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   2008| April-June  | Volume 26 | Issue 2  
    Online since April 23, 2008

 
 
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BRIEF COMMUNICATIONS
Antibiotic resistance of Gardnerella vaginalis in recurrent bacterial vaginosis
P Nagaraja
April-June 2008, 26(2):155-157
DOI:10.4103/0255-0857.40531  PMID:18445953
Fifty strains of Gardnerella vaginalis isolated from 321 high vaginal swabs over a period of five months were tested for their antibiotic sensitivity. Sixty eight per cent of all isolates were resistant to metronidazole while 76% were sensitive to clindamycin. All the strains isolated from cases with recurrence of infection were resistant to metronidazole. Clindamycin therapy has a better clinical efficacy than metronidazole in cases of recurrent bacterial vaginosis.
  36,122 914 19
REVIEW ARTICLE
Onychomycosis - epidemiology, diagnosis and management
R Kaur, B Kashyap, P Bhalla
April-June 2008, 26(2):108-116
DOI:10.4103/0255-0857.40522  PMID:18445944
Onychomycosis is a fungal infection of nails caused by dermatophytes, yeasts or nondermatophyte molds and represents about 30% of mycotic cutaneous infections. Increasingly onychomychosis is being viewed as more than a mere cosmetic problem. In spite of improved personal hygiene and living environment, onychomycosis continues to spread and persist. The prevalence rate of onychomycosis is determined by age, predisposing factor, social class, occupation, climate, living environment and frequency of travel. Onychomycosis in immunocompromised patients can pose a more serious health problem. Dermatophytes are the most frequently implicated causative agents in onychomycosis. Previously regarded as contaminants, yeasts are now increasingly recognised as pathogens in fingernail infections, as are some moulds. Clinical diagnosis of onychomycosis is based on the patients' history; a physical examination, microscopy and culture of nail specimens. The treatment of onychomycosis has been attempted throughout the ages, but only in the last two decades have safe, effective systemic treatments been available for this chronic superficial fungal disease. Oral Griseofulvin and Ketoconazole; once the agents of choice for the treatment of onychomycosis, have been superseded by newer systemic compounds that have a higher cure and lower relapse rates, cause fewer side effects and are suitable for short-term dosing.
  33,863 2,396 68
ORIGINAL ARTICLES
Diagnosing different stages of hepatitis B infection using a competitive polymerase chain reaction assay
H Changotra, A Dwivedi, AK Nayyar, PK Sehajpal
April-June 2008, 26(2):138-142
DOI:10.4103/0255-0857.40527  PMID:18445949
Purpose: Different stages of hepatitis B virus (HBV) infection can be defined by serum HBV DNA levels. This study attempts to (1) investigate serum HBV DNA levels in inactive carriers and patients with chronic HBV (CHB) infection and (2) define cut-off value between inactive carriers and HBeAg (precore antigen of HBV) negative CHB patients in Indian population. Methods: One hundred and forty samples encompassing 42 inactive HBsAg carriers and 98 CHB patients (53 HBeAg-positive and 45 HBeAg-negative) were analysed. Serum HBV DNA levels were determined employing an in-house competitive polymerase chain reaction (cPCR) assay. Results: The HBeAg-positive patients were found to have the maximum median HBV DNA load, which was significantly higher than the HBeAg-negative ones (median; 1.25 10 8 vs. 2.30 10 5 copies/mL ; P < 0.05). Interestingly, the latter group has significantly higher HBV DNA levels than the inactive carriers (median; 2.30 10 5 vs. 4.28 10 3 copies/mL ; P < 0.05). The 2.5 10 4 copies/ml HBV DNA levels were optimal for discriminating CHB patients (HBeAg-negative) from inactive carriers with 75.6 and 78.6% sensitivity and specificity, respectively. Conclusions: Despite the extensive overlapping of HBV DNA levels in inactive carriers and HBeAg negative CHB patients, 2.5 10 4 copies/mL is the most favourable cut-off value to classify these individuals and would be imperative in the better management of this dreadful disease.
