Evaluation of an Immunochromatographic Assay as a Canine Rabies Surveillance Tool in Goa, India

Rabies is a fatal zoonotic disease transmitted by the bite of a rabid animal. More than 95% of the human rabies cases in India are attributed to exposure to rabid dogs. This study evaluated the utility of a lateral flow immunochromatographic assay (LFA) (Anigen Rapid Rabies Ag Test Kit, Bionote, Hwaseong-si, Korea) for rapid post mortem diagnosis of rabies in dogs. Brain tissue was collected from 202 animals that were screened through the Government of Goa rabies surveillance system. The brain tissue samples were obtained from 188 dogs, nine cats, three bovines, one jackal and one monkey. In addition, 10 dogs that died due to trauma from road accidents were included as negative controls for the study. The diagnostic performance of LFA was evaluated using results from direct fluorescence antibody test (dFT); the current gold standard post mortem test for rabies infection. Three samples were removed from the analysis as they were autolysed and not fit for testing by dFT. Of the 209 samples tested, 117 tested positive by LFA and 92 tested negative, while 121 tested positive by dFT and 88 tested negative. Estimates of LFA sensitivity and specificity were 0.96 (95% CI 0.91–0.99) and 0.99 (95% CI 0.94–1.00), respectively. The LFA is a simple and low-cost assay that aids in the rapid diagnosis of rabies in the field without the need for expensive laboratory equipment or technical expertise. This study found that Bionote LFA has potential as a screening tool in rabies endemic countries

Orbital evolution studies of two HMXB pulsars

High mass X-ray binary (H M X B) pulsars are of two types, persistent and transient. 4U 1538-52 is a persistent HMXB whose orbit was previously measured to be circular but the RXTE observations revealed an eccentric orbit. We observed this system with RXTE-PCA in August 2003 and our timing analysis supports the eccentric orbit of the system. However, we do not find any evidence for orbital evolution. Rotational and tidal interactions between the stars of a closed binary system result in apsidal motion which can be measured in systems with eccentric orbit. 4U0115+63 is a Be-transient HMXB whose eccentric orbit was well-determined during its 1978 outburst. We report preliminary results from analysis of data obtained during the 1999 outburst of this source with the RXTE-PCA

Orbital evolution and orbital phase resolved spectroscopy of the HMXB pulsar 4U 1538-52 with RXTE-PCA and BeppoSAX

We report here results from detailed timing and spectral studies of the high mass X-ray binary pulsar 4U 1538-52 over several binary periods using observations made with the Rossi X-ray Timing Explorer (RXTE) and BeppoSAX satellites. Pulse timing analysis with the 2003 RXTE data over two binary orbits confirms an eccentric orbit of the system. Combining the orbitial parameters determined from this observation with the earlier measurements we did not find any evidence of orbital decay in this X-ray binary. We have carried out orbital phase resolved spectroscopy to measure changes in the spectral parameters with orbital phase, particularly the absorption column density and the iron line flux. The RXTE-PCA spectra in the 3-20 keV energy range were fitted with a power law and a high energy cut-off along with a Gaussian line at similar to 6.4 keV, whereas the BeppoSAX spectra needed only a power law and Gaussian emission line at similar to 6.4keV in the restricted energy range of 0.3-10.0 keV. An absorption along the line of sight was included for both the RXTE and BeppoSAX data. The variation of the free spectral parameters over the binary orbit was investigated and we found that the variation of the column density of absorbing material in the line of sight with orbital phase is in reasonable agreement with a simple model of a spherically symmetric stellar wind from the companion star

Desmoplastic fibroma of the mandible: A rare case report

Desmoplastic fibroma (DF) is a rare, locally aggressive benign fibrous tumor of the bone that has been reported in the maxillofacial skeleton. In this case report, we present imaging findings of a histopathologically proven desmoplastic fibroma involving the left mandibular body region in a 27-year-old male patient. We have also discussed epidemiological data, clinical, radiographical, and histopathological features, along with the prognosis and treatment of DF

Rapid exome sequencing: revolutionises the management of acutely unwell neonates.

