Right atrial mural thrombi: An autopsy study of an under-diagnosed complication at an unusual site.

BACKGROUND: Right atrial mural thrombi (RAMT) are often seen in association with cardiac diseases or foreign bodies. Unusual locations at the flutter isthmus and the atrial appendage prompted us to evaluate our 2-year autopsy data on such thrombi. MATERIALS AND METHODS: In the 2-year retrospective autopsy, the clinical and autopsy records of patients with RAMT were reviewed, with particular reference to the presence of central venous catheter (CVC), its site of insertion, its type, material and size, its duration of placement, and the drugs infused through the catheter. RESULTS: Of the 940 autopsies performed in 2 years, RAMT was seen in 24 hearts and was related to an insertion of a CVC in 23 patients (95.8%). The risk and/or associated factors for this complication were tunneled and polyethylene catheters, Intensive Care Unit admission, infused drugs, underlying cardiac diseases, and pregnancy. A noteworthy feature was the location of the thrombi in the flutter isthmus in 16 hearts (66.7%) and atrial appendage in another six hearts. Localized endocarditis/myocarditis and pulmonary thromboembolism were observed in six and four patients, respectively. CONCLUSIONS: This autopsy study, which has a high incidence of catheter-related RAMT, does not reflect the true incidence but reiterates the importance of guided insertion of central venous and prompt recognition of thrombus formation.

Correction: Identification of Novel Pre-Erythrocytic Malaria Antigen Candidates for Combination Vaccines with Circumsporozoite Protein.

[This corrects the article DOI: 10.1371/journal.pone.0159449.].

Radiation safety aspects of the operation of first three synchrotron beam lines of Indus-2.

Five synchrotron radiation beam lines are commissioned and now under regular operation at the Synchrotron Radiation Source, Indus-2 at Raja Ramanna Centre For Advanced Technology (RRCAT), Indore, India. Nine beam lines are under trial operation, and six beam lines are in the installation stage. In the early phase of installation of beam lines on Indus-2, three bending magnet beam lines, Extended X-ray Absorption Fine Structure (EXAFS, BL-8), Energy Dispersive X-ray Diffraction (EDXRD, BL-11) and Angle Dispersive X-ray Diffraction (ADXRD, BL-12), were installed and commissioned, after approval from Atomic Energy Regulatory Board (AERB), India. These beam lines are pink (BL-8), white (BL-11) and monochromatic (BL-12), which are housed in specially designed shielded hutches. In order to ensure safety of users and other working personnel from ionizing radiations present in these beam lines, several safety systems are incorporated and safety procedures are followed. The paper describes the radiological safety aspects of the three beam lines during its initial commissioning trials and also the measurements on radiation levels carried out in and around the beam line hutches.

Leprosy elimination campaigns in Orissa.

Four Modified Leprosy Elimination Campaigns (MLECs) were conducted in Orissa by March 2003. Their impact on various leprosy indicators was analyzed. More than 70% of the people of the State were examined during these campaigns. The suspect rate decreased from 1.44% to 0.37% towards the fourth MLEC. About 15% of the suspects were clinically confirmed to be having leprosy. The total number of new cases detected during the MLEC years was on the decrease. A marked fall in new case-detection rate was observed during inter-MLEC years. This has resulted in fluctuation in the prevalence rate during the MLEC years, but the overall PR/10,000 population decreased from 12.18 in 1996-97 to 7.3 in March 2003. More than 40% of the total new cases and about 45% of total new child cases for the corresponding year were detected during the MLECs, and the proportion of total new case-detection was as high as 60.8% during the first MLEC. The proportion of female cases detected during succeeding MLECs improved and an almost equal number of female cases were detected during MLECs III and IV. Considering the present leprosy situation in Orissa and the effectiveness of MLECs in case-detection, it was recommended that such campaigns should be undertaken in select high prevalent blocks of the State at regular intervals, along with the strengthening of the integration of NLEP activities into primary health care activities.

Equine rabies immunoglobulin: a study on its clinical safety.