  13,230 595 1
BRIEF COMMUNICATIONS
Chronic diarrhoea in HIV patients: Prevalence of coccidian parasites
S Gupta, S Narang, V Nunavath, S Singh
April-June 2008, 26(2):172-175
DOI:10.4103/0255-0857.40536  PMID:18445958
The purpose of this study was to determine the prevalence of intestinal parasites in HIV patients with or without diarrhoea and to see an association between diarrhoea and the coccidian parasites in our setting. Stool samples from 113 HIV patients, 34 chronic diarrhoea and 79 without any history of diarrhoea were collected and examined for enteric parasites by microscopy. One hundred and thirteen control samples from HIV negative patients complaining of prolonged diarrhoea were also collected and analysed. Prevalence of coccidian parasites in HIV and non-HIV patients; with and without diarrhoea was compared using chi-square tests. Enteric parasites were detected in 55.8% HIV patients with diarrhoea compared to 16.4% in patients without diarrhoea ( P < 0.001). Isospora belli was found in 41.1% (14/34) of chronic diarrhoea and 6.3% (5/79) in non-diarrhoeal cases ( P < 0.001). Cryptosporidium was detected in 20.6% (7/34) of chronic diarrhoea and 2.5% (2/79) in non-diarrhoeal cases ( P < 0.01). Cyclospora cayetanensis associated diarrhoea was detected in only one case of chronic diarrhoea (2.9%). CD4+ T-cell count was lower (180 cells/μl0 ) in diarrhoeal HIV patients as compared to non-diarrhoeal patients. Coccidian parasites were seen at a mean CD4+ T-cell count of 186.3 cells/μL. This study concluded that Isospora belli was the predominant parasite followed by Cryptosporidium spp. and both were strongly associated with diarrhoea among HIV patients.
  12,662 854 34
ORIGINAL ARTICLES
Evaluation of the effectiveness of peracetic acid in the sterilization of dental equipment
R Ceretta, MMS Paula, Ev Angioletto, MM Meier, FG Mitellstadt, CT Pich, SA Junior, E Angioletto
April-June 2008, 26(2):117-122
DOI:10.4103/0255-0857.40523  PMID:18445945
Purpose: To evaluate the effectiveness of peracetic acid in the microbiological sterilisation of dental materials. Methods: Peracetic acid solution was evaluated at concentrations of 800, 1500 and 2500 ppm. At these concentrations, it was determined whether peracetic acid caused corrosion to dental instruments and induced cellular mutagenicity and cytotoxicidity. In addition, the minimum inhibitory concentration (MIC), the minimum bactericidal concentration (MBC), agar diffusion and diffusion by well method, were also verified. Results: The corrosion rate, calculated from potentiodynamic assays was 10 -6 cm/year, indicating that the product does not damage equipment. The sterilisation capacity of peracetic acid at 2500 ppm was the best. The comet assay indicated genotoxic activity at 2500 ppm. Conclusions: This study demonstrated the effectiveness of peracetic acid for sterilizing dental equipment, providing another alternative for the prevention of infections in clinics.
