Comparison of ondansetron, dexamethasone, ondansetron plus dexamethasone and placebo in the prevention of nausea and vomiting after laparoscopic tubal ligation

Laparoscopic tubal ligation is associated with an appreciably high rate of postoperative nausea and vomiting. This study was designed to compare the effectiveness of ondansetron, dexamethasone, ondansetron plus dexamethasone or placebo in the prevention of postoperative nausea and vomiting in patients after laparoscopic tubal ligation. In a prospective, randomised, double blind placebo controlled trial, 160 ASA I-II females received one of four regimens; ondansetron 4 mg, dexamethasone 8 mg, ondansetron 4 mg plus dexamethasone 8 mg or placebo (n=40 each) intravenously immediately before induction of anaesthesia. Patients were then observed for 24 hours postoperatively. The incidence of emetic episodes in the ondansetron with dexamethasone group was lower than in the placebo (p<0.001) and ondansetron (p=0.091) and dexamethasone (p=0.143) groups. A complete response (as no postoperative nausea and vomiting) was achieved in 60% of patients given ondansetron, 63% of the patients given dexamethasone, 78% of patients given ondansetron with dexamethasone and 37% of patients received placebo. The prophylactic use of ondansetron with dexamethasone is more effective in preventing postoperative nausea and vomiting.

Record of a fatal oomycotic disease of the fresh water fish Anabas cobojius in India caused by Aplanes braunii

The fresh water fish Anabas cobojius (Hamilton-Buchanan 1822), was found to be parasitised by Aplanes braunii de Bary 1888. It is the first and only report of any Aplanes de Bary to cause disease on any fish. A. braunii was found to be a virulent parasite of A. cobojius causing cotton-wool disease involving the skin and fins. The hyphae also penetrated into the tissues of the infected fish and all of them ultimately died.

Aplanes braunii (Phylum Oomycota) causes mortality in Anabas cobojius

The fresh water fish Anabas cobojius (Hamilton-Buchanan 1822), was found to be parasitised by Aplanes braunii de Bary 1888. It is the first report of Aplanes braunii to cause disease on any fish. A. braunii is a virulent parasite that caused cotton-wool disease involving the skin, fins and muscles of A. cobojius. The hyphae also penetrated deep into the tissues of the infected fish and all of them ultimately died.

Predictors of gastrointestinal bleeding in acute intracerebral haemorrhage

BACKGROUND

Gastrointestinal (GI) haemorrhage is an important and sometimes serious complication in critically ill neurological patients who suffered from stroke and head injury and those in intensive care. There is no study evaluating frequency, severity and risk factors of GI haemorrhage in patients with primary intracerebral haemorrhage (ICH).

AIMS

To evaluate the frequency, severity and predictors of GI haemorrhage in patients with ICH.

METHODS

In a prospective hospital-based study, consecutive CT-proven ICH patients within 10 days of the ictus were included. The patients with history of peptic ulcer, GI haemorrhage, liver and kidney disease, bleeding diathesis and those on antiplatelet, anticoagulant or nonsteroidal antiinflammatory drugs (NSAIDS) were excluded. A detailed neurological evaluation was carried out. Glasgow coma scale (GCS) was used for assessment of consciousness level and Canadian neurological scale (CNS) for severity of stroke. The haematomas were classified into small (<20 ml), medium (20-40 ml) and large (>40 ml). The occurrence of GI haemorrhage during 14 days of ictus was considered due to ICH. To evaluate the predictors of GI haemorrhage, various clinical and CT scan findings were evaluated by univariate followed by multivariate logistic regression analysis.

RESULTS

Fifty-one patients with ICH were included whose age ranged between 30 and 80 years and 14 were female. The mean GCS score was 8.9 (3-15) and CNS score was 2.2 (2-4). Haematoma was small (<20 ml) in 11 patients and medium (20-40 ml) and large (>40 ml) in 20 patients each. Evidences of septicemia were present in 20 patients. Gastric haemorrhage (GH) was noted in 15 patients which was more than 40 ml in 4 patients and one of these patients needed blood transfusion. On univariate analysis, the size of haematoma, septicemia, motor signs on the nonhemiplegic side and pupillary asymmetry were significantly related to GI haemorrhage. On multivariate analysis, the best set of predictors of gastric haemorrhage included size of haematoma, septicemia and GCS score.

