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Aims: The efficacy of cardioversion (DCCV) for restoration of sinus rhythm (SR) in persistent atrial fibrillation (AF) is limited by a high relapse rate. Relapse may be reduced by amiodarone but no placebo-controlled trials of efficacy have been performed and the appropriate duration of therapy is unknown., Methods and Results: In this double-blind study, 161 subjects with persistent AF were randomized to one of three groups-placebo (n=38); amiodarone 400mg BD for 2 weeks prior to DCCV and 200mg daily for 8 weeks followed by placebo for 44 weeks (n=62, short-term amiodarone); amiodarone 400mg BD for 2 weeks then 200mg daily for 52 weeks (n=61, long-term amiodarone). Spontaneous reversion to SR occurred before DCCV in 21% (26/123) patients on amiodarone and none of the 38 patients on placebo (absolute difference 21%, 95% confidence interval (CI): 10 to 29%, P=0.002). At 8 weeks following DCCV, 51% (63/123) patients on amiodarone remained in SR compared to 16% (6/38) taking placebo (difference-35% 95% CI: -48 to -18%, P<0.001). At 1 year, 49% (30/61) patients on long-term amiodarone were in SR compared to 33% (21/62) taking short-term amiodarone (difference-15%, 95% CI: -31 to 2%, P=0.085). There was no difference in adverse event rate or quality of life scores between groups., Conclusions: Amiodarone pre-treatment before electrical DCCV for persistent AF allows chemical conversion in one-fifth of patients without altering the efficacy of subsequent DC conversion. Amiodarone is more effective than placebo in the maintenance of SR when continued for 8 weeks following successful DCCV. More patients taking long-term amiodarone remained in SR at 52 weeks, but more had serious adverse effects requiring discontinuation of therapy. Eight weeks of adjuvant therapy with amiodarone following successful DCCV may be the preferred option.

Dracunculiasis, popularly known as Guinea worm disease, has been eradicated from Tamil Nadu, India, and there have been no indigenous cases reported since 1981. This report describes a female bonnet monkey with dracunculiasis. She presented with fever and a blister in left hind limb. The blister ruptured on exposure to water and a 7-cm-long worm was extruded. The worm died before it could be histologically examined. The diagnosis was based on the typical clinical course, which was pathognomonic of dracunculiasis. Review of literature did not reveal any previous report of dracunculiasis in South Indian bonnet monkeys (Macaca radiata). This paper raises the question whether wild monkeys might act as reservoirs of human infection and cause resurgence of the disease in South India.

Success in neural tissue transplants at central nervous system suggest that the site may be immunologically privileged. However, this experimental study in which an antigen (Sheep Red Blood Cells) was administered into the third ventricle does not support the above concept. The antibody titre and soluble immune complex levels seen in these animals are similar to the levels seen in animals immunized with the same amount of antigen through the intraperitoneal route. Intraventricular immunization is rather a more potent modulator in decreasing the total WBC count (P < 0.05) and neutrophils (P < 0.001). Further a marked increase in lymphocytes (P < 0.01) in peripheral blood was observed in these animals. Intraventricular immunization also increased the killing power (NBT reduction) of the neutrophils (P < 0.05).

A study was made on the physical, chemical, energetic, conformational, geometric, and dynamic property potentials of amino acid residues in protein secondary structures: alpha-helix and beta-strand. Property patterns were obtained by computing the average property values for specified residue units partitioned longitudinally and transversely about the chain. It was found that in alpha-helices with not more than 15 residues, there exist longitudinally opposing portions, one characteristically higher in average property potentials than the other. The helical chain, in general, acquires either an increasing or decreasing average potential in the N-terminal to C-terminal direction. The sequence-wise and surface-wise variations of property potentials in the elements of beta-structure also revealed such general patterns. Possible wrong predictions in statistical methods of one secondary structural class over the other are pointed out.