IMMUNOCHROMATOGRAPHIC TEST: A NEW DIMENSION IN DIAGNOSIS OF PLASMODIUM FALCIPARUM MALARIA

75 patients with clinical features suggestive of malaria were studied to evaluate the efficacy of immunochromatographic test (ICT), which detects histidine rich protein-2 antigen secreted by Plasmodium falciparum (Pfhrp-2), as against direct microscopy. There were 40 cases of P falciparum malaria, 14 cases of P vivax malaria and 21 cases of non-malarial fevers. Direct microscopy could detect 27(67.5%) P falciparum cases but failed to detect 13 cases (32.5%) whereas ICT could detect 35(87.5%) P falciparum cases out of 40 but failed to detect 5(12.5%) cases. All the P vivax cases and non-malarial fever cases were negative for ICT. The sensitivity and specificity of ICT is 87.5% and 100% respectively where as the positive predictive value and the negative predictive value of the test is 100% and 87.5% respectively. It is concluded that ICT test is a good adjunct to blood smear studies in fever cases with neurological and multiorgan dysfunction and in antenatal ladies.Key Words: ICT, P falciparum     

腹腔镜胆囊切除术后胆瘘及急性胰腺炎1例

1病例报告女,53岁,慢性胆囊炎急性发作,经抗炎后行腹腔镜胆囊切除术(LC),术后7 d发热,T 37.5～38.9℃.     

Body Mass Index and Obesity : Tailoring “cut-off” for an Asian Indian Male Population

Background

Obesity/overweight is a recognized risk factor for a host of disorders. The disease risk stratification is commonly based on the Quetelets Index (Body Mass Index- BMI), a surrogate measure of fatness. The currently used BMI cut-offs to classify people as overweight or obese in Armed Forces have been defined in studies on Caucasian populations. However, because of differences in body structure and composition in different ethnic, socioeconomic, cultural and regional groups the correspondence between BMI and body fat content varies between populations. We conducted this pilot study in the Indian Navy to define BMI cut-offs for overweight and obesity using body fat content derived from Skin Fold Thickness as the standard.

Material and Methods

The study was conducted on 121 volunteers from a naval hospital staff in the age range of 18 to 47 years. The mean age, height, weight, BMI, body fat in the study group was 26.73 years (± 5.5098), 168.56 cm (± 6.1034), 65.92 Kg (± 10.2746), 23.17 Kg/m² (± 3.0265) and 19.91% (± 4.831) respectively.

Results

The prevalence of overweight/obesity was 20.66% by BMI and 47.11% by body fat content. Receiver operating characteristic (ROC) curve analysis defined a BMI of 23.85 kg/m² as the cut off for overweight with a sensitivity of 70.2% (95% CI 56.6 – 81.6) and 87.5% specificity (95% CI 76.8-94.4) and a BMI of 24.38 kg/m²with 90% sensitivity (95% CI 68.3-98.5) and 81.2% specificity (95% CI 72.2-88.3) for obesity.

Conclusion

The results of our study suggest lower BMI cut offs for overweight and obesity in Indian populations than those recommended by WHO.Key Words: Body Mass Index, Body fat content, Skin fold thickness     

Fungal infections associated with HIV infection

Oral candidiasis is perhaps the commonest infection seen in HIV disease. The aim of this workshop was to provide a sketch of the multifarious aspects of the disease from a global perspective. To this end the panellists addressed issues such as the virulence of Candida , emergence of antifungal resistance, management of candidiasis and other exotic, oral mycotic diseases. An all-pervasive theme was the dramatic differences in the management of fungal infections consequential to the availability (or the lack) of anti-HIV drugs in the developed and the developing world. Further, the social stigmata associated with the HIV disease in many developing regions in Africa and Asia appears to modify the therapeutic strategies. Additionally, the lesser-known regional variations in the disease manifestations and therapeutic approaches were stark. Further work is direly needed to address these issues.     

噻托溴铵升级治疗成人未控制支气管哮喘

背景和目的:对于单用吸入糖皮质激素控制不佳的成人支气管哮喘(简称哮喘)患者,加用长效β-受体激动剂(LABA)可有效改善患者的症状及肺功能.但是最近对LABA长期治疗的安全性受到了美国食品药品管理局(FDA)及部分哮喘专家的质疑.另外,鉴于每个哮喘患者对治疗的反应不尽相同,因此寻求未控制哮喘患者的其他治疗方法是必要的.