CONCLUSION

GI haemorrhage is more likely present in patients with larger haematoma having septicemia. Our study highlights the importance of septicemia, which is an important and modifiable risk factor for GI bleeding in ICH patients.

Efficacy of GM-CSF as an adjuvant to hepatitis B vaccination in patients with chronic renal failure--results of a prospective, randomized trial

BACKGROUND

Chronic renal failure patients on hemodialysis are at an increased risk of acquiring hepatitis B infection. Hence vaccination against hepatitis B assumes great importance in these patients. However, the response to hepatitis B vaccination is poor, even when 4 double doses (40 microg) of the vaccine are given. This study was conducted to determine the efficacy of GM-CSF as an adjuvant to hepatitis B vaccine in CRF patients.

METHODS

CRF patients including both hemodialysis (HD) and non-dialysis (ND) patients were randomized to receive either placebo or a single injection of GM-CSF (in varying doses of 50 microg, 100 microg, 150 microg) a day prior to the 1st dose of recombinant hepatitis B vaccine (40 microg). Three more doses of the vaccine were given at 1, 2, and 6 months. The anti-HBs antibody titres were measured by ELISA at 3 and 7 months. Patients having antibody titres less than 10 IU/L were considered non-responders. The response rate and mean antibody titers were compared between the control (I) and GM-CSF (II) groups.

RESULTS

In group I, 31 and 27 patients were available for evaluation at 3 and 7 months respectively. In group II, 33 and 28 patients could be evaluated at the same time points. Within the control group (group I), the response rate in hemodialysis patients (63.6%) was lower as compared to non-dialysis patients (81.2%). The response rate in group II was higher than that in group I at both 3 months as well as 7 months (78.1% vs. 62.3% and 89.3% vs. 74.1%, p = ns). The best response rates in group II were observed when GM-CSF was used in a dose of 150 microg (90.9% at 3 months and 100% at 7 months). The mean antibody titers were also found to be higher in the group II as compared to group I (409.6 vs. 243.9 IU/L, p = 0.01).

CONCLUSION

The results of this randomized, prospective study suggest that: 1. Patients with chronic renal failure should be vaccinated for hepatitis B as chronic renal insufficiency is established. 2. GM-CSF is an effective adjuvant to hepatitis B vaccine in these patients especially when a priming dose of 150 microg is used prior to 1st dose of hepatitis B vaccination.

Disseminated tuberculosis presenting as hemobilia, successfully treated by arterial embolization

Tuberculosis, specially disseminated tuberculosis, involves the liver frequently. Focal hepatic tuberculosis with local hemorrhage has been reported. We report on a twenty-one year female with disseminated tuberculosis presenting with initially non-localisable massive upper gastrointestinal bleeding, subsequently found to have pancreatitis, right sided pleural effusion and hemobilia which was treated successfully.

Humoral immune response to an allogenic foetus in normal fertile women and recurrent aborters

BACKGROUND: Several humoral immune factors are responsible for a successful pregnancy. There are a few studies, which demonstrate the role of antipaternal cytotoxic antibodies (APCA) and mixed lymphocyte reaction blocking factor (MLR-Bf) in the maintenance of pregnancy. However, these factors have not been studied in women with history of recurrent spontaneous abortion (RSA). We designed this study to review the role of APCA and MLR-Bf in normal pregnancy as well as in women with a history of RSA. METHODS: One hundred and five women with unexplained recurrent spontaneous abortion were included in the present study. These women were screened for all other known causes of recurrent abortion. We also included 60 normal fertile women, fifteen from each trimester and fifteen women during the post partum period (up to six months). RSA and controls (normal pregnancy) were matched for age, caste, and socio economic background and also for parity. APCA and MLR-Bf were evaluated in all the groups. All women with RSA who conceived during the study period were on follow up. RESULTS: We have analyzed the status of APCA and MLR-Bf in normal pregnancy (different gestational periods and during post partum), and in women with history of RSA. Our results show that APCA was significantly higher in controls as compared to RSA women. MLR-Bf was directed against the husbands' cells in normal pregnancy and was virtually absent in RSA women. CONCLUSION: Our results indicate that there is a significantly low titer of APCA and MLR-Bf in women with recurrent spontaneous abortion. This highlights the role of these factors in the maintenance of successful pregnancy.

Management of the Budd-Chiari syndrome by balloon cavoplasty

BACKGROUND

Obstruction of the suprahepatic inferior vena cava (IVC) by a membrane or stricture is the commonest cause of Budd-Chiari syndrome in the eastern hemisphere. We present our experience with the outcome of balloon cavoplasty in such cases.

