A unique approach to screen for blood donors lacking high-prevalence antigen Inb of the Indian blood group system.

The Inb antigen of the Indian blood group system is a high-prevalence antigen. The presence of alloanti-Inb in a recipient may pose a problem in finding compatible blood for transfusion. The aim of this study was to screen blood donors for Inb and to include individuals found to be In(b-) in our rare donor registry. To save resources, a unique study design was constructed. Blood group O donors were tested for Inb because their red blood cell (RBC) units could serve recipients across all ABO groups. EDTA blood samples were used for serologic and genomic testing. These samples were first tested serologically for Ina, and samples typed as In(a+) were then tested both serologically and molecularly for Ina and Inb to find homozygous IN*01/01 [i.e., the predicted In(b-) phenotype]. A cost-conservative approach in using recycling of antibody was adopted to economize available resources. Of 6300 donors, 196 donor samples typed as In(a+) and were also found to be In(b+) when tested by serologic and genomic methods. Although none of the donors typed as In(b-), the statistical analysis suggests the expected prevalence for this rare phenotype to be 0.02 percent among the total number of donors tested. In conclusion, this report presents a unique cost-conservative approach using limited reagents to screen a large number of donors for the rare In(b-) phenotype.The Inb antigen of the Indian blood group system is a high-prevalence antigen. The presence of alloanti-Inb in a recipient may pose a problem in finding compatible blood for transfusion. The aim of this study was to screen blood donors for Inb and to include individuals found to be In(b­) in our rare donor registry. To save resources, a unique study design was constructed. Blood group O donors were tested for Inb because their red blood cell (RBC) units could serve recipients across all ABO groups. EDTA blood samples were used for serologic and genomic testing. These samples were first tested serologically for Ina, and samples typed as In(a+) were then tested both serologically and molecularly for Ina and Inb to find homozygous IN*01/01 [i.e., the predicted In(b­) phenotype]. A cost-conservative approach in using recycling of antibody was adopted to economize available resources. Of 6300 donors, 196 donor samples typed as In(a+) and were also found to be In(b+) when tested by serologic and genomic methods. Although none of the donors typed as In(b­), the statistical analysis suggests the expected prevalence for this rare phenotype to be 0.02 percent among the total number of donors tested. In conclusion, this report presents a unique cost-conservative approach using limited reagents to screen a large number of donors for the rare In(b­) phenotype.

In vitro biocontrol activity of halotolerant Streptomyces aureofaciens K20: A potent antagonist against Macrophomina phaseolina (Tassi) Goid.

A halotolerant actinobacterial strain isolated from salinity affected soil of Eastern Indo-Gangetic plains (IGP), Uttar Pradesh, India, was characterised for its antagonistic potential against Macrophomina phaseolina by dual-culture assay. It was shown to effectively inhibit the growth of M. phaseolina with an inhibition zone of 27 ± 1.33 mm. Further the actinobacterial strain was evaluated for its plant growth promoting (PGP) properties and its ability to produce biocontrol related extracellular enzymes viz. amylase, protease, cellulase, chitinase, gelatinase and urease. The results revealed that the actinobacterial strain had PGP potential along with positive assay for amylase, chitinase and urease. The interaction study between antagonist strain and fungal pathogen, performed by scanning electron microscopy technique revealed that the actinobacterium was able to damage fungal mycelia may be due to chitinase, establishing its role as a potential antagonist against M. phaseolina. The actinobacterial isolate was characterised by 16S rDNA gene sequencing, and was identified as Streptomyces genera. The identified gene sequence was deposited to NCBI GenBank with an accession number KP331758.

Dextran Carrier Macromolecules for Colon-specific Delivery of 5-Aminosalicylic Acid.

Present manuscript describes the sustained and targeted delivery of 5-aminosalicylic acid to the distal ileum and proximal colon, using dextran (40 kDa) as a carrier for targeting 5-aminosalicylic acid at the colonic site by attaching p-aminobenzoic acid and benzoic acid as linkers. Prepared conjugate were characterized by UV, HPLC, FT-IR, and (1)H NMR. The degree of substitution was estimated by complete hydrolysis of conjugates in borate buffer and in vitro hydrolysis study of conjugates was performed in different biological media. It was observed that 5-aminosalicylic acid alone have produced high incidence of gastric ulcer with high ulcer index whereas lower ulcer index was found for the dextran conjugates of 5-aminosalicylic acid. The release pattern of conjugates in 3% w/v rat caecal content was confirmed the colon specificity of 5-aminosalicylic acid conjugates.

