THE STUDY OF SERO-PREVALENCE AND TRENDS OF HIV VIRAL MARKERS AMONG BLOOD DONORS IN NORTHERN INDIA

Transfusion of blood and blood components could be responsible for saving millions of life each year throughout the world. However, on the other hand , an improperly screened donated blood can be a source of transfusion transmitted infections (TTIs). Some important prevalent infections are caused by human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), Treponema pallidum and malaria parasite. To study the sero-prevalence and trends of HIV viral markers amidst blood donors in Northern India.The study was carried out in the blood bank section of Department of Pathology, Era's Lucknow Medical College, Era University, Lucknow. The present study was conducted as a retrospective & prospective observational study. Retrospective data of past eight years before commencement of study (2008 to 2015) and prospective data of one and a half years (2016 and 2017) was used in the study. Data of 22192 blood donors was explored for the present study. Only 10 donors were found to be positive for HIV viral markers. Prevalence of HIV positivity was relatively much lower than that reported in contemporary studies. Nevertheless, the present study underscored the need to carry out screening of viral markers and their periodic audit in order to understand the changing trends of sero-positivity among blood donors.

Evaluation of Efficacy and Tolerability of Perindopril 8 mg in Bangladeshi Hypertensive Patients: Results from an Open-label, Observational, Multi-center Study (CONTROL).

Background: The CONTROL (COversyl in Newly diagnosed stage-II & unconTROlled hypertensive patients triaL) was performed with an objective to evaluate the blood pressure (BP) lowering efficacy and tolerability of Perindopril 8mg in newly diagnosed stage II patients and uncontrolled hypertensive patients among Bangladeshi population. Methods: This was an open-label, observational, multi-center study conducted in consultation centers for out-patients located in different cities of Bangladesh. Adults, aged above 18 years with newly diagnosed stage-II hypertension or uncontrolled hypertension, were recruited. Patients were treated with Perindopril 4mg daily for first 1 week, afterwards uptitrated to Perindopril 8 mg daily and continued treatment for 12 weeks. Patients were followed-up at week-1, week-4, week-8 and week-12. Results: In total, 245 patients were enrolled. Among them, 88 were newly diagnosed stage-II (Group- I) and 157 were uncontrolled (Group-II) hypertensive patients. Male and female distribution was 57% and 43% respectively. Mean age of patients was 54.5 ±11.7 years. After 12 weeks treatment, there was a significant reduction in BP from baseline (p<0.001) in overall population as well as in Group I and in Group II. In overall population, the mean BP reduction was -31/-15 mmHg (from 163.7/96.8 mmHg to 132.4/81.7 mmHg. In Group I, the reduction was -33/-16 mmHg (from 166.5/98.2 mmHg to 133.4/82.0 mmHg) and in Group II, -30/-14 mmHg (from 159.3/ 95.6 mmHg to 129.1/81.6 mmHg). 10 patients (4.1%) had to discontinue the treatment due to adverse effects. Dry cough (2%) and hypotension (1.2%) were the main cause of discontinuation. Perindopril 8mg was well tolerated as indicated by the high proportion of physicians (81%) reporting ‘good’ to ‘excellent’ tolerability at week 12. Conclusion: This study suggests that Perindopril 8mg is effective and safe in the treatment of hypertension in Bangladeshi patients.

Familial Hypoparathyroidism with Pregnancy- Challenging Issue for Patient as well as for Physician.

Familial hypoparathyroidism is a rare cause of hypoparathyroidism. It may be x-linked recessive, autosomal dominant or autosomal recessive. In autosomal dominant hypoparathyroidism there is activating mutation of the calcium sensing receptor leading to inhibition of Parathormone (PTH) secretion at inappropriately low serum ionized calcium level. The disease often manifests in the first decade but may appear later. Clinical signs primarily involving neuromuscular disturbances including generalized seizure. Management of pregnancy in hypoparathyroidism is challenging as both under treatment and over treatment is dangerous for fetus. Treatment of hypoparathyroidism in pregnancy includes combination of oral calcium supplementation with calcitriol with an aim to keep serum calcium within normal range. Here we discussed a case of 21 year pregnant lady with familial hypoparathyroidism with successful delivery of a healthy baby.

Malignant hemangiopericytoma in the gluteal region: a rare entity.