METHODS

We followed up 40 consecutive cases of Budd-Chiari syndrome over seven years. Doppler study of hepatic venous outflow tract (in all cases), liver biopsy (30 cases) and necropsy (two cases) were performed. Balloon cavoplasty was done in selected cases.

RESULTS

Of 40 patients with BCS (mean age 35.2 [SD 8.7] years; 26 men) 5, 5 and 30 had fulminant, acute and chronic presentation, respectively. Inferior vena cavography was performed in 32 cases, and showed membranous obstruction of the IVC in 12, segmental occlusion of the IVC in 11 cases, and block in both the IVC and the main hepatic veins in the rest. Successful balloon cavoplasty was done in 18 cases with obstruction of the IVC (membrane or stricture); 15 of them are well over a mean follow up of 56 (14.6) months. Three patients developed restenosis; two of them, treated with redilatation, are doing well, and one died of septicemia and hepatic failure following a surgical bypass. Pressure gradient between the IVC and right atrium decreased significantly after cavoplasty (15.4 [2.8] vs 6.6 [2.0] mmHg; p< 0.001).

CONCLUSION

Balloon cavoplasty gave encouraging results in the management of Budd-Chiari syndrome due to membranous obstruction or stricture of the IVC.

The effect of ship scrapping industry and its associated wastes on the biomass production and biodiversity of biota in in situ condition at Alang

The main pollutants for the ship scrapping industry and its associated wastes at Alang are heavy metals, petroleum hydrocarbon and bacterial contaminations. The concentration of iron, manganese, cobalt, copper, zinc, lead, cadmium, nickel and mercury were 25 to 15,500% more at nearshore station of Alang as compared to control site at Piram. The concentration of heavy metals in the nearshore station of Alang was always higher than its concentration at 10 km away. The concentration of petroleum hydrocarbon was 16,973 and 53,900% more at the nearshore and 10 km away respectively at Alang as compared to controls. The concentration of chlorophyll-a and phaeophytin were in non-detectable range (< 0.2 and < 0.1 mg m3) or much lower concentration at both the stations of Alang as compared to controls. The total viable count, total coliform, Escherichia coli, Vibrio cholerae, Vibrio parahaemolyticus and other Vibrio, Streptococcus faecalis, Shigella, Salmonella, Proteus, and Klebsiella were always higher (17%-605%) at the nearshore station of Alang as compared to control. Similar trend was observed at 10 km away from Alang. Bacteria in sediment also showed the same pattern of variation. Phytoplankton counts at the nearshore station and 10 km away from Alang were only slightly raised. In contrast to phytoplankton, the zooplankton showed considerable reduction of growth (-10 to -66%) at Alang.

Involvement of male genitalia in leprosy

Four hundred and sixty-seven male patients with leprosy were screened for genital involvement. Genital lesions were observed in 6.6% of all male cases of leprosy. They were seen most frequently in lepromatous leprosy (25.8%), followed by borderline lepromatous (13.3%) and borderline tuberculoid (1.4%) leprosy.

Identification of thyroid regulatory elements in the Na-K-ATPase alpha3 gene promoter

A -1027 bp to + 108 bp region of Na-K-ATPase alpha3 gene promoter has been searched for the presence of thyroid response elements (TRE). Computer analysis of this sequence using a consensus TRE sequence revealed the presence of four putative TRE rich regions referred to as regions I (-636 to -457 bp), II (-218 to -106 bp), III (-106 to -6 bp) and IV (-6 to +108 bp). Cotransfection of the luciferase linked full length construct as well as constructs progressively devoid of the TRE rich regions in Cos1 cells revealed that regions I and III are positively regulated by T3 whereas there are some sequences in region II which can suppress the positive regulatory effect of region III but not of region I. TRE IV seems to have no functional role. EMSA of the three functional TRE rich regions (I, II and III) showed strong and specific interaction with thyroid hormone receptor (TR) cloned and expressed in baculovirus. The overall results suggest the regulation of Na-K-ATPase alpha3 gene by T3 is complex involving several thyroidal regulatory elements.

