Postpartum and Newborn Care - A Qualitative study

Community-based postpartum care of mothers and newborns is vital to achieve mortality reduction. This qualitative study explored cultural beliefs and practices regarding postpartum care of mothers and newborns in rural Karnataka. Focus group discussions with newly delivered mothers and their caregivers in a rural maternity hospital, and in-depth interviews with community level health workers revealed cessation of the practice of withholding colostrum and the barbaric practice of branding, but found persisting harmful cultural beliefs and practices like withholding nutritious foods considered “hot” or “cold”, inadequate postpartum ambulation, separating husband and wife for up to a year or more after the birth, application of various substances to the umbilical stump and eyes of the newborn and giving pre-lacteal feeds. Antenatal and postpartum mothers, their caregivers, including elders in the family should be targeted by community level health workers for counseling and behavior change.

Epidemiology & risk factors of scrub typhus in south India.

Background & objectives: Scrub typhus is a major public health threat in South and Southeastern Asian countries including India. Understanding local patterns of disease and factors that place individuals at risk is pivotal to future preventive measures against scrub typhus. The primary aim of this study was to identify specific epidemiological and geographical factors associated with an increased risk of developing scrub typhus in this region. Methods: We mapped 709 patients from Tamil Nadu, Andhra Pradesh and Telangana who were admitted to the Christian Medical College (CMC) Hospital, Vellore, Tamil Nadu, India, for the period 2006-2011, assessed seasonality using monthly counts of scrub typhus cases, and conducted a case-control study among a subset of patients residing in Vellore. Results: The geographic distribution of cases at CMC Hospital clusters around the Tamil Nadu-Andhra Pradesh border. However, distinct hotspots clearly exist distal to this area, near Madurai and the coast in Tamil Nadu, and in the Northeast of Andhra Pradesh. Seasonally, the highest numbers of cases were observed in the cooler months of the year, i.e. September to January. In the case-control analysis, cases were more likely to be agricultural laborers (OR 1.79, 95% CI 1.01 - 3.15), not wear a shirt at home (OR 4.23, 95% CI 1.12 - 16.3), live in houses adjacent to bushes or shrubs (OR 1.95, 95% CI 1.08 - 3.53), and live in a single room home (OR 1.75, 95% CI 1.02 - 3.01). On binary logistic regression, the first three of these variables were statistically significant. Interpretation & conclusions: With the growing number of cases detected in India, scrub typhus is fast emerging as a public health threat and further research to protect the population from this deadly infection is essential. Health education campaigns focusing on the agricultural workers of Southern India, especially during the cooler months of the year, can serve as an important public health measure to control infection.

DHR-ICMR Guidelines for diagnosis & management of Rickettsial diseases in India.

Rickettsial diseases, caused by a variety of obligate intracellular, gram-negative bacteria from the genera Rickettsia, Orientia, Ehrlichia, Neorickettsia, Neoehrlichia, and Anaplasma, belonging to the Alphaproteobacteria, are considered some of the most covert emerging and re-emerging diseases and are being increasingly recognized. Among the major groups of rickettsioses, commonly reported diseases in India are scrub typhus, murine flea-borne typhus, Indian tick typhus and Q fever. Rickettsial infections are generally incapacitating and difficult to diagnose; untreated cases have case fatality rates as high as 30-45 per cent with multiple organ dysfunction, if not promptly diagnosed and appropriately treated. The vast variability and non-specific presentation of this infection have often made it difficult to diagnose clinically. Prompt antibiotic therapy shortens the course of the disease, lowers the risk of complications and in turn reduces morbidity and mortality due to rickettsial diseases. There is a distinct need for physicians and health care workers at all levels of care in India to be aware of the clinical features, available diagnostic tests and their interpretation, and the therapy of these infections. Therefore, a Task Force was constituted by the Indian Council of Medical Research (ICMR) to formulate guidelines for diagnosis and management of rickettsial diseases. These guidelines include presenting manifestations, case definition, laboratory criteria (specific and supportive investigations) and treatment.