Mental health and welfare in Australian anaesthetists.

This survey was designed to evaluate the factors affecting mental health and welfare in Australian anaesthetists and to investigate current sources of support. An electronic survey was sent to 500 randomly selected Fellows and trainees of the Australian and New Zealand College of Anaesthetists. Questions were related to: anxiety, stress, depression, substance misuse, self-medication, suicide, reporting illness, and help-seeking. Current psychological wellbeing was assessed using the Kessler Psychological Distress Scale (K10). A total of 191 completed surveys were received (a response rate of 38%): 26% had attended their general practitioner for mental health issues, of whom half had been diagnosed with a mental illness; 7% of all respondents were currently prescribed medication for this; 25% had previously self-prescribed psychoactive medication; 17% admitted to using alcohol to deal with stress, anxiety or depression; and 8% responded that mental illness had at some point impaired clinical care. Sixteen percent of all respondents reported previous suicidal ideation. Despite a low response rate, and the possibility of responder bias, the mental health of Australian anaesthetists would appear to be subject to common and persistent risk factors, many of which are well described in previous studies. We identify general practitioners as particularly valuable in targeting initiatives for improvements in mental health and welfare. The significant prevalence of suicidal ideation and reluctance to approach senior colleagues with concerns about mental health or welfare issues are specific causes for concern and suggest that further investigation, education and a potential review of support networks is required.

A double output pulsed high current thyratron driver.

The design and development of a double output pulsed high current driver for high power multi-grid thyratron is reported. The driver generates a 100 A current pulse of 2 µs duration with a compliance voltage of 1000 V for driving grid-1. A voltage pulse of 1200 V and 1.2 µs duration, superimposed with -150 V bias has been generated for driving grid-2. A delay of 1 µs between the two drive pulses is achieved with the use of a simple circuit. The rate of rise of voltage better than 10 kV/µs and jitter of ±3 ns is achieved for grid-2 pulse. This driver module has been successfully used in a 50 kV, CX1575C thyratron switched pulsed power supply to drive a multi-joule transversely excited atmospheric CO(2) laser at 100 Hz. The grid driver module can also be used for driving any high current thyratrons with minor external changes.

A follow up study on revised national tuberculosis control programme (rntcp): results from a single centre study.

OBJECTIVE: To know the follow up status of tuberculosis patients after 1 year of completion of treatment in RNTCP. MATERIALS #ENTITYSTARTX00026; METHODS: Those patients of tuberculosis, who were registered from June 2003 to June 2004 at DOTS centre of our institution, were followed up at their homes after one year of completion of treatment between August 2005 and August 2006, with the help of health visitor. Patients were followed up clinically and symptomatic patients were also followed radiologically as well as bacteriologicalty. Results of the study were recorded in terms of number of patients remained asymptomatic, number of patients relapsed and number of patients died. RESULTS: Out of 237 patients registered, 8 patients died during treatment period, 12 patients defaulted the treatment, the number of failures was 5 and 212 patients were declared cured/treatment completed. Out of these 212 patients 60 were unavailable for interview due to various reasons. The study observed that out of a total of 152 patients interviewed, 137 patients (90.1%) of remained asymptomatic, 11 patients (7.2%) had relapsed and 4 patients (2.6%) died during follow up. CONCLUSION: The study observed that majority of patients (90.1%) re-mained asymptomatic after the completion of one year of treatment under DOTS.

Concurrent Estimation of Clopidogrel Bisulfate and Aspirin in Tablets by Validated RP-HPLC Method.

A simple, rapid, precise RP-HPLC method was developed for simultaneous estimation of aspirin and clopidogrel bisulphate in tablet dosage form used in the treatment of cardiovascular diseases. To achieve the maximum resolution, acetonitrile:50 mM potassium dihydrogen phosphate buffer:methanol, solution pH adjusted to 3, in the ratio 50:30:20; v/v was selected as mobile phase. This mixture was found to be appropriate allowing good separation of both the components at a flow rate of 1.5 ml/min and detection wavelength 240 nm. In these conditions clopidogrel bisulfate and aspirin were eluated at the 7.47 and 2.2 min. The linearity was found in the concentration range 1.5-7.5 and 3.5-15.0 µg/ml, respectively. All the analytical validation parameters were determined and found with in the limit as per ICH guideline, which indicates the validity of method.

