May Measurement Month 2018: an analysis of blood pressure screening results from Oman.

As per WHO estimates, around 17% of the adult Omani population are hypertensive. However, people with hypertension are often unaware of the diagnosis, and so the May Measurement Month (MMM) programme was set up to raise awareness of the importance of blood pressure (BP) screening. A cross-sectional screening of BP of subjects aged 18 years or more was carried out in May 2018 at various sites in Muscat, Oman. Screening sites were set up at the reception areas of participating hospitals, and at a few public areas such as shopping malls and workplaces of the volunteers. Blood pressure was measured according to a standardized protocol, and hypertension was defined as per the 2018 European Society of Hypertension guidelines. The data were analysed centrally by the MMM project team. A total of 12 689 individuals (mean age 40.6 ± 12.5 years, 72% male) were screened. The crude mean BP of the second and third readings (where three readings were taken, n = 4 738) was 127.1/79.2 mmHg. After multiple imputations, the average age and sex standardized BP was 127.3/80.2 mmHg. Of all participants, 29.8% had hypertension. There were 1 983 patients with a previous diagnosis of hypertension, of whom 1 810 were on antihypertensive medication. A further 1 973 subjects were newly diagnosed with hypertension. Of those on antihypertensive medication, 34.9% had uncontrolled BP readings. Screening programmes such as MMM are useful to identify persons with undiagnosed hypertension. However, more educational activities are required to increase the public awareness regarding the dangers of hypertension.

Impact of DDT spraying on malaria transmission in Bareilly District, Uttar Pradesh, India.

BACKGROUND & OBJECTIVES: Impact of indoor residual spraying of DDT on malaria transmission and vector density was evaluated in six villages of Shergarh PHC, Bareilly district, Uttar Pradesh under the operational condition of National Vector Borne Disease Control Programme (NVBDCP) from July 2001 to March 2002 (one transmission season only). METHODS: Two rounds of DDT (50% WDP) spraying @ 1 g/m2 were done both in the experimental and control villages by the state health authorities. The spraying in experimental villages was supervised by Malaria Research Centre (MRC) whereas the district health authorities supervised the operation in control villages. Mass blood surveys were made three times--before the first round, in between the first and second rounds and after the second round of spraying. The blood smears were examined by the trained microscopists of MRC, Haldwani. From the above examinations epidemiological indicators such as slide positivity rate (SPR), slide falciparum rate (SFR) and infant parasite rate (IPR) were calculated. All malaria positive cases were given radical treatment as per NVBDCP schedule. Entomological parameters such as per man hour mosquito density, parity rate, gonotrophic condition and adult susceptibility status of Anopheles culicifacies to diagnostic dosages of DDT (4%) were monitored as per the standard techniques. RESULTS: A total of 988.5 kg of DDT was consumed during two rounds of spray. The house coverage varied from 87 to 95.3%. Parasitological evaluation revealed significant reduction in malaria cases (p < 0.0005) and infant parasite rate declined from 2.9 to 0%. Entomological observations revealed considerable reduction in the density of malaria vector An. culicifacies despite of its 21.4% mortality against DDT test papers. INTERPRETATION & CONCLUSION: The overall results of the study revealed that DDT is still a viable insecticide in indoor residual spraying owing to its effectivity in well supervised spray operation and high excito-repellency factor.

First time detection of Japanese encephalitis virus antigen in dry and unpreserved mosquito Culex tritaeniorhynchus Giles, 1901, from Karnal district of Haryana state of India.

Japanese encephalitis virus (JEV) antigen has been detected by antigen capture enzyme linked immunosorbentassay (ELISA) in dry specimens of the mosquito Culex tritaeniorhynchus Giles, 1901, collected from Karnal district of Haryana state in northern India. These mosquitoes were stored in dry condition for 20 months, at room temperature, before processing. The procedure of detecting JEV infection in long time stored, dry vector mosquitoes, has important application in the surveillance of Japanese encephalitis.

Entomological indices of Aedes aegypti at some international airports and seaports of southern India--a report.