Priocharax nanus, a new miniature characid from the rio negro, Amazon basin (ostariophysi: characiformes), with an updated list of miniature neotropical freshwater fishes

Priocharax nanus, new species, is described from the rio Negro, Brazil. It is a miniature fish that retains as an adult the larval rayless pectoral fin, a diagnostic character of the genus. Priocharax nanus possesses fewer reductive features compared to congeners, P. ariel and P. pygmaeus, from which it can be distinguished by the presence of i,6 pelvic-fin rays (vs. i,5), the presence of the claustrum (vs. claustrum absent) and the presence of two postcleithra (vs. postcleithra absent). An updated list of 213 species of miniature Neotropical freshwater fishes is presented. The greatest diversity among them is represented by the Characiformes with 87 miniature species.

Priocharax nanus, espécie nova, é descrita do rio Negro, Brasil. É um peixe miniatura que retém no adulto a forma larval da nadadeira peitoral, um caráter diagnóstico do gênero. Priocharax nanus possui um número menor de caracteres redutivos quando comparado aos congêneres, P. ariel and P. pygmaeus, dos quais pode ser distinguida pela presença de i,6 raios na nadadeira pélvica (vs. i,5), presença do claustrum (vs. claustrum ausente) e presença de dois pós-cleitros (vs. pós-cleitros ausentes). Uma lista atualizada de 213 espécies de peixes miniatura de água doce neotropicais é apresentada. A maior diversidade entre eles é representada pelos Characiformes, com 87 espécies miniatura.

Taxonomic study of hoplias microlepis (Günther, 1864), a trans-andean species of trahiras (ostariophysi: characiformes: erythrinidae)

The Hoplias malabaricus species group represents one of the most complexes taxonomical problems in the systematics of Neotropical fishes, including specimens widely distributed in most drainages of South America and part of Central America with great variation or overlap of putative diagnostic characters. The large number of nominal species, many of which without known type material, renders the problem more complicated. Currently, at least three nominal species can be included in the Hoplias malabaricus species group based on the form of the medial margins of dentaries and presence of tooth plates on the tongue: Hoplias malabaricus, H. teres, and H. microlepis, the latter representing the only exclusively trans-Andean known species of the genus. We present herein a taxonomic study of Hoplias microlepis based on examination of syntypes and recently collected specimens, including a redescription of the species. Hoplias microlepis occurs in the Pacific drainages of Panama and Southwestern Costa Rica, in addition to the río Guayas basin in Ecuador and the region near its mouth (río Tumbes, Northwestern Peru). Records of the species on the Atlantic coast of Panama are restricted to the Canal Zone, suggesting dispersal through the Panama Canal. We also designate lectotype and paralectotypes.

O grupo de espécies Hoplias malabaricus representa um dos problemas taxonômicos mais complexos na sistemática de peixes Neotropicais, com ampla distribuição em quase todas as bacias da América do Sul e parte da América Central e grande variação ou sobreposição de prováveis caracteres diagnósticos. O grande número de espécies nominais, muitas delas sem material-tipo conhecido, é um fator complicador nessa questão. Atualmente, pelo menos três espécies nominais podem ser incluídas no grupo de espécies Hoplias malabaricus, com base no formato das margens mediais dos dentários e presença de dentes na língua: Hoplias malabaricus, H. teres e H. microlepis, a última sendo a única espécie exclusivamente trans-andina do gênero conhecida até o momento. Apresentamos aqui um estudo taxonômico de Hoplias microlepis, com exame dos síntipos e exemplares coletados mais recentemente, incluindo uma redescrição da espécie. Hoplias microlepis distribui-se nas bacias da costa Pacífica do Panamá e sudoeste da Costa Rica, além da bacia do río Guayas no Equador e região próxima à sua foz (río Tumbes, noroeste do Peru). Registros da espécie na costa Atlântica do Panamá são restritos à Zona do Canal, sugerindo dispersão através do Canal do Panamá. São designados também lectótipo e paralectótipos.

Ontogenetic development of heterocharax macrolepis eigenmann (Ostariophysi: characiformes: characidae) with comments on the form of the yolk sac in the heterocharacinae

Fishes in early developmental stages frequently have morphological features that differ from those of adult stages, and many characters found later in ontogeny are not available in initial stages. Hence, morphological descriptions of early stages are useful to provide information for the identification of eggs and larvae, a knowledge still restricted among Neotropical fishes. We studied the development of Heterocharax macrolepis, a heterocharacine whose adult specimens from the aquarium trade were kept and spawned at around 23-24ºC. A developmental series of 51 specimens was preserved, ranging from 3.2 mm notochord length to 18.6 mm standard length, covering approximately the first 73 days post-hatching. We described the development of main morphological features emphasizing those useful in the identification of H. macrolepis larvae (i.e., appearance of preopercle spine and development of the pseudotympanum). We also compared H. macrolepis with photographs taken of live larval specimens of Gnathocharax steindachneri, recently included in the Heterocharacinae. Both species have a yolk sac with a small rounded projection directed posteroventrally. Although this information is not yet available for all pertinent taxa, the different yolk sac shape in other representatives of the Characiformes may indicate that this peculiar yolk sac represents an additional synapomorphy of the Heterocharacini.