  10,665 540 -
Prevalence and correlates of bacterial vaginosis among young women of reproductive age in Mysore, India
P Madhivanan, K Krupp, V Chandrasekaran, C Karat, A Arun, CR Cohen, AL Reingold, JD Klausner
April-June 2008, 26(2):132-137
DOI:10.4103/0255-0857.40526  PMID:18445948
Purpose: Bacterial vaginosis (BV) is the most common cause of abnormal vaginal discharge among women of childbearing age and is associated with STI/HIV and adverse birth outcomes. The objective of this study was to determine the prevalence and correlates of BV among young women of reproductive age in Mysore, India. Methods: Between October 2005 and December 2006, 898 sexually active women of 15-30 years of age were enrolled from two reproductive health clinics in Mysore. The women underwent an interview followed by physical examination, HSV-2 serologic testing, endocervical culture for Neisseria gonorrhoeae , and vaginal swabs for diagnosis of BV, Trichomonas vaginalis infection and candidiasis. Statistical analyses included conventional descriptive statistics and multivariable analysis using logistic regression. Results: Of the 898 women, 391 (43.5%) were diagnosed with ≥1 endogenous reproductive tract infection and 157 (17.4%) with ≥1 sexually transmitted infection. Only 863 women had Gram-stained vaginal smears available, out of which 165 (19.1, 95% confidence interval [CI]: 16.3%-22.2%) were found to have BV and 133 (15.4, 95% CI: 12.9%-18.3%) were in the 'intermediate' stage. BV was related to concurrent infections with T. vaginalis (odds ratio [OR] = 4.07, 95% CI: 2.45-6.72) and HSV-2 seropositivity (OR = 2.22, 95% CI: 1.39-3.53). Conclusions: In this population, the prevalence of BV at 19% was relatively low. Coinfection with T. vaginalis , however, was common. BV was independently associated with concurrent T. vaginalis infection and partner's alcohol use. Muslim women had reduced odds of BV as compared to non-Muslim women. Further research is needed to understand the role of T. vaginalis infection in the pathogenesis of BV and the sociocultural context surrounding the condition in India.
  10,346 839 33
CASE REPORTS
Myiasis in different types of carcinoma cases in southern India
S Gopalakrishnan, R Srinivasan, SK Saxena, J Shanmugapriya
April-June 2008, 26(2):189-192
DOI:10.4103/0255-0857.40542  PMID:18445964
Myiasis maggots were isolated from the cancerous wounds, when the patients reported to the Department of ENT-OPD, JIPMER, Pondicherry. Maggots were identified to Chrysomyia bezziana based on characteristic patterns of posterior and anterior spiracles. Although the categories of cancer wounds were different, invasions were due to C. bezziana , which is very common in suburban areas of Tamil Nadu and Pondicherry in southern parts of India. This observation showed the importance of hygiene and sanitation in tropical countries with high fly population and emphasised the need for correct diagnosis of this obligatory myiasis, which was destructive. Through proper health care, further destabilization due to myiasis was avoided.
  10,856 270 8
EDITORIAL
Need for national/regional guidelines and policies in India to combat antibiotic resistance
V Lakshmi
April-June 2008, 26(2):105-107
DOI:10.4103/0255-0857.40521  PMID:18445943
  9,548 977 4
CASE REPORTS
Primary cutaneous actinomycosis: A rare soft tissue infection
SC Metgud
April-June 2008, 26(2):184-186
DOI:10.4103/0255-0857.40540  PMID:18445962
Actinomycosis caused by Actinomyces spp. is a chronic and suppurative infection caused by an endogenous gram positive bacterium. The unusual sites of infection are the head and neck, thorax and abdomen and are almost always endogenous in origin. Primary cutaneous actinomycosis is very rare and is usually associated with external trauma and local ischemia. We report a case of a primary cutaneous actinomycosis of the thigh in a 30-year-old man. The patient acquired the infection through an injection wound which progressed to multiple discharging sinuses. Clinical material from the wound demonstrated the presence of Actinomyces in smears and cultures. The patient was diagnosed and successfully treated with surgical resection and combined antibiotic therapy.
  8,903 413 4
Soft tissue infections with arcanobacterium haemolyticum: Report of three cases
A Malini, EK Deepa, PV Manohar, K Borappa, SR Prasad
April-June 2008, 26(2):192-195
DOI:10.4103/0255-0857.40543  PMID:18445965
We report here three polymicrobial wound infections associated with Arcanobacterium haemolyticum in rural patients aged between 60-65 years. In two patients, one with cellulitis and the other with postoperative wound infection following amputation of the limb, Arcanobacterium haemolyticum was isolated repeatedly along with β haemolytic streptococci (BHS). The BHS belonged to Lancefield's group G and group C respectively. In another patient, who was a diabetic with chronic osteomyelitis, Arcanobacterium haemolyticum was isolated along with Proteus vulgaris . All the three isolates of Arcanobacterium haemolyticum isolated by us were uniformly resistant to cotrimoxazole and sensitive to penicillin, erythromycin, clindamycin, ciprofloxacin and gentamicin. Erythromycin alone or combined therapy of penicillin with erythromycin or penicillin with ciprofloxacin was effective in treating these infections.
