Health-seeking behaviour of women selling sex in Lahore, Pakistan

The aim of this study was to describe the knowledge and health-seeking behaviour related to sexually transmitted infections (STIs) and abortion among women selling sex in Lahore, Pakistan. This was a cross-sectional, community-based, quantitative study. A total of 730 women selling sex were recruited by respondent-driven sampling. A pretested structured questionnaire was administered through face-to-face interviews. The median age of the participants was 30 years. Thirteen percent of the participants said it was common for them to have an abnormal vaginal discharge. Seventy-five percent of the participants recognized STIs as either leucorrhoea or AIDS. Sixty-five percent of the participants complained of having suffered from STI(s) in the six months preceding the survey, of whom 28% sought treatment. Women selling sex who reported consistent condom use were 1.5 times (95% confidence interval [CI]: 1.1–2.2) more likely to seek treatment than women who did not report consistent condom use. The level of knowledge about STIs remains low among women selling sex in Lahore, Pakistan, and health-seeking behaviour for the management of STIs and abortions is influenced by ability to pay and ease of access in the private sector.

Long-term results of treatment of malignant carcinoid syndrome with prolonged release Lanreotide (Somatuline Autogel)

BACKGROUND

Somatostatin analogues are the mainstay of therapy for malignant carcinoid syndrome. There is clear evidence that the once monthly intramuscular formulation, Octreotide LAR, controls symptoms of carcinoid syndrome, and recent data also suggests an antitumour effect. There is limited data on prolonged release Lanreotide (Somatuline Autogel, Ipsen Pharma Biotech, Signes, France) and no long-term data to date.

AIM

To present long-term results of prolonged release Lanreotide in a large cohort of patients with malignant carcinoid syndrome, assessing clinical and objective response and tolerance.

METHODS

Seventy six patients with metastatic midgut neuroendocrine tumours and carcinoid syndrome were included in this 9-year retrospective study. Clinical response was based on symptom score with radiological assessment based on RECIST (Response Evaluation Criteria In Solid Tumours).

RESULTS

Data were available in 69 patients. Ninety four percent achieved symptomatic response at first follow-up visit. Forty six percent had loss of symptomatic response, but 44% of these achieved control with an increase in dose of prolonged release Lanreotide. Overall, symptoms were well controlled throughout the study period with prolonged release Lanreotide alone in 74% of patients. Twenty six percent required additional treatment despite good initial response. Only 30% demonstrated radiological progression. Eleven patients who were switched from Octreotide LAR had return of symptomatic control. No significant adverse effects were experienced.

CONCLUSIONS

Prolonged release Lanreotide provides good symptomatic control of diarrhoea and flushing as well as tumour stability in patients with malignant carcinoid syndrome.

The safety and efficacy of botulinum toxin-A in the management of bladder oversensitivity: a randomised double-blind placebo-controlled trial

OBJECTIVE

To assess the safety and efficacy of botulinum toxin-A (botn-A) in the management of patients with bladder oversensitivity (BO).

PATIENTS AND METHODS

Twenty-three consecutive patients with a diagnosis of BO refractory to anticholinergics were enrolled in this randomised, double blind, placebo-controlled trial. Patients were randomly allocated to receive intradetrusor injections of either botn-A (100 U Botox) or saline (placebo) via a flexible cystoscopic approach. The study was designed to have 90% power to detect a change in the maximum cystometric capacity (MCC) of 30%. It was calculated that a total cohort of 58 patients would be required. Urodynamic assessment (UDS), voiding diaries (VD) and quality of life (QoL) were assessed at baseline and at 4 and 12 weeks following intervention.

RESULTS

An interim analysis was performed and the trial halted after recruitment of 23 patients as a result of poorly perceived patient benefit. Data were analysed for 21 patients (10 botn-A; 11 placebo). In the treatment arm, there was a significant increase in MCC (mean rise 105 ml; p = 0.009). However, storage symptoms remained statistically unchanged following botn-A. Three patients in the treatment arm were required to perform clean intermittent self-catheterisation with no clinical improvement. The limitations of this trial include the small sample size and the unplanned interim analysis.

