The area under the receiver operating characteristic (ROC) curve for predicting leptospirosis of simplified THAI-LEPTO score model II (7 variable), comparing with IgM rapid test in validation study.

<p>AUC; area under ROC curve.</p

Effects of Neuro Polyvalent Snake Antivenom (NPAV) on the cardio-respiratory depressant and neuromuscular blocking effects.

<p>Changes in percentage (%) of (A) mean blood pressure, (B) heart rate, (C) respiratory rate and (D) muscle twitch tension, upon intramuscular injection of <i>N. sputatrix</i> venom (6 mg/kg) at 0 min in ‘NsV/-’ group (n = 3; green circle) and ‘NsV/NPAV’ group (n = 3; blue square ); and intramuscular injection of saline in ‘saline/-’ group (n = 3; red diamond) , which served as the control group. The ‘NsV/NPAV’ group received intravenous injection of 1 mL NPAV each at 10, 30 and 50 min (3 mL in total) post venom injection. *P<0.05 by one-way ANOVA between the ‘NsV/-’ group and ‘NsV/NPAV’ group, within the range indicated by the curly bracket. #P<0.05 by one-way ANOVA between the ‘saline/-’ group and ‘NsV/NPAV’ group, within the range indicated by the curly bracket. The animals in ‘NsV/-’ group died within 125–130 min upon venom injection. All values are expressed as mean ± S.D.</p

Accuracy of the simplified THAI-LEPTO score comparing with IgM rapid test in validation cohort analysis (n = 92).

<p>Accuracy of the simplified THAI-LEPTO score comparing with IgM rapid test in validation cohort analysis (n = 92).</p

THAI-LEPTO score of the development cohort at the best cutoff value to predict leptospirosis in suspected cases, comparing with IgM rapid test (n = 211).

<p>THAI-LEPTO score of the development cohort at the best cutoff value to predict leptospirosis in suspected cases, comparing with IgM rapid test (n = 211).</p

Performance of available diagnostic score models of leptospirosis.

<p>Performance of available diagnostic score models of leptospirosis.</p

<i>In vitro</i> and <i>in vivo</i> neutralization of cobra and krait venoms by NPAV and NKMAV.

<p>Abbreviations: NPAV: Neuro Polyvalent Antivenom; NKMAV: <i>Naja kaouthia</i> monovalent antivenom.</p><p>Data for NPAV are extracted from <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001672#pntd-0001672-t001" target="_blank">Table 1</a> for comparison purpose. For LD₅₀ and ED₅₀, values in brackets are 95% CI.</p><p>Challenge dose for all venoms: 5 LD₅₀.</p

Elution profiles of (A) Neuro Polyvalent Snake Antivenom (NPAV) and (B) <i>Naja kaouthia</i> monovalent antivenom (NKMAV).

<p>One mg of each sample was applied to Superdex 200 10/300 GL gel column. The arrows identify the peaks. The results of integration of the areas-under-the-curve are shown in the insert table on the upper left. LMWC stands for low molecular weight components.</p

Flow chart of subject disposition for the THAI-LEPTO score study in development cohort (A) and validation cohort comparing between THAI-LEPTO score and IgM rapid test (B).

<p>^aDevelopment cohort in 11 centers during 2012 to 2014. ^bValidation cohort in 4 centers during 2015 to 2016.^cSimplified THAI-LEPTO score model II (7 variables) with cutoff value of 4 was used in the validation analysis.</p

Patients’ clinical and laboratory characteristics (on admission) of confirmed-leptospirosis and non-leptospirosis group in development cohort (n = 211).

<p>Patients’ clinical and laboratory characteristics (on admission) of confirmed-leptospirosis and non-leptospirosis group in development cohort (n = 211).</p

<i>In vitro</i> neutralization of lethality of Afro-Asian cobra and krait venoms by NPAV.

<p>For LD₅₀ and ED₅₀, values in brackets are 95% CI.</p><p>2.5 or 5.0 LD₅₀ of venom in 50 µL was premixed with 200 µL of NPAV (Neuro Polyvalent Snake Antivenom) and incubated for 30 min. The mixture was then injected into mice (n = 4, 20–25 g) and monitored for 48 h. NE: Not effective at maximum volume of antivenom (200 µL) permitted.</p>*<p>: estimated value, as the maximum volume of antivenom (200 µL) only achieved 50% protection of the animals.</p