Isolation and identification of Coxsackievirus A16 strains in Kunming,Yunnan Province in 2019 and analysis of genetic characteristics of VP1 gene / 中国生物制品学杂志

@#Objective To analyze the genetic characteristics of the entire VP1 gene of Coxsackievirus A16(CVA16) strains isolated from the feces of patients with hand,foot and mouth disease(HFMD) in Yunnan Province in 2019.Methods The virus was isolated from human embryonic lung diploid fibroblast(KMB-17) cells and African green monkey kidney(Vero)cells,and the primers for the complete VP1 gene sequence of CVA16 were designed.The target fragment was amplified by RT-PCR and sequenced;the complete VP1 sequence was analyzed by softwares such as MEGA 7.0 and Geneious 9.0.2.Results A total of 26 CVA16 strains were isolated,including eight KMB-17 isolates and 18 Vero isolates.Twenty CVA16isolates were randomly selected for analysis,and three isolates were found to have Bla and 17 B1b genotypes;the nucleotide and amino acid homology of 17 CVA16 B1b isolates were 93.8%—100% and 98.3%—100%,and the nucleotide and amino acid homology with other domestic isolates was 91.1 %—99.2% and 97.3%—99.0%,respectively;the nucleotide and amino acid homology of the three Bla isolates was 98.0%—98.1% and 99.3%,and those with other domestic Bla isolates was 88.7%—98.1% and 98.3%—99.7%,respectively;17 B1b isolates and other three Bla isolates showed the nucleotide and amino acid homology of 87.4%—88.4% and 97.3%—98.7%.Conclusion The CVA16 prevalent in Kunming in 2019 belonged to Bla and B1b genotypes,with B1b as the main strain,and all of them were prevalent strains in the mainland of China.

Stroke � Next Wave of Complications from COVID-19

Since the declaration of COVID-19 infection as Pandemic in March, 2020, There has been rise in Multisystem Complications apart from regular Acute Respiratory Syndrome which is hallmark of COVID-19 infection. As the second wave surge of COVID-19 has occurred, most of the patients already suffered from dyspnoea but also rare complications like CVA (Infarct and Haemorrhage) , Seizure and altered sensorium related to Hypoxic Brain Injury. COVID-19 frequently presents with a state of altered coagulability which increases the risk of pulmonary embolism and other Thrombotic events such as Cerebrovascular events. This case report is limited to Neurological complications seen in COVID-19 Infected patients

Progress in research on Coxsackievirus A6 / 中国生物制品学杂志

@#Hand-foot-mouth disease(HFMD) is an infectious disease that seriously affects the health of infants and young children and has become a major public health problem worldwide,especially in the Asia-Pacific region.HFMD can be caused by a variety of enteroviruses,the most common being enterovirus 71(EV71) and Coxsackievirus A16(CVA16).In recent years,with the significant increase of HFMD caused by Coxsackievirus A6(CVA6) infection,CVA6 has gradually become the main pathogen of HFMD in many countries and regions around the world.CVA6 is not only susceptible to children,but also infects adults with normal immune function.The paper reviewed the CVA6 related etiology,epidemiology,clinical symptoms,laboratory diagnosis and development of vaccine.

Complete genome comparative analysis of Coxsackievirus A6 causing hand,foot and mouth disease and herpangina in Yunnan Province in 2018 / 中国生物制品学杂志

@#ObjectiveTo analyze the genome-wide characteristics of 17 strains of Coxsackievirus A6(CVA6)that cause hand,foot and mouth disease(HFMD)and herpangina(HA)in Yunnan Province in 2018,and understand the genetic differences between different pathogenic CVA6.MethodsA total of 1 909 stool samples clinically diagnosed as HFMD and HA in Kunming Children′s Hospital in 2018 were randomly selected for detection using enterovirus group A universal primers and screening of CVA6 positive samples. The CVA6 whole genome sequence was amplified with CVA6 whole genome primers,spliced by BioEdit splicting software,and analyzed for the whole genome characteristics by BioEdit,MEGA 7.0,Simplot,Heml 1.0 and Phyre2softwares.ResultsA total of 929 CVA6 positive samples were screened,and 17CVA6 complete gene sequences were obtained(9 of which were clinically diagnosed as HFMD and 8 were clinically diagnosed as HA). All 17 CVA6 strains were in type IV clade on the whole phylogenetic tree. No significant recombination occurred in HA and HFMD representative strains,while mutations occurred in non-structural protein 3D region. HFMD and HA representative strains showed differences in VP1 loci S597T,Q705L and Q663L. Online predictive analysis showed that the secondary structure of VP1 was consistent with that of CVA6 with no change.ConclusionThe 17 CVA6 strains causing HFMD and HA had high genomic homology,as well as nucleotide and amino acid differences,which may affect the replication and adaptability of CVA6.

