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Biomedical subjects

V Ravi

Publications and source records attributed to V Ravi.

65 records · Page 4Linked to original sources

Herpes simplex encephalitis: a diagnostic and therapeutic reapprisal.

Herpes Simplex Encephalitis (HSE) appears to be underdiagnosed in India, though viral encephalitides constitutes an important entity with significant morbidity. With an upsurge in AIDS, HSE may perhaps emerge as an important opportunistic infection in future. We discuss the clinical features and laboratory evaluation of nine cases of HSE seen in the last 12 years at our center. Diagnosis was established by brain biopsy in one, virological studies in six and at autopsy in three. Immunocytochemically viral antigens could be localized in 4 biopsied/autopsied brain tissue and in CSF cells on a cytospin preparation in one. This has facilitated rapid diagnosis in our cases. Virus isolation was successful in two. Three subjects were treated with acyclovir and all survived with variable morbidity. Four patients expired and none of them had received any specific antiviral drugs. Rapid diagnosis and early treatment with acyclovir has been highlighted.

Acyclovir↗

Laboratory diagnosis of Japanese encephalitis using monoclonal antibodies and correlation of findings with the outcome.

Detection of virus, viral antigen, and class-specific antibody was carried out in cerebrospinal fluid (CSF) and sera of 27 children with Japanese encephalitis. The diagnosis could be confirmed in 78.57% of cases (22/27) by demonstration of virus-specific IgM in CSF (15/22), viral antigen in CSF (5/22), or by virus isolation (2/22). Absence of virus specific IgM in CSF was associated with a fatal outcome (P = 0.05).

Adolescent↗

A reverse passive haemagglutination test for detection of Japanese encephalitis virus antigens in cerebrospinal fluid.

A rapid sensitive and specific reverse passive haemagglutination test (RPHA) was developed for the detection of Japanese encephalitis virus (JEV) antigens in human cerebrospinal fluid (CSF). Sheep red cells were sensitized with five monoclonal antibodies (109, 112, 203, 204 and 301) reactive with envelope glycoprotein of JEV. Viral antigens were detected in CSF from 35 of 58 (60%) clinical cases of JE when the five MAb coated cells were used in combination. An IgM capture ELISA detected JEV specific antibodies in CSF among 52 of these 58 cases (90%). While 29 specimens contained both antigen and IgM antibodies, 23 had only IgM antibodies and 6 had only antigen. RPHA proved valuable for detection of viral antigens in CSF samples obtained within 10 days after onset of clinical symptoms. Amongst the five MAbs used, the individual antigen detection rates were 44, 12, 43, 12 and 36%, for MAbs 109, 112, 203, 204 and 301, respectively.

Animals↗

Coxsackie virus and rheumatic fever. A correlative study.

Twenty-one patients of whom 13 had acute rheumatic fever and 8 had recurrence of rheumatic fever were studied for the evidence of coxsackie B viral infection using neutralisation test. A significant rise was noted in 17 cases (81%) and two cases had very high initial titre of neutralising antibodies to coxsackie B viruses type 1 to 6. Mixed infection with more than one serotype was seen in 11 cases. Coxsackie B2 was the commonest type and 14 patients had antistreptolysin 'O' anti-bodies. The high incidence of coxsackie B viral infection in rheumatic fever and the coexistent streptococcal infection and their relationship are discussed.

Adolescent↗

Wuchereria bancrofti: cloning and characterization of heat shock protein 70 from the human lymphatic filarial parasite.

Heat shock protein 70 (HSP70) was identified as an immunodominant antigen by screening a Wuchereria bancrofti (Wb) microfilarial cDNA library with pooled Wb-infected sera, with 28% of the immunopositive clones coding for Wb-HSP70. The deduced amino acid sequence showed greater than 97 and 85% identity with HSP70 from filarial nematodes and humans, respectively. Recombinant HSP70 (74 kDa) and a recombinant protein from the C-terminal portion (43 kDa) also reacted with pooled Wb-infected sera, suggesting that the C-terminal region of HSP70 contains at least one antibody epitope. Brugia malayi L3 larvae showed increasing levels of HSP70 with increasing temperatures. Further, a polyclonal mouse anti-Wb-HSP70 antibody had reactivity to the HSP70 of cattle filarial parasite Settaria digitata and to human HSP70 derived from a Hep-2 cell line. Immune reactivity to Wb-HSP70 was strong, with uninfected non-endemic normal sera showing significantly greater reactions than sera from filaria-infected individuals. Both immunodominant self-HSP70 and HSP70 from other microbial infections may be primary targets for developing autoantibodies naturally.

Amino Acid Sequence↗

Cryptococcosis in the immunocompromised host with special reference to AIDS.

Cryptococcosis is increasing because of an ever rising population of immunocompromised individuals especially those with acquired immune deficiency syndrome (AIDS). Cryptococcal infection of the central nervous system (CNS) were diagnosed in 149 cases over a period of 19.5 years (January 1978-June 1998). Culture was positive in all cases except three who were already on antifungal therapy. India ink mounts of cerebrospinal fluid (CSF) revealed encapsulated cryptococci in 134, and cryptococcal antigen was detected in 111 of 114 patients tested. A comparison of laboratory and certain clinical parameters in patients with and without associated HIV infection showed that a poor CSF cell response and culture of cryptococci from extra-neural sites was more often associated with HIV infection and was statistically significant. Further, presence of concomitant infection especially tuberculosis, and mortality were higher in the HIV positive group.

AIDS-Related Opportunistic Infections↗

Immunoreactive antigenic sites of Cysticercus cellulosae relevant to human neurocysticercosis--immunocytochemical localization using human CSF as source of antibody.

With a view to identify the relevant antigens of Cysticercus cellulosae, recognized within human central nervous system, immunocytochemical localization of antigens on the cestode larva has been carried out using cerebrospinal fluid of patients as the source of primary antibody. CSF from nine proven cases of neurocysticercosis, two cases of culture proven tuberculous meningitis and two cases of spinal disc prolapse with no other infective or neurological disorder were used in this study. The CSF from all the cases of neurocysticercosis intensely reacted with the glycocalyx over the integument of the cyst bladder wall. The other structures recognised by the CSF antibodies were cytoplasm of the tegumentary cytons, stroma and the ductular system of the bladder wall. The cells, stroma and calcareous corpuscles of the scolex reacted variably with the CSF. Tegument of the spiral canal and sucker muscles in the scolex were not immunoreactive. We strongly suggest that the glycocalyx is the most antigenic anatomical structure of the Cysticercus cellulosae and the patients develop antibodies to it.

Animals↗

Peripheral neuropathy in subacute sclerosing panencephalitis--immunohistochemical and ultrastructural evidence.

A patient with SSPE who had prominent diffuse white matter hypodensities on CT scan indicating central white matter demyelination and nerve conduction abnormalities suggestive of peripheral neuropathy is reported. Diagnosis was established by demonstration of elevated CSF measles antibody titers and presence of virus antigen and nucleocapsid in peripheral nerve. To our knowledge, this is the first report of demonstration of measles virus nucleocapsides and antigen in the peripheral nerve in SSPE.

Antigens, Viral↗