Cutaneous Eruptions in Indian Tick Typhus

Although frequently unrecognized, rickettsial infections may be an important cause for fever and exanthem in persons presenting to physicians in South India. Most often these patients are referred to dermatology departments with a diagnosis of "drug eruption." In the current study the authors analyzed 12 cases of rickettsial fever that were seen in the dermatology department of St. John's Medical College Hospital, Bangalore, between 1985 and 1989. The distinctive cutaneous eruption was found to be an important clue to an early clinical diagnosis. Specific serodiagnosis enabled us to confirm that Indian tick typhus, a member of the spotted fever group, was the most frequent cause for rickettsial fever presenting at our hospital.     

Complete genomic analysis of a Bangladeshi G1P[8] rotavirus strain detected in 2003 reveals a close evolutionary relationship with contemporary human Wa-like strains

More than 120 variants of rotavirus strains with different VP7 (G type) and VP4 (P type) combinations are reported thus far. Among them Wa-like G1P[8] rotaviruses are the most common human strains worldwide. However, characterization of their entire genome complement is limited to a few old prototype strains, and no complete genome data for any G1P[8] strain isolated in the last decade are available. Both the currently licensed rotavirus vaccines Rotarix? and RotaTeq? possess the G1 and P[8] specificities. Therefore, comprehensive genetic information of the currently circulating G1P[8] strain is important to assess the impact of rotavirus vaccines on the circulating rotavirus strains. Here we report the complete genome sequence of a G1P[8] rotavirus strain Dhaka16-03 isolated in 2003 from a Bangladeshi child hospitalized with severe diarrhea. Based on a full-genome classification system, Dhaka16-03 was shown to posses the typical Wa-like genotype constellation: G1-P[8]-I1-R1-C1-M1-A1-N1-T1-E1-E1-H1. The strain was phylogenetically more closely related to contemporary human rotavirus strains (isolated in the 2000s) with a range of G and P-genotypes than to those of the prototype G1P[8] strains. Since the vaccine strains are developed based on strains isolated several decades ago, it is important to know how much the vaccine strains differ from the currently circulating G1P[8] and other Wa-like strains. Our complete genome characterization of a recent G1P[8] strain will be helpful to assess the ongoing rotavirus vaccine trials and their implementation programs in the forthcoming years.     

A novel norovirus recombinant strain GII.4/GII.21 in Bangladesh, 2011

We identified a novel inter-genotype recombinant norovirus strain, Dhaka85/2011/BGD, collected from a stool specimen of a nine-month-old infant who was hospitalized with diarrhea. Molecular investigation and phylogenetic analysis classified its RNA polymerase gene as GII.4-like, which commonly circulates in humans. The capsid gene was classified as GII.21-like, most likely originated from water. The discovery of this novel strain is an illustration of the enormous diversity among the norovirus strains, especially in developing countries and has important implications for future vaccine strategies.     

The effects of orthognathic surgery on speech: a review.

PURPOSE: To assess the effects of orthognathic surgery on speech in non-cleft individuals. MATERIALS AND METHODS: A literature survey was undertaken using the Medline (Entrez Pubmed) and EMBASE databases (1966 to 2006). Key orthodontic, orthognathic, and speech journals were also hand searched. No language limitations were imposed. Randomized controlled trials, prospective and retrospective longitudinal trials (with and without controls), and case series were considered for inclusion. RESULTS: Eighteen studies were identified as fulfilling the inclusion criteria. Controls were used in one fifth of the trials; 13 articles reported preoperative articulation errors. In 8 of the trials, speech articulation either improved or was corrected for the majority of individuals assessed. In the studies assessed, the type of surgery or degree of movement did not appear to affect speech. CONCLUSION: There is no clear evidence directly relating malocclusions to speech discrepancies. Furthermore, it is difficult to draw any firm conclusions with respect to the effect of orthognathic surgery on speech. Further investigation is required.     

Imaging of liver cancer

Improvements in imaging technology allow exploitation of the dual blood supply of the liver to aid in the identification and characterisation of both malignant and benign liver lesions. Imaging techniques available include contrast enhanced ultrasound, computed tomography and magnetic resonance imaging. This review discusses the application of several imaging techniques in the diagnosis and staging of both hepatocellular carcinoma and cholangiocarcinoma and outlines certain characteristics of benign liver lesions. The advantages of each imaging technique are highlighted, while underscoring the potential pitfalls and limitations of each imaging modality.     

Identification of the date‐rape drug GHB and its precursor GBL by Raman spectroscopy

Gamma hydroxybutyric acid (GHB), also known as ‘liquid ecstasy’, has recently become associated with drug‐facilitated sexual assaults, known colloquially as ‘date rape’, due to the ability of the drug to cause loss of consciousness. The drug is commonly found ‘spiked’ into alcoholic beverages, as alcohol increases its sedative effects. Gamma hydroxybutyric acid and the corresponding lactone gamma‐butyrolactone (GBL) will reach an equilibrium in solution which favours the lactone in basic conditions and GHB in acidic conditions (less than pH 4). Therefore, we have studied both GHB and GBL, as a mildly acidic beverage ‘spiked’ with GHB will contain both GHB and GBL. We report the analysis of GHB as a sodium salt and GBL, its precursor, using bench‐top and portable Raman spectroscopy. It has been demonstrated that we are able to detect GHB and GBL in a variety of containers including colourless and amber glass vials, plastic vials and polythene bags. We have also demonstrated the ability to detect both GBL and GHB in a range of liquid matrices simulating ‘spiked’ beverages. Copyright © 2009 John Wiley & Sons, Ltd.     

L’expérimentation médicale sur les prisonniers (partie 1): les évènements historiques marquants

The exploitation of prisoners in medical research is an ancient phenomenon. However, the history of the XX^th century was marked by major events that reached the peak of horror during the second world war. Although the collective mind has remembered the outrages of the Nazi regime, the truth is that these practices were adopted by the majority of the military powers of that time, and continued after the end of the war. This history note is the first in a series that aims to review the circumstances and implications of these dark moments in the history of medical research in order to pay tribute to the countless victims who paid with their lives for «scientific progress» and to understand the reasons for current ethical considerations in biomedical experimentation on persons deprived of liberty.