Bioinformatics analysis of VP1 of Coxsackievirus A10 / 公共卫生与预防医学

Objective To predict and analyze the physicochemical properties, structural characteristics, and antigenic epitopes of viral protein (VP) VP1 of Coxsackievirus A10 (CV-A10) by bioinformatics methods. Methods The physicochemical properties and structural characteristics of CV-A10 VP1 were predicted by ProtParam, SOPMA, SWISS-MODEL, PDBsum, and ProSA-web. The antigenic epitopes of CV-A10 VP1 were predicted and analyzed by DNAstar, ABCpred, Bepipred 2.0, ElliPro, DiscoTope-2.0, NetMHCpan-4.1, NetMHCIIpan-4.0, Consurf, VaxiJen v.2.0, AllerTOP v.2.0, ToxinPred2, and IEDB immunogenicity. Results Bioinformatics analysis showed that CV-A10 VP1 was a basic, unstable, and hydrophilic protein, of which the secondary structure mainly consisted of random coil. The analysis revealed that CV-A10 VP1 had multiple potential B and T cell antigenic epitopes as well as a dominant antigenic epitope based on the potential epitope. Conclusion CV-A10 VP1 has multiple potential sites that induce specific humoral and cellular immunity, providing important support for its experimental identification, molecular epidemiological studies, and vaccine development.

Construction and immunogenicity evaluation of SARS-Co V-2 self-amplifying RNA vaccine based on Coxsackievirus-A5 replicon / 中国生物制品学杂志

@#ObjectiveTo construct self-amplifying RNA(saRNA)vaccine of severe acute respiratory syndrome coronavirus2(SARS-CoV-2)Delta mutant strain(B.1.617.2)based on Coxsackievirus-A5(CV-A5)replicon and evaluate its immunogenicity.MethodsThe recombinant plasmids pDelta-S10,pDelta-S5 and pDelta-S1(10,5 and 1 amino acid residues at the upstream of S-VP1/2A cleavage site of the fusion polyprotein respectively)were constructed by In-fusion cloning of the plasmids containing the full-length genome sequence of CV-A5 and substituting the S protein gene of SARS-CoV-2 Delta mutant for the P1 structural protein gene of CV-A5 with different lengths.Three RNA molecules,Delta-S10,Delta-S5 and Delta-S1,were obtained by in vitro transcription of linearized recombinant plasmids and transfected into HEK-293T cells respectively,which were analyzed for the expression of S protein by Western blot.The RNA molecule with the highest expression of S protein was screened out and detected for the self-amplification in HEK-293T cells by qPCR.BALB/c mice(female,6 ～ 8 weeks old and five for each group)were immunized i.m.with two doses(0.5 and 2.5 μg)of the screened Delta-S packaged with lipid nanoparticles for once on day 1 and day 14 seperately.Blood samples were collected on days 14and 28,detected for serum binding antibody titers by ELISA,and detected for neutralizing antibody titers by micro neutralization method.The spleens were harvested on day 42 and detected for the level of IFNγ secreted by mouse spleen cells by enzyme linked enzyme linked immunospot assay(ELISPOT).ResultsThe recombinant RNA molecule Delta-S10showed the highest expression of S protein and self-amplified in HEK-293T cells,which of both high and low doses induced specific binding antibody against SARS-CoV-2 Delta S1 protein in mice with obvious dose effect and enhanced immune effect;The high dose of Delta-S10 induced neutralizing antibodies and cellular immune responses in mice.ConclusionThe SARS-CoV-2 Delta mutant(B.1.617.2)saRNA vaccine Delta-S10 based on CV-A5 replicon was successfully constructed,which induced humoral and cellular immune responses in mice,laying a foundation of the further study of the construction of SARS-CoV-2 saRNA vaccine by enterovirus replication elements.

