Distribution of Plasmodium falciparum genotypes in clinically mild and severe malaria cases in Orissa, India.

A cross-sectional study was conducted in a malaria hyperendemic state of India to ascertain the distribution of Plasmodium falciparum genotypes in patients with mild (n=40) and severe (n=35) malaria. PCR and nested PCR were used to determine the glutamate-rich protein (GLURP), merozoite surface proteins 1 and 2 (MSP1 and MSP2) and knob-associated histidine-rich protein (KAHRP) for characterization of the parasite. The results indicate that (i) the 200bp allele of the MAD20 family of MSP1 and the 550bp allele of the 3D7 family of MSP2 show over-representation in severe malaria cases; (ii) the multiplicity of infection with respect to MSP2 alleles is significantly higher (P<0.001) in severe cases than in mild cases; and (iii) comparison with the findings of other studies leads to the conclusion that the distribution of P. falciparum genotypes between different clinical groups differs geographically.

The prevalence of eye disease in Leicester: a comparison of adults of Asian and European descent.

Random samples of people aged 40 years and over were drawn from lists of patients registered with two neighbouring inner-city general practices: one predominantly with Asian patients and the other predominantly with European patients. The people selected were invited to attend specially arranged eye clinics for examination by an ophthalmologist and an optician. We examined 377 people and found that, compared to people of European descent, Asians had a significantly higher prevalence of age-related cataract: 30% compared to 3% in people aged under 60 years and 78% compared to 54% in those aged 60 years and over. The age of onset of cataract seems to be earlier in Asians. After adjustment for age, there were no statistically significant ethnic differences in the prevalences of open-angle glaucoma, macular degeneration or diabetic retinopathy.

Coronary artery disease in women. How it is--and isn't--unique.

Various risk factors, such as smoking and diabetes, have an adverse effect on women's inherent biological protection from coronary artery disease (CAD). In women, CAD is most likely to present as angina. Although infarction as the initial event is less common in women than in men, it is more likely to be fatal. The prognosis for women with diabetes and CAD is especially poor. Differences in the therapeutic approach to CAD in men and women do not appear justified. Preventive strategies for women center around cessation of smoking, aspirin therapy, diet modification, and estrogen therapy.

On structural aspects of peptidoglycan of bacterial cell wall with special attention on mycobacteria by computer modelling.

The cell wall components of mycobacteria are said to be vitally linked with their pathogenicity. Peptidoglycan, one of the major cell wall component in most of the bacteria are multilayered in gram positive bacteria and it is diverse in nature for the Gram positive strain rather than gram negative. The cell wall of bacteria are primary targets for many drugs and antibiotics and conformation of the major cell wall components provide invaluable information and understanding at molecular level to medicinal chemists and drug designers. Mycobacterial peptidoglycan has been studied critically by computer modelling on various aspects. A plausible structure and conformation has been identified and glycan chain is found to have a pseudo two fold symmetry taking disaccharide unit as monomer with Knox & Murthy H-bond scheme. This paper attempts to clarify the understanding of organisation and possible interaction mode of peptidoglycan of organisation in complex mycobacterial cell wall structure.

Surgical reconstruction for absence of sternum and pericardium in a newborn.

We report the surgical management of a 3 day old baby with absent sternum and pericardium with impending rupture of the skin cover. The repair described is innovative and may be used in place of primary repair by bringing the ribs together. Review of embryology and various modalities of closure are provided.

Paediatric aspects of family planning.

PIP: This is a review of some of the literature dealing with the relationship between parity and several indices of child health and child survival in India. The indices covered are: stillbirth, neonatal mortality, maternal health, prematurity and birth weight, physical growth of children, intelligence and mental deficiency, effect on child care, and influence on diseases. Stillbirth rates are highest for 1st pregnancy and rise again after the 3rd or 4th birth with marked increases following the 5th birth. Multiparous women have been found to have higher incidences of premature birth and other complications of pregnancy. Children from higher parity families develop slower both mentally and physically. Malnutrition diseases occur more often in larger families. Other factors having an important, though lesser, effect on child survival rates are maternal age at birth, race, and socioeconomic status of the family.^ieng

Ligation of internal iliac arteries in pelvic haemorrhage.

OBJECTIVE: To study the value of bilateral ligation of internal iliac arteries in the management of intractable postpartum haemorrhage and to curtail blood transfusion during operations for gynaecological cancers. METHODS: Internal iliac arteries were ligated in 15 cases of PPH, 4 cases of secondary haemorrhage after hysterectomy and in 27 cases of gynaecological cancers during surgery, over a period of 5 years in a general hospital at Calcutta. RESULTS: The method controlled PPH in all cases except one who required hysterectomy. Secondary haemorrhage was arrested in all. No blood transfusion was necessary during operations for gynaecological cancers except one. CONCLUSION: The method was effective in 75% of atonic PPH and in majority of PPH due to other causes including caesarean section. It almost entirely avoid blood transfusion during operation for gynaecological cancers. The procedure was simple and did not involve any hazard.

Cytomegalovirus retinitis.

Cytomegalovirus retinitis is the most common ocular opportunistic infection in patients infected with human immunodeficiency virus and remains a significant cause of visual loss in patients with the acquired immunodeficiency syndrome. Drugs are now available to treat this condition and recent advances in delivery techniques offer promising alternatives to traditional methods.

