Analysis of structure-function relationship in porcine rotavirus A enterotoxin gene

Rotavirus (RV)-infected piglets are presumed to be latent sources of heterologous RV infection in humans and other animals. In RVs, non-structural protein 4 (NSP4) is the major virulence factor with pleiotropic properties. In this study, we analyzed the nsp4 gene from porcine RVs isolated from diarrheic and non-diarrheic cases at different levels of protein folding to explore correlations to diarrhea-inducing capabilities and evolution of nsp4 in the porcine population. Full-length nsp4 genes were amplified, cloned, sequenced, and then analyzed for antigenic epitopes, RotaC classification, homology, genetic relationship, modeling of NSP4 protein, and prediction of post-translational modification. RV presence was observed in both diarrheic and non-diarrheic piglets. All nsp4 genes possessed the E1 genotype. Comparison of primary, secondary, and tertiary structure and the prediction of post-translational modifications of NSP4 from diarrheic and non-diarrheic piglets revealed no apparent differences. Sequence analysis indicated that nsp4 genes have a multi-phyletic evolutionary origin and exhibit species independent genetic diversity. The results emphasize the evolution of the E9 nsp4 genotype from the E1 genotype and suggest that the diarrhea-inducing capability of porcine RVs may not be exclusively linked to its enterotoxin gene.

Conservation of T cell epitopes between seasonal inlfuenza viruses and the novel inlfuenza A H7N9 virus / 中国病毒学·英文版

A novel avian influenza A (H7N9) virus recently emerged in the Yangtze River delta and caused diseases, often severe, in over 130 people. This H7N9 virus appeared to infect humans with greater ease than previous avian inlfuenza virus subtypes such as H5N1 and H9N2. While there are other potential explanations for this large number of human infections with an avian influenza virus, we investigated whether a lack of conserved T-cell epitopes between endemic H1N1 and H3N2 inlfuenza viruses and the novel H7N9 virus contributes to this observation. Here we demonstrate that a number of T cell epitopes are conserved between endemic H1N1 and H3N2 viruses and H7N9 virus. Most of these conserved epitopes are from viral internal proteins. The extent of conservation between endemic human seasonal inlfuenza and avian inlfuenza H7N9 was comparable to that with the highly pathogenic avian inlfuenza H5N1. Thus, the ease of inter-species transmission of H7N9 viruses (compared with avian H5N1 viruses) cannot be attributed to the lack of conservation of such T cell epitopes. On the contrary, our ifndings predict signiifcant T-cell based cross-reactions in the human population to the novel H7N9 virus. Our findings also have implications for H7N9 virus vaccine design.

Breastfeeding reduces breast cancer risk: a case-control study in India

Worldwide, breast cancer is the most common cancer among women. In India and other developing countries, breast carcinoma ranks second only to cervical carcinoma among women. Although studies have been done globally, to find the association between breastfeeding and breast cancer, very few studies in India document such a benefit. A case-control study was done from August 2009 to July 2010 in the wards of General Surgery and Oncosurgery at Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India. A total of 128 histopathologically confirmed new cases of breast cancer during the study period were taken as cases. Equal numbers of controls were selected by simple random sampling. Controls were matched for age with a range of +/- 2 years. Subjects were interviewed using a pretested questionnaire after obtaining written informed consent. The categorical data were analyzed statistically using the Chi-square test and odds ratio with a 95% confidence interval. Continuous variables were analyzed using an independent t-test. All the analysis was done using SPSS, version 17. The age group of the cases was 25-78 years, while that of the controls was 24-79 years. The proportions of cases [56.3%] and controls [63.3%] living in rural areas were more than those living in urban areas. A significant association of breast cancer cases was found with caste, age at marriage, age at the first pregnancy, number of live births, and lifetime duration of breastfeeding. Breastfeeding has a significant role in reducing breast cancer, and so information, education, and communication activities for the promotion of breastfeeding and creating awareness about this fatal disease are the need of the hour