Neurological disease in the time of COVID-19. A case series

Introduction: we present a series of patients with neurological problems and SARS-CoV-2 infection, and review the respective evidence. Patients and methods: a retrospective descriptive study of consecutive RT-PCR SARS-CoV-2-positive patients in a neurology department from August 1 to December 31, 2020. Results: we recorded 30 patients: 16 men (53%), with a mean age of 65±17.3. In 53%, the neu rological problem preceded the respiratory symptoms and SARS-CoV-2 infection diagnosis. At the syndromic level, the following were found: CVAs 43% (13), seizures 10% (3), posterior reversible encephalopathy 10% (3), encephalopathy 7% (2), brief psychotic disorder 7% (2), myelopathy 3% (1), Guillain-Barré syndrome 3% (1), headache 3% (1), vasculitis 3% (1), intracerebral hemorrhage 3% (1), myasthenic crisis 3% (1) and recurrent optic neuritis 3% (1). Conclusions: SARS-CoV-2 induced neurological problems produce a wide variety of symptoms and may be the first manifestation, even without the development of respiratory symptoms from this infection. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2233).

Introducción: se presenta una serie de pacientes con compromiso neurológico e infección por SARS-CoV-2 y se revisa la evidencia al respecto. Pacientes y métodos: estudio descriptivo, retrospectivo de pacientes consecutivos RT-PCR positivos para SARS-CoV-2 del servicio de neurología desde el 1° de agosto hasta 31 de diciembre de 2020. Resultados: registramos 30 pacientes, 16 hombres (53%), edad media: 65±17.3. En el 53% el compromiso neurológico antecedió los síntomas respiratorios y el diagnóstico de infección por SARS-CoV-2. A nivel sindromático se observó: ACV 43% (13), crisis convulsivas 10% (3), encefalopatía posterior reversible 10% (3), encefalopatía 7% (2), trastorno psicótico breve 7% (2), mielopatía 3% (1), síndrome de Guillain-Barré 3% (1), cefalea 3% (1), vasculitis 3% (1), hemorragia intracerebral 3% (1), crisis miasténica 3% (1) y neuritis óptica recurrente 3% (1). Conclusiones: el compromiso neurológico por el SARS-CoV-2 produce una gran variedad de síntomas y puede ser la primera manifestación incluso sin el desarrollo de síntomas respiratorios por esta infección. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2233).

Revisão de remuneração do SUS para linha de cuidado do AVC isquêmico por meio de microcusteio / Review of SUS remuneration for ischemic stroke care line through micro-costing

Objetivo: O objetivo do estudo é medir o custo assistencial por paciente e revisar o ressarcimento do Sistema Único de Saúde (SUS) na linha de cuidado de acidente vascular cerebral isquêmico (AVCi). Métodos: Estudo prospectivo, com 24 pacientes na amostra, na unidade de referência na instituição para tratamento de AVC, no período de novembro/2019 a dezembro/2019. O método utilizado para apuração de custos foi o custeio baseado em atividade e tempo (TDABC), no qual os custos são coletados focando o paciente e os cuidados dispensados durante a assistência. A perspectiva do estudo é a do prestador de serviços do SUS, que se concentrou na avaliação de custos. Foram realizadas as análises de custo total por paciente, componente de custo, custo e tempo por fase na linha de cuidado, custo médio diário e custo médio diário do SUS. Resultados: O custo médio do paciente com AVCi auferido pelo método TDABC é de R$ 14.079,70, sendo a sua maioria justificada em custos de estrutura da unidade de AVC. A atividade com mais custos foi a unidade de AVC e realização de exames. Conclusões: Foi identificado no estudo que os principais contribuintes para a geração de custos na linha de cuidado são as atividades que demandam mais tempo, os medicamentos dispensados e os exames denominados de "alto custo" realizados. Os custos reais aferidos em relação ao ressarcimento previsto pelo SUS e estabelecimentos de saúde credenciados neste estudo demonstram que apenas 39% do custo real está coberto pelo SUS no AVCi.