Entomological surveys were undertaken at some of the international airports/seaports (Bangalore, Calicut, Chennai, Cochin, Thiruvanathapuram and Vishakapatnam) to find out the breeding prevalence of dengue vector mosquito in diverse breeding containers from 1998 to 2004. Three vector indices (House index, Container index and Breateu index) were used to assess the breeding potential at each airport/seaport. International Health Regulations urged national governments to keep all the international airports/seaports and peripheral areas up to 400 meters free from Aedes aegypti mosquitoes. However, surveys revealed high vector indices at all the airports and seaports. Health authorities of airports/seaports need to take cognizance of these facts and develop action plan for appropriate control measures with emphasis on vector surveillance.

Pulmonary arterial anatomy in tetralogy of Fallot.

We have searched for any abnormalities of the pulmonary arteries visualized by angiography in 200 consecutive patients with tetralogy of Fallot. All the patients were studied by conventional right ventricular angiography in the right and left anterior oblique views. Thirty six patients (18%) showed a total of 61 pulmonary artery stenoses, 32 being severe (52%), 17 moderate (28%) and 12 mild (20%). Bifurcational stenoses were the most common (31), followed by stenosis of the main pulmonary trunk, the right or the left pulmonary arteries (22), combined central and peripheral stenosis (6), and isolated peripheral pulmonary artery stenosis (2). Nine patients showed segmental stenosis involving both the right and left pulmonary arteries and three of them had atresia of the left pulmonary artery. The detailed preoperative evaluation of obstruction within the pulmonary arterial pathways is essential in tetralogy of Fallot to ensure normalisation of the right ventricular pressure following total correction.

Cell mediated immune response of chicks following fowl adenovirus type-1 infection.

Cellular immune response of 6-week-old chickens infected with fowl adenovirus type-1 was evaluated by both in vivo and in vitro assay. In vitro assay, enumerating peripheral T lymphocyte by alphanaphthyl acetate esterase staining, revealed that cellular immunity appeared as early as 1 week post-infection and was maintained up to 5 weeks post-infection. In vivo assay by phytohaemagglutin skin test showed cellular immunity until 2 weeks post-infection. Thereafter no immunity was observed by this assay.

Comparative studies on the antigenicity of extra- and intracellular viruses of fowl pox.

The intra- and extracellular virus of three strains of fowl pox virus, when precipitated in succession with different saturation of ammonium sulphate revealed three antigens in gel diffusion test in the precipitates obtained at 25%, 50% and 75% of saturation. Further analysis of each positive antigen by dot ELISA revealed that the extracellular virus of FS-8 and HP 1 strains possessed excess antigenic protein at 50% saturation compared to their intracellular viruses. While no difference between extra- and intracellular viruses of FS-4 strain was observed.

An improved dot ELISA to detect fowl adenovirus type-1 antigen.

An improved dot immunobinding assay to detect fowl adenovirus type-1 is described. The method consists of spotting of antigen on nitrocellulose membrane sheet, blocking with either 5% acetic acid or with 5% defatted milk powder and fixation of either antigen or antigen-antibody complex, with either 50% methanol or 0.25% glutaraldehyde or 0.2% tannic acid. The results revealed that fixation of both antigen and antigen-antibody complex resulted in 4-fold increase in sensitivity when acetic acid was used as blocking agent. The use of two substrates simultaneously resulted in more colour intensity and clarity than using both substrates separately.

Immune response of chicks to oral vaccination against Newcastle disease and fowl pox.

The humoral immune response and immunity conferred in chicks were compared following separate and combined oral vaccination with F strain of Newcastle disease virus (NDV) and HP1 strain of fowl pox virus. The haemagglutination inhibition (HI) antibody titre against NDV and passive haemagglutination (PHA) antibody titre against fowl pox virus were comparable in two respective groups. The serum IgG concentration increased significantly after the second vaccination in all the groups. The NDV vaccine induced significantly higher IgG production as compared to fowl pox virus vaccine. There was no significant difference in serum IgG concentration produced by combined vaccine and separate F strain vaccine. The protection afforded by combined and separate vaccinations did not vary significantly against challenge with virulent strains of NDV and fowl pox virus at different stages.

The pathology of Cysticercus tenuicollis infection in goats.