Frequency of group A rotavirus with mixed G and P genotypes in bovines: predominance of G3 genotype and its emergence in combination with G8/G10 types

The present study describes the genotypic distribution of rotaviruses (RVs) in an Indian bovine population with unexpectedly higher proportions of G3 alone or in combination of G8/G10. PCR-genotyping confirmed that 39.4% (13/33) of the prevalent RVs were the G3 type while 60.6% (20/33) were dual G3G10 or G3G8 types. P typing revealed that 93.9% (31/33) of the samples were P[11] while 6.1% (2/33) possessed a dual P[1]P[11] type. Sequence analysis of the VP7 gene from G3 strains viz. B-46, 0970, and BR-133 showed that these strains had sequence identities of 90.5% to 100% with other bovine G3 strains. The highest identity (98.9% to 100%) was observed with RUBV3 bovine G3 strains from eastern India. The G3 strains (B-46, 0970, and BR-133) showed 97.5% to 98.8% sequence homologies with the Indian equine RV strain Erv-80. Phylogenetic analysis demonstrated that G3 strains clustered with bovine RUBV3 and J-63, and equine Erv-80 G3. Overall, these results confirmed that the incidence of infection by RVs with the G3 genotype and mixed genotypes in the bovine population was higher than previously predicted. This finding reinforces the importance of constantly monitoring circulating viral strains with the G3 genotype in future surveillance studies.

HIV/AIDS knowledge among first year MBBS, nursing, pharmacy students of a health university, India

To determine level of HIV/AIDS knowledge among first-year MBBS, nursing and pharmacy students of a health university. A pre-designed, pre-tested, anonymous self-administered, semi-structured questionnaire was circulated among available 129, 53 and 55 first-year MBBS, nursing and pharmacy students during Oct' 09. Data entry, management and analysis were carried out using MS excel and software statistical package. Out of the total 237 students, there were 123 [51.9%] female and 103 [44.0%] students from rural native place. A majority of students were able to correctly write the full form of AIDS [95.8%] in comparison to HIV [72.6%] and the difference between two terminologies were known to 87.6%, 81.1% and 70.9% of MBBS, nursing and pharmacy students, respectively. All four common routes of transmission of infection and methods of prevention were known to majority of the lot. However, injecting drug users [IDU] and truck driver as a risk category was correctly reported by 67.5% and 55.3% students, whereas 35.9% incorrectly mentioned that smoking is a risk factor for acquiring infection. A statistically significant [P <0.05] proportion of MBBS followed by nursing and pharmacy students were aware that infection neither spreads by social activities like handshake/playing nor by mosquito bite. However, low level was ascertained with regard to items related to non-curability of infection [57.4%] and availability of anti-retro viral therapy [27.4%]. Overall high level of knowledge was recorded in the present study with a difference noted among students in three professional streams

Novel Coronaviruses and Astroviruses in Bats / 中国病毒学·英文版

Zoonotic transmissions of emerging pathogens from wildlife to human have shaped the history of mankind. These events have also highlighted our poor understanding of microorganisms circulated in wild animals. Coronaviruses and astroviruses, which can be found from a wide range of mammals, were recently detected in bats. Strikingly, these bat viruses are genetically highly diverse and these interesting findings might help to better understand the evolution and ecology of these viruses. The discoveries of these novel bats viruses not only suggested that bats are important hosts for these virus families, but also reiterated the role of bats as a reservoir of viruses that might pose a zoonotic threat to human health.

