Extensive genetic diversity with novel mutations in spike glycoprotein of severe acute respiratory syndrome coronavirus 2, Bangladesh in late 2020.

In Bangladesh, coronavirus disease 2019 (COVID-19) has been highly prevalent during late 2020, with nearly 500 000 confirmed cases. In the present study, the spike (S) protein of severe acute respiratory coronavirus 2 (SARS-CoV-2) circulating in Bangladesh was genetically investigated to elucidate the diversity of mutations and their prevalence. The nucleotide sequence of the S protein gene was determined for 15 SARS-CoV-2 samples collected from eight divisions in Bangladesh, and analysed for mutations compared with the reference strain (hCoV-19/Wuhan/WIV04/2019). All the SARS-CoV-2 S genes were assigned to B.1 lineage in G clade, and individual S proteins had 1-25 mutations causing amino acid substitution/deletion. A total of 133 mutations were detected in 15 samples, with D614G being present in all the samples; 53 were novel mutations as of January 2021. On the receptor-binding domain, 21 substitutions including ten novel mutations were identified. Other novel mutations were located on the N-terminal domain (S1 subunit) and dispersed sites in the S2 subunit, including two substitutions that remove potential N-glycosylation sites. A P681R substitution adjacent to the furin cleavage site was detected in one sample. All the mutations detected were located on positions that are functionally linked to host transition, antigenic drift, host surface receptor binding or antibody recognition sites, and viral oligomerization interfaces, which presumably related to viral transmission and pathogenic capacity.

Comparison between 2D and 3D Echocardiography in Efficient Detection of Commissural Calcification in Rheumatic Mitral Stenosis.

Rheumatic heart disease causes a substantial number of morbidity and mortality in Southeast Asia. In Bangladesh prevalence of Rheumatic Fever and Rheumatic heart disease is still high, 0.6 and 0.3 per thousand populations, respectively. Mitral valve mostly involved in the form of mitral stenosis in the rheumatic process. Treatment selections and its success largely depend upon the severity of disease especially the extent and distribution of calcification. Echocardiography has got the key role in determining the pattern, extent and severity of mitral stenosis. Two dimensional and Doppler echocardiography are conventionally used. With the increasing availability of 3D echocardiography, better cardiac imaging is possible now. The heart being a complex three-dimensional structure, the 3D evaluation would definitely offer better imaging for accurate assessment of the severity of mitral stenosis, especially details of commissural involvements. Many scoring systems are available for the assessment of the severity of rheumatic Mintral Stenosis (MS), mostly 2DE based; among them, Wilkins is mostly practiced. This cross-sectional observational study was conducted in University Cardiac Centre, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from May 2012 to October 2012. Data were collected from 50 subjects who underwent transthoracic 2D and 3D Echocardiography for the assessment of rheumatic mitral stenosis especially detection of calcification also it's severity, extent, and distribution, furthermore the presence of commissural calcification. Precise measurement of Mitral valvular area is essential in the assessment of severity, which is found similar by both 2DE (0.98±0.24cm²) and 3DE (0.92±0.23cm²). But in identifying calcification and its extent especially commissural involvement is better detected by 3DE (p=0.002). This has paramount importance in therapeutic decision making of chronic rheumatic MS. To make a well-organized management plan and also for the confident prediction of complications, three-dimensional echocardiography has promising prospects in detecting commissural calcification and should be considered as an essential adjuvant to the conventional two-dimensional echocardiography.

Functional constipation - prevalence and life style factors in a district of bangladesh.