CONCLUSIONS

This is the first randomised, double blind, placebo-controlled trial examining the effects of botn-A exclusively in patients with BO. A significant increase in MCC was observed but this did not translate to clinical benefit with no change observed in the symptoms and quality of life for the majority of patients.

[Effect of curcumin on nitric oxide induced structural and functional modifications of high molecular weight cystatin from the goat brain]

Cystatins are thiol proteinase inhibitors ubiquitously present in the mammalian body. In brain, they prevent unwanted proteolysis and are involved in several neurodegenerative diseases. Under physiological conditions nitric oxide can be found in almost all the tissues, but under pathological conditions NO has damaging effects. Its increased concentration, under various neural diseases leads to cell damage through formation of highly reactive peroxynitrite. Our present study was designed to investigate the protective effect of curcumin against NO induced damage of HM-GBC. NO caused intensive structural and functional damage of HM-GBC, resulting in 89% loss of its antiproteolytic activity after 2 h of incubation. Structural damage occurs in the form of protein degradation. Curcumin significantly protected HM-GBC against this damage. This suggests that curcumin has a significant potential in the treatment of diseases caused by nitrogen free radicals and this potential must be further explored for the development of novel drugs.

Management of open tibial fractures - a regional experience

INTRODUCTION

The treatment of soft-tissue injuries associated with tibial diaphyseal fractures presents a clinical challenge that is best managed by a combined plastic and orthopaedic surgery approach. The current study was undertaken to assess early treatment outcomes and burden of service provision across five regional plastic surgery units in the South-West of England.

SUBJECTS AND METHODS

We conducted a prospective 6-month audit of open tibial diaphyseal fracture management in five plastic surgery units (Bristol, Exeter, Plymouth, Salisbury, Swansea) with a collective catchment of 9.2 million people. Detailed data were collected on patient demographics, injury pattern, surgical management and outcome followed to discharge.

RESULTS

The study group consisted of 55 patients (40 male, 15 female). Twenty-two patients presented directly to the emergency department at the specialist hospital (primary group), 33 patients were initially managed at a local hospital (tertiary group). The mean time from injury to soft tissue cover was significantly less (P < 0.001) in the primary group (3.6 ± 0.8 days) than the tertiary group (10.8 ± 2.2 days), principally due to a delay in referral in the latter group (5.4 ± 1.7 days). Cover was achieved with 39 flaps (19 free, 20 local), eight split skin grafts. Nine wounds closed directly or by secondary intention. There were 11 early complications (20%) including one flap failure and four infections. The overall mean length of stay was 17.5 ± 2.8 days.

CONCLUSIONS

Multidisciplinary management of severe open tibial diaphyseal may not be feasible at presentation of injury depending on local hospital specialist services available. Our results highlight the need for robust assessment, triage and senior orthopaedic review in the early post-injury phase. However, broader improvements in the management of lower limb trauma will additionally require further development of combined specialist trauma centres.

Adsorption of fluoride from water by surface-functionalized polyurethane foam

Surface-functionalized polyurethane foam (SPUF) showed an exceptionally high adsorption potential for defluoridation of drinking water. Kinetic experiments of fluoride adsorption on SPUF demonstrated quick adsorption in first 60 min and then achieved maximum adsorption (7.8 mg g⁻¹). The adsorption isotherm was described using Bradley equation. The adsorption capacity of SPUF was significantly influenced by the pH of the solution. The highest adsorption capacity was attained at pH 6.7 and no drastic reduction noticed in the adsorption capacity of SPUF at normal pH range (5.8-8.2). The fluoride adsorption capacity of SPUF was compared with other adsorbents like activated carbon, soil, alumina and carbon nanotubes. The added advantage of SPUF adsorbent is, it can be easily recharged by altering the pH of the solution using NaOH or Ca(OH)₂. The high adsorption capacity and easy-to-use nature of SPUF in batch mode and continuous system makes the new adsorbent a promising material for defluoridation of drinking water.