Objective: The objective of the study is to measure the cost of care per patient and review the SUS reimbursement in the ischemic stroke (CVA) line of care. Methods: A prospective study, 24 patients in the sample at the reference unit at the institution for the treatment of stroke from November/2019 to December/2019. The method used to calculate costs was activity and timebased costing (TDABC), in which costs are collected focusing on the patient and the care provided during care. The perspective of the study is that of the SUS service provider who focused on cost assessment. Analyzes of total cost per patient, per cost component, cost and time per phase in the care line, average daily cost and average daily SUS cost were performed. Results: The average cost of a patient with ischemic stroke earned by the TDABC method is R$ 14,079.70, most of which are justified in the cost of the structure of the stroke unit. The activity with the most costs was the stroke unit and examinations. Conclusions: The main contributors to the generation of cost in the care line were identified in the study: the activities that demand more time, the medicines dispensed, and the so-called "high cost" tests performed. The real costs measured in relation to the reimbursement provided by the SUS and accredited health establishments in this study demonstrate that only 39% of the real cost is covered by the SUS in Ischemic Stroke.

Paciente joven con accidente cerebrovascular isquémico: ¿Se debe buscar una trombofilia? / Ischemic stroke in a young patient, is it needed to look for a thrombophilia?

Resumen El accidente cerebrovascular isquémico es un evento de gran importancia debido a las implicaciones y el impacto en la calidad de vida de la población afectada. Su incidencia es más alta en adultos mayores y en personas con factores de riesgo cardiovascular. Existe un grupo de pacientes jóvenes (18-44 años) sin factores de riesgo que presentan dicho evento, por lo que, en la práctica clínica, se tiende a evaluar rutinariamente las trombofilias hereditarias y adquiridas como factor etiológico principal para los eventos isquémicos en este grupo etario. No obstante, son pocos los casos donde se documenta algún trastorno de este tipo, ya que es más frecuente la presencia de otras etiologías como el cardioembolismo y trastornos vasculares. La evaluación de las trombofilias es compleja, dado el alto costo, las limitaciones técnicas para hacerlo y el impacto clínico y terapéutico incierto al documentarse estos estados. Se realiza esta revisión de tema con el fin de orientar al clínico acerca de la pertinencia de objetivar estas condiciones en el paciente joven con accidente cerebrovascular isquémico.

Abstract Acute ischemic stroke is a pathology of great complexity due to the implications and impact on the quality of life of the affected population. The incidence of this pathology is higher in older adults and in people with cardiovascular risk factors. There is a group of young patients with no risk factors who present these events. Therefore, in clinical practice, hereditary thrombophilias tend to be frequently evaluated as the main etiological factor for this age group. However, there are few cases where a disorder of this type is documented and the presence of other etiologies such as cardioembolism and vascular disorders are more frequent. Thus, the evaluation of thrombophilia is complex due to its high cost, technical limitations when evaluating, and its uncertain clinical and therapeutic impact when documented. For this reason, this review is carried out in order to guide the clinician about the relevance of objectifying these conditions in young patient with acute ischemic stroke

Pattern of neurological disorders managed in neurology clinics in Kano, Nigeria

To determine the pattern of neurological disorders managed in some neurology clinics in Kano, Nigeria. Materials and Methods: A five-year retrospective descriptive survey (2016-2020) of patients with neurological disorders attending neurology out-patient clinics at three selected hospitals in Kano metropolis. A research proforma was used to collect information on socio-demographic and health characteristics of the participants. Case folders and outpatient registers were used as a source of information about the patients. Data obtained was analyzed using IBM Statistical package for social science (SPSS) version 20 and results presented using descriptive statistics of frequency and percentage. Results: Out of the 433 cases with neurological disorders surveyed, 58% were adult and 42% were pediatric. Males (54.3%) were found to be more affected. Majority (83.4%) of the participants were from an urban area, with married (79.7%) individuals mostly affected. Stroke was the most prevalent (33.7%) neurological disorder. Hypokinesia (5.1%) and hyperkinesia(3%) as a primary and secondary movement disorder respectively were the most prevalent forms of movement disorder. Psychotic symptoms, weakness, paresthesia, fever, vomiting and convulsion were the most common manifestations that comes with the neurological disorders. Of the common neurological disorders, stroke was most associated with motor (56.2%), sensory (36.4%) and psychiatric (43.5%) manifestations. Conclusion: Paediatric age group contributed close to half of neurological disorders. Stroke was the most prevalent form of neurological disorder and most associated with motor, sensory and psychiatric manifestations. Hypokinesia and hyperkinesia had close prevalence and were the most common primary and secondary movement disorders respectively.