Peixes em estágios iniciais de desenvolvimento frequentemente apresentam características morfológicas distintas dos adultos e muitos caracteres presentes em estágios avançados não são disponíveis em estágios iniciais. Assim, descrições morfológicas dos estágios iniciais de desenvolvimento de peixes são úteis por fornecerem subsídios para a identificação de ovos e larvas, um conhecimento ainda escasso entre peixes Neotropicais. Estudamos o desenvolvimento de Heterocharax macrolepis, espécie de Heterocharacinae cujos exemplares adultos provenientes do aquarismo foram mantidos e reproduzidos entre 23-24ºC. Uma série de desenvolvimento de 51 exemplares foi preservada, medindo entre 3,2 mm de comprimento da notocorda e 18,6 mm de comprimento padrão, incluindo os primeiros 73 dias pós-eclosão. Descreveram-se detalhadamente os principais aspectos morfológicos, enfatizando características úteis na identificação de larvas de H. macrolepis (i.e., surgimento do espinho do pré-opérculo, desenvolvimento do pseudotímpano). Comparamos H. macrolepis com fotografias de larvas vivas de Gnathocharax steindachneri, recentemente incluída em Heterocharacinae. Ambas espécies possuem saco vitelínico com pequena projeção arredondada póstero-ventral. Ainda que a informação não esteja disponível para os táxons pertinentes, o distinto formato do saco vitelínico em outras linhagens de Characiformes pode indicar que esta forma do saco vitelínico peculiar represente sinapomorfia adicional de Heterocharacini.

Periapical tissue reaction to calcium phosphate root canal sealer in porcine model.

Background: Calcium phosphate cements (CPC) are a group of biomaterials possessing wide scope of use in various branches of medical science. These materials have been proposed to be highly biocompatible and osteoconductive. This study is based on a newly developed CPC formulation (Chitra-CPC) and is aimed at the evaluation of its biocompatibility through an Endodontic Usage Test in a porcine study model. Objective: To evaluate the periapical tissue reaction to Chitra-CPC when used as a root canal sealer/filler material in comparison with a resin sealer, AH Plus (Dentsply). Materials and Methods: The procedure was done on porcine animal model following the ISO 7405 criteria. The material was implanted intentionally into the periapical area of 36 teeth through a root canal procedure carried out in six animals which were divided equally among 1-month and 3-month time periods. Results were based on the histological evaluation of the autopsied specimens after the prescribed time periods. Results: Mild to moderate periapical tissue reaction was found in Chitra-CPC samples belonging to the 1-month time period, whereas majority of the 3-month CPC samples showed an absence of inflammation. Samples of AH Plus in 1-month period showed severe to moderate inflammation, whereas 3-month AH Plus samples had a mild to moderate inflammation. Conclusions: Chitra-CPC is a biocompatible material.

A study of aetiology of portal hypertension in adults (including the elderly) at a tertiary centre in southern India.

Background & objectives: There are only a few studies on aetiology of portal hypertension among adults presenting to tertiary care centres in India; hence we conducted this study to assess the aetiological reasons for portal hypertension in adult patients attending a tertiary care centre in southern India. Methods: Causes of portal hypertension were studied in consecutive new adult patients with portal hypertension attending department of Hepatatology at a tertiary care centre in south India during July 2009 to July 2010. Results: A total of 583 adult patients (>18 yr old) were enrolled in the study. After non-invasive testing, commonest causes of portal hypertension were cryptogenic chronic liver disease (35%), chronic liver disease due to alcohol (29%), hepatitis B (17%) or hepatitis C (9%). Of the 203 patients with cryptogenic chronic liver disease, 39 had liver biopsy - amongst the latter, idiopathic non cirrhotic intrahepatic portal hypertension (NCIPH) was seen in 16 patients (41%), while five patients had cirrhosis due to non alcoholic fatty liver disease. Fifty six (10%) adult patients with portal hypertension had vascular liver disorders. Predominant causes of portal hypertension in elderly (>60 yrs; n=83) were cryptogenic chronic liver disease (54%) and alcohol related chronic liver disease (16%). Interpretation & conclusions: Cryptogenic chronic liver disease was the commonest cause of portal hypertension in adults, followed by alcohol or hepatitis B related chronic liver disease. Of patients with cryptogenic chronic liver disease who had liver biopsy, NCIPH was the commonest cause identified. Vascular liver disorders caused portal hypertension in 10 per cent of adult patients. Cryptogenic chronic liver disease was also the commonest cause in elderly patients.

