Study on validity of a rapid diagnostic test kit versus light microscopy for malaria diagnosis in Ahmedabad city, India.

Light microscopy of blood smears for diagnosis of malaria in the field has several limitations, notably delays in diagnosis. This study in Ahmedabad in Gujarat State, India, evaluated the diagnostic performance of a rapid diagnostic test for malaria (SD Bioline Malaria Ag P.f/Pan) versus blood smear examination as the gold standard. All fever cases presenting at 13 urban health centres were subjected to rapid diagnostic testing and thick and thin blood smears. A total of 677 cases with fever were examined; 135 (20.0%) tested positive by rapid diagnostic test and 86 (12.7%) by blood smear. The sensitivity of the rapid diagnostic test for malaria was 98.8%, specificity was 91.5%, positive predictive value 63.0% and negative predictive value 99.8%. For detection of Plasmodium falciparum the sensitivity of rapid diagnostic test was 100% and specificity was 97.3%. The results show the acceptability of the rapid test as an alternative to light microscopy in the field setting.

COVID-19 disease in peritoneal dialysis patients: a single centre experience from India.

BACKGROUND: This study presents our data on mortality in end stage renal disease (ESRD) patients on peritoneal dialysis (PD) who developed COVID-19. MATERIALS AND METHODS: Sri Padmavathi Medical College Hospital, Sri Venkateswara Institute of Medical Sciences University, was designated the State COVID Hospital in March 2020. In a retrospective observational study, we collected the data of ESRD patients on PD and identified the risk factors for mortality. RESULTS: Prior to the pandemic, 136 patients with ESRD were on peritoneal dialysis at our Institute. Among them, 27 (19.8%) eventually developed COVID-19, and 14 of them (51.8%) died. Serum albumin levels were lower and D-dimer levels were significantly higher in deceased patients than in survivors. DISCUSSION: The mortality rate in ESRD patients on PD with COVID-19 at our institution was higher than in other published studies.

Validity and reliability of haemoglobin colour scale and its comparison with clinical signs in diagnosing anaemia in pregnancy in Ahmedabad, India.

This study compared the validity of the haemoglobin colour scale (HCS) and clinical signs in diagnosing anaemia against Sahli's haemoglobinometer method as the gold standard, and assessed the reliability of HCS. The sample comprised 129 pregnant women recruited from 6 urban health centres in Ahmedabad. The prevalence of anaemia was 69.8% by Sahli's method, 78.3% by HCS and 89.9% by clinical signs; there was no statistically significant difference between Sahli's method and HCS whereas there was between Sahlis method and clinical signs. The mean haemoglobin level by Sahli's method and HCS differed significantly. The sensitivity, specificity, positive predictive value and negative predictive value of HCS was 83.3%, 33.3%, 74.3% and 46.4% respectively and that of clinical signs was 91.1%, 12.8%, 70.7% and 38.5% respectively. Interobserver agreement for HCS was moderate (K = 0.43). Clinical signs are better than HCS for diagnosing anaemia. HCS can be used in the field provided assessors are adequately trained.

Karanjin.

Karanjin [IUPAC: 3-methoxy-2-phenylfuro-(2,3-h-chrome-4-ol)], a bioactive furanoflavonoid and a potent biomolecule, was first isolated from Pongamia pinnata (L.). The crude extracts from root, leaf and seed having active constituent karanjin is highly valued in both traditional and modern knowledge systems. This review highlights, critically assesses, and presents the probable biosynthetic pathways of karanjin and its isolation methodologies with a view to actualizing its full potential. Karanjin exhibits multiple health benefits and applications, with evident anti-diabetic, anti-cancer, anti-inflammatory, anti-hyperglycemic, antioxidant, anti-colitis, anti-ulcer, and anti-Alzheimer properties. Consequently, the physiochemical properties and biological effects of karanjin have been detailed and analyzed. The efficacy of karanjin has been attenuated by toxicological studies that have proven karanjin to be non-toxic at physiological conditions as substantiated by in vitro and in vivo studies. In addition, the multiple insect repellent/insecticidal properties of karanjin and its availability as an acaricide/bio-insecticide have been reviewed. This review article underscores and endorses the immense potential for novel drug leads in various medicinal and industrial applications, suggesting a deeper insight into its metabolic fate, bioavailability, and cellular effects that await further investigations.

Physical map of a conditionally dispensable chromosome in Nectria haematococca mating population VI and location of chromosome breakpoints.