Robotic radical cystectomy for bladder cancer

This article will focus on the evolution of robotic-assisted radical cystectomy (RARC) as the treatment for muscle invasive or uncontrolled superficial bladder cancer. Authors describe the current implementation of technology in their patients. The results of published case series and comparative studies on RARC available to date are also reviewed, to identify the surgical, pathological, oncological and quality of life outcomes of RARC.

Management of gastroentero-pancreatic neuroendocrine tumors (GEP-NETs)

Neuroendocrine tumors (NETs) are relatively rare neoplasms that often present as diagnostic dilemmas due to obscure or non-specific symptoms. The ability of carcinoid tumors to cause clinical symptoms by secretion of hormones or biogenic amines is best recognised in the form of the carcinoid syndrome. Although generally slow growing, a significant minority demonstrate aggressive tumor growth. Ten-twenty percent of pancreatic NETs may be associated with hereditary disorders such as multiple endocrine neoplasia-1 (MEN-1) and less frequently, Von Hippel Lindau, which should be considered in the investigation and management of these patients. A small percentage of NETs are associated with co-existing synchronous non-carcinoid neoplasm. The aim of this paper was to review the optimal management in patients with NETs. The therapeutic options which are reviewed, including the use of somatostatin analogues, the role of surgery, the use of chemotherapy, biotherapy using interferon, peptide receptor targeted therapy. In addition, the challenging interventional management of liver metastases is discussed, including the role of hepatic-artery embolization, radiofrequency ablation and the place of orthotoptic liver transplantation in selected patients. Authors have focused on the newest therapeutic modalities, e.g., radionuclide peptide receptor targeted therapy with Yttrium-90 and Lutetium-177, the newest somatostatin analogues such as pasireotide and angiogenic inhibitors. In conclusion, with the increasing number of investigative procedures and therapeutic options available to diagnose and treat carcinoid tumors, it is vital to have a multidisciplinary approach. Furthermore, additional scientific research and controlled clinical trials are needed to determine the efficacy of the many treatment options, which for these rare tumors can only be achieved by collaboration.

Plant growth promotion by phosphate solubilizing bacteria

Most agronomic soils contain large reserves of total phosphorus [P], but the fixation and precipitation of P cause P deficiency, and in turn, restrict the growth of crops severely. Phosphorus replenishment, especially in sustainable production systems, remains a major challenge as it is mainly fertilizer-dependent. Though the use of chemical P fertilizers is obviously the best means to circumvent P deficiency in different agro-ecosystems, their use is always limited due to its spiralling cost. A greater interest has, therefore, been generated to find an alternative yet inexpensive technology that could provide sufficient P to plants while reducing the dependence on expensive chemical P fertilizers. Among the heterogeneous and naturally abundant microbes inhabiting the rhizosphere, the phosphate solubilizing microorganisms (PSM) including bacteria have provided an alternative biotechnological solution in sustainable agriculture to meet the P demands of plants. These organisms in addition to providing P to plants also facilitate plant growth by other mechanisms. Despite their different ecological niches and multiple functional properties, P-solubilizing bacteria have yet to fulfil their promise as commercial bio-inoculants. Current developments in our understanding of the functional diversity, rhizosphere colonizing ability, mode of actions and judicious application are likely to facilitate their use as reliable components in the management of sustainable agricultural systems.

The expression of the proliferation marker Ki-67 and oestrogen and progesterone receptors in the proximal and distal fallopian tube

Significant epithelial proliferation is identified more frequently in the fallopian tube in patients with ovarian tumours than in control patients. More extensive sampling of the fallopian tube is also associated with a more frequent identification of epithelial proliferation. We compared cellular proliferation at either end of the fallopian tube as detected with an antiserum to the Ki-67 protein. Variations in oestrogen and progesterone receptor proteins were also examined. Proliferative activity as expressed by the Ki-67 protein, and oestrogen receptor expression was greater in the proximal fallopian tube and progesterone receptor expression was greater in the distal fallopian tube. Only the difference in progesterone receptor expression was statistically significant (P =0.0431). This study indicates that variations in Ki-67, oestrogen and progesterone receptor protein expression occur at different sites in the fallopian tube. This should be taken into account when planning studies of epithelial cell proliferation in the fallopian tube in the future.

