Lymphatic filariasis in man: demonstration of circulating antigens in Wuchereria bancrofti infection

Summary Five hundred and twenty-nine sera obtained from people dwelling in an area endemic for bancroftian filariasis were analysed for the presence of soluble circulating antigens (SCA) of filarial origin by counter Immunoelectrophoresis and 303 were found positive. It, therefore, appears that 57.3% subjects could be diagnosed by the detection of SCA irrespective of their clinical status. Of the three groups investigated, microfilaraemic, amicrofilaraemic and clinical, SCA could be demonstrated in maximum number of sera obtained from clinical cases. The parasite specificity of the SCA was determined by enzyme linked immunosorbent assay (ELISA), immunofluorescent antibody test (IFAT), counter Immunoelectrophoresis (CIEP) and gel diffusion (GD) using antisera raised against Litomo-soides carinii in rabbits and antigens derived from Wuchereria bancrofti microfilariae or antigens present in sera of patients with bancroftian filariasis. This anti-carinii hyperimmune serum under study did not show positive reactions with parasites other than filaria, or with the sera obtained from pre-immunized rabbits and non-endemic controls. A demonstration of a distinct precipitin band in CIEP and GD indicates that either monospecific hyperimmune sera or monoclonal antibodies could be raised for the development of a simple method for immunodiagnosis of bancroftian filariasis.     

高原地区与平原地区孕产妇产前保健及妊娠结局对比分析

目的 调查高原地区及平原地区孕产妇孕期保健及妊娠结局情况的特点,比较高原地区及平原地区孕产妇孕期保健及妊娠结局的差异,为提高产科医疗服务质量提供参考.方法 随机选取西藏山南地区妇幼保健院(高原组)310例产妇及湖北省鄂东医疗集团黄石市妇幼保健院(平原组)302例产妇,对两组孕产妇的围产保健手册及住院病历资料进行登记,进行回顾性对比分析.结果 5次以下产前检查率高原组高于平原组(χ2=192.284,P<0.05);初次产检孕周高原组晚于平原组(χ2=519.388,P<0.05);妊娠并发症发生率及剖宫产发生率高原组均低于平原组(χ2值分别为13.477、99.652,均P<0.05).高原组剖宫产手术指征主要为妊娠期高血压疾病、横位(或臀位)、过期妊娠;平原组主要为胎儿窘迫、巨大胎儿、羊水过少.高原组足月新生儿平均出生体重低于平原组(t=8.672,P<0.05),高原组新生儿窒息发生率高于平原组(χ2=4.414,P<0.05),早产发生率低于平原组(χ2=5.724,P<0.05),巨大胎儿发生率低于平原组(χ2=4.995,P<0.05),足月小于胎龄儿发生率高于平原组(χ2=6.153,P<0.05),差异均有统计学意义.结论 高原地区孕产妇产前保健意识薄弱,产检率低、初次产检时间较晚;高原地区孕产妇的妊娠并发症率及剖宫产发生率显著低于平原地区的孕产妇;高原地区新生儿窒息发生率高于平原地区,新生儿出生体重、早产发生率、巨大胎儿发生率均低于平原地区,足月小于胎龄儿发生率高于平原地区.     

A case of poppy tea dependence in an octogenarian lady

While poppy seed and poppy tea dependence has been described, it is unusual to see such patients actively seek treatment in India. We report the case of an 82‐year‐old client with dependent use of poppy for 55 years. She was brought for treatment as access to poppy became difficult following legal restrictions. She was successfully maintained on buprenorphine maintainence.[Subodh BN, Murthy P, Chand PK, Arun K, Bala SN, Benegal V, Madhusudhan S. A case of poppy tea dependence in an octogenarian lady. Drug Alcohol Rev 2009]     

The predictive value of early neurological examination in neonatal hypoxic–ischaemic encephalopathy and neurodevelopmental outcome at 24 months

Aim The clinical and electrographic signs of hypoxic–ischaemic encephalopathy (HIE) evolve over the first days of life. We examined the evolution of neurological signs over the first 3 days of life, and determined whether serial administration of the Amiel‐Tison Neurological Assessment at Term (ATNAT) would predict neurodevelopmental outcome at 24 months. Method Term (>37wks’ gestation) neonates born with suspected HIE between May 2003 and May 2005 in a Cork maternity unit were recruited prospectively. Modified Sarnat grading was assigned. The ATNAT was administered on days 1, 2, and 3 of life and a discharge neurological examination. Time to oral feeding and demographic variables were recorded. Developmental status was assessed using the revised Griffiths Mental Development Scales at 6, 12, and 24 months. Results Fifty‐seven infants were recruited, with 51 (31 males, 20 females) included for follow‐up. Neurological examination evolved and normalized over the first 3 days of life in many cases. At 24 months, 21 children had an adverse outcome, including six deaths. Examination at all time points correlated significantly with neurological outcome at 24 months. The best correlations were found to be (1) neurological examination at discharge (r=0.65, p<0.001), (2) Sarnat grading (r=0.64, p<0.001), and (3) ATNAT on day 3 (r=0.46, p<0.001). The best predictive value was seen with neurological examination at discharge (positive and negative predictive values of 86% and 72% respectively). Interpretation Persistence of abnormal neurological signs correlates significantly with adverse outcome. The later a neonatal neurological examination was performed, the better its predictive ability.     

New Endpoint for Ablation of Ventricular Tachycardia: Change in QRS Morphology with Pacing at Protected Isthmus as Index of Isthmus Block

New Endpoint for Ablation of Ventricular Tachycardia. Introduction: Endpoints confirming block in the critical isthmus in sinus rhythm and with pace mapping have not been established. Methods and Results: A 44‐year‐old man with a history of Tetralogy of Fallot presented with recurrent ventricular tachycardia (VT). Entrainment mapping was consistent with a macroreentrant circuit rotating in a clockwise fashion under the pulmonic valve. After termination of the VT in a critical isthmus located on the conal free wall, a pace map proximal to the site of successful ablation was consistent with a change in QRS morphology. This change in QRS morphology suggested critical isthmus block and successful ablation, which was confirmed by noninducibility with programmed stimulation. Conclusion: Evidence of conduction block can be used as an additional endpoint for successful ablation of VT. (J Cardiovasc Electrophysiol, Vol. 21, pp. 320–324, March 2010)