The pathology of Cysticercus tenuicollis in goats was studied on Days 7, 15, 30 and 60 post-infection. The characteristic gross lesions on the 15th day of infection included accumulation of a large quantity of serofibrinous fluid in the peritoneal and thoracic cavities and a large number of small-sized cysts floating in the fluid of the peritoneal cavity. Large circular brown to red areas with alternate areas of haemorrhages also appeared on the liver surface and in the parenchyma due to migrating C. tenuicollis. The microscopic lesions in the liver included cyst-like channels with a mass of fibrin and erythrocytes. Hepatic cells were mostly degenerated with focal areas of parenchymal destruction. Sinusoids were dilated and the bile ducts revealed degenerative changes. Lungs of animals killed on Day 15, revealed focal areas of emphysema and haemorrhages with lodged larvae of C. tenuicollis. Pleura appeared oedematous. Alveoli showed the presence of serous exudate.

Isolation of infectious bronchitis virus from intestine and reproductive organs of laying hens with dropped egg production.

A total of 52 samples (22 cloacal swabs and 30 pooled ovaries and oviducts) from hens with a history of a 25 to 40% drop in egg production from 30 flocks were examined for the isolation of infectious bronchitis virus in embryonated chicken eggs. Five isolates were obtained: three from cloacal swabs and two from reproductive organs. These isolates were identified and characterized on the basis of agar-gel-precipitation, hemagglutination, and neutralization tests and other physicochemical characteristics.

Acid-base status and blood gas alterations following experimental uremia in cattle.

Experimental uremia created by obstructing the urethra of 7 cross-bred bulls was associated with significant (P less than 0.05) increases in PCV, blood urea nitrogen concentration, arterial and venous pH and PCO2, arterial bicarbonate, and base excess. Total serum protein concentration decreased nonsignificantly. Arterial PO2 reduced significantly during later stages of uremia. Arterial and venous oxygen saturation, arteriovenous oxygen difference, oxygen extraction ratio, and arteriovenous pH difference were not affected significantly. Uremia was characterized by progressive metabolic alkalosis with, as a compensation, hypercapnia, and arterial hypoxemia. There was no evidence of systemic shunting of blood except in 1 animal.

Left ventricular pseudoaneurysm following infective endocarditis--a case report.

A patient with pseudoaneurysm involving anterolateral border of left ventricle following infective endocarditis of aortic valve with severe aortic incompetence is reported. He showed clinical improvement after aneurysmectomy and aortic valve replacement.

Silent myocardial ischaemia in patients with angiographically proven coronary artery disease.

Twenty patients with angiographically proven coronary artery disease (CAD) were evaluated by Holter monitoring for assessment of total ischaemic burden during daily activities. Thirteen patients revealed ischaemia on Holter monitoring (symptomatic-2, silent-4 and both types-7). As compared to symptomatic ischaemia, the silent myocardial ischaemic episodes were more frequent (25 vs 10 episodes), longer in duration (15-53 minutes vs 8-45 minutes), occurred at lower heart rates (65-75/minute (mean 68) vs 70-90 per minute (mean 76) and silent ischaemic episodes exceeded symptomatic ones in both morning (10 vs 4) and evening (15 vs 6) peaks. Occurrence of symptomatic as well as silent ischaemia had no relation to rest, activity, left ventricular functions, and there was no difference in the extent (1-3mm) and type (horizontal or downsloping) of ST-segment depression. We conclude that in patients with significant coronary artery disease, silent myocardial ischaemia is more frequent than the symptomatic ischaemia during daily activities. It occurs at lower heart rates, lasts longer, and bears no relation to rest, activity or left ventricular function. Evening peaks may be as frequent or more than the morning peaks. Holter monitoring thus is helpful for assessment of total ischaemic burden in CAD patients.

Our experience with percutaneous transluminal coronary angioplasty--two years follow-up study.

The results of 130 consecutive percutaneous transluminal coronary angioplasty (PTCA) procedures carried out in 112 patients between November, 1986 and October, 1988 are reported. The follow-up period ranged from 1 month to 24 months. Eighty-four patients (75%) had single vessel disease, and 28 (25%) had multivessel disease. Two-vessel dilatation was done in 23 patients. The primary success rate was 92%. In successful cases, the diameter of stenosis was changed on an average from an initial 85% to 23%. Acute occlusion of the vessel occurred on 9 occasions (6.8%). Emergency coronary bypass surgery (CABG) was done in 3 (2.7%), 2 patients (1.8%) were subjected to immediate re-dilatation. One patient who underwent CABG died (case fatality 0.8%). Occlusion of the dilated vessels did not occur after the patients were discharged from hospital. Follow-up data revealed that long-term clinical success (class I status) was seen in 78 patients who had a successful primary dilatation. Of the 25 patients who were studied by a repeat coronary arteriography, 7 had developed restenosis. Five of these patients have been successfully redilated. It is concluded that PTCA is an effective and safe method of treatment in selected patients with coronary artery disease in our setting.