Certain isolates of the plant pathogenic fungus Nectria haematococca mating population (MP) VI contain a 1.6-Mb conditionally dispensable (CD) chromosome carrying the phytoalexin detoxification genes MAK1 and PDA6-1. This chromosome is structurally unstable during sexual reproduction. As a first step in our analysis of the mechanisms underlying this chromosomal instability, hybridization between overlapping cosmid clones was used to construct a map of the MAK1 PDA6-1 chromosome. The map consists of 33 probes that are linked by 199 cosmid clones. The polymerase chain reaction and Southern analysis of N. haematococca MP VI DNA digested with infrequently cutting restriction enzymes were used to close gaps and order the hybridization-derived contigs. Hybridization to a probe extended from telomeric repeats was used to anchor the ends of the map to the actual chromosome ends. The resulting map is estimated to cover 95% of the MAK1 PDA6-1 chromosome and is composed of two ordered contigs. Thirty-eight percent of the clones in the minimal map are known to contain repeated DNA sequences. Three dispersed repeats were cloned during map construction; each is present in five to seven copies on the chromosome. The cosmid clones representing the map were probed with deleted forms of the CD chromosome and the results were integrated into the map. This allowed the identification of chromosome breakpoints and deletions.

Echocardiographic detection of cardiac involvement in patients with chronic renal failure.

Echocardiography was performed in 50 patients in chronic renal failure with symptoms suggestive of possible cardiac involvement. Pericardial effusions were detected in 33 and pericardial thickening in 22. In five patients solid material, probably fibrinous, was seen adherent to the parietal or visceral pericardium. The left ventricle was dilated in 18 patients and showed definitely impaired contractility in 16. The left ventricular (LV) posterior wall was abnormally thick in 19 patients. In two, the ventricular septum was more than 1.3 times as thick as the LV posterior wall. Other echocardiographic findings included calcification in the mitral annulus region, mitral valve vegetations, and thickened chordae tendineae. Echocardiography has proved to be of great help in the assessment of symptomatic patients with chronic renal failure not only in diagnosing the presence and extent of pericardial effusion and thickening, but also in detecting impaired myocardial contractility, calcification in the posterior mitral annulus region, and vegetations of bacterial endocarditis.

Nht1, a transposable element cloned from a dispensable chromosome in Nectria haematococca.

Certain isolates of the plant-pathogenic fungus Nectria haematococca mating population VI (MPVI) contain dispensable chromosomes that are unstable during sexual reproduction. Several of these chromosomes carry genes for phytoalexin detoxification and thus contribute to the pathogenic potential of this organism. A repeated DNA sequence, Nht1, was cloned from one of these dispensable chromosomes in N. haematococca MPVI. One copy of the repeated element (Nht1A) was completely sequenced. It is 2,198 bp long and it possesses incomplete inverted terminal repeats (ITRs) at each end. Nht1B, a partially sequenced copy of Nht1, has complete ITRs. Nht1A appears to contain 2 introns and encodes a protein of 550 amino acids that is highly similar to the protein encoded by the Fusarium oxysporum transposon, Fot1. Due to the presence of ITRs, its repeated nature, and its similarity to Fot1, we conclude that Nht1 is a transposable element. Within North American N. Haematococca MPVI populations, Nht1 is distributed discontinuously. Its copy number in different field isolates varies from zero to approximately 100 copies per genome. The Nht1A source isolate is estimated to contain nine to 11 copies of Nht1; at least six are on the chromosome from which Nht1A was cloned.

Management of post-traumatic vascular malformations of the liver by catheter embolization.

Trauma to the liver occasionally produces vascular malformations, usually pseudoaneurysms of the hepatic artery and sometimes arteriovenous fistulas. Hemorrhagic complications, usually in the form of hemobilia, can result, and portal hypertension is a late complication of an arterial-portal vein fistula. The true incidence of these post-traumatic lesions is apparently much higher than previously realized, and they can regress spontaneously. A case is presented in which both complications appeared simultaneously after a stab wound to the liver. Treatment using selective arterial catheterization and embolization with thrombogenic material was successful. The literature on the use of catheter embolization in hepatic trauma is reviewed. We suggest that catheter embolization be added to the standard therapeutic armamentarium for these lesions. Selective catheter embolization is suggested as the initial therapeutic maneuver in treating both of these lesions because of the relatively low morbidity, the great precision available in limiting the area of devascularization and the good expectation of success on the basis of the reported results of this technique in other traumatized organs, as well as the initially promising reports of its use in hepatic lesions. It should be considered at the time of diagnostic arteriography.

A multicentre, double-blind, amitriptyline-controlled study of mirtazapine in patients with major depression.

BACKGROUND: the efficacy and tolerability of the new antidepressant mirtazapine were evaluated in a multicentre, randomized, double-blind, amitriptyline-controlled, 5 week clinical study. METHOD: 156 patients with a DSM-III diagnosis of major depressive episode and 21-item Hamilton Psychiatric Rating Scale for Depression (HPRSD) score ≥ 18, were randomized to treatment with either mirtazapine 20-60 mg/day or amitriptyline 75-225 mg/day. RESULTS: mirtazapine and amitriptyline were equally effective in reducing depressive symptoms, as assessed by the 17-item HPRSD and MADRS scales. Mirtazapine was better tolerated than amitriptyline, with fewer drop-outs due to adverse events and lower incidences of adverse events both at the beginning and at the end of the trial. CONCLUSION: this study shows that mirtazapine is as effective as amitriptyline in treating major depression, while at the same time better tolerated.

