Incidence of fungal infection in extra hepatic biliary stone disease

50 patients undergoing biliary surgery were studied to know the incidence of fungal infection. Samples such as bile & stones for mycological analysis were obtained from the gall bladder & Common Bile Duct (CBD) at the time of surgery. Fungal aetiology was established in 8 (16.3%) cases. Incidence of fungal infection was more (12.2%) in gall bladder bile as compared to 6% in common bile duct bile. The nucleus of stone yielded growth of fungus in only 2 (4.6%) cases. Candida albicans, C. tropicalies, C, kruzei, Penicillium and Aspergillus were the common fungal isolates in the present study.

Coagglutination test for detection of heat labile enterotoxin producing Escherichia coli strains

A simple particle immunoassay based on the coagglutination (CoA) of Staphylococcus aureus strain Cowan 1 coated with heat labile enterotoxin (LT) specific antibodies was evaluated to detect LT in the cell lysates of blood agar grown Esch. coli. Among strains of Esch. coli isolated from 2661 patients with acute diarrhoea, isolates from 609 patients demonstrated LT production by CoA test. Most prevalent serogroups were 020, 078, 0128, 04, 0117, 068, 0158, 07, 0114, 0148 and 0145. A comparison of CoA with classical rabbit ileal loop and skin permeability factor assay for 100 strains showed 86, 69 and 83 LT positive strains respectively. CoA proved a more specific, simple, rapid and sensitive assay which may be useful for screening of large number of Esch. coli isolates in epidemiological investigations.

Multi drug resistant Salmonella typhi in Ludhiana (Punjab)

280 Salmonella typhi strains isolated from suspected cases of enteric fever during the year 1990 were studied for susceptibility to the antimicrobial agents chloramphenicol, ampicillin, cotrimoxazole, gentamycin, kanamycin, amikacin, ciprofloxacin by Kirby Baur disc diffusion method. All were blood culture positive cases. 63 strains (21.9%) were found resistant to chloramphenicol, ampicillin, cotrimoxazole, but sensitive to the amino glycosides and ciprofloxacin. Present study shows the prevalence of multi drug resistant Salmonella typhi in this region of Punjab.

Incidence of salmonella meningitis in Ludhiana (Punjab)

A retrospective study was carried out at Dayanand Medical College & Hospital, Ludhiana (Pb.) during the period from January 1985 to December 1990 to know the incidence of Salmonella meningitis. Salmonella etiology was established in 8 (3.43%) cases out of 233 cases of bacterial meningitis. Out of 8 cases, 7 were children under the age of 2 years. 4 Patients yielded S. typhimurium, 3, S. typhi and 1 S. senftenberg from cerebrospinal fluid samples. No Salmonella organism was isolated from blood cultures except one in which S. typhi was isolated. S. typhimurium was the predominant isolate showing multi drug resistance to commonly used drugs such as ampicillin, chloramphenicol, streptomycin, tetracycline and kanamycin. S. senftenberg also showed similar drug resistance pattern. S. typhi, on the other hand was sensitive to above antibiotics.

Loss of some virulence factors of enterotoxigenic Escherichia coli on repeated subcultures

Thirty enterotoxigenic Esch. coli (ETEC) strains of predominant serogroups, isolated from patients with diarrhoea in Ludhiana, Punjab were investigated for expression of heat labile (LT) enterotoxin and colonization factor antigens (CFAs) on repeated subculture. These belonged to serogroup 078 (10), 080 (2), 0114 (6), 020 (3), 0128 (3), 0153 (2) and 08 (4) respectively. The isolates exhibited a differential response for expression of LT and CFAs on repeated subculturing. All the strains were positive for both LT and CFA up to six subcultures. Three strains of serogroup 0114 and one of 080 failed to express CFA while one strain each of serogroups 080, 0114, 020 and 08 failed to elaborate LT in the 8th subculture. Only 25 and 19 isolates were detected as stable producer of LT and CFAs up to 10th subculture.

