The entrapped and unravelled coronary wire

No abstract available.

Detection and species identification of Campylobacter in stool samples of children and animals from Vellore, south India

Campylobacter spp. are an important cause of bacterial gastroenteritis frequently isolated from animal, poultry and environmental samples. In this study, we investigated the zoonotic potential of Campylobacter spp. by comparing prevalence rates and species in 394 children with diarrhoea and 652 animals in Vellore using PCR-based tools. Eighteen children (4.5%) had campylobacteriosis, a majority of whom had co-pathogens (15/18) and most were infected with Campylobacter jejuni (16/18). A few C. coli and mixed infections with both species were also seen. Among the animal samples, 16/25 chicken samples (64%) were positive and all were found to be C. jejuni.

Evaluation of coamoxiclav and other antibiotics against S pneumoniae and H influenae from paediatric cases of acute respiratory infections

Streptococcus pneumoniae and Haemophilus influenzae are most important respiratory pathogens with increasing antimicrobial resistance among the key pathogens responsible for community-acquired respiratory tract infections and have the potential to limit the effectiveness of antibiotics available to treat these infections. In the present study, a total of 18 isolates of Streptococcus pneumoniae and 9 isolates of Haemophilus influenzae were characterised from specimens obtained from patients of acute respiratory tract infections including otitis media, tonsillitis, bronchitis, pneumonia and sinusitis. In the present study, all the Streptococcus pneumoniae isolates were sensitive to coamoxiclav and to cefixime, while they showed variable resistance to the other antibiotics screened. The degree of resistance to various antibiotics was as follows: Streptococcus pneumoniae showed resistance to cotrimoxazole (66.7%), azithromycin (55.6%), erythromycin (16.7%), chloramphenicol (16.7%), clindamycin (11.1%) and penicillin (11.1%). Haemophilus influenzae showed resistance to cefixime 100%, chloramphenicol 88.9%, penicillin 77.8%, erythromycin 77.8%, cefuroxime 77.8%, azithromycin 77.8%, and clindamycin 11.1%. The present study showed the emergence of variable resistance to penicillin, cotrimoxazole and other antibiotics.

An improved brain image classification technique with mining and shape prior segmentation procedure

The shape prior segmentation procedure and pruned association rule with ImageApriori algorithm has been used to develop an improved brain image classification system are presented in this paper. The CT scan brain images have been classified into three categories namely normal, benign and malignant, considering the low-level features extracted from the images and high level knowledge from specialists to enhance the accuracy in decision process. The experimental results on pre-diagnosed brain images showed 97% sensitivity, 91% specificity and 98.5% accuracy. The proposed algorithm is expected to assist the physicians for efficient classification with multiple key features per image.

Combination therapeutic effect of cisplatin along with Solanum trilobatum on benzo(a)pyrene induced experimental lung carcinogenesis

Lung cancer is one of the leading causes of cancer death in the world and is notoriously difficult to treat effectively. In the present study, male Swiss albino mice were divided into five groups of six animals each: group I animals received corn oil orally and served as a control; group II cancer-induced animals received benzo(a)pyrene (B[a]P) (50 mg kg(-1) bodyweight dissolved in corn oil, orally) twice weekly for four successive weeks; group III cancer-bearing animals (after 12 weeks of induction) were treated with cisplatin (6 mg kg(-1) bodyweight, i.p.) once weekly for 4 weeks; group IV cancer-bearing animals were treated with cisplatin along with Solanum trilobatum (300 mg kg(-1) bodyweight) orally once weekly for 4 weeks; and group V animals constituted the drug control treated with cisplatin along with S. trilobatum. The serum, lung and liver were investigated biochemically for aryl hydrocarbon hydroxylase, gamma-glutamyl transpeptidase, 5'-nucleotidase, lactate dehydrogenase (LDH) and protein-bound carbohydrate components (hexose, hexosamine and sialic acid). These enzyme activities were increased significantly in cancer-bearing animals compared with control animals. The elevation of these in cancer-bearing animals was indicative of the persistent deteriorating effect of B[a]P in cancer-bearing animals. Our data suggest that cisplatin, administered with S. trilobatum, may extend its chemotherapeutic effect through modulating protein-bound carbohydrate levels and marker enzymes, as they are indicators of cancer. The combination of cisplatin with S. trilobatum could effectively treat the B[a]P-induced lung cancer in mice by offering protection from reactive oxygen species damage and also by suppressing cell proliferation.

