Ocular manifestations of isolated corneal bee sting injury, management strategies, and clinical outcomes

Purpose: The purpose of this study is to describe the presenting features, management strategies, and clinical outcome following bee sting injury to the cornea. Methods: Retrospective case series involving 11 eyes of 11 patients with corneal bee sting injuries who presented over a period of 2 years. Nine of these 11 eyes had the presence of intact bee stinger in the cornea, which was removed immediately under an operating microscope and sent for microbiological and histopathological evaluation. The patients were managed as per the individual treatment protocol of the respective treating physicians. Results: Six eyes (54.5%) had a good clinical outcome (best-corrected visual acuity [BCVA] >20/40) with medical therapy alone with no need for surgical intervention. Five eyes (45.5%) had a poor clinical outcome (BCVA <20/40) with medical therapy and required surgery; of which three required a combined penetrating keratoplasty with cataract surgery, while one required isolated cataract surgery and one underwent penetrating keratoplasty. Glaucoma was present in 3/5 eyes undergoing surgery, one of which required a trabeculectomy. Five of the six eyes who had a good clinical outcome with medical therapy alone had been treated with concomitant oral steroids, along with topical antibiotic-steroid combination therapy. Conclusion: Oral corticosteroid supplementation to the topical steroid antibiotic treatment in patients with corneal bee sting injury where corneal involvement and anterior reaction is severe at presentation or inflammation not ameliorating with topical steroids alone prevents serious vision-threatening complications such as corneal decompensation, cataract, and glaucoma.

Detection and characterization of Rotavirus G and P types from children participating in a Rotavirus vaccine trial in Belém, Brazil

This study sought the characterization of rotaviruses in a trial with a tetravalent rhesus-human rotavirus vaccine in Belém, Brazil in children who received three doses of vaccine or placebo in the 1st, 3rd and 5th months of life. Rotavirus electropherotypes, subgroups, G serotypes, G, [P] and [P],G genotypes were determined in 93.3 percent, 95.9 percent, 93.3 percent, 73.3 percent, 95.5 percent and 92.2 percent of isolates, respectively. Serotypes G1, G2 and G4 were detected in 58.9 percent, 30 percent and 4.4 percent of the cases, respectively. Rotavirus genotype G5 was detected for the first time in Northern region in 4.4 percent of the infections. Rotavirus genotypes P[8], P[4], P[6] and P[8+6] were detected in 54.5 percent, 26.7 percent, 12.2 percent, and 2.2 percent of the cases, respectively. The predominant genotypes were P[8],G1 and P[4],G2 with 53 percent and 26.6 percent of the infections, respectively. Unusual strains accounted for 20.5 percent including P[4],G1, P[6],G1, P[6],G4, P[6],G5, P[8],G2, P[8],G5. Mixed infections involving P[8+6],G2 and P[8+6],G1 were also noted. The neonatal P[6] strains associated with diarrhea were detected among children aged 9-24 months. To our knowledge, this study represents the first in Brazil to analyse, on molecular basis, rotavirus genotypes from children participating in a rotavirus vaccine trial. These results are of potential importance regarding future rotavirus vaccination strategies in Brazil

Inmunogenicidad, inocuidad y eficacia de una vacuna tetravalente obtenida por recombinación genética de rotavirus aislados de monos rhesus y seres humanos en Belém, Brasil / Immunogenicity, safety and efficacy of tetravalent rhesus-human, reassortant rotavirus vaccine in Belém, Brazil

