Prevalence of helicobacter pylori infection among patients undergoing upper gastrointestinal endoscopy in a medical college hospital in kerala, India

BACKGROUND

Helicobacter pylori related gastritis is a major health ailment in developing nations. There is high morbidity and mortality ranging from chronic gastritis to gastric malignancies. Prevalence of H. pylori infection varies markedly from country to country and in a country, region to region.

AIM

To study the prevalence of H. pylori gastritis in patients undergoing endoscopy and its association with the development of gastrointestinal diseases.

SUBJECTS AND METHODS

The study was carried out in a Medical College Hospital in Kerala, India. Patients presenting with dyspeptic symptoms were subjected to upper gastrointestinal endoscopy and investigated for H. pylori infection through histopathological examination and rapid urease test of biopsy specimen. Diagnosis of H. pylori infection was made if one or both diagnostic test results were positive. Data analysis was carried out using the statistical package for social sciences, for Windows version 16.0 (SPSS 16; Chicago, IL, USA).

RESULTS

H. pylori infection was diagnosed in 62.0% (329/530) of patients screened. There was no statistically significant difference in sex and age related distribution (<50 year age group and >50 year age group) of H. pylori infection. However, a statistically significant association of H. pylori infection with the presence of endoscopic abnormalities, peptic ulcer, and dysplasia/cancer was seen.

CONCLUSION

The prevalence of H. pylori infection is significantly high in rural and suburban population of Ernakulam district, Kerala. Early detection and prompt treatment are essential for prevention of serious complications.

Rectal lipoma associated with genital prolapse

Lipomas are the tumors of mature lipocytes with its occurrence most often on the torso, neck, upper thighs, upper arms, and armpits, but they can occur almost anywhere in the body. They are the rare tumors of intestine, more frequently located in large intestine compared to small intestine. We present the case of a 58-year-old post-menopausal lady presenting with rectal bleeding and utero-vaginal prolapse. The prolapsing mass was excised, and histopathological examination diagnosed the lesion to be a lipoma.

Growth, spectral, thermal, dielectric, mechanical, linear and nonlinear optical, birefringence, laser damage threshold studies of semi-organic crystal: dibrucinium sulfate heptahydrate

Dibrucinium sulfate heptahydrate (DBSH), a semi-organic nonlinear optical material, has been synthesized and single crystals were grown from water-ethanol solution at room temperature up to dimensions of 10×7×2 mm(3). The unit cell parameters were determined from single crystal and powder X-ray diffraction studies. The structural perfection of the grown crystal has been analyzed by high-resolution X-ray diffraction (HRXRD) study. FTIR and Raman studies were performed to identify the functional groups present in the title compound. The activation energy (E), entropy (ΔS), enthalpy (ΔH) and Gibbs free energy (ΔG), of the thermal decomposition reaction have been derived from thermo gravimetric (TGA) and differential thermal (DTA) analysis curves, using Coats-Redfern method. The variation of dielectric properties of the grown crystal with respect to frequency has been investigated at different temperatures. Microhardness measurements revealed the mechanical strength of grown crystal. The optical parameters, the optical band gap E(g) and width of localized states Eu were determined using the transmittance data in the spectral range 200-800 nm. The relative second harmonic efficiency of the compound is found to be 1.4 times greater than that of KDP. Birefringence and Laser damage threshold studies were carried out for the grown crystal.

Tropical storm off Myanmar coast sweeps reefs in Ritchie's Archipelago, Andaman

The reefs in some islands of Andaman and Nicobar suffered severe damage following a tropical storm in the Bay of Bengal off Myanmar coast during 13-17 March 2011. Surveys were conducted at eight sites in Andaman, of which five were located in the Ritchie's Archipelago where maximum wind speeds of 11 m s(-1) was observed; and three around Port Blair which lay on the leeward side of the storm and had not experienced wind speeds of more than 9 m s(-1). Corals in the shallow inshore reefs were broken and dislodged by the thrust of the waves. Significant damage in the deeper regions and offshore reefs were caused by the settlement of debris and sand brought down from the shallower regions. The fragile branching corals (Acropora sp.) were reduced to rubbles and the larger boulder corals (Porites sp.) were toppled over or scarred by falling debris. The reefs on the windward side and directly in the path of the storm winds were the worst affected. The investigation exposes the vulnerability of the reefs in Andaman to the oceanographic features which generally remain unnoticed unless the damage is caused to the coastal habitats.