Hydrolytic Degradation Profile and RP-HPLC Estimation of Cilostazol in Tablet Dosage Form.

A simple, selective, precise and stability-indicating high-performance liquid-chromatographic method of analysis of cilostazol in pharmaceutical dosage form was developed and validated. The solvent system consisted of 10 mM phosphate buffer (pH 6.0):acetonitrile:methanol (20:40:40). Retention time of cilostazol in C18 column was 5.7 +/- 0.1 min at the flow rate 1.3 ml/min. Cilostazol was detected at 248 nm at room temperature. The linear regression analysis data for the calibration plots showed good linear relationship with correlation coefficient value, r( 2) =0.9998 in the concentration range 100-3200 ng/ml with slope 43.45 intercept 156.75. The method was validated for linearity, range, accuracy, precision and specificity. Cilostazol was determined in tablet dosage form in range of 99.58-100.67% with 0.4600 standard deviation. Stress studies were conducted in acid and alkali hydrolysis with gradual increasing concentration. Cilostazol was found to be stable in various concentrations of acidic and alkaline.

Assessment of changes in gait parameters and vertical ground reaction forces after total hip arthroplasty.

UNLABELLED: The principal objectives of arthroplasty are relief of pain and enhancement of range of motion. Currently, postoperative pain and functional capacity are assessed largely on the basis of subjective evaluation scores. Because of the lack of control inherent in this method it is often difficult to interpret data presented by different observers in the critical evaluation of surgical method, new components and modes of rehabilitation. Gait analysis is a rapid, simple and reliable method to assess functional outcome. This study was undertaken in an effort to evaluate the gait characteristics of patients who underwent arthroplasty, using an Ultraflex gait analyzer. MATERIALS AND METHODS: The study was based on the assessment of gait and weight-bearing pattern of both hips in patients who underwent total hip replacement and its comparison with an age and sex-matched control group. Twenty subjects of total arthroplasty group having unilateral involvement, operated by posterior approach at our institution with a minimum six-month postoperative period were selected. Control group was age and sex-matched, randomly selected from the general population. Gait analysis was done using Ultraflex gait analyzer. Gait parameters and vertical ground reaction forces assessment was done by measuring the gait cycle properties, step time parameters and VGRF variables. Data of affected limb was compared with unaffected limb as well as control group to assess the weight-bearing pattern. Statistical analysis was done by't' test. RESULTS: Frequency is reduced and gait cycle duration increased in total arthroplasty group as compared with control. Step time parameters including Step time, Stance time and Single support time are significantly reduced (P value <.05) while Double support time and Single swing time are significantly increased (P value <.05) in the THR group. Forces over each sensor are increased more on the unaffected limb of the THR group as compared to the control group. Vertical ground reaction force variables are also altered. CONCLUSION: Significant changes (P value <.05) in gait parameters and vertical ground reaction forces show that gait pattern is not normalized after THR and weight-bearing is not equally shared by both hips. Patient walks with residual antalgic gait even after surgery, which results in abnormal loading around hip joints and the integrity of the prosthesis fixation could be compromised.

Oxetane locked thymidine in the Dickerson-Drew dodecamer causes local base pairing distortions -- an NMR structure and hydration study.