Constipation is a common problem throughout the world and is particularly prevalent in women, children and older adults producing considerable health care expenditure. Data on functional constipation is limited especially in Asian countries. This cross-sectional survey assessed prevalence and association of functional constipation or chronic constipation (FC) with a number of socio-demographic and lifestyle factors. Data were collected from 3000 apparently healthy subjects by personal interview in a home setting with a questionnaire based on Rome III criteria for FC. Persons were selected by cluster sampling method from the population of Sylhet district. Among the 3000 subjects 148 subjects fulfilled the criteria for FC (Male=67, Female=81) giving a prevalence of 4.9%. Functional constipation was more prevalent in elderly (50-60 years, 10.1%, p=0.000), married persons (and widow/widowers, separated) (5.6-9.1%, p=0.000), city dwellers (6.2%), farmers (10.5%, p=0.000), house wives 6.1%, subjects taking vegetable (7.35%) and spices (6.0%) less frequently. The highest prevalent symptoms were feeling of incomplete evacuation (96.6%) and sensation of ano-rectal blockage (93.9%). No significant difference was found in the symptom pattern of FC among men and women. Older age (OR 2.755), female sex (OR 1.249), low intake of vegetable (OR 2.350) and spice (OR 2.050) appeared as important associated factor for FC. BMI and smoking had no significant association with FC. Functional constipation is a less prevalent disorder than IBS in our community. Female gender, old age and low intake of vegetable and spice were important associated factors for FC.

Growth performance, carcass yield, and quality and chemical traits of meat from commercial korean native ducks with 2-way crossbreeding.

This work was conducted to investigate the performance and meat characteristics of commercial Korean native duck (KND). A total of 180 1-d-old ducklings of 2-way crossbreds from A and B lines (from National Institute of Animal Science) were used in this work and divided into 4 groups (3 replicates/group, 15 birds/replicate). The four groups were 4 crossbreds as AA (A line [♀]×A line [♂]), AB (A line [♀]×B line [♂]), BB (Pure line B strains) and BA (B strains [♀]×A strain [♂]). Ducks were fed diets based on corn-soybean meal for 0 to 3 wk (22.4% crude protein [CP], 2,945 kcal/kg metabolizable energy [ME]) and 3 to 8 wk (18.4% CP, 3,047 kcal/kg ME). As a result of this study, average body weight of 4 crossbreds were 625, 1,617, 2,466, and 2,836 g at 2, 4, 6, and 8 weeks, respectively, and significantly increased over the period of time (p<0.05). Body weight of BB group was greater than other crossbreds at the age of 6 weeks (p<0.05). There was a significant difference in weekly body weight gains (p<0.05), which were 573, 991, 850, and 371 g at 2, 4, 6, and 8 weeks old, respectively. Uniformity of 4 crossbreds was 84.9%, 80.5%, and 72.5% at 6, 7, and 8 weeks, respectively, and there was no difference among crossbreds. Body weight gain of BB crossbred was highest among crossbreds (p<0.05). Weekly feed intake significantly increased with weeks as 669, 1,839, 2,812, and 3,381 g at 2, 4, 6, and 8 weeks respectively (p<0.05). Feed intakes of AA and BB crossbreds were higher at 2 to 4 weeks old than others and that of BB crossbred was highest at 4 to 6 weeks old (p<0.05). Weekly feed conversion ratios were 1.17, 1.86, 3.32, and 9.37 at 0 to 2, 2 to 4, 4 to 6, and 6 to 8 weeks old, respectively, and it increased with age (p<0.05). There was no significant difference in feed conversion ratio among crossbreds. Carcass yields of 4 crossbreds were 73.6%, 71.6%, 73.5%, and 71.7%, respectively, so there was no significant difference among crossbreds. There was no difference in wing, neck, breast and leg ratios among crossbreds. However, back ratios of 4 crossbreds were 17.6%, 18.0%, 15.8%, and 17.6%, respectively, and back ratio of BB was the highest among crossbreds. Finally, these results may provide the basic data on the production, carcass quality, fatty acid and amino acid composition of commercial KND with 2-way crossbreeding.

Various levels and forms of dietary α-lipoic acid in broiler chickens: Impact on blood biochemistry, stress response, liver enzymes, and antibody titers.

