Nasal lavage was compared with nasopharyngeal aspiration for diagnosis of respiratory syncytial virus infection. Nasal lavage and nasopharyngeal aspiration were performed on 50 occasions in 32 infants (median age 5 6 months) with acute viral wheezing. Compared with nasopharyngeal aspiration, nasal lavage had a positive predictive value of 95-6% and negative predictive value of 92.5%. These comparable results and lack of adverse effects make nasal lavage the preferred method. (Arch Dis Child 1995; 72: 58- Subjects and methodsWe studied 32 infants who had been admitted to hospital with an acute episode of viral wheezing. Age range was 4 weeks to 2-6 years (median 5-6 months). The study was approved by the hospital ethics committee and parents gave verbal consent.Nasal lavage was performed followed by nasopharyngeal aspiration on 50 occasions; some of these were follow up samples when the children were symptom free. The subject was held in a supine position. Nasal lavage consisted of gently instilling 2 ml of phosphate buffered saline, at room temperature, into each nostril. This was simultaneously suctioned back using a soft rubber 8 or 10 FG Jaques catheter (TFX Medical) from the anterior nares. The catheter was attached to a standard mucus extractor (Universal Hospital Supplies) connected to wall suction. Nasopharyngeal aspiration was conducted using the standard technique. An 8 FG PVC catheter was pushed to the back of the nasopharynx and the aspirate collected into a mucus trap. Each procedure took only a few minutes and adverse effects were not encountered with either technique, although some samples from nasopharyngeal aspiration were mildly bloodstained.Nasal lavage fluid was centrifuged at 3000Xg for 20 minutes. The catheter used for nasopharyngeal aspiration was rinsed first with 1 ml viral transport medium before this mixture was centrifuged at 1500Xg for 10 minutes. The supematant was decanted and the pellet resuspended in sterile phosphate buffered saline. The washing procedure was repeated twice then the pellet was resuspended in 0-4 ml sterile phosphate buffered saline.The pellets contained intact epithelial cells; only 80% of cells obtained by lavage were intact compared with almost 1 00% from nasopharyngeal aspiration, but this was because the lavage samples had been frozen before analysis and would not be expected infresh samples. Direct immunofluorescence for RSV and influenza A antigens was carried out on the epithelial cells using commercial assays (Imagen, Dako Ltd) following the manufacturer's instructions. Influenza A was used as a control to detect non-specific fluorescence. ResultsSamples obtained by both techniques had a similar cellular composition, although nasal lavage gave a better cell yield.There were 24 RSV positive and 26 RSV negative samples from nasopharyngeal aspiration. Taking nasopharyngeal aspiration as gold standard, nasal lavage gave one false positive and two false negative results (table). This means nasal lavage has 96-2% specificity (with 95% confidence interv...

Background & Objectives: Acute myocardial infarction (AMI) is becoming increasingly important problem in developing countries, and thrombolysis is the main modality of treatment here. About 25-50% of patients fail to achieve successful reperfusion and these patients have poor prognosis. Since alternative modes of reperfusion are available, it is important to identify them. To study the effect of thrombolytic therapy in term of success and failure on the type of ST elevation MI, using streptokinase.

SUMMARYPregnancies were identified in which maternal IgG antibodies against rubella virus were not detectable by single radial haemolysis. Twenty paired maternal/cord sera were then tested for haemagglutination-inhibiting (HI) activity against rubella virus without kaolin pretreatment of the sera. In the absence of specific antibody, the HI activity observed could thus be ascribed to the effect ofnon-specific inhibitors. The HI activity in maternal sera was significantly (P < 0 001) higher than that in cord sera. The 20 pairs of sera were similarly tested against a bunyavirus, an alphavirus and a flavivirus, both with and without kaolin pretreatment. The results showed non-specific inhibitors were found to higher titre in maternal sera, with the difference being statistically significant (P < 0 001) for each of the three viruses.

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