The introduction of a North-type sugar conformation constrained oxetane T block, 1-(1',3'-O-anhydro-beta-D-psicofuranosyl) thymine, at the T(7) position of the self-complementary Dickerson-Drew dodecamer, d[(5'-C(1)G(2)C(3)G(4)A(5)A(6)T(7)T(8)C(9)G(10)C(11)G(12)-3')](2), considerably perturbs the conformation of the four central base pairs, reducing the stability of the structure. UV spectroscopy and 1D NMR display a drop in melting temperature of approximately 10 degrees C per modification for the T(7) oxetane modified duplex, where the T(7) block has been introduced in both strands, compared to the native Dickerson-Drew dodecamer. The three dimensional structure has been determined by NMR spectroscopy and has subsequently been compared with the results of 2.4 ns MD simulations of the native and the T(7) oxetane modified duplexes. The modified T(7) residue is found to maintain its constrained sugar- and the related glycosyl torsion conformations in the duplex, resulting in staggered and stretched T(7).A(6) and A(6).T(7) non-linear base pairs. The stacking is less perturbed, but there is an increased roll between the two central residues compared to the native counterpart, which is compensated by tilts of the neighboring base steps. The one dimensional melting profile of base protons of the T(7) and T(8) residues reveals that the introduction of the North-type sugar constrained thymine destabilizes the core of the modified duplex, promoting melting to start simultaneously from the center as well as from the ends. Temperature dependent hydration studies by NMR demonstrate that the central T(7).A(6)/A(6).T(7) base pairs of the T(7) oxetane modified Dickerson-Drew dodecamer have at least one order of magnitude higher water exchange rates (correlated to the opening rate of the base pair) than the corresponding base pairs in the native duplex.

Iodine deficiency disorders among school children of Dakshin Dinajpur District, West Bengal.

Iodine deficiency disorders (IDD) are major public health problems in India, including West Bengal. Existing programme to control IDD needs to be continuously monitored through recommended methods and indicators. Thus we undertook the study to assess the prevalence of goiter, status of urinary iodine excretion (UIE) level and to estimate iodine content of salts at the household level in Dakshin Dinajpur district, West Bengal. We conducted a community-based, cross-sectional study in 2004; among 2250 school children, aged 8-10 years. The '30 cluster' sampling methodology and indicators for assessment of IDD, as recommended by the joint WHO/UNICEF/ICCIDD consultation, were used for the study. Goitre was assessed by standard palpation technique, UIE was analyzed by wet digestion method and salt samples were tested by spot iodine testing kit. Of the 2250 children, 419 (18.6%) had goitre (95% CI = 17.0 - 20.2%). Total goitre rate (TGR) was not significantly different in respect of gender, age and religion. Visible goitre rate was 2.5%. Median urinary iodine excretion level was 16 mcg/dL (normal: > or = 10 mcg/dl.) and 16.5% children had value less than 5 mcg/dL. Only 67.4% of the salt samples tested had adequate iodine content of > or = 15 ppm, with significant difference between Hindus and Muslims (chi2 = 12.68, d.f. = 1, p < 0.01). TGR of 18.6% indicate the district is still endemic for IDD, but median urinary iodine within normal range reflects no current iodine deficiency. The district is in the transition phase from iodine-deficient to iodine-sufficient. Measures are to be sustained for successful transition towards elimination.

Leigh's syndrome.

A 15-month-old female child presented with sudden onset cough and hyperventilation along with evidence of metabolic acidosis. She had past history of recurrent vomiting, episodes of abnormal posturing, difficulty in deglutition and regression of milestones since 12 months of age. CT scan of the brain revealed hypodense lesions in bilateral basal ganglia and on MRI there were T2 hyperintensities in bilateral lentiform nuclei, caudate nuclei, thalamus, red nuclei and dentate nuclei. Biochemical examination revealed persistently elevated serum lactate levels with high lactate/pyruvate ratio. Resuscitative measures were of no avail and the child succumbed to the illness on the second day of admission. Neuropathological examination at autopsy demonstrated marked spongiosis, focal necrosis, endothelial proliferation, reactive astrogliosis and extensive demyelination involving bilateral basal ganglia, midbrain and spinal cord which were typical of Leigh's sub acute necrotizing encephalomyelopathy.

Activation of tumor-associated macrophages by thymosin alpha 1.