Meningococcal meningitis in Ludhiana

A retrospective study was carried out at Dayanand Medical College & Hospital, Ludhiana (Punjab) during the period from January 1985 to June 1990 to know the incidence of meningococcal meningitis. Meningococcal etiology was established in 170 (49.41%) cases out of 344 cases of bacterial meningitis. Out of 170 cases of meningococcal meningitis, 74 (43.52%) were positive only by smear examination, 90 (52.94%) were positive both by smear as well as culture and there were six (3.52%) cases which were positive only by culture. The organisms were sensitive to most of the common antibiotics including penicillin, chloramphenicol, ampicillin and sulphadiazine.

Computer aided study of the interaction of thyroid hormone receptor with DNA

Interaction of the first zinc finger from human thyroid hormone receptor (finger) with hexanucleotide duplex d(AGGTCA).d(TGACCT) from thyroid regulatory element has been studied by molecular mechanics simulation technique. The structure of the finger as well as its complex with DNA is optimized using constrain of tetrahedral coordination of the zinc ion to Cys sulphurs. The finger is stabilized by series of H--bonds (5 in backbone, 2 in side chains and 2 between backbone and side chains). The complex is stabilized by H-bonds between side chains of Tyr 11, His 12, Tyr 13 and Arg 14 with G2, G3 and G8. DNA is in B form. H--bonding network within DNA is preserved. Opposite strand P-P and Cl'-Cl' distances are changed slightly. There is a systematic change in the backbone torsional angles and sugar pucker. Also, there is an evidence of protein-induced conformational change in DNA.

Purification of uridine diphosphate-galactose:glucosyl ceramide, beta 1-4 galactosyltransferase from human kidney

A galactosyltransferase that transfers galactose from UDP-galactose to glucosylceramide was purified 440-fold to apparent homogeneity from normal human kidney "buffy coat" preparation employing detergent extraction, ultrafiltration, and Sepharose Q column chromatography. On reducing and nonreducing gels, the enzyme resolved into two bands with apparent molecular weights on the order of 60,000 and 58,000, respectively. The activity of the enzyme was also associated with these two bands following separation on polyacrylamide gels. Analytical isoelectric focusing revealed that the pI of this enzyme is approximately 4.55. Product characterization and substrate specificity studies employing chromatography, enzymatic digestion with various glycosidases, and use of a variety of glycosphingolipid substrates revealed that the major product synthesized by this enzyme was Cer1-1 beta Glc4-1Gal, and Cer1-1 beta Glc was the preferred substrate. Digestion of the 60- and 58-kDa proteins with Staphylococcus aureus (V-8) protease revealed at least six peptides having identical electrophoretic migration. This finding suggests that the two proteins may be related to each other. Western immunoblot assays revealed that the antibody against UDP-galactose:GlcCer, beta 1-4 galactosyltransferase (GalT-2) but not galactosyltransferase UDP-Gal:N-acetyl-D-glucosaminyl-glycopeptide 4-beta-D-galactosyltransferase (EC 2.4.1.38) (B-GT) immunoprecipitated (recognized) the kidney GalT-2. In contrast, antibody against B-GT did not immunoprecipitate GalT-2. Thus our data indicate that GalT-2 and B-GT are two distinct enzymes. The availability of the enzyme GalT-2 and corresponding antibody will allow functional studies in the near future.

Salmonella typhimurium enterotoxin mediated fluid secretion

Unidirectional Na+ and Cl- fluxes were studied in rats treated with S. typhimurium enterotoxin (S-LT). There was net absorption of Na+ and Cl- in the control group, while in the toxin treated animals there was net secretion of Na+ and Cl- (P less than 0.001). There was no change in the transport of D-glucose in the toxin treated group as compared to the control animals. The Na+, K(+)-ATPase pump was unaltered in the S-LT treated animals (198.67 +/- 11.23 nmoles Pi/mg protein/min) as compared to the control group (189.93 +/- 10.09 nmoles Pi/mg protein/min). There was no change in the unidirectional fluxes of Ca+2 in the S-LT treated animals as compared to the control animals, suggesting no change in the permeability of the S-LT treated intestinal membrane to Ca+2.