Reduced expression and altered distribution of neurofilaments in neurons cultured in thyroid hormone-deficient medium

The effect of thyroid hormone (TH) deficiency on the expression of neurofilament (NF) proteins and their intracellular distribution has been examined in primary cultures of neurons from embryonic rat cerebra. Northern blot analysis showed that in TH-deficient (THdef) neurons, the expression of all three NF mRNAs (NF-L, NF-M and NF-H) are retarded by 50-70% at days 7, 15 and 25 of culture compared with their TH-supplemented (THsup) counterparts. Western blot analysis also showed a decline of 60-80% in the expression of all the NF-proteins at all time points. Immunofluorescent staining of neurons from THdef and THsup cultures at days 7, 15, and 25 with monoclonal anti NF-L antibody showed that with age, TH deficiency reduced the localization of NF-L in the cell body with a corresponding increase in the hillock and proximal axon region. The present neuronal culture system offers an excellent experimental model for studying the biochemical events responsible for the altered NF pathology in degenerating neurons.

A new powerful antibacterial synergistic combination of trimethoprim and trimeprazine

The antihistaminic phenothiazine trimeprazine (Tz) was found to exhibit significant antibacterial activity on the basis of in vitro and in vivo tests. For the study of synergism due to a combination between Tz and trimethoprim (Tm), drug soaked filter paper discs were placed on young culture lawns of sensitive bacteria on nutrient agar plates. Calculation of the area of inhibition zones for determining the degree of synergism between Tz and Tm showed the increase to be statistically significant (p<0.01) when compared with their individual effects. By the checkerboard assessment procedure, the fractional inhibitory concentration (FIC) index was found to be 0.18, confirming synergism. The protective capacity of this combination was then assessed in Swiss white mice using S. typhimurium as the challenge bacterium, and the level of bacterial load was determined from infected autopsied animals. Statistical analysis of the data by students 't' test finally proved that a combination of Tz+Tm was highly synergistic.

Role of clinical, radiological, and neurophysiological changes in predicting the outcome of tuberculous meningitis: a multivariable analysis

OBJECTIVES

The role of EEG and evoked potentials has not been evaluated in predicting the prognosis of tuberculous (TB) meningitis. The present study was aimed at evaluating the prognostic significance of clinical, radiological, and neurophysiological variables using multi-variable analysis.

METHODS

Patients with TB meningitis diagnosed on the basis of clinical, radiological, and CSF criteria have been prospectively evaluated. All the patients were subjected to a detailed neurological evaluation. The outcome was defined 6 months after starting treatment on the basis of the Barthel index (BI) score into poor (BI <12) and good recovery (BI> or =12). Death was included in the poor recovery group for statistical analysis. Thirteen clinical (age, sex, seizure, focal weakness, stage of meningitis, Glasgow coma scale score, methyl prednisolone therapy), CT (infarction, hydrocephalus, tuberculoma) and neurophysiological (EEG, motor and somatosensory evoked potentials) variables were evaluated employing single variable logistic regression followed by multivariable logistic regression analysis. The best set of predictors were obtained by stepdown logistic regression analysis.

RESULTS

Fifty four patients were included in the present study. Their age ranged between 5 and 62 years, 11 were children younger than 12 years and 14 were female. Nine patients were in stage I meningitis, 12 in stage II, and 33 in stage III. On single variable logistic regression analysis the significant predictors of 6 months outcome of TB meningitis included focal weakness, Glasgow coma scale (GCS), motor evoked potential (MEP) and somatosensory evoked potential (SEP). On multivariable analysis the best set of predictors comprised focal weakness, GCS, and SEP.

CONCLUSIONS

In patients with TB meningitis focal weakness, GCS, and SEP are the best predictors of 6 month outcome.

Lipoprotein(a) and coronary heart disease in Indian population

OBJECTIVE

Present study was undertaken to evaluate the role of lipoprotein(a) in coronary heart disease (CHD) patients and its relationship with other established risk factors.

METHODS

Blood samples of 67 control patients (non-cardiovascular problems) and 222 CHD patients (> or = 4 weeks post myocardial infarction) were analyzed. Lipoprotein(a) was measured in serum samples by enzyme-linked immunosorbent assay utilizing rabbit polyclonal antibodies against purified human Lp(a). Step-wise linear discriminant analysis was used to find the important parameters to discriminate CHD and non-CHD subjects.

RESULTS

The LDL to HDL cholesterol ratio (p < 0.01) and serum level of lipoprotein(a) (p < 0.01) were significantly higher in CHD patients. Levels of lipoprotein(a) were found to be higher in females compared to males (p < 0.01). Positive family history of CHD did not show significant difference in Lp(a) levels. Lp(a) level in CHD patients with positive family history of NIDDM and hypertension was higher than in with negative family history.