It was shown earlier that the progressive growth of a transplantable T-cell lymphoma of spontaneous origin, designated as Dalton's lymphoma (DL), in a murine host is associated with an inhibition of macrophages (TAM) along with an involution of thymus. However, it remained unclear if a decline in the level of thymic peptides in DL-bearing host, due to thymic regression, has any implications in the inhibited responses of TAM. Therefore, the present investigation was under taken to study whether the TAM of DL-bearing host can be activated to tumoricidal state by peptides of thymic origin. It was observed that intraperitoneal administration of thymosin alpha 1 to DL-bearing mice resulted in activation of TAM. Such TAM were found to produce enhanced amount of interleukin-1 (IL-1), tumor necrosis factor (TNF), reactive oxygen intermediates (ROI), nitric oxide (NO) and showed an increased abilities of pinocytosis, phagocytosis, antigen presentation and tumor cytotoxicity. The TAM were found to be directly responsive to thymosin alpha1 as in vitro treatment with thymosin alpha 1 could activate TAM to tumoricidal state. Treatment of TAM with thymosin alpha 1 also enhanced their LPS responsiveness for an augmented state of activation. The findings of this study demonstrate for the first time that the TAM of a T cell lymphoma can be activated to tumoricidal state by thymosin alpha 1.

P.C. Sen Memorial best paper award on rural health practice: A study on visual acuity and vitamin A deficiency among primary school students in Naxalbari Village, Darjeeling district of West Bengal.

331 primary school students studying from Nursery classes to Class IV in 2 randomly selected schools in Naxalbari Village in Darjeeling district of West Bengal were tested for visual acuity (VA), Vitamin A deficiency (VAD) and Bitot's spot. 329 students could be tested for visual acuity whereas all 331 students were tested for VAD and Bitot's spot. The prevalence of abnormal Visual Acuity (VA) (VA < 6/9 in any eye) in this study group was 3.65% and it was highest in 7-8 years age group in both the sexes contributing to 75% of the total students having abnormal VA. All these children fell within 50th percentile of weight and height for their respective age and sex. Hindu & ST children accounted for 91.67% & 50% abnormal VA respectively; however, when presence of abnormal VA was compared with its absence between 2 sexes, Hindu and Muslim students and in different castes, no statistically significant differences were found (p > .05). Students of Class-I and Class-II contributed 25% and 50% respectively and together accounted for 75% of abnormal VA. Prevalence of VAD was 8.16%. Among sufferers of VAD Hindus (81.48%) and ST (51.85%) were the main contributors; the differences between presence and absence of VAD in 2 sexes, among 3 religious groups were not statistically significant (p > .05); however, differences among ST and NonSCST groups, and again SC, ST and Non-SCST groups were statistically significant (p < .05). Prevalence of Bitot's spot was 3.63%. Among the students having Bitot's spot, females (58.33%) outnumber the males (41.67%); but the difference between presence and absence of Bitot's spot in 2 sexes was not statistically significant (p > .05). 83.33% each of Hindus and STs had Bitot's spot. No SC and no Muslim student had this spot; the differences between presence and absence of Bitot's spot between Hindu and Christian students were statistically significant (p < .01); similarly when the findings were considered between ST and NonSCST students the difference was found to be statistically highly significant (p < .001).

Effect of thymosin-alpha1 on the production of nitric oxide by tumor-associated macrophages.

The present investigation was conducted to study the effect of thymic peptide: thymosinalpha1 (thyalpha1) on the activation of tumor associated mphi (TAM) obtained from mice bearing a transplantable T cell lymphoma of spontaneous origin designated as Dalton's lymphoma, to produce nitric oxide (NO). It was found that in vivo administration of aqueous thymic extract obtained from thymus of normal mice or thyalpha1 could activate the TAM to produce enhanced amount of NO which was further augmented on in vivo treatment of these TAM by LPS. These observations suggest that thyalpha1 could prime TAM for activation by second signal of LPS. The study also presents evidence that tumor cell elaborate factors that enhance the effect of thyalpha1 on TAM for production of NO. This is the first study to show that thyalpha1 can activate TAM directly even in the absence of LPS, and may, therefore, have clinical significance.

Management of colonic perforation during percutaneous nephrolithotomy in horseshoe kidney.

Few cases of colonic injury during percutaneous nephrolithotomy (PCNL) have been reported in orthotopic kidneys and none in horseshoe kidney, and the management protocol has not been standardized. A plain film on postoperative day 1 following PCNL showed contrast medium in the descending colon, leading to the diagnosis of colonic injury in a 53-year-old male patient with horseshoe kidney and multiple bilateral stones. He was asymptomatic and was treated successfully by minimally invasive techniques. An asymptomatic patient with a colonic injury following PCNL can be treated by minimal manipulations. Computed tomography imaging is necessary prior to percutaneous surgery on a horseshoe kidney.