Quantitative assessment of palatal bone thickness in an ethnic Indian population: A computed tomography study.

Context: Variations in palatal bone thickness (PBT) at various locations have caused considerable problems when using these sites for anchorage purposes. Aims: To find the comparative thickness of the palatal bone at different locations and to validate its morphology for anchorage purposes using mini-implants (MI). Settings and Design: This investigation was undertaken to compare the mean PBT and level of significance of differences between male and female subjects and between two different age-groups. Materials and Methods: The computed tomography (CT) data for 60 patients (30 males and 30 females) in two different age-groups (group A: 15-24 years; group B: 25-35 years) were imported into CAD-based medical software, (MIMICS® ; Materialise, Belgium) for multiplanar reconstruction. The measurements were made in two planes- transverse and sagittal-and at different positions in each of the planes. Statistical Analysis: The mean and standard deviations of the PBT at different points were calculated. The Student's t-test and Mann-Whitney U test were used for comparisons between the groups. Results: Significant variations were observed in the thickness of the palatal bone for both groups tested, with the anterior region at 4 mm behind the incisive papilla showing the maximum thickness. Conclusions: Despite the palatal bone being thickest in the mid-palatal suture (MPS) region, this is not the ideal site for anchorage purposes due to inadequate calcification and interposition of connective tissue, especially in young growing children. So, the alternate optimum position is the paramedian region, 3 mm lateral to the MPS and 4 mm from the incisive foramen (IF).

Addressing healthcare needs of people living below the poverty line: A rapid assessment of the Andhra Pradesh Health Insurance Scheme.

Background. Families living below the poverty line in countries which do not have universal healthcare coverage are drawn into indebtedness and bankruptcy. The state of Andhra Pradesh in India established the Rajiv Aarogyasri Community Health Insurance Scheme (RACHIS) in 2007 with the aim of breaking this cycle by improving the access of below the poverty line (BPL) families to secondary and tertiary healthcare. It covered a wide range of surgical and medical treatments for serious illnesses requiring specialist healthcare resources not always available at district-level government hospitals. The impact of this scheme was evaluated by a rapid assessment, commissioned by the government of Andhra Pradesh. The aim of the assessment was to explore the contribution of the scheme to the reduction of catastrophic health expenditure among the poor and to recommend ways by which delivery of the scheme could be improved. We report the findings of this assessment. Methods. Two types of data were used for the assessment. Patient data pertaining to 89 699 treatment requests approved by the scheme during its first 18 months were examined. Second, surveys of scheme beneficiaries and providers were undertaken in 6 randomly selected districts of Andhra Pradesh. Results. This novel scheme was beginning to reach the BPL households in the state and providing access to free secondary and tertiary healthcare to seriously ill poor people. Conclusion. An integrated model encompassing primary, secondary and tertiary care would be of greater benefit to families below the poverty line and more cost-effective for the government. There is considerable potential for the government to build on this successful start and to strengthen equity of access and the quality of care provided by the scheme.

Consenso brasileiro em transplante de células-tronco hematopoéticas: comitê de hemoglobinopatias / Brazilian consensus meeting on stem cell transplantation: hemoglobinopathies comittee

Os distúrbios hereditários das hemoglobinas são as doenças genéticas mais frequentes do homem e mais difundidas no mundo, abrangendo sobretudo continentes como África, Américas, Europa e extensas regiões da Ásia. Estima-se que haja 270 milhões de portadores de hemoglobinopatias no mundo, dos quais 80 milhões são portadores de talassemia. Aproximadamente 60 mil crianças nascem anualmente no mundo com talassemia e 250 mil com anemia falciforme, dando uma frequência de 2,4 crianças afetadas para cada 1.000 nascimentos. No Brasil, a doença falciforme é a doença hereditária monogênica mais comum, estimando-se que haja entre 20 a 30 mil pacientes portadores desta doença. O transplante de células-tronco hematopoéticas alogênico (TCTH alo) é atualmente a única modalidade terapêutica capaz de curar pacientes com hemoglobinopatias. Neste artigo discutiremos os dados disponíveis na literatura e sugerimos os critérios para a indicação do TCTH nas hemoglobinopatias.