CONCLUSION

Clinical significance of serum level of Lp(a) and albumin in determining the risk of CHD has been observed. Lp(a) alone could correctly discriminate a CHD individual from a control subjects by 95%. Estimating of Lp(a) together with albumin provided 99% correct discrimination between control and CHD patients. These results also suggest that Lp(a) together with malnutrition could be responsible for the increased incidence of CHD in Indians. It is also indicated that in females atherothrombogenic potential of lipoprotein(a) remains suppressed before menopause but after this stage women lose this advantage.

Prognostic predictors of acute transverse myelitis

INTRODUCTION

The role of clinical, MRI and neurophysiological parameters in predicting the outcome of acute transverse myelitis (ATM) is reported.

MATERIALS AND METHODS

Thirty-one patients with ATM were subjected to clinical, MRI, somatosensory and motor evoked potential studies in both upper and lower limbs and concentric needle electromyography. The outcome was defined at the end of 6 months into poor (Barthel Index score <12) and good (> or =12). The relationship of various prognostic variables was evaluated by biserial correlation coefficient and stepwise discriminant analysis.

RESULTS

The mean age of the patients was 30.4 years and 7 were females. Fifteen patients had good and 16 had poor outcome. The variables significantly related to the outcome included severity of weakness, denervation on EMG and unrecordable central motor conduction time to tibialis anterior (CMCT-TA) and tibial somatosensory evoked potentials (SEPs). Combination of severity of weakness and EMG had 90.3% predicting power. Addition of central sensory conduction time (CSCT) or central motor conduction time (CMCT) did not offer further advantage.

CONCLUSION

Severity of weakness and denervation on EMG are most useful for predicting the outcome of ATM at 6 months although in early stage motor and somatosensory evoked potentials may be used instead of EMG.

Assessment of normal weight in males of the age group of 40-60 years with respect to height: a new formula

In the present work, 3000 male human subjects were studied for their health status and endeavour was made to establish the relation between the height and weight. Male individuals between the age group of 40 to 60 years were studied; their heights were between 140-180 cm. They were grouped as Group I-weight above (Height in cm-100 cm) x kg/ cm, Group II-weight between Group I and Group III subjects and Group III-weight below Group I subjects at least by 15%. It was found that Group II subjects were less sufferer from disease like, diabetics, coronary heart diseases, hypertension etc. than Group I subjects, Group III subjects were also similarly less affected by diseases but they are more prone to tiredness to accustomed work than Group II subjects. So it is concluded that the weight of Group II subjects should be considered standard.

Transient renal impairment in acute intracerebral haemorrhage

Transient impairment of renal function was found in 30 of 78 patients with acute intracerebral haemorrhage (ICH). Patients with a history of renal disease, dehydration, nephrotoxic drugs or septicaemia were excluded. In the 1st week, the mean serum creatinine level was 3.4 (range 1.7-7.7) mg/dl, which returned to normal in 2-4 weeks. Employing multivariate stepdown logistic regression analysis, Glasgow Coma Scale score and pulse pressure were found to be significantly related to renal impairment manifesting with a raised serum creatinine level, whereas pupillary asymmetry was of borderline significance. An acute rise in intracranial pressure following ICH may result in sympathetic overactivity, which may account for the renal impairment observed in our patients.

Prognosis of tuberculous meningitis: a multivariate analysis

Twenty-six clinical, laboratory and CT scan features in 49 patients with tuberculous meningitis (TBM) were analysed to identify the parameters of prognostic significance. Employing univariate analysis, seven variables were found to correlate with three month outcome; these variables included the stage of TBM on admission, focal weakness, Glasgow coma scale (GCS), incontinence, infarction, hydrocephalus and shunt surgery. Analysing all 26 variables, a conditional logistic regression model was derived. In this model stage of TBM, age, focal weakness, cranial nerve palsy and hydrocephalus were found to be contributing to the three month outcome of TBM patients as assessed by the Barthel index.