Se evaluó la inocuidad, inmunogenicidad y eficacia de una vacuna tetravalente obtenida por recombinación genética de rotavirus aislados de monos rhesus y seres humanos (RRV-TV) (4 x 104 unidades formadoras de placas por dosis) en un ensayo prospectivo, aleatorio, a doble ciego y controlado con placebo que se efectuó con 540 lactantes brasileños. Se administraron dosis de vacuna o de placebo a la edad de 1, 3 y 5 meses. No se observaron diferencias significativas en la frecuencia de diarrea o vómito en los bebés de ninguno de los dos grupos después de administrar la dosis correspondiente. De 2 a 3% de los vacunados tuvieron fiebre baja los días tercero a quinto después de recibir la primera dosis, pero no después de las dosis segunda o tercera. Se observó una respuesta de anticuerpos del tipo IgA al rotavirus aislado de monos rhesus (RRV) en 58% de los vacunados y en 33% de quienes recibieron placebo. La respuesta de anticuerpos neutralizantes a cada serotipo no pasó de 20% cuando se determinó con la prueba de reducción de focos de fluorescencia, pero fue superior a 40% al medirse con la prueba de neutralización a base de reducción de placas. Se presentaron 91 casos de diarrea causada por rotavirus entre los niños que recibieron las tres dosis (de vacuna o de placebo) durante un seguimiento de 2 años, 36 de ellos en los niños vacunados. La eficacia general de la vacuna fue de 8% (P = 0,005) contra toda clase de diarrea y de 35% (P = 0,03) contra la diarrea causada por rotavirus. La protección durante el primer año de seguimiento, cuando predominó el rotavirus G del serotipo 1, fue de 57% (P = 0,008), pero se redujo a 12% en el segundo año. Se obtuvieron resultados similares al restringir el análisis a episodios en que el rotavirus fue el único agente patógeno identificado. Se observó en la vacuna una mayor tendencia a proteger contra casos de enfermedad con un promedio de seis o más deposiciones diarias. Estos resultados son lo suficientemente...

A tetravalent rhesus-human reassortant rotavirus (RRV-TV) vaccine (4 x 104 plaque-forming units/dose) was evaluated for safety, immunogenicity and efficacy in a prospective, randomized, double-blind, placebo-controlled trial involving 540 Brazilian infants. Doses of vaccine or placebo were given at ages, 1, 3 and 5 months. No significant differences were noted in the occurrence of diarrhoea or vomiting in vaccine and placebo recipients following each dose. Low-grade fever occurred on days 3­5 in 2­3% of vaccinees after the first dose, but not after the second or third doses of vaccine. An IgA antibody response to rhesus rotavirus (RRV) occurred in 58% of vaccinees and 33% of placebo recipients. Neutralizing antibody responses to individual serotypes did not exceed 20% when measured by fluorescent focus reduction, but exceeded 40% when assayed by plaque reduction neutralization. There were 91 cases of rotavirus diarrhoea among the 3-dose (vaccine or placebo) recipients during two years of follow-up, 36 of them among children given the vaccine. Overall vaccine efficacy was 8% (P = 0.005) against any diarrhoea and 35% (P = 0.03) against any rotavirus diarrhoea. Protection during the first year of follow-up, when G serotype 1 rotavirus predominated, was 57% (P = 0.008), but fell to 12% in the second year. Similar results were obtained when analysis was restricted to episodes in which rotavirus was the only identified pathogen. There was a tendency for enhanced protection by vaccine against illness associated with an average of 6 or more stools per day. These results are sufficiently encouraging to warrant further studies of this vaccine in developing countries using a higher dosage in an attempt to improve its immunogenicity and efficacy.

Concomitant rotavirus serotypes 1 and 4 infections in a diarrhoeic from Belem, Brazil

Infeccoes simultaneas por sorotipos 1 e 4 de rotavirus foram observadas em uma crianca de 15 meses de idade, do sexo feminino, internada com diarreia aguda contraida na comunidade que perdurou por 7 dias, evoluindo com desidratacao moderada. As evidencias dessas infeccoes foram inferidas baseadas em testes tais como: a) ensaio imunoenzimatico (ELISA), evidenciando-se reacao positiva para os sorotipos 1 e 4; e b) migracoes extras de segmentos de ARN visualizados a eletroforese em gel de poliacrilamida (EGPA). Esses resultados sugerem que as condicoes precarias de higiene e saneamento em que vivia essa crianca propiciam a infeccao macica por esses agentes virais. Alem disso, a co-circulacao de diferentes sorotipos no mesmo ambiente sustenta a necessidade de utilizar-se, no futuro, uma vacina polivalente, que proteja as criancas contra os quatro sorotipos G, epidemiologicamente importantes

Role of striatal dopamine in the lordosis behaviour.