Diagnosing acutely unwell infants with a potential genetic diagnosis can be challenging for healthcare professionals. Evidence suggests that up to 13% of critically unwell infants on the neonatal intensive care unit (NICU) have an underlying molecular diagnosis and when identified directly affects treatment decisions in 83%. On 1st October 2019, the National Health Service England (NHSE) launched a nationally commissioned service so that rapid whole-exome sequencing can be offered to critically unwell babies and children with a likely monogenic disorder who are admitted to NICU and paediatric intensive care unit (PICU). We present 7 cases from two neonatal units in the West Midlands (UK), where rapid exome sequencing has revealed a genetic diagnosis. Early genetic diagnosis in this cohort has influenced management in all (100%) cases, and in 57% (4 in 7 cases), it has helped in the decision to reorientate care. In some cases, early diagnosis has reduced the need for invasive and unnecessary investigations and avoided the need for post-mortem investigations. The genetic diagnosis has helped in counselling the families regarding the recurrence risk for future pregnancies. In some cases, this has provided parents with the reassurance of a low recurrence. In others, it has resulted in the offer of prenatal diagnosis or assisted conception technologies. What is Known: • Rapid whole-exome sequencing was commissioned in the UK in October 2019. • It is available for critically unwell babies with a likely monogenic aetiology. What is New: • It helps management planning for rare genetic disorders and future pregnancies counselling. • It can reduce the need for invasive investigations and overall intensive care costs.RD&E staff can access the full-text of this article by clicking on the 'Additional Link' above and logging in with NHS OpenAthens if prompted.Published version, accepted version (12 month embargo

Neurological disease in xeroderma pigmentosum: prospective cohort study of its features and progression

Xeroderma pigmentosum (XP) results from biallelic mutations in any of eight genes involved in DNA repair systems, thus defining eight different genotypes (XPA, XPB, XPC, XPD, XPE, XPF, XPG and XP variant or XPV). In addition to cutaneous and ophthalmological features, some patients present with XP neurological disease. It is unknown whether the different neurological signs and their progression differ among groups. Therefore, we aim to characterize the XP neurological disease and its evolution in the heterogeneous UK XP cohort. Patients with XP were followed in the UK National XP Service, from 2009 to 2021. Age of onset for different events was recorded. Cerebellar ataxia and additional neurological signs and symptoms were rated with the Scale for the Assessment and Rating of Ataxia (SARA), the Inventory of Non-Ataxia Signs (INAS) and the Activities of Daily Living questionnaire (ADL). Patients' mutations received scores based on their predicted effects. Data from available ancillary tests were collected. Ninety-three XP patients were recruited. Thirty-six (38.7%) reported neurological symptoms, especially in the XPA, XPD and XPG groups, with early-onset and late-onset forms, and typically appearing after cutaneous and ophthalmological symptoms. XPA, XPD and XPG patients showed higher SARA scores compared to XPC, XPE and XPV. SARA total scores significantly increased over time in XPD (0.91 points/year, 95% confidence interval: 0.61, 1.21) and XPA (0.63 points/year, 95% confidence interval: 0.38, 0.89). Hyporeflexia, hypopallesthaesia, upper motor neuron signs, chorea, dystonia, oculomotor signs and cognitive impairment were frequent findings in XPA, XPD and XPG. Cerebellar and global brain atrophy, axonal sensory and sensorimotor neuropathies, and sensorineural hearing loss were common findings in patients. Some XPC, XPE and XPV cases presented with abnormalities on examination and/or ancillary tests, suggesting underlying neurological involvement. More severe mutations were associated with a faster progression in SARA total score in XPA (0.40 points/year per 1-unit increase in severity score) and XPD (0.60 points/year per 1-unit increase), and in ADL total score in XPA (0.35 points/year per 1-unit increase). Symptomatic and asymptomatic forms of neurological disease are frequent in XP patients, and neurological symptoms can be an important cause of disability. Typically, the neurological disease will be preceded by cutaneous and ophthalmological features, and these should be actively searched in patients with idiopathic late-onset neurological syndromes. Scales assessing cerebellar function, especially walking and speech, and disability can show progression in some of the groups. Mutation severity can be used as a prognostic biomarker for stratification purposes in clinical trials