Hemoglobinopathies are the most prevalent genetic diseases in man. Most cases are described in Europe, Africa and in the Americas. About 270 million hemoglobinopathy carriers are alive today with 80 million being carriers of thalassemia. We estimate that, throughout the world, about 60,000 children are born annually with thalassemia and 250,000 with sickle cell disease with an estimated frequency of 2.4 children in every 1000 births. Sickle cell disease is the most common monogenic hereditary disease in Brazil with a total of from 20,000 to 30,000 patients. Allogeneic stem cell transplantation is the only curative approach. Here we describe published data and propose criteria to indicate stem cell transplantation in thalassemia and sickle cell disease patients.

Carnitine-acylcarnitine translocase deficiency. Clinical course of three Saudi children with a severe phenotype

Carnitine-acylcarnitine translocase [CACT] deficiency [McKusick 212138] is a rare life threatening disorder characterized by hypoketotic hypoglycemia, hyperammonemia, encephalopathy, cardiomyopathy hepatopathy, and myopathy. Here, we present a detailed clinical course of 3 Saudi siblings with a severe phenotype. The third patient was described in more detail. Early medical intervention in the form of 25% dextrose intravenous infusion and carnitine supplement followed by a gradual introduction of a high carbohydrate low fat special formula resulted in a good clinical and biochemical response to the treatment in our patient. However, early nephrocalcinosis, severe hypotonia, and subsequently intravascular cerebral accident could not be prevented. He died at 18 months of age as a result of metabolic decompensation. This suggests that CACT deficiency is still a lethal disorder even with an early and aggressive medical intervention

Revision of the Neotropical trahiras of the Hoplias lacerdae species-group (Ostariophysi: Characiformes: Erythrinidae) with descriptions of two new species

Hoplias lacerdae was originally described from the rio Ribeira de Iguape, Iporanga, São Paulo State. The Hoplias lacerdae group is defined as containing generally large trahiras with the medial margins of dentaries running parallel to each other and lacking teeth on the basihyal compared to the H. malabaricus group in which the medial margins of the dentaries converge towards the mandibular symphysis and which have teeth on the basihyal. A taxonomic revision of the group based on meristic and morphometric data identified five distinct species: H. lacerdae distributed in the rio Ribeira de Iguape and rio Uruguai; H. intermedius from the rio São Francisco, upper rio Paraná basin, and rio Doce; H. brasiliensis from rivers of the Atlantic Coastal drainage from the rio Paraguaçu to the rio Jequitinhonha; H. australis new species, endemic to the rio Uruguai; and H. curupira new species present in northern South America, including the rios Negro, Trombetas, Tapajós, Xingu, Tocantins and Capim in the Amazon basin, upper rio Orinoco near the rio Casiquiare (Venezuela), and coastal rivers of Guyana and Suriname. A lectotype for Hoplias intermedius and a neotype for H. brasiliensis are designated.

Hoplias lacerdae foi descrita originalmente do rio Ribeira de Iguape, Iporanga, São Paulo. O grupo Hoplias lacerdae foi definido como um conjunto de espécies para abrigar as traíras geralmente de grande porte, com as margens mediais dos dentários dispostas paralelamente e sem dentes no basi-hial, em oposição às traíras do grupo Hoplias malabaricus, cujas margens mediais dos dentários convergem em direção à sínfise mandibular e possuem dentes no basi-hial. A revisão taxonômica do grupo baseada em dados merísticos e morfométricos identificou cinco espécies distintas: Hoplias lacerdae distribuída nos rios Ribeira de Iguape e Uruguai; H. intermedius no rio São Francisco, alto rio Paraná e rio Doce; H. brasiliensis nos rios costeiros da drenagem Atlântica, desde o rio Paraguaçu até o rio Jequitinhonha; H. australis espécie nova, endêmica ao rio Uruguai; e H. curupira espécie nova no norte da América do Sul, incluindo os rios Negro, Trombetas, Tapajós, Xingu, Tocantins e Capim na bacia Amazônica; alto rio Orinoco próximo ao rio Casiquiare (Venezuela) e rios costeiros da Guiana e Suriname. São designados um lectótipo para Hoplias intermedius e um neótipo para H. brasiliensis.