Effects of intrastriatal injections of haloperidol (Dopamine antagonist) and D-amphetamine (Dopamine agonist) on lordosis behaviour were studied in ovariectomized female albino rats, after priming with subcutaneous injections of estrogen and progesterone. The lordosis quotient (LQ) significantly increased after haloperidol, and decreased following D-amphetamine treatment. However, the inhibitory effect of D-amphetamine was transient and could be reversed by haloperidol in the same animal when given one hour after the D-amphetamine injection. The ovarian hormones probably act centrally to suppress the DA system in the striatum thereby enhancing the tonic and dorsal immobility responses associated with lordosis.

Effect of intensity and duration of stress on male sexual behaviour.

Male rats were exposed to four different stress conditions, varying in duration and intensity, during separate periods and their copulatory behaviour was studied. The number of mounts and time spent in other sexual behaviours were reduced with intensity of stressor being primarily responsible rather than prolongation of duration of a less severe stress condition.

Effect of stress on organ weight in rats.

The effect of 90 minute supine restraint or forced swim stress, on weights of various organs in sixty adult male albino rats was studied. One group of twenty rats served as control; second group of twenty was immobilized and third group of twenty was forced to swim in water at room temperature. The animals were studied for a period of 15 days. During this period, they were subjected to 90 minutes of stress everyday at the same time. Both the groups of stressed animals showed a statistically significant increase in weight of cerebrum, cerebellum, pituitary, thyroid, and adrenals. Testes and seminal vesicles showed no significant change in weight. There was an apparent increase in weight of liver after immobilization stress, and a statistically significant increase in its weight in forced swim group. Therefore, immobilization and forced swim stresses produce an increase in the weight of brain cerebrum and cerebellum, endocrine organs and liver.

Role of caudate nucleus on modulation of blood pressure responses in cat.

Changes in blood pressure, heart rate and respiration were studied in 15 cats on bilateral stimulation of rostral, middle and caudal regions of caudate nucleus. Hypotensive response was obtained on stimulation of anterior caudate nucleus, which changed to pressor response when posterior caudate nucleus was stimulated. Biphasic blood pressure responses were recorded on stimulation of middle caudatal area. No detectable changes were observed on heart rate and respiration. This suggests a role for caudate nucleus as a modulator in blood pressure regulation.

Effect of interaction between glucose or sodium chloride ingestion and ovarian hormones on some endocrine organs in rats.

Adult female rats with normal oestrus cycles (control), ovariectomized (OVX), ovariectomized with estradiol treatment (OVX-EB) and ovariectomized with progesterone treatment (OVX-P), were provided with Glucose (G/W) or Saline (S/W) through a two bottle preference. They were given food pellets ad libitum. At the end of 3 weeks' period the animals were sacrificed and pituitary, thyroid, adrenal and pancreas were removed and weighed. Adrenal glands showed a significant decrease in OVX and OVX-P rats taking G/W, as also decrease in OVX and OVX-EB and increase in OVX-P rats taking S/W. The pancreas registered an overall increase in OVX, OVX-EB and OVX-P rats taking both G/W and S/W, which was statistically significant only in OVX-EB and OVX-P rats. Ovarian hormones appear to influence the size of these glands when glucose or sodium chloride is ingested.

Differential role of ovarian hormones for taste preferences in rats.

The effects of estrogen (OVX-EB) and progesterone (OVX-P) administration to ovariectomized (OVX) rats on food and fluid intakes were studied in fifty five animals grouped into three series. Animals in each series were given a choice of two fluids viz. tap water and either 5% glucose (5 G/W) or 12% glucose (12 G/W) or 1.5% Sodium chloride (S/W) by two bottle preference. Both hormones had a differential effect on the ingestion of the two concentrations of glucose while progesterone markedly increased the intake of Sodium Chloride. Could the putative role of the ovarian hormones be hedonic for glucose and homeostatic for salt?