To confirm and assess the clinical safety of equine rabies immunoglobulin (ERIG) administered locally for postexposure prophylaxis against rabies since human rabies immunoglobulin is too expensive to be affordable by most patients, a study was carried out among 3723 patients who attended the antirabies clinic, department of community medicine, MKCG Medical College Hospital, an urban tertiary hospital between September 1, 2003 and March 31, 2004. They were advised ERIG, 1621 patients were of high risk due to the nature of the bites or animal, but only 286 patients of them who could afford the treatment received it. Side-effects were monitored during the follow-up visits on days 3,7,14,30,60 and 90. Statistical analysis was done by using simple proportions and chi-square test. Of the 286 cases receiving antirabies treatment, 214 patients had dog bites and in 100 cases the animal showed abnormal behaviour. Pain (n=237) was the most common side-effect and in 18 patients fever was the systemic side-effect. No anaphylaxis was noted in the study. On day 90 none of the patients had developed rabies. So it can be concluded that ERIG is safe for passive immunisation against rabies.

Socio-clinical profile of rabis cases in anti-rabies clinic, M. K. C. G. Medical College, Orissa.

A hospital based study was conducted in the anti-rabies clinic of a medical college of Orissa during April 1988 to May 2002. Of 24 clinically diagnosed and reported rabies cases during the four years study period, 62.5% were children below 15 years of age, 67% were males, 87.5% were victims of stray dogs, 79% had not taken any anti-rabies treatment though all had undergone treatment by traditional systems of medicine.

Perspectives of leprosy patients on MDT services after integration of NLEP functions into primary health care.

Sixty-five leprosy patients residing in rural Digapahandi block of Ganjam district were studied during July-August 2001 in order to ascertain their perspectives regarding different MDT services after NLEP functions were integrated into primary health care (PHC) in Orissa after September 1999. They included 43.08% multibacillary (MB) cases and 61.92% paucibacillary (PB) cases. Assessment was done by personal interviews of adult patients and the parents of child cases after verification of their treatment cards at the sub-centre. Patient's knowledge regarding the availability of MDT services under PHC services and utilization of these services were highlighted. Influence of different socio-demographic factors was also studied. Basing on the study results, recommendations were made for sustained NLEP functions through PHC in order to improve the utilization of MDT services, which will help in the elimination of leprosy.

An interventional strategy to strengthen integration of NLEP into primary health care.

The Government of Orissa implemented the Revised Operational Strategy in September 1999 to integrate the NLEP functions into primary health care activities. An interventional strategy, in the form of consensus on job responsibilities and capacity-building through training of PHC staff, was developed and adopted in a rural block under the Department of Community Medicine to strengthen the integration process. The impact was studied six months after the intervention by comparing it with the leprosy situation in the pre-intervention period. Data were collected by verification of registers at the block PHC and sub-centre levels. Analysis was done using different leprosy indices, such as new case-detection rate (NCDR), child rate, deformity rate, profile of leprosy cases and patient compliance, etc. This integrated approach was found to be more community-oriented and effective in early case-detection in children and women. It also helped in providing continuous MDT services because of the involvement of primary health care functionaries in the post-intervention period.

Less known uses of weeds as medicinal plants.

In this paper the author presents medicinal or otherwise useful weed species with details of family, vernacular name and its medicinal utility. Information on other general economic importance of medicinal weeds is also described here.

Further contributions towards the ethnobotany of madhya pradesh 2: plants used against diarrhoea and dysentery.

The ethnobotanicol survey was made during last two years in the tribal population of Madhya Pradesh. Valuable information about tho medicinal use of certain plants used against Diarrhoea and dysentery amongst tribal population were obtained by personal interviews. The medicinal properties or those plants are also given in this communications.

An ethnobotanical study of madhya pradesh 1: plants used against various disorders among tribal women.

The ethnobotanical survey was made during last two years in the tribal population of Madhya Pradesh. Valuable information about the medicinal use of certain wild species against various diseases amongst tribal women are obtained by personal interviews. Some species are being used by them against various veneral diseases. Different plant parts of few species are also used by them for antifertility purposes. Some of these interesting medicinal properties of plants are given in the present communication.