  7,971 364 3
CORRESPONDENCE
Prevalence of syphilis and biological false positive reactions in VDRL test among injecting drug users: A preliminary study
N Jindal, A Aggarwal
April-June 2008, 26(2):199-200
DOI:10.4103/0255-0857.40547  PMID:18445969
  7,368 334 -
Experience with a fourth generation human immunodeficiency virus serological assay at a tertiary care centre in south India
R Kannangai, M Moorthy, AJ Kandathil, J Sachithanandham, V Thirupavai, G Nithyanandam, G Sridharan
April-June 2008, 26(2):200-202
DOI:10.4103/0255-0857.40548  PMID:18445970
  6,806 308 -
CASE REPORTS
Acanthamoeba encephalitis
V Kaushal, DK Chhina, R Kumar, HS Pannu, HPS Dhooria, RS Chhina
April-June 2008, 26(2):182-184
DOI:10.4103/0255-0857.40539  PMID:18445961
Central nervous system infection with free-living amoebae is rare. We present a fatal case of Acanthamoeba encephalitis in a 63-year-old female from India where acanthamoebae were demonstrated and cultured from CSF. In spite of treatment with amphotericin B, fluconazole and rifampicin the patient did not survive. Amoebic infection should be suspected in a patient of encephalitis of unexplained aetiology as timely diagnosis can lead to a favourable outcome.
  6,671 376 4
Gastrointestinal histoplasmosis presenting as colonic pseudotumour
S Sehgal, R Chawla, PS Loomba, B Mishra
April-June 2008, 26(2):187-189
DOI:10.4103/0255-0857.40541  PMID:18445963
We report a case of gastrointestinal histoplasmosis in a 45-year-old HIV positive man who was misdiagnosed as a case of colonic cancer. The patient presented with low-grade fever, pain in lower abdomen, anorexia and weight loss of six months duration. On examination a lump in the left iliac fossa was detected. Colonoscopy revealed stricture and ulcerated growth in the sigmoid colon. Radiological investigations suggested malignant/inflammatory mass in the sigmoid colon with luminal compromise. Patient was operated and ulcerated tissue was sent for histopathological examination, which revealed numerous intracellular, 2-4 μm, oval, narrow-based budding yeast cells suggestive of Histoplasma capsulatum . Subsequently, the patient developed fluffy opacities on X-ray chest. Examination of sputum revealed presence of acid-fast bacilli and yeast forms of H. capsulatum . Patient was started on amphotericin B but died on the seventeenth postoperative day. The diagnosis of histoplasmosis was made retrospectively. Atypical presentation and rarity of the disease led to this diagnostic pitfall. To the best of our knowledge this is the first report of gastrointestinal histoplasmosis presenting as colonic pseudotumour from India.
  6,600 363 6
ORIGINAL ARTICLES
Advantage of using a home-made elisa kit for detection of Helicobacter pylori infection over commercially imported kits
M Mohammadi, Y Talebkhan, G Khalili, F Mahboudi, S Massarrat, L Zamaninia, A Oghalaei
April-June 2008, 26(2):127-131
DOI:10.4103/0255-0857.40525  PMID:18445947
Purpose: To evaluate a home-made ELISA kit for detection of Helicobacter pylori (Hp) infection and comparison of its immunologic criteria with those of foreign commercial kits. Methods: A home-made IgG ELISA kit was developed using soluble antigenic fractions of Hp proteins. Confirmed sera were tested and serological criteria were evaluated through assessment of 199 serum samples. Results: The accuracy, sensitivity and specificity values of home-made kit were 92, 92 and 90.4%, respectively. These immunologic criteria for Trinity kit were 95.2, 95.2 and 95% in comparison with IBL kit (91.3, 92.2 and 88.5%), BIOHIT kit (72.4, 41.6 and 94.1%) and HelicoBlot2.1 (94.2, 93.4 and 100%). Kappa agreement assessment demonstrated that two of the imported ELISA kits had fair to moderate agreement with the home-made kit while the other one had a poor agreement value. Conclusions: Apart from comparable values between the home-made kit and the most efficient imported kit (Trinity) there was significant cost benefit. Therefore, we recommend the home-made kit as a suitable substitution for detection of Hp infection in the Iranian population.