The prevalence of age related cataract in the Asian community in Leicester: a community based study.

A community based ophthalmic survey has been carried out in the city of Leicester. Samples of Asians and Caucasians aged 40 years and over were randomly selected from the patients of four general practitioners and invited to have an ophthalmic examination. After adjustment for age, the prevalence rate of age-related cataract was significantly higher in the Asians when compared to the Caucasians. Age-related cataract was found to develop earlier in the Asians. A strict vegetarian diet was found to be a significant risk factor for age-related cataract in the Asian Community in Leicester.

Variation of serum potassium and creatinine phosphokinase levels in suxamethonium-induced muscle relaxation.

Popular depolarising muscle relaxant, suxamethonium (succinylcholine chloride), produces fasciculation in group of muscles and 'after pain'. Mode of its action is neuromuscular blockage. It also may be associated with muscle fibre injury and altered membrane permeability. These may cause rise of serum K+ and creatinine phosphokinase (CPK) levels. But use of diazepam either during or as pretreatment may reduce the fasciculation, 'after pain' and rise of K+ and CPK levels. Present study was undertaken to show whether any correlation of the degree of fasciculation and postsuxamethonium myalgia is present or not and whether diazepam has any role in reducing muscle injury and in turn reducing the levels of serum K+ and CPK.

Tear glucose estimation--an alternative to blood glucose estimation.

Dextrostix, being very sensitive to measure glucose level by glucose oxidase method, was chosen to measure tear glucose level to evaluate the relationship of tear glucose to blood glucose level in 94 cases. It was found that in our population the measurement of tear glucose has definite value in interpretation of glucose status of individual. So, it was suggested to use this simple method of detection of tear glucose to interpret hyperglycaemic state of the patients. The present study was undertaken (1) to sort out a definite relationship between tear and plasma glucose concentration and (2) to devise a rapid method for detection of tear glucose level semiquantitatively with glucose oxidase impregnated strips and to evaluate its role as indicator of plasma glucose level.

Individual renal clearances determined at renal vein catheterization.

Renal para-aminohippurate (PAH) clearances were predicted in 16 kidneys of eight hypertensive patients with renal artery stenosis, pyelonephritis, or obstructive nephropathy, without individual ureteral catheterization. Predictions of left or right kidney clearance (CL or CR) were based on roentgenographic renal frontal areas (A), on total PAH clearances (CT), and on individual PAH extractions (E) measured at renal vein catheterization according to the formula (formula: see text). When these patients underwent ureteral catheterization for diagnostic reasons, individual PAH clearances were measured and ranged from 22 to 286 cm3/min. After correction for differences in total PAH clearance on the two occasions, predicted and individually measured values corresponded closely along a line of identity. The 95% confidence limit (+/- 2 SEM) for predictions of individual PAH clearance was approximately +/- 38 cm3/min and for percet of total PAH clearance distributed to left or right kidney, +/- 6%. Individual renal PAH clearances can therefore be predicted at renal vein catheterization with acceptable error. Thus, the substantially invasive procedure of ureteral catheterization is not required to ascertain left and right kidney PAH clearance in patients already at risk from renal disease.

Use of a rule based graph-theoretical system in evaluating the activity of a class of nucleoside analogues against human immunodeficiency virus.

A rule based graph-theoretical system has been used to evaluate qualitatively the activity of a class of nucleoside analogues against human immunodeficiency virus (HIV). The system identifies biologically relevant vertices (atoms) in the molecular graphs of the compounds which have the biological activity of interest. The idea is to relate biological activity with the structural or substructural characteristics of the compounds from the point of view of molecular topology (connectivity). The system brings vertices of similar or close topological environment in the respective compounds together and this is reflected in the ranges of values formed by a distance based index of the vertices, the 'distance exponent index (Dx)', where x is any real number. It is found that the system makes correct prediction of the activity of all the compounds (active as well as inactives) of both training set and the test set against HIV. It is also apparent from this study that the index D-4, which has been used here, can make a useful classification of the vertices according to their molecular environment and the system can produce significant result in a small as well as diverse data base.

The PfCRT (K76T) point mutation favours clone multiplicity and disease severity in Plasmodium falciparum infection.

In Orissa, a malaria-hyperendemic area of India, we assessed the relationship between the PfCRT (K76T) point mutation of Plasmodium falciparum and the clinical severity of malaria. Forty uncomplicated and 36 severe malaria cases were selected, and parasite species, density and schizontaemia determined by examination of Giemsa-stained thick or thin blood films. The PfCRT point mutation was analysed by PCR-RFLP and genotypes of the parasite isolates investigated by nested PCR using the polymorphic region of the merozoite surface protein-2. We found that (i) the prevalence of the PfCRT point mutation was significantly higher (P < 0.01) in severe malaria cases and that (ii) heavy parasitaemia along with clone multiplicity was statistically more common (P < 0.01) in severe cases. These associations may be due to progression of uncomplicated to severe disease after chloroquine treatment failure and/or increased virulence of chloroquine-resistant parasites. The implications for antimalarial treatment policy are discussed.