CT virtual colonoscopy

CT Virtual Colonoscopy is a medical imaging procedure which uses x-rays and computers to produce two and three-dimensional images of the colon [large intestine] from the rectum, all the way to the lower end of the small intestine using only air as contrast medium and display them on a screen. The procedure is used to diagnose colon and bowel disease like polyps, diverticulosis and tumour. It also provides 3D reconstructed endoluminal views of the bowel. It holds significant promise for effective large-scale colorectal cancer screening. Although many radiologists continue to use the 2D images for polyp detection, more emphasis on the 3D images for primary detection of polyps has yielded the best results for screening. The primary target lesion for colorectal screening is the adenomatous polyp, since detection and removal of all larger or advanced lesions could potentially prevent approximately 95% or more of all colon cancers. A total of 13 cases were evaluated in our study. The patients presented with varying complaints ranging from abdominal pain to bloody diarrhoea. The age range was from 30-70 years. Eight cases turned out to be normal. One case showed synchronous carcinoma colon which was confirmed peroperatively and on histopathology. Two cases were of diverticulosis while one case showed inflammatory mass at the ilio cecal region while the other was of para rectal abscess. It is thus concluded that C. T. virtual colonoscopy is an excellent diagnostic modality for most of the co/owe lesions

Aetiological considerations of acquired aplastic anaemia

Acquired aplastic anaemia is one of the important causes of pancytopenia. This study was conducted to observe the mode of presentation of acquired aplastic anaemia and to find out its possible etiological factors. It is a hospital based descriptive study of 100 patients of acquired aplastic anaemia. Out of 100 patients 60 were male and 40 female. Majority [44%] of the patients were between 12-20 years of age. Patient presented with variable symptoms majority [40%] with fever. Most of the patients had haemoglobin levels between 4-6 gm/dl. [53%. Seventy percent of the cases had no obvious cause, while in 30% some known causative factors were found. Chloramphenicol was found to be the most common causative drug. Mortality was 35%. Thirty patients were partially treated and 15 were lost to follow up. Twenty patients showed improvement with treatment. Acquired aplastic anaemia is common among males and more prevalent in younger age group. It is idiopathic in 70% cases while 30% had some cause. It has very high mortality. Doctors need to keep in mind this fatal condition in patients presenting with anaemia and should properly investigate before prescribing antibiotics and haematinics

Role of transvaginal ultrasound in cervical length changes during normal pregnancy

The objectives of this study was to examine the relationship between cervical length and gestational age in normal pregnancy in nulliparous versus parous women. We studied a cross-sectional sample of 321 pregnant women, including 185 nulliparous and 136 multiparous women. The inclusion criteria were sonographic confirmation of gestational age within the 12th week, the absence of any risk factors for preterm birth, and uncomplicated pregnancy with expected delivery during the 38th to 42nd weeks. Cervical length was measured in a straight line if the cervix did not show any curvature; in the presence of cervical curvature, the measurement was broken down into 2 or more segments. It was found that there was a relationship between gestational age and cervical length, which could be described with a linear function [R = 0.92; R2 = 0.85; P<001]. Moreover, there was no statistically significant difference between multiparous and nulliparous women. Our study shows that cervical length is comparable in nulliparous and multiparous women throughout pregnancy. In both groups, it actually shows a progressive, linear reduction between the 10th and 40th weeks. Reference ranges constructed for the whole gestational period might be more useful than a single cut off value for more efficient prevention and management of preterm birth

Medial perforator flap for coverage of defects around the ankle

Wounds around the ankle with exposed bones, tendons and nerves are very common in our practice and their reconstruction remains a challenge for the plastic surgeons. They often lead to infection and mal-union if early vascularized cover is not provided. To evaluate efficacy of medial perforator flap for reconstruction of this difficult area. A total number of 40 patients with injuries around the ankle were studied between December 2004 to December 2006 and all of them underwent reconstruction with medial perforator flaps. The Medial perforator flap is a quick, versatile, reliable reconstructive option and has minimal donor site morbidity

Cleft lip and palate surgery "where do we stand in the 21st century?" based on study of referral patterns to a tertiary care cantre

A prospective study was carried out over the period of six years including 215 patients. The objective of this study has been to evaluate the types of the clefts, their predisposing factors, age at first presentation and need for revisional surgery and to compare these with published studies on the subject and to draw conclusion about the epidemiology and the facilities available for its surgical correction. Prospective, observational study. 215 patients were evaluated over a period of six years by filling a proforma, which was entered into database. Different parameters were evaluated. There are a significant number of cleft patients presenting for first time above the age of 10 years. A large number of inappropriately treated patients require revisional surgery because of lack of properly trained cleft surgeons. Due to lack of specialized cleft care teams in our country no patient in this study could get comprehensive care for this deformity. It is need of the hour to pr ovide multidisciplinary care to these patients