The present experiment was conducted to evaluate the impact of various levels and forms of α-lipoic acid (ALA) on blood biochemistry, immune and stress response, and antibody titers in broiler chickens. The four levels (7.5, 15, 75, and 150 ppm) and 2 sources (powder, P-ALA and encapsulated, E-ALA) of ALA along with negative (C-) and positive control (C+; contains antibiotics) diets consisted of 10 dietary treatments, and these treatments were allocated to 1,200 1-d-old chicks and were replicated 12 times with 10 birds per replicate. Among the blood biochemistry parameters, creatinine levels were almost 3 times lower in E-ALA-supplemented diets compared to the C- diet (0.09 vs. 0.25 mg/dL; P<0.0001). Neither level nor source of ALA affected blood urea nitrogen (BUN), total protein (TP), albumin, globulin, or albumin to globulin ratio (AGR). The supplemented diets decreased serum levels of the liver enzymes aspartate-aminotransferase (AST; P<0.006) and alanine-aminotransferase (ALT; P<0.0003). The Newcastle disease virus (NDV) antibody response in supplemented groups was poor at day zero (P<0.0001) but increased by d 14 (P<0.03). Birds did not respond to infectious bronchitis virus (IBV) vaccination at any observed stage (P>0.05). The concentration of cortisol was reduced in chickens fed ALA-supplemented diets as compared to the C- diet (P<0.001). Results suggest that ALA-supplemented diets ameliorated blood biochemistry profiles and immune responses and reduced stress in broiler chickens. The encapsulated form of ALA was more effective than the powder form.

Ginger extracts influence the expression of IL-27 and IL-33 in the central nervous system in experimental autoimmune encephalomyelitis and ameliorates the clinical symptoms of disease.

The immunomodulatory effects of the IL-27 and IL-33 and the anti-inflammatory effects of ginger have been reported in some studies. The aim was to evaluate the effects of the ginger extract on the expression of IL-27 and IL-33 in a model of experimental autoimmune encephalomyelitis (EAE). In PBS-treated EAE mice the expression of IL-27 P28 was significantly lower whereas the expression of IL-33 was significantly higher than unimmunized control mice. In 200 and 300 mg/kg ginger-treated EAE groups the expression of IL-27 P28 and IL-27 EBI3 was significantly higher whereas the expression of IL-33 was significantly lower than PBS-treated EAE mice. The EAE clinical symptoms and the pathological scores were significantly lower in ginger-treated EAE groups. These results showed that the ginger extract modulates the expression of the IL-27 and IL-33 in the spinal cord of EAE mice and ameliorates the clinical symptoms of disease.

Role of ascitic fluid adenosine deaminase (ADA) and serum CA-125 in the diagnosis of tuberculous peritonitis.

This cross sectional study was carried out in the department of gastroenterology, BIRDEM, Dhaka from January 2010 to May 2011 to determine the role of ascitic fluid ADA and serum CA-125 in the diagnosis of clinically suspected tubercular peritonitis. Total 30 patients (age 39.69 ± 21.26, 18M/12F) with clinical suspicion of tuberculosis peritonitis were included in this study after analyzing selection criteria. Laparoscopic peritoneal biopsy with 'histopathological diagnosis' was considered gold standard against which accuracics of two biomarkers (ADA & CA-125) were compared. Cut off value of ADA and CA-125 are 24 u/l, 35 U/ml respectively. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ADA as a diagnostic modality in tuberculos peritonitis were 87.5%, 83.33%, 95.45%, 62.5% and 86.67% respectively where as CA-125 was found to have 83.33% sensitivity, 50% specificity, 86.9% positive predictive value, 42.85% negative predictive value and 76.6% accuracy. Both biomarkers are simple, non-invasive, rapid and relatively cheap diagnostic test where as laparoscopy is an invasive procedure, costly & requires trained staff and not without risk and also not feasible in all the centre in our country. So ascitic fluid ADA and serum CA-125 are important diagnostic test for peritoneal tuberculosis.

