Does cord clamp affect the proper positioning of breastfeeding?

To determine the appropriateness of breastfeeding position as assessed by 4-point standard objective criteria in the presence of commercial plastic cord clamp. 50 babies each with and without cord clamp were selected randomly in post natal ward. Mean gestational age in both the periods was comparable (39±1.13 and 39±1.34 weeks). On evaluation by the standard 4 points of proper positioning, babies with cord clamp failed to keep their head and body straight (66% vs 94%, P=0.001), keep their baby’s body touching mothers abdomen (16% vs 94% P=0.000), and body well supported (72% vs 96%, P=0.002). However, both groups were appropriately able to turn baby’s body towards mother and nose opposite the nipple (98% vs 88%, P=0.112). On evaluation of mother’s satisfaction score, there was no significant difference except in the mother’s concern about care of cord clamp (P<0.001).     

Conservation and Variability of West Nile Virus Proteins

West Nile virus (WNV) has emerged globally as an increasingly important pathogen for humans and domestic animals. Studies of the evolutionary diversity of the virus over its known history will help to elucidate conserved sites, and characterize their correspondence to other pathogens and their relevance to the immune system. We describe a large-scale analysis of the entire WNV proteome, aimed at identifying and characterizing evolutionarily conserved amino acid sequences. This study, which used 2,746 WNV protein sequences collected from the NCBI GenPept database, focused on analysis of peptides of length 9 amino acids or more, which are immunologically relevant as potential T-cell epitopes. Entropy-based analysis of the diversity of WNV sequences, revealed the presence of numerous evolutionarily stable nonamer positions across the proteome (entropy value of ≤1). The representation (frequency) of nonamers variant to the predominant peptide at these stable positions was, generally, low (≤10% of the WNV sequences analyzed). Eighty-eight fragments of length 9–29 amino acids, representing ~34% of the WNV polyprotein length, were identified to be identical and evolutionarily stable in all analyzed WNV sequences. Of the 88 completely conserved sequences, 67 are also present in other flaviviruses, and several have been associated with the functional and structural properties of viral proteins. Immunoinformatic analysis revealed that the majority (78/88) of conserved sequences are potentially immunogenic, while 44 contained experimentally confirmed human T-cell epitopes. This study identified a comprehensive catalogue of completely conserved WNV sequences, many of which are shared by other flaviviruses, and majority are potential epitopes. The complete conservation of these immunologically relevant sequences through the entire recorded WNV history suggests they will be valuable as components of peptide-specific vaccines or other therapeutic applications, for sequence-specific diagnosis of a wide-range of Flavivivirus infections, and for studies of homologous sequences among other flaviviruses.     

Role of red cell distribution width in classifying microcytic hypochromic anaemia

Red cell distribution width (RDW) is an automated laboratory determination of red cell anisocytosis. The aim of the study was to analyse the role of RDW in differentiating iron deficiency anaemia (IDA) from thalassaemia trait. There were 500 patients who were screened for the study. Selection criteria of microcytic anaemia were Hb < 13 g/dl in males, Hb < 12 g/dl in females with mean corpuscular volume (MCV) < 80fl. These cases were subjected to complete iron profile and haemoglobin chromatography for definite diagnosis. The values of RDW were analysed in all these cases to see the utility of RDW in classifying microcytic anaemia; especially differentiating iron deficiency anaemia from thalassaemia minor cases. There were 133 out of 500 cases anaemic; 105/133 cases had microcytic anaemia, of which 53 had iron deficiency anaemia, 39 were thalassaemia traits, 6 were thalassaemia major, and 7 had other haemoglobinopathies. Thirty-six cases (67.92%) out of 53 iron deficiency anaemia had increased RDW, 32.08% (n = 17) had normal RDW; 71.79% (n = 28) of thalassaemia trait had increased RDW, 28.21% (n =11) had normal RDW. Evaluation of RDW as screening test to detect microcytic anaemia had sensitivity of 71.42% and specificity of 40%, Evaluation of RDW as a screening test for IDA had sensitivity of 67.9% and specificity 25%. It was found uniform increase in RDW in all cases of microcytosis. It is concluded that RDW adds useful but limited information in classifying microcytic anaemia.