Closing the diarrhoea diagnostic gap in Indian children by the application of molecular techniques

A large proportion of diarrhoeal illnesses in children in developing countries are ascribed to an unknown aetiology because the only available methods, such as microscopy and culture, have low sensitivity. This study was aimed at decreasing the diagnostic gap in diarrhoeal disease by the application of molecular techniques. Faecal samples from 158 children with and 99 children without diarrhoea in a hospital in South India were tested for enteric pathogens using conventional diagnostic methods (culture, microscopy and enzyme immunoassays) and molecular methods (six PCR-based assays). The additional use of molecular techniques increased identification to at least one aetiological agent in 76.5 % of diarrhoeal specimens, compared with 40.5 % using conventional methods. Rotavirus (43.3 %), enteropathogenic Escherichia coli (15.8 %), norovirus (15.8 %) and Cryptosporidium spp. (15.2 %) are currently the most common causes of diarrhoea in hospitalized children in Vellore, in contrast to a study conducted two decades earlier in the same hospital, where bacterial pathogens such as Shigella spp., Campylobacter spp. and enterotoxigenic E. coli were more prevalent. Molecular techniques significantly increased the detection rates of pathogens in children with diarrhoea, but a more intensive study, testing for a wider range of infectious agents and including more information on non-infectious causes of diarrhoea, is required to close the diagnostic gap in diarrhoeal disease.

Effect of mangiferin on benzo(a)pyrene induced lung carcinogenesis in experimental Swiss albino mice

The present study is an effort to identify a potent chemopreventive agent against cancer, in which oxidative stress plays an important causative role. The modulatory effect of mangiferin on mitochondrial lipid peroxidation (LPO), tricarboxylic acid (TCA) cycle key enzymes and electron transport chain complexes was investigated against lung carcinogenesis induced by benzo(a)pyrene (50 mg kg(-1) b/w orally) in Swiss albino mice. Decreased activities of electron transport chain complexes and TCA cycle key enzymes such as isocitrate dehydrogenase (ICDH), succinate dehydrogenase (SDH), malate dehydrogenase (MDH) and alpha-ketoglutarate dehydrogenase (alpha-KGDH), in lung cancer bearing animals were observed. Pre- and post-treatment with mangiferin (100 mg kg(-1) b/w orally) for 18 weeks, prevented the above biochemical changes, which were inclined towards normal control animal values. This study further confirms the chemopreventive and chemotherapeutic effect of mangiferin and these results are consistent with our hypothesis that mangiferin is a promising chemopreventive agent.

Seroepidemiological study on hantavirus infections in India

Hantaviruses are etiological agents of hemorrhagic fever with renal syndrome in many parts of Asia and Europe. There has been no documented case of hantavirus disease from India, although serological evidence exists. We investigated the prevalence of hantavirus in the Indian population and tried to identify potential risk groups for hantavirus infections. The presence of hantavirus-specific IgG antibodies was prospectively evaluated in 661 subjects belonging to different groups, i.e. patients with chronic renal disease, warehouse workers and tribal members engaged in rodent trapping. Healthy volunteer blood donors were included as a control group. Thirty-eight seropositive samples were found using a combination of a commercial ELISA followed by an indirect immunofluorescence assay. Western blot using recombinant Hantaan virus nucleocapsid antigen confirmed the presence of anti-hantavirus IgG in 28 (74%) of the 38 sera tested. This study confirms the presence of hantaviruses in India and warrants increasing awareness of the problems of emerging pathogens and the threats they may pose to the public health system.

Diagnostic utility of serologic markers for genital chlamydial infection in STD patients in Chennai, India

OBJECTIVES

To evaluate the diagnostic utility of serological markers for C. trachomatis in different clinical groups of STD patients.

METHODS

Blood and genital swab specimens were collected from symptomatic STD patients (n=143) attending the STD out patient clinic at the Institute of STDs, Government General hospital, Chennai who enrolled for the study. Serological determination for IgM, IgA and IgG antibodies to C. trachomatis was done using commercial kits. PCR analysis was performed on genital swab samples by using plasmid and major outer membrane protein (MOMP) based primers and patients who were positive by both PCR assays were considered as proven cases of C. trachomatis infection. The serological marker positivity was analysed with PCR positivity.

RESULTS

Serologic positivity by IgM, IgA and IgG was 22.4%, 28.7% and 58.7% respectively. The PCR analysis showed 44 (30.8%) cases with confirmed C. trachomatis infection. Seropositivity for IgM (34.1% (15/44) vs. 17.2% (17/99); P<0.05) as well as for IgA (40.9% (18/44) vs. 23.2% (23/99); P<0.05) significantly correlated to PCR positivity, while significant correlation was not seen with IgG positivity. The overall seropositivity (IgM/IgA/IgG) in the study population was 68.5%.