Assessment of the modified internal gas generator system for isolation of Campylobacter

The modified internal gas generator system (MIGGS) to create microaerophilic conditions for the isolation of Campylobacter was compared with two conventional methods viz., the Gaspak and the hydrogen and carbon dioxide gas mixture from gas cylinders. Ten reference strains of C. jejuni, C. coli and C. laridis were grown on Butzler's medium at optimum temperature under microaerophilic conditions. The MIGGS and Gaspak gave identical results which were better than with the compressed gas mixture. As the chemicals required for MIGGS are commonly available in the market, it works out to be less expensive than the commercial Gaspak. Further, investigations with MIGGS revealed Campylobacter in the faecal samples of 1.9 per cent (50 out of 2661) patients of diarrhoea visiting a Teaching Hospital in Ludhiana (Punjab). None of the 105 healthy volunteers excreted Campylobacter in their faeces. In the 50 positive patients, highest (22%) occurrence was observed in April followed by 16 per cent in May. High prevalence of Campylobacter diarrhoea was observed among infants and children up to 10 yr. Male patients were found to be more susceptible to infection than females (1.9:1). All strains were sensitive to the common antimicrobial agents tested.

Studies on the mechanism of Salmonella typhimurium enterotoxin-induced diarrhoea

The unidirectional fluxes of Na+ and Cl- were studied in Salmonella typhimurium enterotoxin-treated rats. There was net secretion of Na+ and Cl- in toxin-treated animals, while in control animals there was net absorption of these ions. In the presence of the Ca(2+)-ionophore, there was net secretion of Na+ and Cl- in the control group, while the ionophore enhanced the secretion of these ions in experimental animals. The calcium channel blocker, verapamil, decreased the secretion induced by salmonella toxin, but could not reverse the secretion to absorption. There was no difference in the net absorption of Ca2+ in both the control and experimental animals. There was a significant increase in the intracellular free calcium concentrations in enterocytes isolated from toxin-treated rat intestines as compared to that in enterocytes isolated from control animals. In the presence of PMA (phorbol-12-myristated-13-acetate) there was net secretion of Na+ and Cl- in the control group, while in the experimental group there was no change in the fluxes of these ions. The selective, potent inhibitor of protein kinase C, H-7 (1-(5-isoquinolinylsulphonyl)-2-methylpiperazine) reversed the secretion of Na+ and Cl- in the toxin-treated group to absorption. The addition of indomethacin also inhibited the secretion induced by salmonella toxin, but failed to reverse it to absorption. However, the addition both H-7 and indomethacin to the experimental group had a partial additive effect. These studies demonstrate that the Salmonella enterotoxin-mediated fluid secretion involves protein kinase C and the arachidonic acid metabolites and perhaps does not involve the extracellular calcium pools.

ELISA for detection of heat stable enterotoxin producing Escherichia coli strains

Among 557 strains of Esch. coli isolated from patients with acute diarrhoea, 392 (70.4%) isolates demonstrated ST production by ELISA. Predominant ST producing serogroups were 020 (45), 078 (40), 0128 (21), 061 (19), 0149 (9), 04, 055, 0106 and 0114 (8 each). The inhibition ELISA range was between 10.5 and 40.5 per cent. Visual difference between a negative and a positive ELISA test was distinct. A comparison of ELISA with classical suckling mouse assay for 100 strains showed 88 and 80 positive strains respectively for ST. ELISA proved a more specific, rapid and sensitive assay which may be useful for screening large number of isolates in epidemiological studies.

The correlation of biochemical virulence factors and enterotoxin production with LD50 of Salmonella typhimurium in mice

Five strains of Salmonella typhimurium were examined to determine the parameters of virulence. The virulent species significantly resisted the macrophage bactericidal activity (p less than 0.05). The chemiluminescent (CL) response was studied to determine the level of Oxygen-free radicals (OFR) generated and the antioxidant enzymes superoxidase dismutase (SOD), catalase and glutathione peroxidase were assayed to determine the antioxidant mechanism of S. typhimurium to subvert these microbicidal pathways. The levels of the various enzymes were correlated with the virulence (as determined by LD50) and the ability of the microorganisms to induce diarrhoea. Oxygen free radical (OFR) generation elicited by macrophages, in the presence of virulent and avirulent salmonellae was not statistically significant (p greater than 0.05). No correlation was found between the levels of the antioxidant enzymes and the LD50 values. Thus the oxygen-dependent pathways do not appear to play a role in the pathogenesis of salmonellosis, and do not specify the virulence of the microorganism. Immunological and biological assays revealed the virulent strain to be more toxigenic than the avirulent strain. Therefore, the basis of differing virulence in S. typhimurium may be the ability to make and release more toxin in vivo.

