A study of 10 cases of velopharyngeal incompetence treated by flap pharyngoplasty

Velopharyngeal incompetence (VPI) is a condition of incomplete closure of V.P. port area, normally formed by velum and posterior pharyngeal watt. The condition primarily results in various types of speech defects, which form- the main complaint of the patient. We have studied 10 cases of VPI due to various causes and the speech improvement obtained by flap pharyngoplasty procedures. The results have been evaluated with a follow-up of six months. Highly encouraging results only indicate a more frequent need to undertake such surgery without any hesitation if the ENT surgeon is familiar with and has an adequate exposure to this simple and effective procedure.     

印度结核病流行病学:综述

印度的结核病形势可以用高患病率、高发病率高传染率来描述。自二十世纪50年代以来在印度不同地区进行的疾病监测报告显示:涂阳肺结核患病率为0.6-7.6/1000,培阳肺结核患病率为1.7-9.8/1000,培阳和/或涂阳结核患病率为1.8-12.7/1000。从已进行的有限的研究资料分析,涂阳肺结核的发病率在1.0-1.6/1000之间,培阳肺结核发病率在1.0-2.5/1000之间。根据不同时期在不同地区进行的结核菌素监测估计,结核年感染率(ARTI)为1-2%。在2000-2003年进行的全国范围研究估计,平均ARTI为1.5%。多数在第3级卫生保健中心进行的研究显示在结核病例中人类免疫缺陷病毒(HIV)血清阳性率在增加,不同研究的结果介于0.4%-28.8%之间。新病例中耐多药(MDR)率相对较低,约0.5-5.3%之间。但在复治病例中MDR为8%-67%。     

Oral clonidine pretreatment for haemodynamic stability during craniotomy.

We have studied the effect of clonidine pretreatment on cardiovascular responses to various stimuli during craniotomy. Fifty-eight patients (ASA Class I-II), scheduled for supratentorial surgery, were randomly given either oral clonidine, mean dose 3.6 micrograms/kg (n = 28), or oral diazepam, 0.2 mg/kg (n = 30), ninety to one hundred minutes before surgery. Anaesthesia was induced with thiopentone and maintained with nitrous oxide:oxygen, pentazocine and halothane. Pancuronium was used as a neuromuscular blocker. Mean arterial pressure and heart rate were recorded before and after several stimuli. In the clonidine group hypertensive response was significantly less on laryngoscopy (6.5% increases versus 11.2% in the diazepam group), intubation (9.2% versus 16.5%), Mayfield clamp application (14.5% versus 29.91%) and after skin infiltration with lignocaine-adrenaline solution (2.95% versus 5.42%). Heart rate response to laryngoscopy, intubation and skin infiltration was also significantly attenuated in the clonidine group. The sleep dose of thiopentone was smaller in patients pretreated with clonidine. Patients in the diazepam group required more medical intervention. No adverse effect occurred in any patient.     

Microbiological study of vaginal discharge associated with the use of CuT 200.

A microbiological study of the vaginal discharge was conducted on 75 women attending family planning outdoors. In 24 out of 25 symptomatic CuT 200 users suffering from non-specific vaginitis, Gardnerella vaginalis was isolated from 19 cases (79%). The difference in the recovery rate of Gardnerella vaginalis was highly significant between symptomatic CuT 200 users and non-users (p less than 0.001) and that between symptomatic and asymptomatic CuT 200 users (p less than 0.05). But the difference between asymptomatic CuT 200 users and non-users was not statistically significant. The presence of clue cells on direct Gram's staining of vaginal discharge is significantly (p less than 0.05) related to the recovery of Gardnerella vaginalis on culture.     

Intensification of measles vaccination coverage

Better coverage of susceptibles with measles vaccine has clear demonstratable impact on disease incidence. Education and strong motivation of implementors and community at large and improvement in other managerial and administrative support actions for the programme are considered essential to boost up measles immunisation coverage. It is therefore, expected that with well planned and sustained implementation of country wide campaign of measles immunisation, the disease can be brought under control. This needs strong will, determination and urgency for well planned and sustained actions if we have to achieve desired goal--"IMMUNISATION FOR ALL BY 1990". The efforts required for achieving the targets are discussed in this paper.     