Infection control education: impact on ventilator-associated pneumonia rates in a public sector intensive care unit in Pakistan

We describe efforts towards introducing infection control (IC) practices and establishment of antimicrobial resistance (AMR) surveillance in a public sector hospital in Pakistan. The study was conducted in an eight-bed intensive care unit. IC principles, introduced through interactive sessions, were used as an intervention and their impact was observed by conducting surveillance for ventilator-associated pneumonia (VAP) before and after the intervention. Respiratory isolates of VAP patients in the period after intervention were screened for AMR, and empiric antibiotic at the time of admission was compared with the antimicrobial sensitivity pattern reported. VAP rates were high in general and declined in the period after intervention, although the difference was not significant. Of 37 VAP patients in the period after intervention, 68% had more than one clinically significant organism isolated from the respiratory specimen. Acinetobacter spp. were isolated from 76% of patients and Pseudomonas aeruginosa from 43%. All Acinetobacter spp. and 72% P. aeruginosa were multidrug resistant. The mean stay of the nosocomially infected patients was significantly higher than for the uninfected group (6.5 vs. 2.1 days, P<0.001). Our study suggests IC education needs to be supplemented by a hospital system that facilitates IC practices and development of surveillance programmes.

Anti H.pylori IgM in symptomatic and asymptomatic population

To evaluate the usefulness of specific IgM in the diagnosis of Helicobacter pylori infection, a cross sectional study was carried out in the Department of Microbiology, Mymensingh Medical College between July 2006 to June 2007. A total of 45 patients having upper gastrointestinal symptoms underwent endoscopy and were subsequently diagnosed as patients with gastritis, peptic ulcer (PU) and non-ulcer dyspepsia (NUD) and another 45 asymptomatic individuals aged 18-65 years, were included in the study. The serum samples of participants were tested for presence of anti-H pylori IgM by using ELISA method. The ELISA for anti H. pylori IgM provided sensitivity and specificity of 73.33%, 93.33% respectively.

Ablative and reconstructive robotic-assisted laparoscopic renal surgery

INTRODUCTION

The increasing role of robotic technology to facilitate surgical procedures has attracted much attention from surgeons and patients alike. In particular, the dramatic increase in the number of laparoscopic radical prostatectomies performed using the da Vinci surgical system has led to interest in using this technology for other procedures. We have evaluated our own experience performing ablative and reconstructive laparoscopic renal surgery using the da Vinci system to determine its potential role.

AIMS

To review our experience of robotic-assisted laparoscopic procedures of the upper urinary tract.

MATERIALS AND METHODS

Our da Vinci system was installed in June 2004. A prospective database has been maintained concerning all patients and procedures performed from that time. Procedures involving the upper urinary tract were identified and the data was examined. This included patient demographics, operative time, blood loss, hospital stay and patient outcomes.

RESULTS

Twenty-six robotic procedures involved the upper urinary tract. Of these, two had to be converted to conventional laparoscopic surgery because of da Vinci mechanical failure. Robotic-assisted procedures included pyeloplasty (n = 15), simple nephrectomy (n = 2), radical nephrectomy (n = 1), nephroureterectomy (n = 2), and live donor nephrectomy (n = 4). The mean operative time was 215 min. The anastomotic time for the pyeloplasties averaged 47 min. The mean blood loss was 75 ml. There were no conversions to open surgery. The complication rate was 8.7%. Postoperative stay averaged 2.9 days.

CONCLUSION

The da Vinci surgical system may be safely used to assist in the performance of laparoscopic renal surgery.

Robotic assisted radical cystectomy: short to medium-term oncologic and functional outcomes

PURPOSE

To report short- and medium-term oncological and functional outcomes of the first robotic-assisted laparoscopic radical cystectomy (RARC) series from the UK.

MATERIALS AND METHODS

Thirty patients underwent RARC between 2004 and 2007 at our unit. We report oncological and functional outcomes of this procedure in 20 patients (17 ileal conduit and three Studer Pouches), who have completed at least 6 months of follow up.