Aeromonas-associated diarrhoea in north India

The incidence of Aeromonas-associated diarrhoea in patients attending the hospital attached to the Dayanand Medical College, Ludhiana, India was investigated during May 1984-May 1987. Microbiological examination of single faecal samples from 2,661 patients showed the presence of various enteropathogens of which details of only Aeromonas isolations are given and discussed in the present article. A small control sample of 105 age-matched healthy volunteers were also examined. Only 55 patients (2.1% of all patients) showed Aeromonas spp. in their stool samples on culture. Aeromonas as a single pathogen was isolated from 37 patients and, from 18 patients it was mixed with other enteropathogens. Stools of healthy controls did not contain any pathogen. Seven of 25 isolates of A. caviae, all 18 isolates of A. sobria and all 7 isolates of A. hydrophilla were shown to be enterotoxigenic by rabbit ileal loop test. There was no immunological cross-reaction between Aeromonas enterotoxin and Escherichia coli labile toxin antiserum. The Aeromonas isolates were susceptible to most of the commonly used antimicrobial agents except ampicillin and cephalothin.

Role of oxygen dependent mechanisms in virulence of Salmonella typhimurium

Catalase and superoxide dismutase (SOD) activities of five strains of S. typhimurium, namely SF 1546 LT2 71, SF 1835 C5 50, 386 SF 1591 Ra 20, SF 1567 Rd1, and an Indian strain were determined and correlated with their virulence profile. All five Salmonella strains exhibited catalase and SOD activities. No correlation was observed between either SOD and/or catalase activity and LD50 values of the isolates. Oxygen free radical generation elicited by macrophages, in the presence of virulent and avirulent salmonellae was also not statistically significant (P greater than 0.05), although the virulent species significantly resisted the macrophage bactericidal activity (P less than 0.05). It appears, therefore, that oxygen-dependent bactericidal mechanisms may not be important in phagocytic killing of S. typhimurium.

Incidence of fungal infections in chronic maxillary sinusitis

A study conducted on seventy-five cases of chronic maxillary sinusitis presenting at the E.N.T. Outpatients' Department of Dayanand Medical College, Ludhiana revealed the presence of fungi in 8 cases. The return fluids of proof puncture and antral lavage of the sinuses were subjected to standard extraction procedures. Methods of isolation and identification of the causal fungi are described. The role of fungi, particularly Aspergillus, as pathogen is discussed in the context of antibiotic and immuno-suppressive therapy and local predisposing factors.

Seasonal fluctuations in the occurrence of enteroinvasive Escherichia coli diarrhoea

Enteroinvasive Esch. coli (EIEC) was implicated in 2.1 per cent (57 out of 2661) diarrhoeal patients investigated at Ludhiana (Punjab). The predominant serogroups isolated were 028, 0147, 0124 and 0112. High prevalence of EIEC infection was noticed among infants (50.6%) followed by children up to 10 yr (19.3%). The peak incidence (24.5%) occurred during the hot and dry month of May as compared to 1.7 per cent in February. The disease incidence was positively correlated with mean minimum temperature and mean maximum temperature. All strains gave Sereny's test positive and were mostly susceptible to cephalothin, gentamicin, nalidixic acid, furazolidine and neomycin.

Bioecological factors & rotavirus diarrhoea

Rotavirus was detected (using Rotalex) in 11.72 per cent (120 of 1024) children below 3 yr age with diarrhoea. None of the 25 healthy control children excreted rotavirus in their faeces. Group specific ELISA for 89 Rotalex positive samples revealed 30 subgroup I and 43 subgroup II whereas 10 were untypable. Rotavirus infection ranged from 2.8 to 22.20 per cent in different months. There was no correlation with mean minimum and maximum temperatures. However, the incidence showed a negative correlation (r = -0.645) with relative humidity. Children between the age of 10 to 12 months had the maximum incidence of rotavirus infection. Male patients were found to be more susceptible to infection than females (3.3:1).

