The Department of Defense laboratory-based global influenza surveillance system.

Military global influenza surveillance began in 1976 as an Air Force program. In 1997, the Department of Defense (DoD) Global Emerging Infections Surveillance and Response System expanded the program to include all services. Also included were local residents in areas where DoD overseas research activities operated. This new, worldwide DoD surveillance infrastructure provides valuable information and can respond quickly to outbreaks. This was demonstrated during the current influenza season when a suspected outbreak was reported in Panama. In less than 3 weeks, specimens were collected, transported, and cultured, and isolates were subtyped and sent to the Centers for Disease Control and Prevention for further studies. This influenza surveillance initiative combines viral isolation, antigenic characterization, and molecular sequencing with clinical and public health management of information. The information obtained is shared with the Centers for Disease Control and Prevention and the World Health Organization and has contributed to important decisions in influenza vaccine composition.

The prevalence of hypertension and diabetes defined by fasting and 2-h plasma glucose criteria in urban Nepal.

AIMS: To determine the prevalence of diabetes, impaired fasting glucose and impaired glucose tolerance (IGT) in people aged >/= 40 years in urban communities of Nepal, comparing the fasting and 2-h plasma glucose (PG) criteria for diagnosis of diabetes and to relate the prevalence to age, gender and hypertension. METHODS: Field surveys of fasting and 2-h PG and blood pressure (BP) were done by cluster sampling in seven urban populations of Nepal. Of 1180 eligible individuals invited, 1012 (85.7%) aged >/= 40 years participated. RESULT: The age and sex standardized prevalence of diabetes (known and newly diagnosed), IGT and impaired fasting glycaemia (IFG) were 19.0%, 10.6% and 9.9%, respectively. Of the total population, 30.5% (37.8% of men and 25.3% of women) had some abnormality of glucose tolerance. Of all diabetic individuals, 54.4% (53.8% of men and 55.1% of women) were undiagnosed. The prevalence of diabetes increased with age until the age of 75 years. The prevalence of diabetes was higher in men than in women (P < 0.001). The sensitivity of the fasting plasma glucose (FPG) criterion compared with either FPG or 2-h PG or both criteria for the diagnosis of diabetes was 70.5%[95% confidence interval (CI) 60.7, 78.8] and the corresponding sensitivity of 2-h PG criterion was 79% (95% CI 69.8, 86.1). The age- and sex-standardized prevalence of hypertension (BP >/= 140/90 mmHg) was 22.7%. Hypertension was less common in subjects with normal plasma glucose than in those with diabetes (18.8% vs. 36.7%). Similarly, of all subjects with hypertension, 29.1% had diabetes (known or newly diagnosed) and 43.0% had glucose intolerance of some form. CONCLUSIONS: Our study shows that diabetes and hypertension are common and related problems in people aged >/= 40 years in urban Nepal. The overall sensitivity of the 2-h PG criteria was greater than that of the FPG criteria for diagnosing diabetes, except in subjects aged >/= 60 years.

A case report and overview of organophosphate (OP) poisoning.

A case of organophosphate (OP) poisoning who recovered after requiring almost 1000 mg of atropine, 10 gm of PAM and ventilatory support for 7 days is presented here. The overview of organophosphate poisoning and its management is given. With the approach adopted, the mortality reported in the general medicine unit in the central hospital in Nepal is 7.4%. The two important aspects of the management are vigilance of the atropine drip, especially at night, and other physical and psychological support care of the patients.

Nature of the chromophore binding site of bacteriorhodopsin: the potential role of Arg82 as a principal counterion.

The nature of the chromophore binding site of light-adapted bacteriorhodopsin is analyzed by using modified neglect of differential overlap with partial single and double configuration interaction (MNDO-PSDCI) molecular orbital theory to interpret previously reported linear and nonlinear optical spectroscopic measurements. We conclude that in the absence of divalent metal cations in close interaction with Asp85 and Asp212, a positively charged amino acid must be present in the same vicinity. We find that models in which Arg82 is pointed upward into the chromophore binding site and directly stabilizes Asp85 and Asp212 are successful in rationalizing the observed one-photon and two-photon properties. We conclude further that a water molecule is strongly hydrogen bonded to the chromophore imine proton. The chromophore "1Bu*+" and "1Ag*-" states, despite extensive mixing, exhibit significantly different configurational character. The lowest-lying "1Bu*+" state is dominated by single excitations, whereas the second-excited "1Ag*-" state is dominated by double excitations. We can rule out the possibility of a negatively charged binding site, because such a site would produce a lowest-lying "1Ag*-" state, which is contrary to experimental observation. The possibility that Arg82 migrates toward the extracellular surface during the photocycle is examined.