Generando pseudorréplicas, a partir de variables morfométricas reales, para contrastar hipótesis taxonómicas y evolutivas: el caso de un pez ampliamente distribuido en las tierras bajas de la orinoquia venezolana / Generating pseudo-replicates, from real morphometric variables, for contrast taxonomic and evolutionary hypotheses: the case of a widely distributed fish in the lowlands of the Venezuelan Orinoquia

RESUMEN: Con el propósito de evaluar la distintividad morfométrica de cinco poblaciones de Mikrogeophagus ramirezi (Pisces: Cichlidae) de las tierras bajas de la Orinoquia venezolana, se tomaron 14 hitos homólogos a 83 individuos, y se transformaron a variables Procrustes. Se realizó una prueba MANOVA/CVA, pero ésta no funcionó bien, por el bajo número de ejemplares usados, y se decidió ampliar el tamaño de la muestra. Se determinó la distribución probabilística de las variables, que fue normal, después se detectó que las varianzas eran similares. Luego se procedió a generar 100 valores de cada variable, bajo el modelo Y= X + ε, donde Y es el valor a estimar de la variable, X es el valor promedio de esa variable, y ε es el producto de la desviación estándar real multiplicado por valores aleatorios de una distribución normal, para cada variable y población. Esta simulación, se realizó para tres tipos de desviaciones estándar: La de las variables reales, la de valores ponderados simple y con media calculada con bootstrap. Los datos generados fueron validados comparando con los valores reales, y a través de algunas propiedades de ellos, tanto antes, como después de aplicar la prueba MANOVA/CVA. En todas las pruebas, los valores generados no fueron distintos a los valores reales. Usando los valores generados, como sustitutos válidos, se determinó, estadísticamente, que las cinco poblaciones eran morfométricamente diferentes, y candidatas a ser consideradas especies plenas. Por otra parte, se realizó una regresión entre las coordenadas de los centroides de las muestras reales y se comparó con las de los generados, mientras las coordenadas reales se distribuyen sobre una línea recta casi perfecta, y altísimamente correlacionada, las de los valores generados están muy dispersas. Se infiere que esta línea, llamada Línea de Estasis Centroidal, sea una señal filogenética surgida de los datos reales.

SUMMARY: In order to evaluate the morphometric differences of five populations of Mikrogeophagus ramirezi (Pisces: Cichlidae) from the lowlands of the Venezuelan Orinoquia,14 homologous landmarks from 83 specimens were taken and transformed to Procrustes variates. A MANOVA/CVA test was performed, however, this test did not perform well due to the low number of specimens used, and it was decided to increase the sample size. The probabilistic normal distribution for the variables was determined, and variances of these variables were similar. Subsequently, 100 values for each variable were generated, from the model Y= X + ε, being Y the variable value to estimate, X is the real mean value of that variable, and ? is the product between real standard deviate and random values of a normal distribution. This simulation was made for three types of standard deviates: the real variables SD, the prorated values from real variables, and mean bootstrap prorated values. The data generated values were validated with the real data, and some inner properties, both before and after applying the MANOVA/CVA test. In all tests, the values generated were no different from the real ones. Using the generated values as a valid surrogate, it was statistically determined that five populations were different morphometrically, and candidate species. On other hand, a regression between real data coordinates was performed, and compared with the generated data. Whilst the real data coordinates arranged on an almost perfect straight line, and were highly correlated, the generated data ones were dispersedly arranged. This fact, did permit infers that this line, the Stasis Centroid Line, is a phylogenetic signal emerging from the real data.

Analysis of microRNAs and target genes associated with immune response to EVA71 and CVA16 infection in human respiratory epithelial cells / 中华微生物学和免疫学杂志

