Evaluation of dengue blot test

Dengue blot test is a dot enzyme immuno-assay which detects the antibodies to dengue virus of all tyes (1 to 4). The result of the test can be obtained after three hours.In the management od dengue haemorrhagic fever confirmation of diagnosis should be made at early stage.This requires a test which is highly specific, highly sensitive and quick.To determine the usefulness of dengue blot test in diagnosing dengue haemorrhagic fever, this study was carried out in 319 patients who were clinically diagnosed as dengue haemorrhagic fever at Yangon Children Hospital.They were tested for both blot test and standard test of haemagglutination inhibition (HI).Blot test was positive in 304 patients out of which only one is negative for HI test (True positive 303 false positive 1).Out of 15 patients who were negative for blot test 10 were positive for HI test (True negative 5, false negative 10).This test was found to be highly sensitive (sensitivity 96

), and specific (specificity 83

).Positive predictive valve was 99.6

but negative predictive value was only 33.3

.

Bacterial pathogens and drug susceptibility pattern: from diarrhoea cases of children

Stool specimens from 200 cases of children with ages of less than five years with history of acute diarrhoea from Yangon Children's Hospital were proceeded for isolation of bacterial pathogens. Enterotoxigenic Escherichia coli ETEC (15.5 per cent), enteropathogenic Escherichia coli EPEC (19 per cent), Shigellae (3.5 per cent), Salmonellae (2.5 per cent), ETEC + EPEC (6.5 per cent), ETEC+Shigellae (1.0 per cent) were isolated. Antibiotic susceptibility pattern of EPEC revealed that they were resistant to ampicillin (96 per cent), tetracycline (90 per cent), streptomycin (82 per cent), chloramphenicol (80 per cent) and septrin (61 per cent); but were sensitive to nalidixic acid (100 per cent), furazolidone (92 per cent), sisomycin (90 per cent), gentamicin (88 per cent), norfloxacin (70 per cent), and cephalothin (66 per cent). For Shigellae they were resistant to ampicillin (100 per cent), cephalothin, chloramphenicol, furazolidone, streptomycin (66.7 per cent) but were 100

sensitive to sisomycin, minocycline, norfloxacin, gentamicin; tobramycin (89 per cent), neomycin (67 per cent) and septrin (56 per cent). For Salmonellae they were resistant to ampicillin (100 per cent), chloramphenicol and tetracycline (80 per cent) but were 100 per cent sensitive to cephalothin, furazolidone, gentamicin, nalidixic acid, norfloxacin, septrin and sisomycin. For ETEC they were resistant to ampicillin (100 per cent), tetracycline (79 per cent), chloramphenicol (53 per cent) and septrin (53 per cent ). They were 100 per cent sensitive to cephalothin, furazolidone, gentamicin, nalidixic acid, neomycin, norfloxacin, septrin and sisomycin.

Birth weight estimation of newborns utilizing chest and arm circumference

A study of 547 births in Thaketa township showed a strong correlation between birth weight with chest circumference (r = 0.71) and mid arm circumference (r = 0.70). Multiple regression analysis of birth weight on chest and mid arm circumference was: Birth weight = - 1870.41 + (mid arm circumference x 192.03) + (chest circumference x 91.97). The value of F statistic (371.97) was significant (p < 0.001) indicating the usefulness of chest and mid arm circumference in predicting birth weight.

Observations on neonatal tetanus cases in Rangoon Children's Hospital

1. The risk of developing neonatal tetanus is definitely higher if the baby is delivered at home than delivered in the hospital. 2. The risk of developing neonatal tetanus seems to be slightly lowered if delivery is undertaken by the health personnel though the difference is not statistically significant. 3. The peak season is during the lat part of the rainy season. 4. Some townships have a definite higher incidence of neonatal tetanus than others.

Comparison of high and low dosage of antitetanus serum in the treatment of neonatal tetanus

A study was conducted on 106 cases to compare the high dose (50,000 IU) and low dose (10,000 IU) of anti-tetanus serum (horse antitoxin) in the treatment of neonatal tetanus. The cases were graded into 'Mild group' and 'Severe Group' before being included into the trial. The cases in each group were then subjected to 'high dose' or 'low dose' by randomization. The mortality results of the two dosage regimens were compared by sequential "analysis in the 'Severe Group'. Sequential analysis showed that the mortality produced by the two regimens were not statistically significant. Sequential analysis of mortality could not be carried out on the 'Mild Group' as there was only one untied pair, but it was concluded that the two dosage regimens probably would produce the same effect. The clinical course of the patient judged by (a} disappearance of spasms (b) ability to cry (c) starts taking feeds and (d) duration of stay in hospital in the two treatment regimens were also similar in both the 'mild' and 'severe' groups. The comparability of the patients receiving 'high dose' or 'low dose' regimens in relation to prognostic criteria and contributing factors of cause of death were presented and discussed. 'Rationales underlying the design of the study were discussed by review of the literature.