Current concepts in cardiopulmonary resuscitation in adults.

Cardiopulmonary resuscitation (CPR) provides artificial circulation and ventilation during cardiopulmonary arrest. CPR is further categorised as basic life support (BLS), advanced cardiac life support (ACLS) and postresuscitation support. BLS consists of provision of a patent upper airway, ventilation and circulation of blood by closed chest cardiac compressions. ACLS includes use of specialised equipment to maintain the airway, early defibrillation and pharmacologic therapy. Successful outcome from an arrest depends on the total duration of an arrest and early defibrillation, as ventricular fibrillation is the most common cardiac rhythm found in adult cardiac arrest. Initial drug therapy during CPR aims at correction of arterial hypoxaemia and restoring coronary and cerebral perfusion. Oxygen and epinephrine constitute the mainstay of drug therapy during CPR. In patients with ventricular tachycardia, lidocaine is the drug of choice, followed by bretylium. Magnesium has proved to be useful in both refractory pulseless ventricular tachycardia and fibrillation. Atropine has not been demonstrated to improve outcome from arrest but can be administered in bradyasystolic cardiac arrest. The routine administration of bicarbonate and calcium is no longer recommended but situations exist where they can be used appropriately. Administration of drugs during CPR should preferably be via a central route, but epinephrine, lidocaine and atropine can be administered via the endotracheal tube if intravenous access has not been established. Postresuscitation care includes mechanical ventilation if necessary to optimise oxygenation and ventilation and steps to maintain vital organ and optimal brain protection, which includes avoidance of hypertension, hypotension and hyperglycaemia.

Protein A linked latex antisera test for detection of infectious flacherie of silkworm, Bombyx mori L. caused by B. mori infectious flacherie virus.

Protein A linked latex antisera (PALLAS) test was used for detection of B. mori infectious flacherie virus (BmIFV) in silkworms. The test was found superior to direct latex agglutination (DLA) test for detection of BmIFV in infected larval and faecal matter extracts and purified preparations. Latex beads sensitized with anti-BmIFV IgG were able to detect up to 75 ng/ml BmIFV in PALLAS test and 300 ng/ml in DLA test. BmIFV was detected in diluted extracts of infected larvae (up to 1:200) and their faecal matter (up to 1:500). BmIFV progressive infection was detected at 12 and 24 hr of post infection in PALLAS and DLA tests, respectively in both larval and faecal matter extracts. PALLAS tests provides a simple, specific and highly sensitive test for detection of infectious flacherie virus.

Etiologic spectrum of acute sporadic viral hepatitis in children in India.

The relative magnitude by hepatitis A virus (HAV), hepatitis B virus (HBV) and hepatitis Non-A, Non-B virus (HNANBV) was determined in 496 children from three different parts of India suffering from acute viral hepatitis by tests for specific IgM class anti-HAV and anti-HBV antibodies in the serum. HAV, HBV and NANB infections accounted for 55.8 per cent, 20.2 per cent and 23.2 per cent of cases respectively. Hepatitis A largely (59.5%) affected younger children of 1-5 yr. Nearly a third of children affected by NANB hepatitis were additionally positive for HBsAg. The proportions of HAV and HBV infected cases respectively decreased and increased with increasing age whereas the incidence of HNANBV infection remained almost constant throughout childhood. Acute NANB hepatitis, a major health problem in the adults of India is also common throughout childhood. This study suggests that this infection does not impart long lasting protective immunity.