Development and Evaluation of Weaning Foods Using Locally Available Nutritious Fruits in Bangladesh

Bangladesh has one of the highest rates of malnutrition in the world although the country is endowed with agricultural produce that could be properly utilised to prepare adequate food for children. Considering this, three weaning foods were formulated using locally available cereals and nutritious fruits such as wheat, soya flour, jackfruit and mango. Methods: Standard procedures of Association of Official Analytical Chemists (AOAC) and American Public Health Association (APHA) were used to determine the chemical composition and microbiological analysis. Organoleptic qualities were analysed by twenty adult panelists of the Institute of Food Science and Technology, Bangladesh, using a 9-hedonic scale against a cereal based commercial brand as standard for proximate and sensory properties. Results: The moisture content of the developed weaning foods ranged from 2.78-3.59%, crude protein content 14.74-16.55%, fat 11.04-12.70%, ash 1.38-1.68%, crude fibre 1.04-1.52%, carbohydrate 65.83-71.09% and energy content from 445.80-465.48 kcal/100g of the foods. The formulated weaning foods A, B and C were significantly different (p<0.05) in moisture, protein, fat, carbohydrate and energy contents from the commercial brand, D. According to rat bioassay method, the prepared weaning foods C and B had the highest Protein Efficiency Ratio and Feed Efficiency Ratio than the commercial brand, D. Total bacterial counts were nil for all weaning foods. Sensory analysis revealed acceptability of all the weaning foods and preference for weaning food C that compared favorably with the standard in all the quality attributes. Conclusion: The formulated weaning foods are inexpensive and nutritious, and its ingredients are locally available. These foods have the potential for improving malnutrition problems facing children in Bangladesh.

Influence of monochromatic light on quality traits, nutritional, fatty acid, and amino acid profiles of broiler chicken meat.

The role of monochromatic lights was investigated on meat quality in 1-d-old straight-run broiler chicks (n = 360), divided into 6 light sources with 6 replicates having 10 chicks in each replicate. Six light sources were described as incandescent bulbs (IBL, as a control) and light-emitting diode (LED) light colors as white light (WL), blue light, red light (RL), green light, and yellow light. Among LED groups, the RL increased the concentration of monounsaturated fatty acids (P < 0.001), saturated fatty acids (P < 0.001), and the saturated:polyunsaturated fatty acid ratio (P < 0.001), but reduced the concentration of polyunsaturated fatty acid, n-3 fatty acid, and n-6 fatty acid. The IBL increased the n-3 and sulfur-containing amino acids but reduced the n-6:n-3 nonessential amino acids. The WL improved the concentration of most of the essential amino acids (P < 0.01) and nonessential amino acids (P < 0.01) of breast meat. It can be extracted that the light produced by LED responded similar to the IBL light in influencing nutrient contents of meat. Moreover, LED is not decisive in improving fatty acid composition of meat. However, the role of IBL in reducing n-6:n-3 ratio and enhancing n-3 cannot be neglected. Among LED, WL is helpful in improving essential and nonessential amino acid contents of broiler meat.

Growth performance and hematological traits of broiler chickens reared under assorted monochromatic light sources.

A study was conducted to investigate the effect of different monochromatic lights on growth performance and hematological response of growing broiler chickens. A total of 360 one-day-old broiler chicks were randomly divided into 6 lighting treatments, which were replicated 6 times with 10 chicks in each replicate. Six light treatments include incandescent bulbs (as a control) and light-emitting diode white light, blue light, red light, green light, and yellow light (YL). The birds were provided with similar nutritional specifications and environmental management facilities, except for the lights throughout the experimental period. Growth performance was evaluated in terms of BW, BW gain, feed intake, and feed conversion ratio at weekly intervals. At the end of 5 wk, 2 birds from each replicate were randomly selected for blood collection to determine hematological response. The BW and feed intake was numerically higher in YL at 5 wk of age. But interestingly, this did not result in improved feed conversion ratio in YL; nevertheless, numerical values were lower in YL at 5 wk (P > 0.05). Red blood cells, blood platelet count, and percent hematocrit were numerically higher under YL, whereas white blood cell counts and percent hemoglobin remained unaffected due to light treatments. It was concluded that monochromatic light is a potential light source that might provide a beneficial effect on growth performance but is inconclusive for hematological measures of broilers.

