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Background: The Western blot assay is the gold standard for the detection of antibodies to human immunodeficiency virus type1 (HIV-1). However, indeterminate Western blot reactivity to HIV-1 proteins may occur in individuals, who may not be infected with HIV. Aim: This retrospective study was aimed to determine the diagnostic value of the interpretation criteria in relation to commercial kits for HIV -1 diagnosis. Methods and Materials: A total of 556 serum/plasma specimens collected from high-risk population attending our HIV clinic from 2000 - 2004 were tested by three different western blot kits: NEW LAV BLOT I (n=244), HIV BLOT 2.2; (n=112), Genetic Systems HIV-1 (n=237). And the results of western blot strips were analyzed using the various interpretation criteria: WHO/NACO, CDC/ ASTPHLD, ARC, FDA, CRSS and JHU. Some specimens were run on more than one kit. RT-PCR assay was performed on 5 specimens, which were indeterminate with LAV BLOT I. Results: The discrepancy in LAV BLOT I positive results were between 157(64)-176(72), and indeterminate results were between 44(18) to 63(25). No such variations were observed in genetic systems. There are some HIV negative (by PCR) specimens were indeterminate in LAV BLOT I revealing the kit more sensitive and less effective for diagnostic purpose. Conclusion: The genetic systems kit is superior to other kits we analyzed and its results are concordant with HIV-1 PCR results. To report, the choice of western blot commercial kit is paramount important than the use of particular interpretation criteria for the diagnosis of HIV -1.

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Background: Fractures of the humeral shaft are relatively common injuries. Literature suggests that humeral shaft fractures represent approximately 3 % of all fractures. There are several modalities for the management of diaphyseal humeral fractures. The latest investigations emphasize the concept of minimal exposure and rigid fixation. Aim: The aim of the study is to evaluate the results of antegrade intramedullary nailing in humeral shaft fractures. Design: A retrospective review Settings: Patients were treated in private hospital settings by 3 orthopaedics surgeon Material and Methods: Between 1995 and 2003, the technique of antegrade locked intramedullary nailing with UHN in humeral shaft fractures was performed on 114 patients. Forty-two (36%) patients sustained multiple traumas, and 22 (19%) fractures were open. The outcomes were evaluated with a mean follow-up of 41 months. Statistical analysis used: Ranges of results given Results:0 In 109 fractures primary union observed. In the other five patients union achieved after removal of the nail and fixation with DCP and bone grafting. The average time for union was 13 weeks (range, 10-36 weeks). One hundred-five patients had excellent or satisfactory recovery of shoulder and elbow function. Complications included impingement due to proximal locking screws in two patients and prominent nail in three patients, transient postoperative radial nerve palsy in four patients. Conclusions: This study shows that antegrade locked nailing in humeral shaft fractures are reliable and also effective in multiply injured patients.

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Background: Alcohol dependence often cannot be diagnosed based on self-report alone. Various biochemical and haematological parameters have been used to screen alcohol use disorders. Aim:0 To develop discriminant equations based on lipid and liver measures independently for identifying alcohol dependent and non-dependent subjects. Settings and Design: Case control study in a tertiary care hospital. Methods and Material: One hundred subjects fulfilling the criteria of alcohol dependence and seventy healthy controls were included. The socio-demographic details, caloric intake, height, weight and blood pressure were recorded. Samples were analysed for various lipid measures as well as liver function. Statistical analysis used: Diagnostic values such as sensitivity, specificity, positive predictive value (PV+), negative predictive value (PV-) and discriminant analysis. Results:0 Using discriminant analysis, two equations were constructed based on liver and lipid measures independently. 84.7% of the subjects on the basis of total cholesterol (TC), apolipoprotein B (ApoB) and low density lipoprotein /high density lipoprotein-cholesterol (LDL/HDL-c and 89.1% on the basis of aspartate amino transferase (AST) and gamma glutamyl transferase (GGT) were correctly classified into their respective groups. Conclusions: This study demonstrates the ability of TC, ApoB and LDL/HDL-c (among lipid measures) and AST and GGT (among liver measures) in discriminating alcohol dependents from non-dependent subjects.

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Angioedema is a potentially life threatening condition and may be either inherited or acquired. The latter is rare with only a handful of cases reported in the world literature. Presenting complaints are often vague. Those most commonly described include swelling in the subcutaneous and submucosal tissues. Patients presenting with laryngeal edema have high mortality, and high clinical suspicion is necessary to avoid instrumentation, which can precipitate laryngeal spasm. We present a review of reported cases of hormonally induced hereditary angioedema, along with a report of a patient with acquired angioedema secondary to hormone replacement therapy. To the best of our knowledge, this case probably represents the first reported case of acquired angioedema secondary to hormone replacement therapy.

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CONTEXT: Nephrotic syndrome is one of the commonest renal problem encountered in children. It is difficult to predict at onset, the clinical course in terms of steroid responsiveness or resistance. Angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism has been studied as a predictor of clinical course in common multi-factorial diseases including focal segmental glomerulosclerosis. There is no study available from our country till date to find out any correlation of the steroid response in idiopathic nephrotic syndrome and ACE gene polymorphism. AIM: To study distribution and correlation of ACE gene I/D polymorphism in idiopathic steroid sensitive nephrotic syndrome SETTINGS & DESIGN: Case-control retrospective study. SUBJECTS & METHODS: We studied ACE gene polymorphism in 90 consecutive patients (82% males, 18% females) with steroid sensitive idiopathic nephrotic syndrome and 300 normal controls (NC). STATISTICAL ANALYSIS: Chi-square test and Fisher's exact test (for cases with insufficient expected cell frequencies) RESULTS: The mean age of onset was 5.3 ± 4 years. Steroid sensitive (SS) patients showed II (SS - 48%, NC - 26%) genotype was more frequent than normal controls (p=0.002). There was no significant difference in genotype frequencies among steroid SS subgroups. CONCLUSIONS: In our study II genotype was more frequent in steroid sensitive nephrotic syndrome children in comparison to normal controls. Further functional studies with large number of children are required to investigate the role of II genotype in steroid sensitive nephrotic syndrome. Comparison of the genotypic frequency with steroid resistant patients may provide information, which might be useful in clinical practice.

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