Para-umbilical perforator based abdominal flap for forearm/hand resurfacing

A prospective study was carried out from October 1999 to December 2005 including 38 patients. The objective of the study has been to evaluate paraumblical perforator based abdominal flap for large forearm and hand defects. Prospective, interventional study. Methodology: 38 patients were evaluated for a period of six years and two months by filling a Performa which was entered in a database and different variables were evaluated. paraumblical perforator based abdominal flap is very useful for resurfacing large hand and forearm defects

Ruptured uterus - an ongoing problem

To determine frequency of ruptured uterus, its causes, site, post operative maternal morbidity and mortality and to suggest its preventive measures. A prospective study. Jan. 2004 to Dec. 2005, Lady Aitcheson Hospital Lahore. This study was carried on 23 patients with rupture of uterus. Total no of deliveries during this period were 7533. We received 23 patients with rupture of uterus. Out of these 17 were unbooked and only 6 were booked. Out of the booked patients 4 took trial of labour outside the hospital. Only 2 patients had uterine rupture in the hospital and that also was due to scar dehiscence. All laboring patients should be given due trial before embarking upon first c/s, moreover c/s should be done only for obstetric reasons and preferably by lower segment transverse incision under proper aseptic conditions by a competent surgeon. Patients should be counselled for early booking in next pregnancy and delivery should be conducted in the hospital

Pregnancy in a patient with acute porphyria

A 27 years old female was diagnosed to have acute intermittent porphyria in 1997. In 2002 she became pregnant. The first trimester was uneventful obstetrically but the duration, frequency and severity of porphyria attacks increased. As the pregnancy advanced to second trimester the condition of patient deteriorated. The symptoms were continuous with no period of relief. In the third trimester she became increasingly irritable and dyspnoeic, and developed facial edema, muscle weakness, and fecal and urinary incontinence. At 33 weeks of gestation USG showed absent liquor and decreased fetal movements; S/D [systolic diastolic ratio] was increased [>4.3]. Elective Cesarean-section was performed at 33 weeks. Her condition settled in one week. Porphyria is an uncommon disorder. It affects women more frequently than men. Not only it has adverse effects on pregnancy but the frequency of porphyria attacks also increases during pregnancy. We herewith present a case report of a female with acute intermittent porphyria who conceived

Effect of placenta previa on fetal and maternal morbidity/mortality

To see the effect of placenta previa on fetal and maternal mortality/ morbidity. This was a case series study. Study was conducted in Gynecology unit BV Hospital Bahawalpur during year 2000 to 2003. All the patients presenting with or with out painless bleeding in antenatal clinic and proved to be due placenta previa were included in the study. Patients presenting with pain less bleeding in the antenatal clinic due to other reasons were excluded from the study. In all the patients' history along with the risk factors clinical and sonography finding, any intervention needed and final out come was recorded. SPSS was used for data collection and analysis. Total 50 patients were studied Out of these 84% of patients were symptomatic a t admission the symptoms found were Bleeding, shock and Pain. Strong associations o f risk factors like Age, Parity, ERCP, Smoking and previous C. Section was found in our study. Severe hemorrhage, prematurity, stillbirths and ENND was associated with Placenta Previa. Placenta previa is not an uncommon but underestimated, under reported and preventable condition. Prevention is possible in case of Known risk factors. Early diagnosis is necessary as the delay in some cases may end up in disaster