  6,531 412 6
BRIEF COMMUNICATIONS
Detection of Enterobacteriaceae producing CTX-M extended spectrum β-lactamases from a tertiary care hospital in south India
S Baby Padmini, B Appala Raju, KR Mani
April-June 2008, 26(2):163-166
DOI:10.4103/0255-0857.40534  PMID:18445956
A total of 23 clinical isolates (15 Escherichia coli and 8 Klebsiella pneumoniae ), resistant to cefotaxime and ceftazidime recovered during 2002 and 2003, were investigated for production of CTX-M extended spectrum β-lactamase (ESBL) by phenotypic and molecular methods. The presence of ESBL was tested by NCCLS phenotypic confirmatory test using cephalosporin/clavulanate combination discs and E-test ESBL strips. Determination of MIC of cefotaxime and ceftazidime was done with and without the presence of clavulanic acid by agar dilution technique. Polymerase chain reaction revealed the presence of CTX-M type ESBLs in 19 isolates. Further sequencing resulted in identification of CTX-M-15 ESBLs. This is the first report identifying CTX-M type ESBL from clinical isolates of E. coli and K. pneumoniae from a tertiary care hospital in south India.
  6,067 714 22
Comparison of efficacy of three commercially available antibiotic discs
A Joshi, V Iyer, U Balasubramaniam, A Kagal, R Bharadwaj
April-June 2008, 26(2):160-162
DOI:10.4103/0255-0857.40533  PMID:18445955
A study was undertaken to evaluate the efficacy of commercially available antimicrobial discs manufactured by Oxoid, UK, HiMedia Laboratories, Mumbai and Span Diagnostics, Surat. The discs were evaluated for their performance on the basis of percentage of coefficient of variation (%CV) which is a measure of reproducibility, mean zone diameters which is a measure of accuracy and range of zone diameter using both standard ATCC strains and clinical isolates. The data showed variation for all three manufacturers and therefore routine and regular quality control of discs as well as meticulous following of good laboratory practices is strongly advocated in clinical laboratories
  6,231 330 1
CORRESPONDENCE
Prevalence of tuberculosis, hepatitis B, hepatitis C and syphilis co-infections among HIV/AIDS patients
A Mahajan, VR Tandon, S Verma, JB Singh, M Sharma
April-June 2008, 26(2):196-197
DOI:10.4103/0255-0857.40544  PMID:18445966
  5,865 568 2
Preservation of Vibrio cholerae by suspension in normal saline
S Chitnis, V Chitnis, H Nanda, DS Chitnis
April-June 2008, 26(2):198-199
DOI:10.4103/0255-0857.40546  PMID:18445968
  6,094 281 1
BRIEF COMMUNICATIONS
Detection of mutation in isoniazid-resistant Mycobacterium tuberculosis isolates from tuberculosis patients in Belarus
SZ Bostanabad, LP Titov, A Bahrmand, SA Nojoumi
April-June 2008, 26(2):143-147
DOI:10.4103/0255-0857.40528  PMID:18445950
The aim of this study was to investigate the frequency, location and type of katG mutations in Mycobacterium tuberculosis strains isolated from patients in Belarus. Forty two isoniazid-resistant isolates were identified from sputum of 163 patients with active pulmonary tuberculosis. Drug susceptibility testing was determined by using CDC standard conventional proportional method and BACTEC system. Standard PCR method for detection of isoniazid resistance associated mutations was performed by katG gene amplification and DNA sequencing. Most mutations were found in katG gene codons 315, 316 and 309. Four types of mutations were identified in codon 315: AGC→ACC ( n = 36) 85%, AGC→AGG ( n = 1) 2.3%, AGC→AAC ( n = 2) 4.7%, AGC→GGC ( n = 1) 2.3%. One type of mutation was found in codon 316: GGC→AGC ( n = 18)41.4%, four types of mutations were detected in codon 309: GGT→GGT ( n = 7)16.1%, GGT→GCT ( n = 4)9.2%, GGT→GTC ( n = 3)6.9%, GGT→GGG ( n = 1)2.7%. The highest frequency of mutations sharing between primary and secondary infections was found in codon 315.