Growth Performance, Carcass Traits and Serum Mineral Chemistry as Affected by Dietary Sodium and Sodium Salts Fed to Broiler Chickens Reared under Phase Feeding System.

A basal diet (0.8 g/kg dNa) was formulated in which each of the two sources (NaHCO3 and Na2SO4) were supplemented in such a way to attain four levels (1.7, 2.6, 3.5, and 4.4 g/kg) of total dNa, respectively, under 4×2 factorial arrangement. Eight dietary treatments were replicated four times, with 40 birds in each replicate (n = 1,280). The diets supplemented with Na2SO4 to attain higher levels of dNa showed highest BW gain and feed intake (FI) during d 1 to 10 (interaction effects) while 2.6 g/kg dNa exhibited improved BW gain and gain:feed (FG) during d 11 to 20. Linear rise in daily water intake (DWI) was associated with diets containing increasing dNa during d 1 to 42 (p≤0.036). During the first 10 d, DWI:FI was found highest in NaHCO3 diets while Na2SO4 diets showed highest DWI:FI during last 10 d of the experiment (p≤0.036). Increasing dNa and changing Na2SO4 with NaHCO3 salt increased pH and resulted in poor growth performance. Dressing weight (p≤0.001) and abdominal fat (p≤0.001; quadratic effect) were reduced, whereas breast (p≤0.001) and thigh (p<0.001) weights were aggravated with increasing dNa (linear effects). Present findings suggested higher levels of dNa from Na2SO4 as the supplemental salt in broiler diets would produce better growth performance, especially in first ten days of life, and improve carcass and body organ characteristics.

Growth Performance, Carcass Characteristics and Plasma Mineral Chemistry as Affected by Dietary Chloride and Chloride Salts Fed to Broiler Chickens Reared under Phase Feeding System.

Requirements of dietary chloride (dCl) and chloride salts were determined by using 4×2 factorial arrangement under four phase feeding program. Four levels (0.31, 0.45, 0.59 and 0.73%) and two sources (NH4Cl and CaCl2) of the dCl were allocated to 1,472 chicks in eight dietary treatments in which each treatment was replicated four times with 46 birds per replicate. The four phase feeding program was comprised of four dietary phases: Prestarter (d 1 to 10), Starter (d 11 to 20), Grower (d 21 to 33) and Finisher (d 34 to 42); and diets were separately prepared for each phase. The cations, anions, pH, dissolved oxygen (DO), temperature, electrical conductivity (EC), total dissolved solids (TDS) and salinity were analyzed in drinking water and were not affected by dietary treatments. BW gain (BWG; p≤0.009) and feed:gain (FG; p≤0.03) were improved in CaCl2 supplemented diets during d 1 to 10. The maximum response of BWG and FG was observed at 0.38% and 0.42% dCl, respectively, for d 34 to 42. However, the level of dCl for BWG during d 21 to 33 (p≤0.04) and d 34 to 42 (p≤0.009) was optimized at 0.60% and 0.42%, respectively. The level of dCl for optimized feed intake (FI; p≤0.006), FG (p≤0.007) and litter moisture (LM; p≤0.001) was observed at 0.60%, 0.38% and 0.73%, respectively, for d 1 to 42. Water intake (DWI) was not affected by increasing dCl supplementation (p>0.05); however, the ratio between DWI and FI (DWI:FI) was found highest at 0.73% dCl during d 1 to 10 (p≤0.05) and d 21 to 33 (p≤0.009). Except for d 34 to 42 (p≤0.006), the increasing level of dCl did not result in a significant difference in mortality during any phase. Blood pH and glucose, and breast and thigh weights (percentage of dressed weight) were improved while dressing percentage (DP) and gastrointestinal health were exacerbated with NH4Cl as compared to CaCl2 supplemented diets (p≤0.001). Higher plasma Na(+) and HCO3 (-) and lower Cl(-) and Ca(++) were observed in NH4Cl supplemented diets (p≤0.001). Increasing supplementation of dCl increased plasma Cl(-) (p≤0.04; quadratically) and linearly reduced plasma K(+) (p≤0.001), Ca(++) (p≤0.003), HCO3 (-) (p≤0.001), and Na(+) (p≤0.001; quadratically). Consequently, higher requirements of dietary chloride are suggested for feed intake; nevertheless, lower levels of dietary chloride are sufficient to support optimal BWG and FG with increasing age. The NH4Cl supplemented diets ameliorate breast and thigh meat yield along with overall energy balance (glucose).