Objective:To analyze differentially expressed microRNAs (miRNAs) and target genes in human respiratory epithelial cells (16HBE) after enterovirus 71 (EV71) and coxsackievirus A16 (CVA16) infection using high-throughput sequencing.Methods:TargetScan and miRDB databases were used to predict the target genes of miRNAs that were both up-regulated or down-regulated after EV71 and CVA16 infection. The genes that were both up-regulated and down-regulated were screened out. GO and pathway analysis of the target genes were conducted to screen immune-related target genes and their corresponding miRNAs. The target genes and their corresponding miRNAs that were up-regulated or down-regulated in both immune-related GO and pathway were further screened. Some miRNAs and their target genes were selected for qRT-PCR verification.Results:There were 598 target genes of up-regulated miRNAs and 1 311 target genes of down-regulated miRNAs and 62 target genes that might be up-regulated or down-regulated simultaneously were screened out. The number of up-regulated target genes involved in immune-related GO and pathway were 17 and 13, respectively, and the number of corresponding miRNAs were 15 and 17, respectively. There were 58 and 47 down-regulated target genes involved in immune-related GO and pathway, respectively, and the number of corresponding miRNAs were 30 and 42, respectively. Three up-regulated target genes were involved in both immune-related GO and pathway and regulated by four miRNAs. Nine down-regulated target genes were involved in both immune-related GO and pathway and regulated by 13 miRNAs.Conclusions:This study was conducive to elucidate the host-pathogen interaction after EV71 and CVA16 infection, and provided reference for studying the pathogenesis of hand, foot and mouth disease.

Different Changes In Electrocardiogram In Cases Of Acute Cerebrovascular Accidents

INTRODUCTION:Stroke is dened as a "neurological decit of cerebrovascular cause that persists beyond 24 hours or is interrupted by death within 24 hours"[1] .CVA can be classied into two major categories- ischemic and hemorrhagic strokes.[2] About 87% are ischemic strokes and the rest being hemorrhagic in origin. studies have demonstrated the fact that primary neurologic abnormalities may produce ECG changes without any myocardial lesion. ECG changes affecting T waves, U wave,ST segment, QT interval and arrhythmias have been reported. These changes may resemble those of myocardial ischemia and myocardial infarction, leading to misinterpretation and delay in operative management of sub arachanoid hemorrhage[3]. There are evidences suggesting, that patients who had ECG changes following CVA had poor prognosis compared to who don't have changes in ECG. Approximately 2-6% of all CVA patients die from cardiac causes in rst 3 months after ischemic stroke[4].

A Study Of Etiology, Clinical Profile And Complications Of Patients With Atrial Fibrillation

BACKGROUND: Atrial fiillation (AF) is the most common cardiac arrhythmia, occurring in 1–2% of the general population. AF confers a 5–fold risk of stroke. Much earlier detection of the arrhythmia might allow the timely introduction of therapies to protect the patient, not only from the consequences of the arrhythmia, but also from progression of AF from an easily treated condition to an utterly refractory problem. AIM OF STUDY: Analysis of etiological features, clinical features and Complications of atrial fiillation. METHODOLOGY: 100 cases of atrial fiillation both male and female were included in the study. The diagnosis was made on clinical grounds and then confirmed by ECG and Echo cardiogram. RESULTS: In this study of atrial fiillation, the occurrence of AF is maximum in age group 61 and above. Out of 100 cases 43 cases were male, 57 cases were female, and 60 cases were rheumatic heart disease. CONCLUSION: In this study common aetiology of AF was RHD 60% followed by Hypertensive heart disease and Ischemic heart disease each carries 10%. The most common symptomatic presentations were dyspnea and palpitation followed by chest pain and dizziness. The commonest complication noted was heart failure.

A case of lateral medullary syndrome with unilateral selective thermoanaesthesia

A 42-year-old female was admitted to tertiary care teaching hospital with history of headache, vertigo, difficulty in swallowing both liquids and solids, vomiting, gait ataxia, drooping of left eyelid, inability to feel hot and cold on right side of body and diplopia of forty-fivedays’ duration. Clinical examination and neuroimaging were suggestive a posterior circulation stroke, with lateral medullary syndrome.The patient had selective thermoanaesthesia on the right side, including the face, which is an atypical finding, given the clinical setting.

A Study Of Prognosis Of Stroke With Special Reference To Electrocardiographic Changes And 2d-Echo.