Biochemical and immunological characterization of deoxythymidine kinase of thymidine kinaseless HeLa cells biochemically transformed by herpes simplex virus type.

Thymidine kinase (TK) from herpes simplex virus type 1 (HSV-1) biochemically transformed HeLa cells, purified by affinity chromatography, has been characterized with respect to its electrophoretic mobility, molecular weight, activation energy, substrate specificity, and immunological specificity. TK purified from HSV-1-transformed HeLa cells has the same electrophoretic mobility as TK purified from HeLa cells lytically infected with HSV-1. The sedimentation velocity of purified TK from transformed cells was similar to that previously reported for the lytic enzyme, and its molecular weight was estimated to be 70,000. The activation energy of purified transformed-cell TK was 18.3 kcal/mol. Antiserum prepared against purified HSV-1 TK, although it showed some cross-reactivity, preferentially neutralized homologous TK. The transformed-cell TK antiserum also neutralized the deoxycytidine kinase activity of HSV-1-infected cell extracts but had no effect on deoxycytidine kinase activity of HSV-2-infected cell extract. These results further support the notion that TK acquired by HeLa cells transformed by HSV-1 is of viral and not of cellular origin.     

Immunoregulatory effects of morphine on human lymphocytes.

It is now well established that parenteral drug abuse is a significant risk factor for contracting human immunodeficiency virus type 1 (HIV-1) infection and subsequently developing AIDS. Earlier studies have shown that morphine can modulate various immune responses and therefore support the premise that morphine is a cofactor in susceptibility to and progression of HIV infection. Dysregulation of interferon (IFN) production, nonspecific apoptosis of T cells, and the immune response to soluble HIV gene products have been associated with potential mechanisms of pathogenesis in HIV disease. The present study was undertaken to examine the immunomodulatory role of morphine on HIV protein-induced lymphocyte proliferative responses, Sendai and Newcastle disease virus-induced alpha IFN (IFN-alpha) and IFN-beta production by lymphocytes and fibroblast cells, respectively, and induction of apoptosis of normal lymphocytes in vitro. Our results demonstrate that HIV protein-induced human lymphocyte proliferative responses were significantly inhibited by morphine in a dose-dependent manner. Furthermore, morphine significantly inhibited both IFN-alpha and IFN-beta production by normal lymphocytes and fibroblasts but induced apoptosis of normal lymphocytes. Inhibition of IFN-alpha production by morphine could be reversed by the opiate receptor antagonist naloxone. This suggests that the immunomodulatory effects of morphine are mediated through the opioid receptor. These studies support a role of morphine as a cofactor in the pathogenesis of HIV infection and describe some of the possible pathologic mechanisms which underlie the immunoregulatory effects of morphine.     

Hepatitis B virus genotypes and serotypes in western India: lack of clinical significance

To determine hepatitis B virus genotype and subtype distribution among HBV infected individuals with different clinical manifestations in western India, serum samples from 19 asymptomatic hepatitis B surface antigen carriers, 30 chronic hepatitis B patients, 8 acute hepatitis B patients, 5 fulminant hepatitis B patients, and with circulating HBV DNA were genotyped and subtyped on the basis of the nucleotide sequence analysis of S region of the HBV genome. Genotype D was the predominant genotype circulating in western India (57/62; 91.93%). All 19 asymptomatic hepatitis B surface antigen carriers, 8 acute hepatitis B patients, 5 fulminant hepatic failure patients and 25/30 chronic hepatitis B patients were circulating genotype D and ayw3/ayw2 subtypes. HBV genotype A was prevalent in 8% (5/62) of the total number of patients and all belonged to chronic hepatitis B category. Subtyping analysis showed that all genotype A isolates were of subtype adw2. As most of the patients from different clinical categories were infected with HBV genotype D, it is concluded that this genotype did not influence the outcome of HBV infection.