as the carbon source by a one-pot hydrothermal route. Glutathione (GSH) was passivated on the surface of the CDs to form a sensor probe, which exhibited excellent optical properties and water solubility. The prepared sensor was successfully characterized by UV-visible spectrophotometry, fluorescence spectrophotometry, Fourier transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD), scanning electron microscopy (SEM), and transmission electron microscopy (TEM). The simple sensing platform developed by the GSH-CDs was highly sensitive and selective with a “turn-off” fluorescence response for the dual detection of As³⁺ and ClO⁻ ions in drinking water. This sensing system exhibited effective quenching in the presence of As³⁺ and ClO⁻ ions to display the formation of metal complexes and surface interaction with an oxygen functional group. The oxygen-rich GSH-CDs afforded a better selectivity for As³⁺/ClO⁻ ions over other competitive ions. The fluorescence quenching measurement quantified the concentration range as 2–12 nM and 10–90 μM with the lower detection limit of 2.3 nM and 0.016 μM for the detection of As³⁺ and ClO⁻ ions, respectively. Further, we explored the potential applications of this simple, reliable, and cost-effective sensor for the detection of As³⁺/ClO⁻ ions in environmental samples for practical analysis.

Efforts were made to develop a simple new approach for the green synthesis of surface-passivated carbon dots from edible prickly pear cactus fruit as the carbon source by a one-pot hydrothermal route.

Does treadmill running performance, heart rate and breathing rate response during maximal graded exercise improve after volitional respiratory muscle training?

AIM

Maximal physical exertion in sports usually causes fatigue in the exercising muscles, but not in the respiratory muscles due to triggering of the Respiratory muscle metabo-reflex, a sympathetic vasoconstrictor response leading to preferential increment in blood flow to respiratory muscles.1 We planned to investigate whether a six week yogic pranayama based Volitional Respiratory Muscle Training (VRMT) can improve maximal Graded Exercise Treadmill Test (GXTT) performance in healthy adult recreational sportspersons.

METHODS

Consecutive, consenting healthy adult recreational sportspersons aged 20.56±2.49 years (n=30), volunteered to 'baseline recording' of resting heart rate (HR), blood pressure (BP), respiratory rate (RR), and Bruce ramp protocol maximal GXTT until volitional exhaustion providing total test time (TTT), derived VO2max, Metabolic Equivalent of Task (METs), HR and BP response during maximal GXTT and drop in recovery HR data. After six weeks of observation, they underwent 'pre-intervention recording' followed by supervised VRMT intervention for 6 weeks (30 minutes a day; 5 days a week) and then 'post-intervention recording'. Repeated measures ANOVA with pairwise t statistical comparison was used to analyse the data.

RESULTS

After supervised VRMT, we observed significant decrease in their resting supine RR (p<0.001), resting supine HR (p=0.001), HR after 5 minutes of assuming standing posture (p=0.003); significant increase in TTT (p<0.001), derived VO2max (p<0.001), METs (p<0.001) and drop in recovery HR (p=0.038); altered HR response and BP response during exercise.

CONCLUSIONS

We hypothesize that these changes are probably due to VRMT induced learnt behaviour to control the breathing pattern that improves breathing economy, improvement in respiratory muscle aerobic capacity, attenuation of respiratory muscle metabo-reflex, increase in cardiac stroke volume and autonomic resetting towards parasympatho-dominance. Yogic Pranayama based VRMT can be used in sports conditioning programme of athletes to further improve their maximal exercise performance, and as part of rehabilitation training during return from injury.

Quantum mechanical investigation into the electronic transport properties of a memantine-functionalized gold nanopore biosensor for natural and mutated DNA nucleobase detection

Quantum mechanical studies of the electronic transport properties of a memantine-functionalized gold nanopore biosensor for natural and mutated DNA nucleobase detection are reported.

A hybrid magnetic core–shell fibrous silica nanocomposite for a chemosensor-based highly effective fluorescent detection of Cu(ii)

Herein, a novel hybrid magnetic core–shell fibrous silica nanocomposite (RhB–Fe₃O₄/MnO₂/SiO₂/KCC-1) probe-based chemosensor was designed and its behaviour towards Cu(ii) metal ion was investigated using a fluorescence spectrometer.

Recovery of Platelet Count among Apheresis Platelet Donors

INTRODUCTION

Increase in awareness regarding use of single donor platelets and the availability of technology has resulted in increased platelet pheresis procedures. The interval between two succesive plateletpheresis donations is much less compared to whole blood donations. Plateletpheresis procedures are associated with short term and long term adverse events. The effect of plateletpheresis on haematopoietic system remains significant.

AIM

To study the recovery of platelet count to baseline in plateletpheresis donors.

MATERIALS AND METHODS

Fifty, first time apheresis donors were followed for platelet count recovery. Platelet count was measured before donation and at 30 minutes, 48 hours, 7^th day and 14^th day post-donation. Donor platelet count recovery to baseline was observed during the two week period. Results were analysed statistically, p<0.05 was considered statistically significant.

RESULTS

Platelet count recovered to baseline by 7^th day post-donation in 50% of donors in groups I (Pre-donation platelet count 1.5 lacs/μl to 2.2 lacs/μl) and II (Donors with platelet count >2.2 lacs/μl to 2.75 lacs/μl), 30% of donors in group III (Donors with platelet count >2.75 lacs/μl to 3.5 lacs/μl) of the donors. Donor's platelet count recovered to baseline in 85% of donors by day 14 in across the three groups. Recruitment of platelets from spleen was observed in donors with pre-donation platelet count on the lower limit of normal.

CONCLUSION

By day 7, donor's platelet count recovered to baseline in majority of the donors. Allowing enough recovery periods for donor platelet count, the minimum interval between two apheresis donations can be 7 days till more prospective studies conclude on the frequency and minimum interval between plateletpheresis donations.

National epilepsy surgery support activity

While there are over one million people with drug-resistant epilepsy in India, today, there are only a handful of centers equipped to undertake presurgical evaluation and epilepsy surgery. The only solution to overcome this large surgical treatment gap is to establish comprehensive epilepsy care centers across the country that are capable of evaluating and selecting the patients for epilepsy surgery with the locally available technology and in a cost-effective manner. The National Epilepsy Surgery Support Activity (NESSA) aims to provide proper guidance and support in establishing epilepsy surgery programs across India and in neighboring resource-poor countries, and in sustaining them.

Direct synthesis of 5- and 6-substituted 2-aminopyrimidines as potential non-natural nucleobase analogues

A series of 2-aminopyrimidine derivatives, substituted at 5- and 6-positions, were synthesized.

Need for a national epilepsy control program

This article briefly outlines the proposed national epilepsy control program. The content of the article is based on four meetings held by invitation of the Ministry of Health. Invitees by ministry – Drs. D. C. Jain, M. Gourie Devi, V. Saxena, S. Jain, P. Satish. Chandra, M. Gupta, K. Bala, V. Puri, K. S. Anand, S. Gulati, S. Johri, P. S. Chandra, M. Behari, K. Radhakrishnan, D. Bachani. Presentations were made by Dr. M. Tripathi.The program will involve all neurologists across the country in teaching and training at state levels and a central monitoring committee.