Bis(2,3-dimeth-oxy-10-oxostrychni-din-ium) phthalate nonahydrate

The asymmetric unit of the title compound 2C₂₃H₂₇N₂O₄⁺·C₈H₄O₄²⁻·9H₂O, contains a cation, an anionon a twofold axis and four and half mol­ecules of water, one of which is located on the twofold axis. In the cation, both fused pyrrolidine rings exhibit twisted conformations, while the piperidine rings adopt screw–boat and boat conformations. In the crystal, the components are linked by N—H⋯O and O—H⋯O hydrogen bonds. The brucinium cations form typical undulating head-to-tail ribbon structuresalong the a-axis direction, which associate with the carb­oxy phthalate and the water mol­ecules.

Emergence of Klebsiella pneumoniae co-producing NDM-type and OXA-181 carbapenemases

The emergence of carbapenemase-producing Enterobacteriaceae is a rapidly evolving threat worldwide. Here, we report the molecular characterization of two Klebsiella pneumoniae isolates carrying both bla(OXA -181) and bla(NDM -1) or bla(NDM -5) isolated from epidemiologically unrelated patients in Singapore. The bla(OXA -181) genes were found existing in different genetic environments.

2,3-Dimeth-oxy-10-oxostrychnidinium hydrogen oxalate dihydrate

In the cation of the title salt, C23H27N2O4 (+)·C2HO4 (-)·2H2O, both fused pyrrolidine rings exhibit twisted conformations, while the piperidine rings adopt screw-boat and boat conformations. In the crystal, the three components are linked via O-H⋯O and N-H⋯O inter-actions, forming a tape along the b axis. The tapes are further linked by weak C-H⋯O hydrogen bonds. forming a three-dimensional network.

Growth, nonlinear optical, thermal, dielectric and laser damage threshold studies of semiorganic crystal: monohydrate piperazine hydrogen phosphate

Monohydrate piperazine hydrogen phosphate (MPHP), a semi organic nonlinear optical material has been synthesized and single crystals were grown from aqueous solution by slow evaporation technique. Single crystal X-ray diffraction study on grown crystal reveals that they belong to monoclinic crystal system with space group P2(1)/c; (a=6.39Å; b=12.22Å; c=11.16Å; β=97.14°; V=864Å(3)). The structural perfection of the grown crystal was analyzed by high-resolution X-ray diffraction (HRXRD) rocking curve measurements. FTIR spectrum confirms the presence of the functional groups in synthesized material. UV-Vis spectrum indicates that the crystal is transparent in the entire visible region with a lower cut off wavelength of 387 nm. The variation of dielectric properties of the grown crystal with respect to frequency has been investigated at different temperatures. Thermal analysis carried out on the MPHP crystal shows that the crystal is stable up to 135°C. Relative powder second harmonic generation efficiency tested by Kurtz-Perry powder technique, which was about 0.638 times that of Potassium dihydrogen phosphate.

Growth and characterization of Melaminium bis (trichloroacetate) dihydrate

Single crystals of melaminium bis (trichloroacetate) dihydrate have been grown successfully by slow evaporation solution growth technique at room temperature. Single crystal X-ray diffraction analysis reveals that the compound crystallizes in monoclinic system with non -centrosymmetric space group C2 with lattice parameters a=17.70 Å, b=8.44 Å, c=6.09 Å, α=90°, β=100.24°, γ=90° and V=900 (Å)3. The UV-Vis transmittance spectrum shows that the crystal has a good optical transmittance in the entire visible region with lower cutoff wavelength of 351 nm. The vibrational frequencies of various functional groups present in the crystal have been derived from FI-IR, FT-Raman and Confocal Raman analyses. The chemical structure of the compound was established by 1H and 13C NMR spectrum. TGA-DTA analysis reveals that the materials have good thermal stability and the melting point of the crystal is found to be 195°C. The dielectric response of the crystals was studied in the frequency range 50 Hz to 5 MHz at different temperatures and the results are discussed. Etching studies show the growth pattern of the crystals. The second harmonic generation efficiency was measured in comparison with KDP by employing powder Kurtz method.