Introduction: Stroke is the second most common cause of death and major cause of disability worldwide. Approximately 20 million people each year suffer from stroke of which 5 million do not survive. Cerebral infarction is responsible for about 80% of all rst ever in a lifetime strokes. There are many risk factors for cerebrovascular accidents like hypertension, diabetes, aneurysm & coagulopathy . This study was undertaken to determine ECG changes in stroke with diabetic and its prognostic signicance. Aims & Objectives: The present study aims to determine the 2D ECHO and ST-T changes among stroke patients and its implication in assessing prognosis. Material and Methods: The present study was carried out in100 patients admitted in department of medicine, S.S. medical college and associated S.G.M.H hospital, Rewa (M.P.) from july 2014 to Jun. 2015. Inclusion Criteria: The stroke patients of both sexes aged >16 years admitted to SGMH, Rewa. Neurodecit lasting >24 hours. Detailed neurological examination including fundoscopy and cardiovascular examination was carried out in all the cases. A12 lead ECG was done within 24 hours of admission. Result: th th Stroke was most common in 5 and 6 decade (55%). Males had higher preponderance among stroke patients (Male-female ratio 1.5:1). Hypertension was the most common risk factor in 45% of patients. In infarct the most common presenting complaints were headache(25%), Vomiting(19.11%) & Convulsion(8.82%). Such complaints were signicantly higher in hemorrhage Headache(65.62%), vomiting(78.12%) & convulsion(12.50%). Abnormal ECG changes were more common among hemorrhagic patients (78.12%) compared to infarct patients (67.64%). LVdysfunction was the most common abnormality noted in both groups i.e., infarct (23.53%) and hemorrhage (56.26%). Conclusion: ST segment depression in infarct(30%),hemorrhage(53.33%), QTc prolongation infarct(35.71),hemorrhage(46.66%) and prominent U wave infarct(50%),hemorrhage(53.33%) are the common ECG abnormalities in strokes. ECG abnormalities in stroke patients do not have any prognostic signicance. 2D echo abnormalities were more common among hemorrhage group (75%) than in infarct (44.12%). LV dysfunction showed signicant mortality in stroke patients and was statistically signicant (p<0.001).

A Study of Risk Factors of Cerebrovascular Accident at a Tertiary Care Centre in Western UP

A stroke or CVA is defined by the abrupt onset of a neurologic deficit that is attributable to a focal vascular cause. Important modifiable risk factors include diabetes, hypertension, smoking, alcohol intake, sedentary life style, dyslipidemia, heart disease and OCP intake in females and non-modifiable risk factors include old age, gender predisposition and family history. The aim of study is to determine the types of stroke and presenting clinical features and modifiable and non-modifiable risk factors associated with development of stroke. Methods: The present study is a prospective observational study conducted in Teerthanker Mahaveer Medical College over a period of one year i.e January 2017 to January 2018.Total 110 cases presenting with stroke were included in the study. Results: The study shows that ischemic stroke is commoner than hemorrhagic stroke.The risk of stroke increases with age and common in males.Diabetes mellitus was seen in 29.1% cases presenting with stroke, 39.1% cases had hypertension.43.6% and 22.7 were smokers and alcoholic respectively. Dyslipidemia was present in 37.3% cases.15.4% cases had history of heart disease.17.2% cases had previous history of stroke. Conclusion: The modifiable risk factors pose a huge burden by increasing the morbidity and mortality due to stroke. Proper control of these risk factors can reduce the burden of disease.

Biological characteristics of coxsackievirus A6 clinical isolates / 中华微生物学和免疫学杂志

Objective To analyze the biological characteristics of clinical isolates of coxsackievir-us A6 (CVA6), a pathogen of hand,foot and mouth disease (HFMD), and to provide reference for vaccine development. Methods CVA6 strains were isolated from 21 stool and throat swab specimens of patients with HFMD in Yunnan Province and then identified. Their growth characteristics, plaque morphology and virulence to suckling mice were analyzed. Results Five CVA6 strains, named CVA6-129, CVA6-113, CVA6-57, CVA6-94 and CVA6-162, were isolated and all belonged to D3 subtype. Only the CVA6-129 strain could proliferate rapidly in Vero and KMB17 cells and the proliferation peaked 30 h after inoculation. The infectious titer of the CVA6-129 strain was 7. 54 lgCCID50 (50％ cell culture infective dose) / ml in KMB17 cells. Different morphologies of plaques were formed by the CVA6-129 strain in Vero and KMB17 cells at the same time points, which were small and round with clear edges in Vero cells, and large and irregular with blurry edges in KMB17 cells. Suckling mice were susceptible to CVA6 via intramuscular and intraperito-neal injection. The most common symptoms in infected suckling mice were reduced mobility, hind limb pa-ralysis and quadriplegia. CVA6 infection could result in death in severe cases. Conclusions This study isolated five CVA6 strains from a number of clinical samples of suspected HFMD cases, of which the CVA6-129 strain showed potential as a vaccine candidate.