Evaluation of coagglutination test for serotyping of enteropathogenic bacteria

Results of conventional agglutination and coagglutination (COA) tests for serotyping of enteropathogenic Escherichia coli (EPEC), Shigella, Salmonella and Vibrio cholerae were compared. Eighty isolates of different serotypes of EPEC falling in the Wellcome polyvalent (OK) 2, 3 and 4 antisera, showed good (4+) agglutination with COA reagent up to 1:960 dilution. Out of 50 strains of Shigella species tested, 25 of Sh. dysenteriae and 5 of Sh. sonnei gave good reaction up to 1:1920 dilution and 15 of Sh. flexneri up to 1:960 dilution in COA test. Similar reaction (4+) by 5 strains of Sh. boydii was seen up to 1:480 dilution only. All 100 isolates of different Salmonella species viz., S. paratyphi A (5), S. typhimurium (50), S. typhi (15), S. weltevreden (5) and S. senftenberg (25), when serotyped by COA, gave good reaction in 1:480 dilution except S. typhi factor 9 and dH antisera, which gave very weak reaction at 1:480 dilution and good reaction at 1:280 dilution. All seven isolates of V. cholerae gave good reaction in COA test even up to 1:1920 dilution. No cross reaction with any COA reagent was obtained in the 1206 heterologus isolates tested. Thus due to its higher efficiency, lower cost and good specificity, COA may prove to be a better method for serotyping of enteropathogens.

In vitro sensitivity of antifungal agents

In vitro sensitivity tests indicated econazole to be the best drug against all 30 isolates of Trichophyton species followed by miconazole, clotrimazole and tolnaftate. Econazole inhibited the growth of all isolates of Trichophyton species in low concentrations of 2-4 micrograms/ml except one isolate of T. rubrum which was inhibited by a concentration of 8 micrograms/ml. Miconazole was also able to inhibit growth of 73.3 per cent isolates of Trichophyton species in low concentrations of 2-4 micrograms/ml. On the other hand, only 13.3 per cent isolates were found sensitive at 2-4 micrograms/ml concentration to tolnaftate and clotrimazole. Relative resistance was encountered by 7 isolates (23.3%) to tolnaftate and 2 isolates (6.6%) to clotrimazole. Isolates of T. tonsurans were resistant to tolnaftate, whereas, the isolate of T. mentagrophytes was sensitive to all the drugs in low concentrations.

Morphogenesis and plant regeneration from cultured endosperm of Emblica officinalis Gaertn

Mature endosperm of Emblica Officinalis (Euphorbiaceae) formed a continously growing callus on MS medium supplemented with an auxin (2,4-D or IAA) and a cytokinin (K or BAP). Subculture of callus on MS with BAP (0.2 mg/l) and IAA (0.1 mg/l) resulted in formation of shoots and embryo-like structures in 50 and 8 per cent cultures, respectively. Regeneration of shoots was more frequent when both BAP (0.2 mg/l) and IAA (0.1 mg/l) were present than on BAP (0.2 mg/l) alone. The embryo-like structures produced plantlets.

Mechanism of hypercalciuria in experimental metabolic acidosis

To study the mechanism of hypercalciuria in metabolic acidosis, ammonium chloride loading (long) test was performed in 68 stone formers and 50 controls. Administration of ammonium chloride in both stone formers and controls produced a significant increase in urinary volume, ammonium and calcium excretions, no change in plasma calcium and creatinine clearance and significant decrease in plasma bicarbonate. However, on the third day of ammonium chloride loading test, urinary ammonium excretion and plasma bicarbonate levels were significantly lower while urinary calcium excretion was significantly greater in stone formers than in controls. Thus calciuresis could be correlated with the degree of metabolic acidosis but not with the rate of urinary ammonium excretion.