Cause of death and correlation with autopsy findings in burns patients

OBJECTIVE

Global mortality from burns is decreasing however there is a relative paucity of mortality data in the literature from burns units in the United Kingdom. We present an analysis of burns deaths and correlation with coroners' autopsy findings from a large regional burns unit.

DESIGN

Retrospective medical note review of patients who died over a 7 year period (January 2005 to April 2011) was undertaken. Patient demographics were recorded in addition to: burn size, depth, length of stay, presence of inhalational injury, organs failing and diagnosis of sepsis. In order to evaluate the accuracy of our pre-mortem clinical diagnosis, we compared post-mortem cause of death with clinical cause of death.

RESULTS

There were 92 deaths out of 4745 admissions for acute burn (crude mortality 1.9%). 37 patients were immediately given comfort care and excluded from analysis. Average age was 52.9 years±19.4, average percentage burn 43.7%±26.8, and length of stay 26.4±45 days. 80% of deaths were attributable to flame burn (44/55), and 51% (28/55) suffered inhalational injury. Multi-organ failure was the primary cause of death (39/55), with sepsis being the primary trigger (20/39, 51%). Pseudomonas was the most common organism isolated in septic patients. There were significant difficulties in obtaining post-mortem reports and an obvious lack of correlation between coroners' reports and clinical cause of death.

CONCLUSIONS

The principal cause of mortality in our unit was multi-organ failure due to sepsis, which concurs with current literature. Autopsy has previously been shown to be a useful retrospective diagnostic tool, however we challenge its reliability as a result of our study.

Suprapubic percutaneous sclero-embolization of symptomatic female pelvic varicocele under local anesthesia

PURPOSE

To evaluate the safety and feasibility of supra-pubic percutaneous sclero-embolization (SE) in the treatment of symptomatic female pelvic varicocele (FPV), performed under local anesthesia.

MATERIALS AND METHODS

The authors selected 28 patients screened by transabdominal and transvaginal ultrasound, with venous Doppler signal. Clinicians performed SE by transfemoral catheterization, under local anesthesia, using of a mix of 2 ml of lauromacrogol 400 (Atossisclerol 3%, Chemische F. Kreussler, Wiesbaden, Germany) and 2 ml of air, in a mixed foam fashion.

RESULTS

The total operative time for SE was 7.6 +/- 2.1 min. Intra-surgical blood loss was 40 +/- 14 ml. No migration of sclerosant material occurred and postoperative analgesic request during a 48 hr period occurred in 6 patients. Technical success was 100%. The Authors embolized 8 women bilaterally (28.5%), 18 on the left ovarian vein (OV) (64.2%) and 2 only in the right OV (7.1%): 7 women complained of transitory flank pain (25%), which disappeared in few minutes. The major complications in 10 days after SE were: fever (> 38 degrees C for two days) in 2 patients (7.1%) and pelvic pain for 3 days in eight patients (28.5%). After 30 days only 6 women suffered of FPV lower symptoms which disappeared in 180 days. A substantial reduction in size of pelvic varicosities was noted in all patients.

CONCLUSIONS

SE is a safe and feasible procedure. It reduces significantly the mean time of scopies, the intensity of radiation emission, and it is performed under local anaesthesia. This minimally invasive procedure could be proposed to all women with supra-pubic FPV for its reproducibility and feasibility.