We present here a case of malignant hemangiopericytoma in a 40-year-old female who presented with a history of slowly growing mass in left gluteal region for about 1.5 years. She was evaluated and a mass of 10 x 7.5 x 5.5 cm 3 was found on computed tomography. The tumor was resected and was sent for histopathological evaluation. Grossly the tumor was encapsulated and on cut section it was nodular. Microscopy showed spindle cells forming cords and sheets separated by thin delicate stroma consisting largely of thin-walled vessels revealed by reticulin stain. Pleomorphism and mitotic figures were seen. It was diagnosed as a case of malignant hemangiopericytoma of gluteal region. The patient underwent radiotherapy and did apparently well. She is on regular follow-up because long-term follow-up is essential in all cases as recurrence can occur several years after treatment.

Management of dengue by the WHO guided national guidelines.

A total of 90 adult patients of Dengue admitted in Sir Salimullah Medical College and Mitford Hospital, Dhaka during the period from July 2002 to December 2002 were studied to see the presentation, spectrum of disease and outcome of management. Majority (52%) of cases was in the age group 21-30 years. Out of 90 patients 74 patients (82.22%) were male and 16 (17.78%) were female. Maximum number of cases (43%) was found in the month of August. Most of the cases (77%) were from Dhaka City. Classical type of Dengue fever was the commonest (80%) variety. Thrombocytopenia was found in 80% cases. Platelet count came down below 10000/cumm only in 1.1% of the patients. The patients were diagnosed mainly by clinical criteria. Serological tests were done only in selected cases. Majority (80%) of the patients was managed by sponging, paracetamol and Oral Rehydration Salt (ORS). Blood transfusion was required in 18% cases and platelet concentrate was given only in 1.1% cases. There was no mortality in this study.

Immunochromatographic (rK39) strip test in the diagnosis of visceral leishmaniasis in Bangladesh.

Immunochromatographic strip test (ICT strip test) for the diagnosis of visceral leishmaniasis was evaluated in this study in the context of a case-control study. A total sixty consecutive cases of kala-azar admitted in all four Medicine Units of Mymensingh Medical College Hospital during the period of May 2002 to February 2003 was included here. Parasitological confirmation was done by demonstration of leishmania donovani bodies in bone marrow or splenic aspiration in all cases. A total 120 controls was taken of which sixty were asymptomatic endemic controls with no previous history of kala-azar and sixty were admitted patients suffering from diseases other than kala-azar (malaria, tuberculosis, enteric fever and chronic liver disease). ICT strip test for kala-azar was done in all cases and controls. Only 2 of the confirmed kala-azar cases were negative and the remaining 58 cases were positive for ICT strip test which gives the sensitivity of this test 96.6%. Among the controls, 118 were negative for ICT strip test and two of the asymptomatic controls were positive for this test with no clinical evidence of kala-azar. So, the estimated specificity of ICT strip test is 98.3%. The predictive value for a negative result was 98.3% and for a positive result was 96.6%. The ICT strip test is easy, quick, requires no technical facilities with higher sensitivity and specificity entails it to be the ideal test for the diagnosis of kala-azar in field level.

Isolation, purification and properties of cathepsin B from buffalo liver.

Cathepsin B was isolated from buffalo liver by salt fractionation, ion-exchange resin treatment, gel filtration and repeated ion-exchange chromatography using a linear salt gradient. The enzyme showed activity, against denatured hemoglobin (or ovalbumin), alpha-N-benzoyl-DL-arginine p-nitroanilide (BAPNA), and alpha-benzoyl-DL-arginine-naphthylamine (BANA). It inactivated buffalo muscle aldolase with a half life period of 21 min. The pH-activity profiles obtained for the digestion of hemoglobin (or ovalbumin) and aldolase inactivation by the enzyme were found to be different. The enzyme (mol wt 27,800 by SDS-PAGE) eluted in gel filtration with a molecular weight of 27,000 and a Stokes radius of 2.31 nm. The results showed buffalo cathepsin B to be a single-chain molecule. The N- and C-terminal amino acids of the enzyme were found to be leucine and aspartic acid, respectively. It contained 0.7% concanavalin A reactive neutral carbohydrate. The amino acid composition of buffalo cathepsin B was found to be similar to that of human liver cathepsin B. The optical properties of the buffalo enzyme were found consistent with its aromatic amino acid content. The isoionic pH of the enzyme was found to be 5.70 and the intrinsic viscosity was 3.48 ml/g whence the frictional ratio, f/f0 was computed to be 1.10 suggesting that the native enzyme conformation is compact and is globular in solution.