New introduction of clade 2.3.2.1 avian influenza virus (H5N1) into Bangladesh.

Since the first outbreak of highly pathogenic H5N1 avian inafluenza (HPAI) in Bangladesh in February 2007, a total of 519 disease events have been reported till 22 October 2011. Partial HA gene sequences of 11 selected H5N1 HPAI isolates of 2007 to 2011 were determined and subjected to phylogenetic analysis. The study revealed a recent introduction of clade 2.3.2 and 2.3.4 viruses into Bangladesh in 2011 in addition to clade 2.2 viruses that had been in circulation since 2007. Clade 2.3.2 virus isolates from Bangladesh are phylogenetically related to the newly designated clade 2.3.2.1 viruses, reported recently from Asia and Eastern Europe.

Stress in mothers of preterm infants in Bangladesh: associations with family, child and maternal factors and children's neuro-development.

BACKGROUND: The aim of this paper was to ascertain stress experienced by mothers of prospectively followed up preterm infants, and associations with family, child and maternal factors and children's neuro-development. METHODS: Within a follow-up study of preterm infants<33 weeks gestational age at a Child Development Center in Dhaka Shishu Hospital, mothers were interviewed with the Self-Report Questionnaire (SRQ) at each visit. Association between SRQ scores and child, family and maternal variables at first and final visit and children's neuro-developmental outcomes was determined. RESULTS: Low income mothers were more compliant (54%) compared with the defaulters (31%) (P=0.0001) among the 159 mothers enrolled. Of the 88 mothers who were followed up until a mean age of 22 months of their child, 29.3% were at high risk for psychiatric morbidity at first visit compared with 23.9% on their last visit. Use of abortifacients (P=0.026) and higher maternal age (P=0.040) were significantly associated with maternal stress at first visit; while at last follow-up, total number of visits had the most significant association (P=0.041). Twenty-five per cent and 19% of mothers were at risk for psychiatric morbidity in children developing normally and those with neuro-developmental impairments respectively. CONCLUSIONS: Mothers at risk for psychiatric morbidity can be helped through follow-up support within public hospitals close to their homes, which is most availed by low income families. Neuro-developmental monitoring of high-risk infants closer to homes may be more feasible in resource poor countries than reliance on hospital visits, which increase stress. Biological markers of stress and coping strategies need further research.

Pott's disease in a young child.

A 16-month-old emaciated, immunized child presented with low-grade fever and progressive kyphosis with a right sided para-vertebral abscess for 9 months. During this period of illness the child had marked loss of appetite and progressive weight loss. There was history of contact with sputum smear positive father. A gibbus was present at thoraco-lumbar region with a cold abscess at the right side of the gibbus and signs of upper motor neuron lesion were found on lower limb examination. Diagnosis was supported by relevant investigations including MRI of dorsolumbar spine and treatment was started beforehand with anti-tubercular drugs. The paravertebral abscess was drained several times and antibiotics were used depending upon the results of microbiological study. At the same time the patient was advised to wear a modified chest brace for immobilization and the management for severe malnutrition was also started accordingly. There was significant clinical improvement observed within one month of starting treatment.