Effects of adrenalectomy on brain weight, body weight and weight of certain endocrine organs in rats.

Albino rats, both males and females were adrenalectomized (Adx.), either on the eleventh or the twenty fifth day after birth and the body weights recorded daily until the sixtieth day when all the animals were sacrificed. Brain (cerebrum and cerebellum), pituitary, thyroid and gonads were weighed post mortem. Body weights decreased in all the Adx. animals, the decrease being statistically significant in the male rats Adx. on day 11 (p less than 0.05). Both cerebrum and cerebellum recorded a significant increase in weight in both the male Adx. groups, whereas pituitary, thyroid and gonads showed a significant decrease. Changes observed in 25 day Adx. female rats were not statistically significant. Thus, adrenalectomy in the young rats appears to have differential effects on the somatic, neural and endocrine growth.

Effect of mid-dorsal caudate nucleus on conditioning for pain stimulus in rats.

Male rats were subjected to conditioning, with light source as conditioned stimulus, followed by a noxious stimulus applied to the tail as unconditioned stimulus. There was development of conditioned response after a few days, which was inhibited later on.

Role of acetylcholine and dopamine in dorsal hippocampus on hoarding behavior in rats.

The probable roles of Acetylcholine (Ach) and Dopamine (DA) in the modulation of instinctual behaviors of feeding and hoarding (HS), as also the body weight and vaginal cyclicity (EI), were studied by instillation of Atropine (Ach antagonist), Haloperidol (DA antagonist) and Apomorphine (DA agonist) in the dorsal hippocampus of nonpregnant female rats. It was observed that the HS was significantly decreased with both Atropine and haloperidol and increased with Apomorphine, although the food intake was decreased with the three chemicals. It appears that action of both Ach and DA on the dorsal hippocampus has a positive influence on hoarding behavior.

Incidencia das diarreias infantis agudas em um bairro periferico de Belem, Para: fase preparatoria de um futuro estudo de campo com uma vacina contra rotavirus / Incidence of the diarrhea infantile acute in one perifheric district of Belem, Para: preparatory phase of one future study of field with one vaccine against rotaviruses

No periodo de fevereiro a setembro de 1988 foram recruta-das e submetidas a acompanhamento sistematico, 78 criancas habitantes de um bairro periferico de Belem, Brasil. Observou-se que cinco (6,4%) desses individuos foram excluidos no decurso do estudo, uma ves que passaram a morar em outra areada cidade. Visitas domiciliares, duas vezes por semana, foram empreendidas por agentes de campo, sendo os cuidados medicos proporcionados por dois profissionaisde nosso grupo. Foram registrados 67 episodios de diarreia, obtendo-se especimesfecais para exames em 62 (92.5%) deles. Rotavirus foram detectados em 4 (6.4%) dos episodios analisados laboratorialmente, todos classificados como subgrupo II(perfil eletroforetico de ARN longo). De 60 especies fecais processados quanto apresenca de enteropatogenos bacterianos, logrou-se obter 7(11,7%) isolamentos deEscherichia coli enteropatogenicas, 3 (5,0%) de Sjigella sonnei e 1 (1,7%) deSalmonella grupo C1. Detectou-se, ainda, Campilobacter sp em 2 (4,9%) dos 41 es-pecimes fecais cultivados com o proposito especifico de detectar-se esse agente Cryptosporidium sp. foi observado em apenas 1 (2.7%) dos 37 especimes fecais analisados. A maior incidencia de diarreia, 24,5%, ocorreu em abril, enquanto que amenor, 9,3%, em marco. Das 78 criancas recrutadas, 52 (66.7%) apresentaram diarreia. A taxa de ataque clinico especifica por idade nao exibiu diferencas niti-das nos intervalos de 0 a 3 e 5 a 8 meses, porem, configurou-se um pico aos 4. Ataxa de diarreia cumulativa atingiu a cifra de 1,4 episodio por crianca, aos oi-to meses. As frequencias de vomitod (75%), febre (50%) e desidartacao (50%) revelaram-se superiores aos mesmos parametros avaliados no grupo de diarreias relacionadas a outros agentes etiologicos.

