A rare case of antepartum posterior reversible encephalopathy syndrome.

Pre-eclampsia and eclampsia are well-known causative factors of posterior reversible encephalopathy syndrome (PRES). There are only a few reported cases of antepartum PRES. We report a 25-year-old primigravid woman who presented with eight months of amenorrhoea and an abrupt onset of eclampsia associated with a history of a fall. A computed tomography scan ruled out intracranial haemorrhage and PRES was diagnosed. She responded well to supportive care, labour was induced and maternal and neonatal outcomes were good. Antepartum PRES poses different challenges to those of PRES in non-obstetric or postpartum patients, because of the additional management aspects required to ensure foetal wellbeing. We were posed with a difficult decision about the disadvantages of caesarean section versus those of vaginal delivery in our patient.

Hydrogen peroxide vapour for decontaminating air-conditioning ducts and rooms of an emergency complex in northern India: time to move on.

Overcrowding and patient overload in emergency services areas often mean that inadequate attention is paid to thorough cleaning, disinfection of rooms and air-conditioning ducts, which would require closing the area concerned. Over a period of time, this leads to accumulation of lint, fibre, dust and fungal growth. This study assessed the effectiveness of hydrogen peroxide fog to decontaminate the air-conditioning ducts as well as for room disinfection without having to close down the area. The Postgraduate Institute of Medical Education and Research emergency complex, Chandigarh, is distributed over three floors housing nine air-handling units (AHUs) and seven wards. The work was carried out over a period of seven days and involved cleaning of air-conditioning ducts and wards, cleaning and disinfection of fittings and furniture, vacuuming and fogging of AHU, ducts and room air. Fogging was done with 20% Ecoshield fog, a complex formulation of stabilised hydrogen peroxide 11% w/v with 0.015% w/v silver nitrate. Pre- and post-fogging samples were taken for microbiological culture, and air samples were also collected. Hydrogen peroxide fogging was highly effective for disinfection of room air, furniture and other articles. It decontaminated the air-conditioning ducts effectively, was rapid and cheaper than formalin, and no adverse effects were noted. There was minimum disturbance to the patients and the treated areas were ready to be populated again after 5-6h. Hydrogen peroxide has the advantage of being safer, less irritating, and has shorter cycle times compared with formalin fumigation which is more commonly practised in India.

Immunodiagnosis of cystic echinocooccosis by antigen detection in serum, urine, and saliva samples.

BACKGROUND: Cystic echinococcosis (CE) being more common in rural areas, the collection of serum may not always be possible or may be hazardous in untrained hands. The alternative, noninvasive samples like saliva and urine which are non invasive and easy to collect need to be evaluated for diagnosis of CE. AIM: The aim of this study was to evaluate hydatid antigen detection by ELISA in urine and saliva samples by comparing them with antigen detection in serum for diagnosis of CE. MATERIALS AND METHODS: Serum, saliva and urine samples were collected from 25 clinically and radiologically diagnosed CE patients, 25 clinically suspected cases of CE, 15 other parasitic disease controls and 25 healthy controls. Hydatid antigen detection was done in these samples by Enzyme linked immunosorbent assay using hyperimmune serum raised in rabbits immunized with hydatid antigen. RESULTS AND CONCLUSIONS: The sensitivity of ELISA for antigen detection in serum, saliva and urine was found to be 40%, 24% and 52% respectively. Urine showed significantly higher (p<0.05) sensitivity than that of saliva samples but not significantly higher (p>0.05) than that of serum samples. The specificity was highest for serum (92.5%) followed by saliva (87.5%) and urine (80%). There was no significant difference in antigen detection in patients with single vs multiple cysts. There was no significant difference in antigen detection in patients with hepatic vs extrahepatic cysts in serum or saliva samples but antigen positivity in urine was significantly higher (p<0.05) in hepatic cysts than that in extrahepatic cysts. The results showed that biological fluids like urine and saliva may be used as an alternative or as an adjunct to serum samples by virtue of their noninvasive, easy collection and similar sensitivity and specificity.

Characterization of expressed sequence tags (ESTs) of pigeonpea (Cajanus cajan L.) and functional validation of selected genes for abiotic stress tolerance in Arabidopsis thaliana.

Pigeonpea, a major grain legume crop with remarkable drought tolerance traits, has been used for the isolation of stress-responsive genes. Herein, we report generation of ESTs, transcript profiles of selected genes and validation of candidate genes obtained from the subtracted cDNA libraries of pigeonpea plants subjected to PEG/water-deficit stress conditions. Cluster analysis of 124 selected ESTs yielded 75 high-quality ESTs. Homology searches disclosed that 55 ESTs share significant similarity with the known/putative proteins or ESTs available in the databases. These ESTs were characterized and genes relevant to the specific physiological processes were identified. Of the 75 ESTs obtained from the cDNA libraries of drought-stressed plants, 20 ESTs proved to be unique to the pigeonpea. These sequences are envisaged to serve as a potential source of stress-inducible genes of the drought stress-response transcriptome, and hence may be used for deciphering the mechanism of drought tolerance of the pigeonpea. Expression profiles of selected genes revealed increased levels of m-RNA transcripts in pigeonpea plants subjected to different abiotic stresses. Transgenic Arabidopsis lines, expressing Cajanus cajan hybrid-proline-rich protein (CcHyPRP), C. cajan cyclophilin (CcCYP) and C. cajan cold and drought regulatory (CcCDR) genes, exhibited marked tolerance, increased plant biomass and enhanced photosynthetic rates under PEG/NaCl/cold/heat stress conditions. This study represents the first report dealing with the isolation of drought-specific ESTs, transcriptome analysis and functional validation of drought-responsive genes of the pigeonpea. These genes, as such, hold promise for engineering crop plants bestowed with tolerance to major abiotic stresses.

Specific antibody detection in serum, urine and saliva samples for the diagnosis of cystic echinococcosis.

Serum, saliva and urine samples of 25 clinically and radiologically diagnosed cystic echinoccosis (CE) patients, 25 clinically suspected cases of CE, 15 other parasitic disease controls and 25 healthy controls were evaluated for anti-hydatid antibody response by ELISA. The sensitivity of serum, saliva and urine was found to be 72, 56 and 84%, respectively, while specificity was 76% in all the samples. Urine showed significantly higher (p<0.05) sensitivity than that of saliva samples but not significantly higher (p>0.05) than that of serum samples. There was no significant difference in the immune response of patients with hepatic versus extrahepatic cysts and single versus multiple cysts. Thus, biological fluid like urine may be used as an alternative or as an adjunct to serum samples by virtue of its non-invasive, easy collection and similar sensitivity and specificity.