Quantitation of hepatitis B virus DNA in plasma using a sensitive cost-effective "in-house" real-time PCR assay.

BACKGROUND: Sensitive nucleic acid testing for the detection and accurate quantitation of hepatitis B virus (HBV) is necessary to reduce transmission through blood and blood products and for monitoring patients on antiviral therapy. The aim of this study is to standardize an "in-house" real-time HBV polymerase chain reaction (PCR) for accurate quantitation and screening of HBV. MATERIALS AND METHODS: The "in-house" real-time assay was compared with a commercial assay using 30 chronically infected individuals and 70 blood donors who are negative for hepatitis B surface antigen, hepatitis C virus (HCV) antibody and human immunodeficiency virus (HIV) antibody. Further, 30 HBV-genotyped samples were tested to evaluate the "in-house" assay's capacity to detect genotypes prevalent among individuals attending this tertiary care hospital. RESULTS: The lower limit of detection of this "in-house" HBV real-time PCR was assessed against the WHO international standard and found to be 50 IU/mL. The interassay and intra-assay coefficient of variation (CV) of this "in-house" assay ranged from 1.4% to 9.4% and 0.0% to 2.3%, respectively. Virus loads as estimated with this "in-house" HBV real-time assay correlated well with the commercial artus HBV RG PCR assay ( r = 0.95, P < 0.0001). CONCLUSION: This assay can be used for the detection and accurate quantitation of HBV viral loads in plasma samples. This assay can be employed for the screening of blood donations and can potentially be adapted to a multiplex format for simultaneous detection of HBV, HIV and HCV to reduce the cost of testing in blood banks.

Correlation between hepatitis B genotypes, 1896 precore mutation, virus loads and liver dysfunction in an Indian population.

BACKGROUND/OBJECTIVES: Hepatitis B virus (HBV) genotypes may differ in pathogenicity. However, the interplay between different virus characteristics such as genotypes, mutants and virus loads has not been well studied . We investigated the association between HBV genotype, presence of 1896 precore mutation and HBV viral loads in patients with HBV-related liver disease. METHODS: One hundred and sixteen HBV DNA-seropositive patients attending a gastroenterology outpatient clinic and 107 HBV DNA-seropositive blood donors were recruited. The subjects were stratified as those with normal (Group I, n=164) and elevated (Group II, n=59) ALT levels. The HBV genotype and the presence of the 1896 precore mutation were determined, and plasma HBV DNA levels measured. RESULTS: Genotype C was more common in Group II than in Group I (10 (17%) vs. 4 (2.4%); p< 0.005). There was no relationship between the 1896 precore mutation and the HBV DNA levels. Subjects with genotype C (n=14) had higher HBV DNA levels than those with genotypes A (n=33) or D (n=158). CONCLUSIONS: The infecting genotype, but not the presence of 1896 precore mutation, correlates with HBV load. The association of genotype C with higher virus loads and with elevated ALT may point to a greater pathogenicity of this genotype.

Effect of Centella Asiatica Extract on Nociception; Experimental Diabetes and Hyperlipidemia in Mice and Rats

This study was undertaken to determine the effect of Centella asiatica aqueous extract (CAEt) on nociception; experimental diabetes and hyperlipidemia in mice and rats. The extract was administered orally and the effects of different doses of the extract on nociception in mice; on blood glucose; glucose-6-phosphatase; and serum and tissue lipids in rats with alloxan-induced diabetes were studied. Diclofenac and chlopropamide were used as standard drugs for nociception and diabetes; respectively. The doses of extract administered were 150; 300; 500 mg/kg body weight. The data obtained indicated that the aqueous extract of Centella asiatica exhibited anti-nociceptive activity in mice. Results of the anti-diabetic study indicated that the extract suppressed the elevated blood glucose. In anti-hyperlipidemic study; lipid levels didn't change in diabetic rats treated with CAEt. These findings show that the extract possesses anti-nociceptive and anti-diabetic activities

Transplante de células-tronco hematopoéticas (TCTH) em doenças falciformes / Hematopoietic stem cell transplantation in sickle cell anemia

O único tratamento curativo para pacientes com doença falciforme é o transplante de células tronco hematopoéticas (TCTH). Neste artigo sumarizamos os resultados do TCTH em pacientes falciformes publicados na literatura e a experiência brasileira. As indicações atuais para o TCTH nestes pacientes serão discutidas.