CONCLUSIONS

The observations of the present study indicate a high exposure rate to chlamydial infection in STD clinic patients in India. The study also suggests the usefulness of serology instead of PCR to trace chlamydial etiology, especially in deep-seated upper genital tract diseases and to facilitate better clinical management as there was good correlation between serology and PCR positivity.

Bacteriological analysis of water samples from tsunami hit coastal areas of Kanyakumari district, Tamil Nadu

Water borne diseases such as cholera, enteric fever and dysentery were expected after the tsunami, which hit the coastal areas of Kanyakumari district, Tamil Nadu. In the present study 151 drinking water sources were collected from the tsunami affected villages and relief shelters and tested for coliforms and pathogens. Nine well water samples were also collected for specific bacteriological analysis. Presence of coliforms was detected in 56 (37%) water samples. One isolate each of Salmonella Paratyphi B and NAG Vibrio were isolated from two well water samples. There was no report of acute diarrhoeal diseases or typhoid illness during the post tsunami period monitored by a field microbiology laboratory for a month.

Incidence of carbapenem resistant nonfermenting gram negative bacilli from patients with respiratory infections in the intensive care units

Resistance to carbapenems is commonly seen in nonfermenting gram negative bacilli (NFGNB). We document herein the prevalence of carbapenem resistance in NFGNB isolated from patients with respiratory tract infections in the intensive care units (ICUs). A total of 460 NFGNB were isolated from 606 endotracheal aspirate specimens during January through December 2003, of which 56 (12.2%) were found to be resistant to imipenem and meropenem. Of these, 24 (42.8%) were Pseudomonas aeruginosa , 8 (14.2%) were Acinetobacter spp. and 24 (42.8%) were other NFGNB. Stringent protocols such as antibiotic policies and resistance surveillance programs are mandatory to curb these bacteria in ICU settings

Community prevalence of hepatitis B infection and modes of transmission in Tamil Nadu, India

BACKGROUND AND OBJECTIVE

There have been very few community based studies on prevalence of hepatitis B virus (HBV) infection in India. We undertook this study to determine the prevalence of HBV infection in a southern State of India, Tamil Nadu and to describe the important factors related to transmission of the virus in the community.

METHODS

Analysis of stored blood samples from a representative population of Tamil Nadu from an earlier community cluster survey on sexually transmitted diseases (STD) prevalence using proportionate to population size (PPS) technique was done. Serum markers of HBV viz., hapatitis B surface antigen (HBsAg), hepatitis B e antigen (HBe Ag) and antibody to surface antigen (anti-HBs) were performed.

RESULTS

1981 subjects were screened in the study. HBsAg prevalence was 5.7 per cent (CI 4.6- 6.8) with 23.5 per cent (25/106) of these having positive HBe-antigen. Community seroprevalence (HbsAg + anti-HBs) of hepatitis B infection was 27.4 per cent (CI: 25.3-29.5) with the highest prevalence of 32.7 per cent (CI: 30.2-35.2) noted in the 15-20 yr age group. Significant independent association (OR 1.4; P=0.006) was detected with family history of exposure to HBV infection by logistic modeling. Other risk factors noted to have significant association were use of disposable needles during injection (OR 0.5; P=0.02) in men, smoking (OR 3; P=0.04) and use of condom (OR 0.6; P=0.08) in women.

INTERPRETATION AND CONCLUSION

This community based study shows a high prevalence of hepatitis B infection in the state of Tamil Nadu with the highest prevalence being in the younger (15-20 yr) age group. High prevalence rate in childhood with e-antigenemia seen in 23.5 per cent of HBsAg positive subjects suggest childhood transmission. Poor injection practices and high-risk sexual behavior were found to be additional risk factors for transmission of the disease in the community.

The effects of ethanol on spatial and nonspatial memory in adolescent and adult rats studied using an appetitive paradigm

Adolescent rats have been reported to be less sensitive than adults to many acute ethanol effects, including ethanol-induced sedation and motor impairment, but conversely more sensitive to ethanol-induced disruptions in spatial memory in a Morris water maze (Markwiese et al., 1998). The present study examined adolescent and adult rats trained for 6 days under spatial or nonspatial versions of a presumably less stressful sand box maze. Moderately food-deprived animals were given 0, 0.5, or 1.5 g/kg ethanol intraperitoneally 30 min before training each day, but were tested without ethanol or reinforcer on test day. Spatial acquisition was impaired by 1.5 g/kg in adults but not adolescents, with no ethanol impairment on the nonspatial task at either age. These results are opposite the ontogenetic profile reported by Markwiese et al., (1998) and may reflect differential activation of prefrontal cortex or other stress-sensitive forebrain regions by the two tasks across age.