Percutaneous balloon valvotomy for aortic valve stenosis using single or double balloon technique.

Percutaneous balloon valvotomy was performed in 21 cases (aged 6 to 62 years) with moderate to severe aortic valve stenosis, using either single (16 cases) or double balloon (5 cases) technique. All patients had basal transaortic pressure gradient 50 mmHG or above. A majority of patients had significant haemodynamic improvement immediately following balloon dilatation. The mean systolic transaortic pressure gradient reduced from 94 mmHg (range 50 to 160) to 42 mmHg (range 14 to 82; P less than 0.05) immediately after the dilatation. The final gradient was less than 40 mmHg in 11 cases. The mean cardiac index improved from 3.86 L/min/M2 (range 2.8 to 5.2) to 4.14 L/min/M2 (range 3.4 to 5.6; P:NS) following the procedure. There was no death or major complication related to the intervention. There was a procedure-related mild aortic regurgitation in 4 cases. We conclude that percutaneous balloon dilatation is an effective, safe, low cost, nonsurgical method for treating patients with aortic valve stenosis.

Study on validity of a rapid diagnostic test kit versus light microscopy for malaria diagnosis in Ahmedabad city, India

Light microscopy of blood smears for diagnosis of malaria in the field has several limitations, notably delays in diagnosis.This study in Ahmedabad in Gujarat State, India, evaluated the diagnostic performance of a rapid diagnostic test for malaria [SD Bioline Malaria Ag P.f/Pan]versus blood smear examination as the gold standard.All fever cases presenting at 13 urban health centres were subjected to rapid diagnostic testing and thick and thin blood smears.A total of 677 cases with fever were examined; 135 [20.0%]tested positive by rapid diagnostic test and 86 [12.7%]by blood smear.The sensitivity of the rapid diagnostic test for malaria was 98.8%, specificity was 91.5%, positive predictive value 63.0% and negative predictive value 99.8%.For detection of Plasmodium falciparum the sensitivity of rapid diagnostic test was 100% and specificity was 97.3%.The results show the acceptability of the rapid test as an alternative to light microscopy in the field setting

لفحص الطاخات الدم بالمجهر الضوئي من أجل تشخيص الملاريا جوانب قصور متعددة، وأهمها التأخر في التشخيص. وقد أجرى الباحثون هذه الدراسة في مدينة أحمد آباد في ولاية غوجرات في الهند لتقييم الأداء التشخيصي للاختبار السريع للملاريا [SD Bioline Malaria Ag P.f/Pan]مقابل فحص لطاخات الدم، باعتباره المعيار الذهبي. وقد أدرج في الدراسة جميع المصابين بالحمى الذين راجعوا 13 مركزا صحيا حضريا فأجريت عليهم اختبارات التشخيص السريع ولطاخات رقيقة وثخينة للدم. وبلغ عدد حالات الحمى التي فحصت 677 حالة، اتضح أن 135 حالة منها إيجابية بالاختبار التشخيصي السريع [20 %]، وأن 86 حالة إيجابية بفحص لطاخة الدم [12.7 %]وكانت حساسية الاختبار التشخيصي السريع للملاريا 98.8 % والنوعية 91.5 % والقيمة التنبؤية الإيجابية 63 % والقيمة التنبؤية السلبية 99.8 %.وبالنسبة لكشف المتصورة المنجلية فقد كانت حساسية الاختبار التشخيصي السريع 100 % ونوعيته 97 %.وتوضح هذه النتائج مقبولية الاختبار السريع باعتباره بديلا للفحص بالمجهر الضوئي في المواقع الميدانية

L'examen microscopique des frottis sanguins pour le diagnostic du paludisme sur le terrain présente plusieurs limites, notamment les retards de diagnostic.La présente étude menée à Ahmedabad dans l'Etat de Gujarat [Inde]a évalué la performance diagnostique d'un test de diagnostic rapide du paludisme [SD Biotine Malaria Ag P.f/Pan]par rapport à l'examen d'un frottis sanguin en tant que méthode de référence.Tous les cas fébriles consultant dans un des 13 centres de soins urbains ont été soumis à un test de diagnostic rapide et à l'examen du frottis mince et de la goutte épaisse.Au total, 677 cas fébriles ont été examinés; 135 [20, 0 %]étaient positifs par la méthode du test de diagnostic rapide et 86 [12, 7%]par la méthode du frottis sanguin.La sensibilité du test de diagnostic rapide pour le paludisme était de 98, 8 %, la spécificité était de 91, 5 %, la valeur prédictive positive de 63, 0 % et la valeur prédictive négative de 99, 8 %.Pour le dépistage de Plasmodium falciparum, la sensibilité du test de diagnostic rapide était de 100 % et la spécificité de 97, 3 %.Les résultats démontrent l'acceptabilité du test de diagnostic rapide en tant qu'alternative à l'examen microscopique sur le terrain