The only curative treatment approach for patients with sickle cell anemia is allogeneic stem cell transplantation. In this article we will review the published data about stem cell transplantation in patients with sickle cell disease and the small Brazilian experience in this field. The possible indications for stem cell patients will be discussed.

Correlação clínico-topográfica em glioblastomas multiformes nas síndromes motoras: significados fisiopatológicos / Clinical topographic findings in glioblastoma multiforme and the relation with motor impairment

O glioblastoma multiforme (GBM) é o tumor glial com maior grau de malignidade. Acomete principalmente os hemisférios cerebrais apresentando sintomas e sinais focais ou gerais, relacionados ao tamanho, localização e taxa de crescimento tumoral. OBJETIVO: Analisar a relação do déficit motor com a topografia do GBM. MÉTODO: Foram estudados 43 casos de GBM, referidos quanto à idade, sexo, localização e a síndrome motora. RESULTADOS: O tumor predominou em adultos (média de 55 anos), sexo masculino (55,82 por cento), localização frontal (aproximadamente 40 por cento). A hemiparesia prevaleceu como distúrbio motor, somente não ocorrendo em 2 casos de lesão frontal, 2 temporais, 1 parietal, 1 occipital e 1 fronto-temporal. CONCLUSÃO: Os achados clínico-topográficos favorecem os efeitos infiltrativos (lesões extensas) como responsáveis pela síndrome motora em detrimento aos efeitos compressivos (lesões localizadas).

Liver histology and immunohistochemical findings in asymptomatic Indians with incidental detection of hepatitis B virus infection.

BACKGROUND AND OBJECTIVES: The relationship between hepatocyte expression of hepatitis B virus (HBV) antigens, liver histology and viral replication in asymptomatic subjects with incidental detection of hepatitis B surface antigen (HBsAg) remains unclear. We evaluated the histological activity index (HAI) and hepatocyte expression of viral antigens with replicative status in asymptomatic chronic HBV infection. METHODS: Asymptomatic subjects with incidental detection of HBsAg and ALT levels less than twice the upper limit of normal were grouped as follows: Group A - negative for HBeAg and HBV DNA (no HBV replication); B - HBeAg negative, HBV DNA positive (low HBV replication or pre-core mutant); C - positive HBeAg and HBV DNA (high viral replication). Liver biopsies were assessed for HAI (Ishak's scoring system). These were also subjected to immunohistochemistry for expression of HBsAg and hepatitis B core antigen (HBcAg); distribution, staining pattern and quantitative measurement of antigen expression were assessed. RESULTS: Median HAI was similar in the three groups (1.0, 2.0 and 2.0 in groups A, B and C, respectively). All subjects in Group C showed discrete cytoplasmic expression of HBsAg, whereas the other two groups showed heterogeneity in distribution and pattern of HBsAg staining. Quantitative measurement of cytoplasmic HBsAg revealed similar results in the three groups. Core antigen (nuclear) was detected in 4 of 5 subjects in Group C and none of those in Groups A and B. Ground-glass hepatocytes were seen in 20 and orcein-positive cells in 26 cases. HBsAg was detected by immunohistochemistry in 37 biopsies. CONCLUSIONS: Among asymptomatic subjects with chronic HBV infection, those with high rate of viral replication had discrete cytoplasmic HBsAg expression and nuclear expression of core antigen; these findings were uncommon in subjects with low or no viral replication.

Constituents of Encyclia longifolia Schltr. (Orchidaceae) / Constituintes de Encyclia longifolia Schltr. (Orchidaceae)

A detailed chemical analysis of the non-volatile secondary metabolites of Encyclia longifolia Schltr. syn. Epidendrum longifolium Barb. Rodr. was carried out in an attempt to lend a chemotaxonomic support for the recent separation of the genus Encyclia into Encyclia Hook and Prosthechea Knowles & Westc.

Uma análise química detalhada dos metabólitos secundários não voláteis de Encyclia longifolia Schltr. Sin. Epidendrum longifolium Barb. Rodr. foi realizada na tentativa de prestar suporte quimiotaxonômico para a recente separação do gênero Encyclia em Encyclia Hook e Prosthechea Knowles & Westc.