A study of prognostic predictors of supratentorial haematomas

The prognosis of supratentorial haematomas is based on clinical signs and radiological features. The role of evoked potentials has not been evaluated systematically. In a prospective study of supratentorial haemorrhage a number of clinical (17), radiological (3) and evoked potential (2) parameters were evaluated employing univariate logistic regression analysis in 69 patients and multivariate logistic regression stepdown analysis in 51 patients. The outcome was graded on the basis of the Barthel index (BI) score at 3 months as good (BI > or = 12) or poor (death or BI < 12) recovery. Employing univariate analysis the significant prognostic variables were Glasgow Coma Scale, Canadian Neurological Scale, tendon reflex, associated medical complications, urinary incontinence, ventricular extension of the haematoma and motor evoked potentials. Using multivariate logistic regression analysis the best set of parameters in relation to outcome included Glasgow Coma Scale (P < 0.05), Canadian Neurological Scale (P < 0.05), tendon reflex (P < 0.1), ventricular extent (P < 0.01) and motor evoked potentials (P < 0.05). From this study it is concluded that, in addition to clinical and radiological parameters, motor evoked potentials also have an important role in predicting outcome.

Epidemiology of Vibrio cholerae O139 with special reference to intrafamilial transmission in Calcutta

A total of 27 families of hospitalised patients (index case families) suffering from acute watery diarrhoea caused by Vibrio cholerae O139, and 14 neighbourhood families were bacteriologically screened for 4 consecutive days to determine the extent of V. cholerae O139 infection amongst healthy contacts and other suspected vehicles of transmission at the intrafamilial level. V. cholerae O139 was isolated from faeces of 14.6% of healthy contacts in index case families as compared to none in neighbourhood families (P = 0.002). The organism could be recovered from 3.7% of handwashings of contacts of index cases and also from stored drinking water (8.0%), open well water (28.6%), flies (3.8%) and pond water (25.0%) used by the index case families and none from neighbourhood families. The large number of asymptomatic infected persons indicate an epidemiological similarity to that of eltor cholera. The organisms may be carried on hands and may act as a potential source of infection to other inmates through contamination of stored drinking water, open wells etc. The results will be useful in formulating strategies for intervention of transmission of V. cholerae O139 at the community level.

Primary amino acid sequence and structure of human pyruvate carboxylase

Pyruvate carboxylase (PC) (pyruvate:carbon dioxide ligase (ADP-forming), EC 6.4.1.1.), a nuclear-encoded mitochondrial enzyme, catalyzes the conversion of pyruvate to oxaloacetate. We have isolated and characterized cDNAs spanning the entire coding region of human PC. The sequence of human PC has an open reading frame of 3537 nucleotides which encodes for a polypeptide with a length of 1178 amino acids. The identity of the cDNA as PC is confirmed by comparison to PC cDNAs of other species and sequenced peptide fragments of mammalian PC. The M(r) of the full length precursor protein is 129,576 and that of the mature apoprotein is 127,370. RNA blot analysis from a variety of human tissues demonstrates that the highest level of PC mRNA is found in liver corresponding to this tissue's high level of PC activity. Based on homology with other biotin-containing proteins, the ATP, pyruvate, and biotin-binding sites can be identified. One of two patients with documented PC deficiency was found to be missing PC mRNA, further confirming the identity of this cDNA.

Prevalence of diarrhoeal diseases amongst tribals of Car Nicobar Island, India

In a cross sectional study of total 14514 tribal Nicobarese people of Car Nicobar Island, an union territory of India, situated in Bay of Bengal, morbidity, mortality and treatment practices of diarrhoeal diseases of under-five children were surveyed. The incidence of diarrhoea (0.2 episode/ch.year), Crude death rate (3.6/1000) and IMR (31/1000 live births) were exceedingly low as compared to SouthEast Asian Countries including mainland of India. ORS utilisation rate was high (41%) as compared to the National figure (12.0%). This is the first study of it's kind carried out in this island and amongst the Nicobarese tribe in India. A preliminary study carried out among the mothers of the hospitalised children indicated that protective behaviours like breast feeding, hand washing, use of chlorinated water and proper disposal of stool were regularly being practiced by the community traditionally. An in-depth study on risk factors of diarrhoea in this island can yield useful clue for describing the same.

Circadian periodicity in microfilarial counts

We propose a second-order harmonic model to describe circadian periodicity in the 24-h cycle of microfilarial counts. Rhesus monkeys (Macaca mulatta) were infected with Brugia malayi. Definite evidence of circadian periodicity was found in the microfilarial counts. The estimates of the parameters, periodicity indices and peak hours were determined.