RESULTS

There were 17 men and three women, median age 66 years (range 38-77 years). Median operating time was 330 min (range 295-510 min), and median blood loss 150 ml (range 100-1150 ml). There were two major complications (10%); a port site bleed and a rectal injury. The median follow up of this cohort is 23 months (range 7-44 months). One patient died of distant metastases at 8 months, and another developed a right ureteric tumour at 7 months. None of the patients had local pelvic or port site recurrence. The overall and disease-free survival are 95% and 90% respectively. Functional complications included a neovesico-urethral stricture at 3 months, a left upper ureteric stricture at 6 months and an incisional hernia at 12 months.

CONCLUSION

Robotic-assisted laparoscopic radical cystectomy is an emerging minimally invasive procedure which at short- to medium-term follow up, in our experience, is oncologically and functionally equivalent to open radical cystectomy.

Influence of number of retransplants on renal graft outcome

BACKGROUND

To assess the influence of number of transplants on the renal graft outcome.

METHODS

Retrospective analysis of various factors that could influence the outcome of kidney retransplantation in patients receiving more than one allograft between 1993 and 2005 at our center.

RESULTS

During the 12-year period (1993-2005), 196 patients received more than one renal transplant. Of these, 163 had two (group 1) and 33 had more than two transplants (group II). In group II, 24 patients had three, eight had four, and one had five consecutive allografts. The control group comprised of 100 randomly selected patients receiving a first graft during the same period. In group I, 53 (32.5%) grafts failed. Eighteen (11.0%) patients died with functioning grafts. In group II, 14 (41.2%) grafts failed while four patients (11.8%) died with functioning grafts. In group I, actuarial graft survival rates at 1, 2, 3, and 4 years were 82.3%, 67.3%, 55.97%, and 42.14%, respectively. In group II, the respective figures were 84.85%, 66.67%, 60.61%, and 51.52%. The difference was not statistically significant (P = .96). In the control group, 1-, 2-, 3-, and 4-year survival rates were 92%, 84, 74%, and 60%, respectively. The difference between the control and study groups was statistically significant (P = .0002).

CONCLUSION

Graft survival after retransplantation is relatively inferior when compared to the primary graft but still remains fairly high. Therefore, previous graft failure should not be considered as a relative contraindication for retransplantation.

The potential use of methotrexate in the treatment of falciparum malaria: in vitro assays against sensitive and multidrug-resistant falciparum strains

The anti-malarial activity of the anti-cancer drug methotrexate against chloroquine-sensitive T9-96 and the multidrug-resistant K1 strains of Plasmodium falciparum was assessed in vitro. Mean IC50 values of 0.32 +/- 0.05 nM and 48.02 +/- 4.40 nM were obtained for T9-96 and K1, respectively, indicating methotrexate's high potency against both sensitive and resistant P. falciparum strains in vitro. Our results suggest that methotrexate is potentially effective against falciparum malaria in short-term, low-dose regimens, minimizing the risk of toxicity. This, along with the practical advantages of methotrexate, warrants the clinical investigation of methotrexate in human cases of falciparum malaria.

Screening of free-living rhizospheric bacteria for their multiple plant growth promoting activities