Intestinal parasitic infections in children from Northern Pakistan

Intestinal parasitic infections cause significant morbidity in children of developing countries, where the vicious cycle of infections and malnutrition impairs their physical growth and development. A community based cross-sectional study on randomly selected children under 15 years of age was performed in two towns of Northern Pakistan. Information on hygiene, sanitation, waste disposal, water supply and maternal education was collected and the nutritional status of these children was assessed. Stool samples of the subjects were collected, immediately preserved and later examined for parasites, with severity of infection being quantified. Of the 89 samples examined, 91% contained one or more parasites. The lowest prevalence of infection was in children less than one year old. Majority of those infected in both towns were girls. Fifty-one percent of the infected children from Yasin and 38% from Singal suffered from malnutrition. Maternal education, family income and drinking water treatment did not affect the prevalence of infection in either town. The most frequent parasites isolated were Ascaris lumbricoides [66.3%], Entamoeba histolytica [27%], Blastocystis hominis [27%], Giardia lamblia [24.7%], and Trichuris trichiura [15.7%]. The results of this study indicate that parasitic infections in northern Pakistan have a high prevalence but low intensity. Programs for early detection and interventional strategies, along with improved hygiene, sanitation and waste disposal facilities are urgently needed to improve the health of these children

Analytical study of deliveries in young females at shaikh zayed hospital, lahore

In 1988, 285 young female subjects who were under the age of thirty at the time of deliveries were studied at Shaikh Zayed Hospital, Lahore. The encouraging aspect of this study is that those under the age of 25 did not suffer from prolonged labour, and the young female is at no risk

Diabetic control and serum lipids in diabetics attending a Pakistani hospital

Diabetes Mellitus is more prevalent in Asians as compared to White Caucasians. Hence, it has great importance as a public health problem. There is a paucity of data about the state of lipids in this disease, from Pakistan. We studied diabetic patients attending outpatients clinic and recorded their personal characteristics, details of their disease and measured their blood glucose, lipids and glycosylated haemoglobin. Design: Case series. Setting: Patients attending outpatients department of a teaching hospital. Subjects and Seventy consecutive diabetics attending the outpatients department were enrolled in the study. Their age, sex, disease duration, body mass index [BMI]; treatment history, occupation and social class were recorded. Fasting plasma sample was collected and glucose, cholesterol [total, HDL, LDL], triglycerides and glycosylated haemoglobin [HBA] estimated. Data was analysed using SPSS statistical package. Most of the patients were non-insulin dependent [N1DDM] diabetics 90%, sedentary workers [70%] and females [66%]. Mean duration of diabetes was 6.2 years [SD 5.2]. Plasma glucose [mean 201 mg/dl], HBA [mean 7.92], triglycerides [mean 215.9 mg/dl] and total cholesterol [mean 221.4 mg/dl] were recorded. About a quarter of cases had a BMI > 28 Kg/m2 and 15% had a BMI > 30 Kg/m2. HDL and LDL cholesterol mean values were 44.1 mg/dl and 134.2 mg/dl respectively. There was good correlation between HBA and fasting plasma glucose. However, the correlation between fasting plasma glucose and various lipid parameters was poor. Conclusions: Majority of diabetics attending hospital outpatients were suffering from NIDDM. A significant proportion of them were obese. As a group they exhibited poor diabetic control and had only modest elevation of plasma lipids. The correlation between fasting plasma glucose [and HBA] and lipid levels was poor. However, there is good correlation between fasting plasma glucose and glycosylated haemoglobinm, highlighting usefulness of the latter for monitoring

Diagnostic value of CT scan in paediatric neurological disorders

Computerised tomography [CT] is now an established and widely available neuroimaging technique. Data regarding 80 children undergoing CT scan at the Nishtar Hospital, Multan were analyzed. Indications for ordering a CT scan included complicated cases of meningitis, seizure disorders, developmental delay, cerebro-vascular lesions and children with suspected space occupying lesions [SOL]. CT scan provided significant help in diagnosis or management in 100% cases of acute hemiparesis and suspected SOL and in 80% cases of complicated meningitis. Diagnostic help was provided by CT in 66% of children with seizures and in 40% with developmental delay. However, in only a very small percentage of children with these disorders, scan findings helped in deciding the course of management. CT scan has been a very significant advance in cranial imaging, however, physicians need to carefully consider relevant clinical findings in children with neurological disorders before considering them a candidate for this costly investigation