Variations in hoarding behavior following regional hippocampal lesions in rats.

Instinctual behaviors of feeding (food intake) and hoarding (HS) so also the body weight and estrus cycles (EI) were studied before and after discrete bilateral electrolytic lesions of dorsal hippocampus in female rats. Following the lesions, there was significant increase in food intake, body weight, hoarding score and disruption of 4-5 days estrus cycles with EI of more than one, as compared to the control (prelesioned) period and the sham operated rats. Lesions of ventral hippocampus in the earlier study (Indian J exp Biol, 26 (1988) 53) had shown a significant decrease in hoarding thus suggesting a differential role of the hippocampus probably mediated through the amygdala and/or hypothalamus both of which either alone or together exert a more direct and pivotal control in the feeding and hoarding behaviour.

Effect of dorsal hippocampal lesion compared to dorsal hippocampal blockade by atropine on reference memory in vision deprived rats.

In order to study the primacy of the hippocampus in place learning function 24 male adult albino rats were hippocampally-lesioned in dorsal hippocampus involving fornical damage (group I); sham operated for comparison with group I (group II); cannulated for instillation of atropine sulphate in the same loci as group I (group III); and cannulated for instillation of saline which served as control for group III (group IV). All the animals were enucleated and their reference memory (long-term memory) was tested, using open 4-arm radial maze. There was loss of reference memory in groups I and III. However, hippocampally-lesioned animals, showed recovery of reference memory deficit within a short period of 10 days or so. Whereas atropinized animals showed persistent reference memory deficit as long as the instillation effect continued. The mechanism involved in the recovery of reference memory in hippocampally-lesioned animals and persistent deficit of reference memory in atropinized animals has been postulated to explain the primacy of hippocampus in the place learning function under normal conditions.

Ingestive behaviour of starved rats after single intraperitoneal injection of fresh plasma from well-fed rats.

Ingestive behaviour of control and experimental rats following 96 hours of starvation was studied. The control animals were injected normal saline intraperitoneally (I.P.) whereas the experimental animals were injected I.P. with fresh plasma obtained from well fed rats. Having been presented with food 15 minutes after the injections, the food intake (Gms +/- SEM) of control animals for the first five hours after injection was 6.00 +/- 0.44, whereas, the intake in experimental animals for the same period was 0.55 +/- 0.05. The food intake was significantly suppressed for the next three days, attaining the normal values by the 4th day. Since all the rats were starved prior to injection, all of them increased in weight during the four days of study, but the increase seen in the experimental group was much subdued. Therefore the plasma factor, suppresses not only the food intake but also the gain in body weight.

Effect of immobilization stress on food intake, body weight and weights of various organs in rat.

Effect of immobilization stress was studied in male albino rats. Experimental rats (E) were restrained in close-fitting wiremesh cylinders. Control rats (C) were not subjected to restraint. Food and water were made available to C for all the 24 hrs while the E were given them for only 6 hrs daily. The initial lower food intake of E was later reversed to near normal levels. There was a steady fall in the body weights of E, while the C displayed a normal growth rate. Cerebrum, cerebellum, pituitary and adrenals of E weighted significantly more. There was an apparent increase in the weight of thyroid. Gonads displayed no change in weight. The results indicate that chronic restraint causes loss of body weight inspite of a near normal food intake. It also produces an increase in the weight of brain, and certain endocrine organs.

Effect of stress on maternal behaviour.

Primiparous female rats subjected to foot shock and/or immobilization stress were tested for maternal behaviour (MB) by determining the pup retrieval rate (PRR) for 5 minutes. On the third day after parturition PRR significantly decreased when foot shock was given and the fall was more pronounced after immobilization both with and without foot shock. The animals exhibited enhanced MB on the 12th day as compared to the third day, but the stressful situations produced significant decreases in MB qualitatively similar to the third day. By the 20th day when the weaning was in progress the MB decreased to the 3rd day levels. This change in the MB may be due to the changes in the pattern of prolactin secretion during the post partum period.