Evaluation of filarial skin test with Brugia malayi larval antigen in the field

To obtain comparable and reproducible results by filaria skin test with B. malayi larval antigen, standard procedure has been evolved. Antigen protein of 2 micrograms per test, injected intracutaneously, was found optimum for positive skin reaction. The reaction ratio based on increase of wheal area by 2 times or more was found to be statistically significant for interpreting positive results. However, in larger field trials, the simpler measurement of increase of wheal diameter by 1 1/2 times or more was found to be equally reliable. Patients treated with diethylcarbamazine citrate, antihistaminics and anti-inflammatory drugs are likely to be unresponsive to filarial antigen and will yield incorrect information.

Vitamin C status of elderly patients on admission into an assessment geriatric ward

A study of the plasma vitamin C concentration in patients in an assessment geriatric ward was carried out for 1 year. The incidence of vitamin C deficiency, as reflected by the plasma vitamin C level was 40.1%. There was almost no difference in its prevalence amongst the sexes or various age groups, but the incidence of vitamin C deficiency was highest in patients admitted from institutions. Furthermore, this study also revealed that patients with certain illnesses were more vulnerable to vitamin C deficiency than other patients and the standard hospital diet alone was not sufficient to improve the vitamin C status of these patients in the short-term.

Binuclear Copper(II) Complexes of Some Tetradentate Pyridyl Phthalazine Ligands. Structure, Electrochemistry and Magnetism - Crystal-Structure of Aqua-µ-[1,4-Di-(4',6'-Dimethylpyridin-2'-Ylamino)-Phthalazine-N1',µ-N2 ,µ-N3,N1'']-µ-Hydroxo-Dinitratodicopper(II) Nitrate

The molecular structure of aqua-μ-[1,4-di(4′,6′-dimethylpyridin-2′- ylamino )phthalazine-N1′,μ-N2,μ-N3,N1′]-μ- hydroxo-dinitratodicopper (II) nitrate has been determined by single-crystal X-ray diffractometry . The compound is triclinic, space group Pī , with two molecules in the unit cell of dimensions a 7.8064(11), b 12.9137(14), c 14.8564(14), α 69.857(8), β 80.074(10), γ 83.659(11). The structure was refined by least-squares to a residual of 0.057 for 2806 reflections. The binuclear centre in the complex involves a five-coordinate and a tetragonally distorted six-coordinate copper atom, each with a coordinated, bidentate nitrate, a copper-copper separation of 3.156 Ǻ and a Cu-O(H)-Cu bridge angle of 113.7°. This complex, and other related systems, exhibit low room-temperature magnetic moments (< 1.2 BM), suggesting antiferromagnetically coupled binuclear copper centres , and in the case of the complex [Cu2( paps )(OH)Cl3].3H2O variable- temperature magnetic data indicate moderately strong exchange with -2J = 432 cm-1. Very high redox potentials are observed for these complexes [0.00-0.83 V (v. s.c.e .)] involving two-electron transfer in one step or two separate steps.

Changes in brain cholesterol and its regional distribution under the influence of prednisolone

Male albino rats were studied for effect of prednisolone on brain cholesterol and water content. Oral administration of prednisolone (5 mg/kg rat/day for 21 days) results in reduction of brain weight and brain cholesterol content but no change in brain water content was seen. The reduction of cholesterol may be the cause of disorders found in neural functions in conditions of glucocorticoid excess.

Effect of low protein diet on manganese neurotoxicity: III. Brain neurotransmitter levels

The effect of concurrent low protein (10% casein) diet and manganese (Mn) exposure (3 mg/ml drinking water) on brain levels of dopamine (DA), norepinephrine (NE) and 5-hydroxytryptamine (5-HT) were investigated in Fo-growing (90 days exposure), Fo-diet rehabilitated (low----normal protein diet-28 days) and F1-weaned rats. Mn exposure in either diet group resulted in a significant increase in the DA and NE levels but a decrease in the 5-HT level. These effects were more pronounced in the rats fed the low protein diet, especially in the F1-offsprings. Diet rehabilitation reduced the effects of Mn exposure.

An outbreak of respiratory syncytial virus infection in a continuing-care geriatric ward

A small outbreak of respiratory syncytial virus infection in a continuing-care geriatric ward during the period December 1982 to March 1983 is reported. It demonstrates that respiratory syncytial virus infection can cause serious lower respiratory tract infection even in patients without any previous history of chest disease.