Non-intellectual factors in learning disability

100 cases of learning disability are investigated to study non-intellectual factors associated with it. The study reveals that urban area, middle class, unitary and small family show high incidence. Impaired relationship with the parents is the most significant factor, followed by adverse influences in school. The findings are discussed.

Long-term cloprednol use in chronic asthma

Cloprednol is an oral synthetic glucocorticoid with a short serum half-life of 110 minutes. Twenty children who had chronic corticosteroid-dependent asthma were empaneled to study the effects of cloprednol for a period of 24 months. Three of these dropped out at the end of one year. Alternate-day doses of prednisone were replaced by equivalent daily 8 am doses of cloprednol. Ten of 17 patients had better control during cloprednol therapy than during previous prednisone regimens, and significant improvement was noted in peak expiratory flow rate during the study period (P less than .001). Long-term side effects were absent. Improvement in the degree of hypothalamopituitary adrenal axis responsiveness, based on fasting 8 am cortisol levels, was noted from baseline to the end of study period.

Safety and effectiveness of terbutaline in children with chronic asthma

The bronchodilator and cardiovascular effects of orally administered tablets containing 2.5 mg of terbutaline and 25 mg of ephedrine were compared in a double-blind parallel manner in children (ages, 7 to 14 years) weighing 25 to 50 kg (44 to 110 lb). Both drugs produced bronchodilation within one-half hour, and this effect was maintained up to six hours, with a peak between two and three hours. Small increases in the pulse rate were measured within an hour following administration of both drugs. No significant variation was noted in blood pressure. No adverse effects (including tachyphylaxis and tremor) were observed for either drug during a three-month period. Both bronchodilator agents were shown to be equally effective in the dosages used. Terbutaline is a safe bronchodilator drug when administered orally in 2.5-mg doses for children with chronic asthma in this range of ages and weights, with minimal cardiovascular side effects and effective bronchodilation.

Phanton limb sensation under subarachnoid and epidural analgesia - a comparative clinical study of two hundred cases

Two hundred patients scheduled for various surgical procedures, under subarachnoid and epidural anaesthesia were divided in two groups of 100 for each technique. Subarachnoid analgesia was obtained with five per cent lidocaine, while epidural analgesia was accomplished with 1.5 per cent or 2 per cent lidocaine with adrenaline. This study shows that phantom sensation is painless and self limiting and that it lasts only for the duration of motor and proprioceptive blockade. It does not require any special treatment except psychotherapy, supplemented if needed by tranquilizers. Patients should be positioned after motor blockade has been established.

Renal excretion of hydrogen ions in stone formers

Urinary hydrogen ion excretion has been studied in 68 adult stone formers and in 50 controls. Under basal state, the stone formers showed statistically significant higher urinary pH, and lower 24-hour urinary titrable acid, ammonium and total hydrogen. On the 3rd day of ammonium chloride loading test, the stone formers showed statistically significant higher urinary pH and lower 24-hour urinary titrable acid, ammonium, total hydrogen and plasma bicarbonate. 'Clearance' indices of hydrogen ion excretion were also depressed in a great majority of the stone formers. The results indicate the frequent co-existence of defective urinary acidification with nephrolithiasis.

Cromolyn sodium, five to six years later

Ninety-five children with difficult to treat asthma were given cromolyn in double-blind, crossover studies. Of these, 70 were studied for the next five to six years by open trial cromolyn prophylaxis to determine decreasing dependency on bronchodilators or corticosteroids. Evaluated at two-month intervals, 28 children required prednisone and bronchodilators, 37 required round-the-clock bronchodilators only and five required neither. Peak expiratory flow rates were below 80% of predicted normal in eight patients, the remaining 62 showed reversibility of airways obstruction. Exercise-induced asthma was reported by 44 during the first two years but persistent improvement in exercise tolerance occurred in 24 patients. IgE specific RAST indicated a continuing extrinsic element in the etiology of 38 of 45 patients tested. Cromolyn was an effective prophylaxis for children with chronic asthma; however, it was difficult to evaluate in 17 steroid-dependent subjects. Attempts to reduce the need for and especially to discontinue steroids were not as successful as other reports indicate.