Plant growth promoting rhizobacteria (PGPR) are known to influence plant growth by various direct or indirect mechanisms. In search of efficient PGPR strains with multiple activities, a total of 72 bacterial isolates belonging to Azotobacter, fluorescent Pseudomonas, Mesorhizobium and Bacillus were isolated from different rhizospheric soil and plant root nodules in the vicinity of Aligarh. These test isolates were biochemically characterized. These isolates were screened in vitro for their plant growth promoting traits like production of indoleacetic acid (IAA), ammonia (NH(3)), hydrogen cyanide (HCN), siderophore, phosphate solubilization and antifungal activity. More than 80% of the isolates of Azotobacter, fluorescent Pseudomonas and Mesorhizobium ciceri produced IAA, whereas only 20% of Bacillus isolates was IAA producer. Solubilization of phosphate was commonly detected in the isolates of Bacillus (80%) followed by Azotobacter (74.47%), Pseudomonas (55.56%) and Mesorhizobium (16.67%). All test isolates could produce ammonia but none of the isolates hydrolyzed chitin. Siderophore production and antifungal activity of these isolates except Mesorhizobium were exhibited by 10-12.77% isolates. HCN production was more common trait of Pseudomonas (88.89%) and Bacillus (50%). On the basis of multiple plant growth promoting activities, eleven bacterial isolates (seven Azotobacter, three Pseudomonas and one Bacillus) were evaluated for their quantitative IAA production, and broad-spectrum (active against three test fungi) antifungal activity. Almost at all concentration of tryptophan (50-500 microg/ml), IAA production was highest in the Pseudomonas followed by Azotobacter and Bacillus isolates. Azotobacter isolates (AZT(3), AZT(13), AZT(23)), Pseudomonas (Ps(5)) and Bacillus (B(1)) showed broad-spectrum antifungal activity on Muller-Hinton medium against Aspergillus, one or more species of Fusarium and Rhizoctonia bataticola. Further evaluation of the isolates exhibiting multiple plant growth promoting (PGP) traits on soil-plant system is needed to uncover their efficacy as effective PGPR.

Evolution of transdermal oxybutynin in the treatment of overactive bladder

Overactive bladder (OAB) syndrome affects millions of people worldwide. In addition to adversely affecting quality of life, the direct and indirect costs in managing patients with OAB incur a substantial financial burden on health services. Among the approved anticholinergics for treating OAB, oxybutynin is the most extensively studied drug in clinical trials. The principle metabolite of oxybutynin has a higher affinity for muscarinic receptors in salivary glands which lead to significantly high dry mouth rates. This prompted the development of alternative formulations of oxybutynin aiming to achieve better tolerability whilst sustaining efficacy. This editorial examines the efficacy and tolerability of transdermal oxybutynin (OXY-TD) in treating OAB. Articles were retrieved from PubMed between 2000 to the present day relating to OXY-TD. Data is presented from phase I-IV trials. The results from placebo-controlled trials indicate that OXY-TD is efficacious in treating patients with OAB associated with urge urinary or mixed incontinence. Systemic side effects most notably dry mouth, appear to be less with this formulation compared with oral anticholinergics. However, further study is required in different OAB populations. The main limitation appears to be related to application site adverse events such as pruritus and erythema. OXY-TD is likely to find its place as first-line pharmacotherapy in the clinicians' armamentarium in treating OAB.

Renal Vein Thrombosis

OBJECTIVE

The aim of this article is to review the published English literature on aetiology, pathology, clinical presentation, diagnostic methods and treatment of renal vein thrombosis.

MATERIALS AND METHODS

We searched the published literature from Medline & Pubmed using keywords renal vein thrombosis, anti-phospholipid syndrome and nephrotic syndrome. Data was extracted from individual case reports, case series, articles on pathology, diagnostic tests, treatment modalities, and previous reviews. Case reports which did not add any new information were excluded.

RESULTS

We selected 60 references based on the above criteria. Renal vein thrombosis is relatively rare. CT angiography is considered the investigation of choice. Alternatives include MR angiography or renal venography in highly selected patients. As the condition is relatively uncommon, consensus on the best form of therapy for this condition has been slow to evolve. The trend in management has shifted to non-surgical therapies particularly systemic anticoagulation except in highly selected group of patients.