Establishment of a Brown-Norway rat model of cough variant asthma / 中国比较医学杂志

Objective To establish a simple animal model of cough variant asthma(CVA)through sensitizing Brown-Norway(BN)rats with ovalbumin(OVA). Methods A total of 36 BN rats were randomly divided into three groups, including the normal control group,the model control group and the montelukast group. BN rats in the model group and the montelukast group were intraperitoneally administered with 2.0 mg of OVA and 100 mg of Al(OH)3,and the same volume of sterile saline was given to the normal group by intraperitoneal injection. Boosting was carried out by intraperitoneal administration with 0.01 mg of OVA and 100 mg of Al(OH)33 weeks later,and the rats in the normal group were injected with the same dose of physiological saline. Three weeks later,the actively sensitized BN rats were challenged with aerosolized OVA for 7 times on alternative days,and the rats in the normal group were treated with sterile saline instead of OVA. At the same time, the montelukast group was given 1.3 mg/kg of montelukast 30 minutes before atomization by intragastric administration once a day for 2 weeks,and the normal group and the model group were given the same volume of water. The tests of cough sensitivity to capsaicin and bronchial responsiveness were performed 24 h after the last administration. Results Compared with the normal group, the times of coughing(P< 0.01)and the lung resistance(RL)(P< 0.05)in the model group were significantly increased,while the lung compliance(Cdyn)was significantly decreased(P< 0.05). There was a significant difference(P < 0.05)in the times of coughing caused by capsaicin between the model group and the montelukast group. Compared with the model group,RLin the montelukast group was decreased significantly(P< 0.05), and Cdynwas increased significantly(P< 0.05). Conclusions This rat model of CVA is similar to a variety of clinical features of CVA and is easy to operate. Thus it can be used as an effective animal model of CVA.

Factores determinantes de la calidad de vida en pacientes sobrevivientes a un ictus / Decisive factors for the quality of life of patients who survived an ictus

Introducción: Las enfermedades cerebrovasculares (ECV) son causa de afectación de la calidad de vida (CV) y de discapacidad; los factores asociados a una afectación de la CV varían entre un estudio y otro, teniendo en cuenta el uso de instrumentos de medición de la calidad de vida (escalas) adaptadas a determinadas áreas geográficas. Objetivo: Determinar aquellos factores más influentes en la afectación de la calidad de vida en pacientes que han sufrido un ictus, a través de los resultados expuestos en la literatura. Material y Métodos: Se consultaron un total de 53 fuentes de información, entre ellas 47 artículos de revistas científicas, 2 tesis doctorales, así como informes estadísticos y se tuvo acceso a los principales gestores de la red informática. Desarrollo:Se consideraron conceptos sobre la calidad de vida relacionada con la salud en pacientes sobrevivientes a un ictus, los factores asociados a su afectación, la valoración de las escalas de calidad de vida para el ictus y la importancia de realizar estudios con un enfoque más integral. Conclusiones: Independientemente de la existencia de un grupo de variables comunes, imprescindibles en todo estudio relacionado con la calidad de vida en pacientes sobrevivientes a un ictus, cada grupo investigador debe tener en cuenta aquellos elementos que más se ajusten según sus objetivos para iniciar el proceso de investigación(AU)

Introduction: Cerebrovascular diseases (CVD) are a cause of affectedness related to quality of life (QL), and disability; the factors related to an affectedness of the quality of life vary from one study to another, considering the use of tools to measure the quality of life (scales) adapted to particular geographic areas. Objective:To determine those factors that influence the most in the affectedness related to the quality of life of patients who have suffered an ictus, through the results presented in the literature on this topic. Material and methods:A total of 53 sources of information were consulted, among them 47 articles from scientific journals, 2 PhD thesis, and statistical reports. Also, it was possible to have access to the main managers of computing networks. Development:Concepts of the health-related quality of life of those patients who survived an ictus were considered, as well as the factors associated with their affectedness, the scales for quality of life assessment of patients with ictus, and the importance to conduct studies with a more integral approach. Conclusions:Independently of the existence of a group of common variables, which are essential in any study related to the quality of life of patients who survive an ictus, each research group has to keep in mind those elements that adapt most to the objectives in order to begin a research process(AU)