Combined anterior interbody fusion and posterior pedicle screw fixation in patients with degenerative lumbar disc disease

We reviewed 47 consecutive patients with degenerative lumbar disc disease. All patients were treated by anterior interbody fusion using an autogenous iliac bone graft in combination with posterior pedicle fixation but without a posterior fusion. There were 32 men and 15 women with a mean age of 44 (range 23-56) years. One third (n=15) of the patients had previous surgery. We saw complications in six patients including two with vascular injury. The mean follow-up was 2.2 years. Seventy-two per cent of the cases had a satisfactory clinical outcome, and the overall fusion rate was 97%.

Microbes in heavy metal remediation

Heavy metal contamination due to natural and anthropogenic sources is a global environmental concern. Release of heavy metal without proper treatment poses a significant threat to public health because of its persistence, biomagnification and accumulation in food chain. Non-biodegradability and sludge production are the two major constraints of metal treatment. Microbial metal bioremediation is an efficient strategy due to its low cost, high efficiency and ecofriendly nature. Recent advances have been made in understanding metal--microbe interaction and their application for metal accumulation/detoxification. This article summarizes the potentials of microbes in metal remediation.

Serodiagnosis of syphilis in a community: an evaluatory study

PURPOSE

To analyse the prevalence of syphilis in the apparently healthy population and to provide data for implementation of the joint STD/HIV control programme, a population based study was undertaken by using 'probability proportional to size' cluster survey method in three randomly chosen districts of Tamil Nadu, India namely Dindigul, Ramnad and Tanjore.

METHODS

Blood samples were collected from adults (n=1873) aged 15-45 years, from the selected households enrolled in this study. The sera were tested parallelly by rapid plasma reagin (RPR) and Treponema pallidum haemagglutination (TPHA) tests. Reactive samples by RPR and/or TPHA were later analysed by fluorescent treponemal antibody absorption (FTA-ABS) test.

RESULTS

The prevalence of syphilis in the community of Tamil Nadu as per RPR positivity was 2.7% (50/1873) as against 0.7% by TPHA (13/1873). FTA-ABS positivity was observed in only 12 out of 48 (25%) RPR/TPHA reactive samples tested. By taking the positivity by two of the three tests, the community prevalence of acute ongoing syphilis in Tamil Nadu was determined as 1.1% (20/1873).

CONCLUSIONS

The results confirmed that no single serological test for syphilis can act as the marker of ongoing acute infection in an apparently healthy population. The study suggests that for specific diagnosis of ongoing syphilis, the FTA-ABS test may be performed along with RPR and TPHA.

Clinical spectrum of inflammatory myositis in South India--a ten year study

OBJECTIVE

To describe the clinical spectrum of inflammatory myopathies at a referral hospital in South India.

METHODS

Patients were assessed for the pattern of muscle involvement, for the presence of arthritis, Raynaud's phenomenon, interstitial lung disease (ILD) and cardiac involvement. Muscle enzymes, electromyogram (EMG) and muscle biopsies were done.

RESULTS

Eighty seven patients with inflammatory myopathies were encountered over 10 years. These included 24 with adult polymyositis, 26 with adult dermatomyositis, one with amyopathic dermatomyositis, five with juvenile myositis, one with dermatomysitis following carcinoma breast and 30 with overlap with other connective tissue diseases. There was a female preponderance (M:F = 1:2.35) except in juvenile myosits group (M:F = 1.5:1). The mean age of onset in years was 33.26 in adult polymyositis, 35.03 in adult dermatomyositis, 7.4 in juvenile dermatomyositis, 42 in malignancy-associated dermatomyositis and 25.51 in the overlap group. Proximal muscle weakness was seen in 98.8% patients, dysphagia in 33.3%, distal muscle weakness in 12.5%, respiratory muscle weakness in 9.2% and dysphonia in 4.6%. Other features included arthritis 35.63%, interstitial lung disease (ILD) 9.2%, Raynaud's 5.7%, myocarditis 4.6% and conduction disturbances 1.15%. Eleveated muscle enzymes were seen in 85.1% patients. Eletromyogram was positive in 66.6%. Muscle biopsy was positive in 85.29%. Anti-nuclear antibody was positive in 67.24%. All received steroids, non-responders needed methotrexate (13 patients) or azathioprine (11 patients). Death occurred in 10 (seven with dermatomyositis predominantly due to respiratory involvement and three with overlap).

CONCLUSION

There was female preponderance except in juvenile myositis group. Proximal muscle weakness was the commonest feature. ILD was the commonest respiratory problem, while myocarditis was the commonest cardiac problem seen. Response to therapy and prognosis in polymyositis were good with no mortality during the study period. Death in the dermatomyositis group was mainly due to respiratory involvement.