Massive haemothorax: a presentation of pulmonary arteriovenous malformation.

Arteriovenous malformations of the lung are relatively uncommon lesions with varied clinical presentation. Nearly half of these are associated with Osler-Rendu-Weber disease. Magnetic resonance angiography is an accurate and non-invasive diagnostic modality. We report a case of a 56-year-old male who had massive haemothorax due to rupture of a pulmonary arteriovenous malformation arising from the right interlobar artery.

Evaluation of direct agglutination test (DAT) as an immunodiagnostic tool for diagnosis of visceral leishmaniasis in Nepal.

Before field application of the direct agglutination test (DAT) for leishmaniasis, it was assessed as a diagnostic tool. Fifteen confirmed visceral leishmaniasis cases (bone marrow aspiration positive), 120 tuberculosis, 58 leprosy, 15 malaria, 26 intestinal parasitic infection cases, 24 endemic healthy controls from adjacent to the study area, and 18 controls from Kathmandu (who had never visited the VL endemic areas) were tested for anti-leishmanial antibody agglutination titers. Two of the tuberculosis cases were positive for anti-leishmanial agglutinating antibodies at 1:800. All the visceral leishmaniasis confirmed cases were reactive to anti-leishmanial antibody at > or = 1:3,200. Other specimens were negative for serology. The sensitivity of the direct agglutination test was 100% and the specificity was 99.2%. The direct agglutination test had positive and negative predictive values of 100% and 99.2% respectively. The direct agglutination test has been found to be simple, rapid, reliable, economic, safe and adaptable to micro-techniques using microtiter plates. It is specific and sensitive. The direct agglutination test is simple enough for it to be performed in a field laboratory.

Resurgence of malaria in Calcutta in 1995: a hospital based study.

A total of 405 cases of fever who were either admitted to the Hospital or attended in paediatric out patient Department or Emergency of Medical College Hospital, Calcutta between January '95 and November '95 were included in the study. Majority of cases presented with usual features of malaria like fever with chill and rigor, hepatosplenomegaly, pallor. Apart from these, complicated manifestations like shock, convulsion D.I.C and jaundice were also observed. Some unusual presentations with severe diarrhoea, dehydration and features like that of acute viral respiratory tract infection were highly confusing in terms of clinical diagnosis. P. falciparum was observed in 35.5% of cases. Overall therapeutic response to chloroquin was good, However, two patients died of cerebral Malaria. Five cases of severe malaria were caused by P. vivax however, other etiological features could not be found to attribute the severe nature of these illnesses.

Novel techniques of graphical representation and analysis of DNA sequences — A review.

The advent of automated DNA sequencing techniques has led to an explosive growth in the number and length of DNAs sequenced frpm different organisms. While this has resulted in a large accumulation of data in the DNA databases, it has also called for the development of suitable techniques for rapid viewing and analysis of the data. Over the last few years several methods have been proposed that address these issues and represent a DNA sequence in a compact graphical form in one-, two- or three-dimensions that can be expandeda s necessaryt o help visualize the patterns in gene sequencesa nd aid in in-depth analysis. Graphical techniques have been found to be useful in highlighting local and global base dominances, to identify regions of extensive repetitive sequencesd, ifferentiate betweenc oding and non-coding regions, and to be indicative of evolutionary divergences. Analysis with graphical methods have also provided insights into new structures' in DNA sequences such as fractals and long range correlations, and some measures have been developed that help quantify the visual patterns. This review presents a comprehensives tudy of the graphical representationm ethods and their applications in viewing and analysing long DNA sequences and evaluates the merits of each of these from a practical viewpoint with prescriptions on domains of applicability of each meth0d. A discussion on the comparative merits and demerits of the various methods and possible future developments have also been included.

Efficacy of sodium antimony gluconate and ketoconazole in the treatment of kala-azar--a comparative study.

The present study was undertaken to determine the efficacy of ketoconazole in comparison to sodium antimony gluconate (SAG) in the treatment of kala-azar. The study was conducted at two centres: All India Institute of Medical Science, New Delhi and Calcutta School of Tropical Medicine, Calcutta. A total of 180 patients with proven kala-azar were recruited. After preliminary investigations, the patients were randomly divided into 2 groups: One group received ketoconazole in a dose of 600 mg/ day in 3 divided doses for 4 weeks while the other group was treated with SAG at a dose of 20 mg/kg/day up to a maximum of 850 mg/day for 4 weeks. The patients were followed up by clinical examination, liver functions, haemogram and the bone marrow/splenic aspiration. Responders were followed up at 3 and 9 months of intervals. Of 90 cases in SAG, 78 (81.7%) got cured initially while under ketoconazole group, only 26 (33.3%) of 78 patients responded initially (p < 0.001). After 3 months of follow up, 75 of 78 SAG-responders (96.2%) and 24 of 26 ketoconazole-responders (92.3%) continued to be in remission. Despite the fact that 2 patients in each group were lost to follow up at 9 months, similar observations were noted with only one relapse in SAG group. The response to SAG was comparable at the two centres. However, the response to ketoconazole was better at Delhi centre as compared to that at Calcutta. There were no significant side effects or hormonal changes in any of the patients in ketoconazole group at Delhi centre. Significantly higher side effects were reported at Calcutta centre in ketoconazole group (P < 0.05). No satisfactory explanation can be given for this difference in response to ketoconazole at two centres. However, it is known that leishmanial parasites of different geographical origin differ in their response to different drugs and this could be one of the reasons for difference observed in response rate to ketoconazole as the study involved different populations of people.