Oral contraceptives in gall stone diseases

A cross sectional study was under taken to evaluate the prevalence of gallstone in fertile women who are taking oral contraceptives. The aim of study was to determine any significant association between oral contractive use and Cholelithiasis. Total number of patient was 340. A standard written questioner, which is dully filled by concerned doctor and examination done. History of use of oral contraceptive pills, duration of use and time of taking oral contraceptives drugs whether before, in between pregnancy or after family completion is recorded. Total number of patient was 340 of them 186 patient taken contraceptives and 154 patients without contraceptives. Incidence of gallstone shows that with contraceptives the 21-30 years age group 72(39.13%) without contraceptives 22(14.28%), in 31-40 years age group with contraceptives 74 (40%), without contraceptives 28(18.8%) where as in 41-50 years age group with contraceptives 37(20.10%) and without contraceptives 44(28.57%), 51 years and above age group with contraceptives is 01(0.54%) and without contraceptives is 60(38.96%). Significantly higher incidence of gallstones found in younger patient taking oral contraceptives than without contraceptives, but in older age group incidence is more in-patients without contraceptives than with contraceptives. Oral contraceptives increase the incidence of gallstones disease in younger women especially in early part of their use of oral contraceptives.

Robotic technology in urology

Urology has increasingly become a technology-driven specialty. The advent of robotic surgical systems in the past 10 years has led to urologists becoming the world leaders in the use of such technology. In this paper, we review the history and current status of robotic technology in urology. From the earliest uses of robots for transurethral resection of the prostate, to robotic devices for manipulating laparoscopes and to the current crop of master-slave devices for robotic-assisted laparoscopic surgery, the evolution of robotics in the urology operating theatre is presented. Future possibilities, including the prospects for nanotechnology in urology, are awaited.

Transplantation of kidneys from deceased adult polycystic donors

Renal transplantation is the best treatment for end-stage renal disease. The discrepancy between donor organ supply and demand continues to widen. Maximum efforts should be made to make use of donor kidneys and we suggest that polycystic kidneys can be suitable marginal donor organs. Five polycystic cadaveric donor kidneys were transplanted in four recipients at our institution between year 2000 and 2004. The donor kidneys were either of normal size or moderately enlarged (less than 15 x 10 cm). Donor ages were 24, 46 and 55 years. All donors had normal serum creatinine at the time of organ retrieval. Recipients gave informed consent to be transplanted with the polycystic kidneys. Three of four recipients had primary graft function. The patient with primary nonfunction required graft nephrectomy 8 weeks post-transplantation. One patient died due to cardiovascular causes with a functioning graft 18 months after transplantation. Two patients remain well, 26 and 58 months after transplantation, with normal graft function. Our experience and the limited evidence from the literature suggest that, with careful selection of both donor and recipient, transplantation of cadaveric polycystic donor kidneys should be considered given the current organ shortage.

A Yellow Mosaic Disease of Soybean in Northern India is Caused by Cotton leaf curl Kokhran virus

Soybean, Glycine max (L.) Merr., is a protein- and oil-rich crop cultivated in India and abroad. A yellow mosaic disease was observed on soybean with 80 to 90% disease incidence during August 2005 at fields of the National Botanical Research Institute, Lucknow, in northern India. Soybean plants were found to be infested with whiteflies (Bemisia tabaci) suggesting begomovirus etiology. The disease agent was transmitted experimentally by whiteflies, and symptoms developed after 23 days. Total DNA was isolated from 51 leaf samples collected from 42 symptomatic and 9 asymptomatic plants. Polymerase chain reaction was performed using begomovirus coat protein-specific primers 5'-ATGGCGAA GCGACCAG-3' and 5'-TTAATTTGTGACCGAATCAT-3' (AM180920/ AM180921). An amplicon of the expected size (~800 bp) was obtained in all 42 symptomatic leaves but not from any of the nine asymptomatic leaf samples. The amplicon was cloned, and the identical sequence of three clones was submitted to GenBank (Accession No. DQ343283). BLAST search of nucleotide sequences revealed 95% identity with Cotton leaf curl Kokhran virus (CLCKV) (GenBank Accession Nos. AJ002449, AJ002448, AJ496286, and AY456683) and 57% identity with Mungbean yellow mosaic India virus (MYMIV-Sb, GenBank Accession No. AY049772). Results indicated that the virus associated with yellow mosaic disease of soybean is an isolate of CLCKV rather than MYMIV-Sb (1) reported earlier on soybean from northern India. To our knowledge, this is the first report of soybean as a new host of Cotton leaf curl Kokhran virus. Reference: (1) K. S. Usharani et al. Curr. Sci. 86:845, 2004.