Coronary arteriographic profile in young and old Indian patients with ischaemic heart disease: a comparative study.

We analysed coronary arteriographic profile in 125 young patients (below 40 years, mean age 37.3 years) with clinical evidence of ischaemic heart disease (IHD) (Group I) and compared it with 125 older patients with IHD (more than 40 years, mean age 52.8 years) (Group II) studied during the same period. Left anterior descending coronary artery was the most frequently involved vessel in both the groups, 102/125 (81.6%) in Group I and 120/125 (96%) in Group II (P less than 0.001). The incidence of left main coronary artery involvement was 5/125 (4%) in Group I and 15/125 (12%) in Group II (P less than 0.05) and coronary artery calcification was 17/125 (13.7%) in Group I and 72/125 (57.6%) in Group II (P less than 0.001). Triple vessel disease was the most common form of involvement, 56/125 (44.8%) in Group I and 65/125 (52.8%) in Group II (P = NS). The incidence of diffuse disease was 35/125 (28%) in Group I vs 39/125 (31.2%) in Group II (P = NS), ectasia was observed in 13/125 (10.1%) in Group I vs 15/125 (12%) in Group II (P = NS) and coronary collaterals were found in 42/125 (33.6%) in Group I and 56/125 (44.8%) in Group II (P = NS). Thus left main and left anterior descending coronary artery disease and coronary calcification were more common in the older age group. Our findings suggest that in young Indian patients with IHD, multivessel and extensive coronary artery involvement in frequently seen. This pattern of involvement has many features resembling the disease pattern in their older counterparts.

Antigenic relationships among sheep pox, goat pox and contagious pustular dermatitis viruses.

Antigenic relationships among sheep pox, goat pox and contagious pustular dermatitis (CPD) viruses were determined by serological techniques using soluble antigens partially purified by DEAE-cellulose chromatography. Homologous antigen-antibody reactions were characterized by the presence of 7 precipitation lines with sheep pox and of 5 ones each with goat pox and CPD viruses. The nature of cross-reactions of sheep pox, goat pox and CPD virus soluble antigens with corresponding sera suggested that sheep pox virus shared 3 soluble antigenic components with goat pox and either 3 or 4 ones with CPD virus. Goat pox virus shared either 2 or 3 soluble antigenic components with CPD virus. Cross-neutralization tests revealed an one-way cross of goat pox virus with sheep pox and CPD viruses, respectively. The results showed that the 3 viruses in question share common soluble antigenic components.

Development of medicated aerosol dressings of chlorhexidine acetate with hemostatics.

Aerosol formulations to act as medicated aerosol dressings have been prepared with an aim of forming a protective film over the wound after spraying combining the properties of antiseptics and hemostatics. Chlorhexidine acetate along with three hemostatics namely zinc acetate, methyl cellulose and Calendula tincture were used for the formulations. The formulations were found to be satisfactory in their performance and purpose.

Evaluation of sterically stabilized liposomes as a vehicle for targeting technetium-99m labelled radiopharmaceuticals.

Sterically stabilized neutral liposomes (multilamellar vesicles) were prepared by sonicating phosphatidylcholine and cholesterol (molar ratio 4:1) film in phosphate buffered saline (50 mM, pH 7.4) containing 4% Tween 20. Tc-99m-GHA was incorporated in these liposomes by treating 0.5 ml of the suspension with lyophilized GHA kit (5 mg GHA and 250 micrograms SnCl2 x 2 H2O) followed by addition of 1 ml 99mTcO4- (1-3 mCi). The labelling yield was 60-70%. Tween 20 has provided significant stability of the radiolabel as compared to that without its addition, when radiolabelled liposomes were incubated in serum up to 24 h. With respect to Tc-99m-GHA alone, radiolabelled liposomes exhibited 4- to 6-fold greater radioactivity in the blood of rabbits (15 min-24 h). Comparison of biodistribution data of radiolabelled liposomes and Tc-99m-GHA in mice demonstrated a 10- to 12-fold greater hepatic accumulation of radiolabelled liposomes with respect to that of Tc-99m-GHA throughout the period of study (15 min-24 h), though their concentration in the kidneys was comparable.