Variation in epitopes of the B subunit of cholera toxin (CT-B) produced by strains of El Tor and classical biotype Vibrio cholerae O1 was examined using monoclonal antibodies prepared to V. cholerae 569B CT. CT-B epitopes were markedly conserved for V. cholerae classical biotypes. In contrast, epitope variation was observed for El Tor biotypes, which produced both a classical-like CT-B and a unique CT-B lacking at least one epitope common to 569B CT-B. The missing epitope was located outside the GM1 ganglioside-binding site. From results of the study reported here, genetic divergence is exhibited in the El Tor biotype CT-B versus classical CT-B. Furthermore, at least five unique epitopes of V. cholerae 569B CT-B can be defined.
Monoclonal antibodies reacting with the B subunit of Vibrio cholerae O1 strain 569B cholera toxin (CT-B) were used to identify unique and common epitopes of V. cholerae non-O1 and Vibrio mimicus CT-B. Vibrio cholerae non-O1 strains produced CT-B showing three monoclonal antibody reaction patterns (epitypes), which corresponded with epitypes described previously for V. cholerae O1 classical biotype CT-B (CT1), El Tor biotype CT-B (CT2), and a unique V. cholerae non-O1 CT-B (CT3), which lacked an epitope located in or near the GM1 ganglioside binding site of 569B CT-B. Vibrio mimicus CT-B was immunologically indistinguishable from 569B CT-B. These and previous results define six epitopes on 569B CT-B, and a fourth epitope in or near the GM1 ganglioside binding site.
Shivering is one of the most common complications of neuraxial blockade. Some patients find shivering sensation worse than surgical pain post-operatively. Therefore, both prevention and treatment of established shivering should be regarded as clinically relevant interventions during the preoperative period. This prospective experimental study was conducted at Wad Madani Maternity Teaching Hospital and aimed to measure the efficacy of pethidine when used for the treatment of postoperative shivering following spinal anesthesia during the period from November 2018 to February 2019. The sample size included of 40Patients within the American Society of Anesthesia type two physical statuses;25 mg pethidine diluted in 5 ml Normal saline-injected intra veins. All patients were monitored for temperature, heart rate, blood pressure, and oxygen saturation, these parameters were recorded preoperative, and post 10 minutes of operative, then after 10 minutes of pethidine dose administration. Data were analyzed by using a statistical package for social sciences (SPSS). The statistical results showed that there was a significant relationship between hypothermia and the presence of shivering. 90% of cases resolved to shivering, whereas 10% did not resolve, just 2.5% had Nausea and Vomiting and no side effects on the Respiratory and cardiac Systems. Based on those results the study concluded that: a small dose of pethidine 25 mg intra veins is very effective in resolving postoperative shivering with minimum side effects in the gastrointestinal tract and Good Cardiopulmonary stability. The study recommended that: warming tools should be available for patients to prevent heat loss, close monitoring of Patient's temperature intraoperative and in the recovery room, and use of 25mg Pethidine in the Presence of shivering intraoperative or post-spinal anesthesia.
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