Studies on the life cycle of Artyfechinostomum oraoni Bandyopadhyay, Manna & Nandy 1989: embryogenesis & development in the intermediate host.

A study was undertaken to elucidate the life cycle of the parasite A.oraoni, isolated from man. For the purpose, operculated eggs were isolated from faeces of oraon tribals belonging to the village Bandipore, district North 24-Parganas of West Bengal province of India. The purified eggs were incubated at different temperatures, salinity and pH. Larvae (miracidia) could be observed to develop between the 7th and 8th day of incubation at a temperature range between 22 degrees-30 degrees C. While the optimum pH was observed to be neutral, larval development did not take place at salinity beyond 0.8 per cent. To identify the correct intermediate host, all available species of snails from the study village were colonised and infected with the laboratory hatched miracidia from human derived operculated eggs. It was observed that of all the snails infected, only Lymnaea supported the development of rediae from miracidia, which could be observed on the 32nd post infection day. Considering the results of the experimental study, it was hypothesised that Lymnaea spp. of snails under natural condition also, might act as the first intermediate host for A. oraoni.

Recent investigations into global characteristics of long DNA sequences.

The sequencing of very large genes comprising tens and hundreds of thousands of bases raises important questions of how the data are to be viewed and analysed and what new information and rules on genome characterisation and organisation may exist in nature. Representation of such gene sequences require more compact techniques than the widely used letter-series method; several graphical techniques have been proposed that partially meet this need and reveal new patterns in sequence composition in conserved genes. Investigations using Chaos techniques have displayed self-similarities in the graphical representation of several classes of gene sequences that point to a fractal nature embedded in the sequence organisation in a scale-independent manner. Scale invariance is also seen in studies that have revealed unexpected correlations in gene sequences that imply that a nucleotide at any position influences nucleotides thousands of base positions away. These observations have given rise to a new way of looking at long gene sequences, but questions on the origin of such patterns and correlations and their implications in gene sequences and evolution remain to be resolved. This review provides a brief overview of the recent papers covering the techniques and the issues raised in these investigations on the global characteristics of long DNA sequences.

Sensitivity of non-cooperative binding parameters of ligand-DNA complex by computer analysis.

A simple user-friendly computer programme has been developed to operate on an IBM-PC compatible machine to aid in the process of curve fitting using the McGhee and von Hippel equation [J. Mol Biol, 86 (1974), 469-489] for the analysis of ligand-DNA interactions and the experimental data on berberine-calf thymus DNA and berberine-poly(dI-dC). poly(dI-dC) for non-cooperative binding. A sensitivity analysis on binding constant (K0) and the number of binding sites (N0) show that a small variation in the latter remarkably alters the fitting curve. At a level of 1% change in N0 from the best fit value, the standard deviation grows by almost 4%, while, on the other hand, a 1% change in K0 affects the same value only by less than 0.4%.

Immunomodulation with corticosteroids and levamisole in leprosy as gauged by in vivo lepromin and in vitro CMI responses.

Corticosteroids and Levamisole are known to be immuno suppressive and immuno stimulating agents respectively. Their effects on polar types of leprosy, tuberculoid and lepromatous have been studied using in vivo lepromin and in vitro lymphocyte count, rosette formation, L.T.T. and L.M.I.T. parameters. Immunosuppressive effect of corticosteroids on tuberculoid leprosy is marked with reduced and negative lepromin sensitivity but same does not hold true with other in vitro C.M.I. tests. Similar results are obtained with levamisole exhibiting its ineffectiveness in lepromin conversion in lepromatous cases although some improvement is observed in other in vitro C.M.I. tests. Evaluation of the results showed: lack of correlation between in vivo lepromin and in vitro other C.M.I. parameters with corticosteroids and levamisole lepromin sensitivity has some unknown influence other than thymic factors, prolonged corticosteroid therapy may produce permanent immunosuppression in tuberculoid cases making them more vulnerable towards lepromatous pole and lepromin sensitivity is more reliable, stable and easy to perform.