Clinical picture of craniopharyngioma in childhood.

This cross sectional and observational study was carried out among the admitted patients of the department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka during the period of 1st March 2004 to 31st March 2005. Among the all intracranial tumours, 2.5-04% are Craniopharyngiomas. Although there is a bi-modal age distribution-1st peak at 5-10 years and the 2nd peak at 55-65 years, the common patients are children (9% of childhood tumour). A typical child with Craniopharyngioma (CP) is short, obese and half blind and has a poor school record. The study has been undertaken to know in details, how child patients with Craniopharyngiomas in Bangladesh present their disease at the hospital. Earlier diagnosis and management may improve the quality of life and longivity. The average age of the patients was 13 years ranging from 07 to 17 years. The vast majority patients were admitted with visual problems as their presenting complaints. Among the patients 33% had total blindness of which 03 had primary optic atrophy and 1 has secondary optic atrophy. Among the remaining 08 patients, 75% were found to have field defect. All patients showed fundal changes ranging from early papilloedema to optic atrophy. We found major endocrinological deficiency in child patients with Craniopharyngioma in 17% cases. Raised Prolactin level may not be significant, because it could be due to stalk effect. Although 25% patients were of short stature, their hormonal profile was within normal range according to age and sex.

Diagnostic efficacy of Aldehyde test in late cases of Kala-azar.

This case control study was carried out in the Paediatric wards of Mymensingh Medical College Hospital for a period of one year from April 2002 to March 2003 to determine the sensitivity, specificity and predictive values of Aldehyde test in the diagnosis of Kala-azar. A total of seventy five febrile cases of Kala-azar from Paediatric wards were enrolled in the study and Seventy five controls having splenomegaly with or without fever were also included from the same source. Aldehyde test was done in both cases and controls. Diagnosis of Kala-azar was confirmed by demonstration of Leish-man-Don-o-van body (LD) in bone marrow or splenic aspirates. Out of 75 parasitologically proven cases of Kala-azar, AT was positive in 56 cases. The sensitivity irrespective of duration of illness was 74.6%. We found sensitivity of AT increases with the duration of illness where AT was sensitive in 34.7% cases having fever for less than 3 months, 90.90% with fever for 3 months to less than 6 months and 100% with fever for 6 months or more in duration. Specificity of AT was calculated as 96% with positive and negative predictive values of 94.9% and 79.1% respectively. So AT is a very sensitive and specific test with high positive and negative predictive values. Considering the cost, availability, simplicity, sensitivity, and specificity we would recommend the Aldehyde test as an important diagnostic tool for field diagnosis of Kala-azar especially after three months of febrile illness.

Calibration and control in haemoglobinometry.

In assigning values to fresh blood specimens used for calibrating automated blood cell analysers, haemoglobin concentration should be determined by the ICSH recommended hemiglobincyanide (HiCN) method. Errors in the reference method may be caused by inadequate blood collection, e.g. incorrect anticoagulation; inadequate dilution, e.g. use of inadequately calibrated pipettes; incomplete conversion of haemoglobins to HiCN, e.g. insufficient time for reactions to come to completion; during measurement, e.g. due to turbidity of the HiCN solution to be measured; or by transcription error. Readily available commercial reagent systems and secondary standards are compared with ICSH standards as to their compliance with these standards.

Immunobiologics and drugs available from the Centers for Disease Control.

The CDC provides to the medical profession various drugs and immunobiological materials, many of which are investigational. The products available at CDC have changed over the years to meet the changing needs of the American public. Availability of the investigational drugs and immunobiologics permits treatment of patients with diseases against which no FDA-approved drug or treatment is effective and permits research and development of new drugs by manufacturers.