Natural host-range and experimental transmission of Laem-Singh virus (LSNV)

Slow growth caused by viral diseases has become a major constraint in shrimp aquaculture. Laem-Singh virus (LSNV), a positive-sense single-stranded RNA (ssRNA) virus, has been identified in Penaeus monodon showing slow growth syndrome. To examine the host-range and transmission modes of the virus, 6 species of penaeid shrimp of varying life stages, sourced from the wild and from farms, as well as juvenile mud crabs Scylla serrata, were screened using RT-nested PCR. LSNV was detected in P. monodon, Fenneropenaeus merguiensis, Metapenaeus dobsoni, and Litopenaeus vannamei, but not in E indicus, Marsupenaeus japonicus or S. serrata. LSNV was most prevalent in P. monodon followed by M. dobsoni, F. merguiensis, and L. vannamei, and real-time quantitative RT-PCR (qRT-PCR) showed that LSNV infection loads were highest in P. monodon, followed by L. vannamei, M. dobsoni, and E merguiensis. The nucleotide sequence of the LSNV RdRP gene fragment amplified by RT-nested PCR was highly conserved (99% identity) across these 4 penaeid species. LSNV was detected in both small and normal-sized P. monodon collected from the same pond. In experimental infections of both P. monodon and S. serrata, LSNV infection loads increased over time. The present study extends the known natural penaeid host-range and geographical distribution of LSNV and shows for the first time the potential susceptibility of S. serrata.

Isolation of the first three cases of Clostridium difficile polymerase chain reaction ribotype 027 in Singapore

INTRODUCTION

The incidence of Clostridium (C.) difficile infection (CDI) was on the rise from 2001 to 2006 in Singapore. Recent unpublished data suggests that its incidence had remained stable or decreased in most local public hospitals between 2006 and 2010. It is, however, not known if the polymerase chain reaction (PCR) ribotype 027 strains have been circulating, although reports suggest that this strain is emerging in Asia, with the first cases reported from Japan in 2007, as well as in Hong Kong and Australia in 2009. We initiated a culture-based surveillance to detect this epidemic strain in Singapore.

METHODS

From September 2008 to December 2009, all non-duplicate toxin-positive stool samples from the three largest public hospitals in Singapore were collected for culture and further analysis.

RESULTS

Out of the 366 samples collected, 272 viable isolates were cultured. Of these, 240 tested toxin-positive and ten tested positive for the binary toxin gene; 35 different PCR ribotypes were found. Three isolates that tested positive for binary toxin contained the same PCR ribotyping pattern as the C. difficile 027 control strain. All three had the 18-bp deletion and single nucleotide tcdC deletion at position 117. Susceptibility testing was performed, demonstrating susceptibility to erythromycin and moxifloxacin.

CONCLUSION

We report the first three isolates of C. difficile 027 from Singapore. However, their susceptibility patterns are more consistent with the historical 027 strains. Rising CDI incidence may not be associated with the emergence of the epidemic 027 strain at this time.

Characterization of seeds of selected wild species of rice (Oryza) stored under high temperature and humidity conditions

Wild progenitors of rice (Oryza) are an invaluable resource for restoring genetic diversity and incorporating useful traits back into cultivars. Studies were conducted to characterize the biochemical changes, including SDS-PAGE banding pattern of storage proteins in seeds of six wild species (Oryza alta, O. grandiglumis, O. meridionalis, O. nivara, O. officinalis and O. rhizomatis) of rice stored under high temperature (45 degrees C) and humidity (approixmately 100%) for 15 days, which facilitated accelerated deterioration. Under the treated conditions, seeds of different wild rice species showed decrease in per cent germination and concentrations of protein and starch, but increase in conductivity of leachate and content of sugar. The SDS-PAGE analysis of seed proteins showed that not only the total number of bands, but also their intensity in terms of thickness differed for each species under storage. The total number of bands ranged from 11 to 22, but none of the species showed all the bands. Similarity index for protein bands between the control and treated seeds was observed to be least in O. rhizomatis and O. alta, while the indices were 0.7 and 0.625 for O. officinalis and O. nivara, respectively. This study clearly showed that seed deterioration led to distinctive biochemical changes, including the presence or absence as well as altered levels of intensity of proteins. Hence, SDS-PAGE protein banding pattern can be used effectively to characterize deterioration of seeds of different wild species of rice.