  5,569 494 6
CORRESPONDENCE
Leptospirosis laboratory, Madras medical college: Review of our experience (2004-2006)
G Sumathi, R Narayanan, S Shivakumar
April-June 2008, 26(2):206-207
DOI:10.4103/0255-0857.40553  PMID:18445975
  5,550 488 3
BRIEF COMMUNICATIONS
Modified PAP method to detect heteroresistance to vancomycin among methicillin resistant Staphylococcus aureus isolates at a tertiary care hospital
RN Iyer, V Hittinahalli
April-June 2008, 26(2):176-179
DOI:10.4103/0255-0857.40537  PMID:18445959
This study was an attempt at developing, establishing, validating and comparing the modified PAP method for detection of hetero-vancomycin resistant Staphylococcus aureus (h-VRSA) with the routine antimicrobial susceptibility testing (using the BSAC standardized disc diffusion method), minimum inhibitory concentrations of vancomycin using standard E-test methodology and the Hiramatsu's screening method. A total of 50 methicillin resistant Staphylococcus aureus obtained from various clinical specimens, along with the Mu 3 and Mu 50 strains as controls, were studied. No VRSA isolates were obtained. However, four of the test strains were positive by the Hiramatsu's screening method, of which only one isolate could be confirmed by the modified PAP analysis method. This isolate was a coloniser from the drain fluid of a liver transplant recipient. The sensitivity, specificity, positive predictive value and the overall efficiency of the Hiramatsu's screening method with the modified PAP analysis as the gold standard were found to be 100, 93.8, 25 and 94%, respectively. It is very essential for clinical laboratories to screen for h-VRSA, given the increasing use of glycopeptide antibiotics in therapy and the potential for failed therapy in patients infected with these strains.
  5,159 626 1
CASE REPORTS
Acute abdomen: An unusual presentation of disseminated Penicillium marneffei infection
IA George, TD Sudarsanam, AB Pulimood, MS Mathews
April-June 2008, 26(2):180-182
DOI:10.4103/0255-0857.40538  PMID:18445960
Varied clinical presentations of Penicillium marneffei , an opportunistic pathogen in HIV disease has been rarely described in literature. We report a patient with advanced AIDS who presented to us with prolonged fever and had features of an acute abdomen. On radiologic imaging he had features of intestinal obstruction and mesenteric lymphadenitis. A diagnosis was made possible by endoscopic biopsies of the small bowel and bone marrow culture which grew P . Marneffei . He was treated with intravenous amphotericin for 2 weeks followed by oral itraconazole. This case is reported for its rarity and unusual presentation and to sensitise clinicians and microbiologists to consider this as an aetiology in patients with advanced HIV/AIDS who present with acute abdomen, more so in patients from a distinct geographic region - South-East Asia
  5,385 343 6
CORRESPONDENCE
Occurrence of cytomegalo virus and herpes simplex virus infections in pregnancy
S Gumber, U Arora, P Devi
April-June 2008, 26(2):204-205
DOI:10.4103/0255-0857.40551  PMID:18445973
  5,014 386 -
ORIGINAL ARTICLES
The highest prevalence of human metapneumovirus in Ahwaz children accompanied by acute respiratory infections
M Arabpour, AR Samarbafzadeh, M Makvandi, A Shamsizadeh, E Percivalle, Janet Englud, Seid Mannut Latifi
April-June 2008, 26(2):123-126
DOI:10.4103/0255-0857.40524  PMID:18445946
Purpose: The newly described human metapneumovirus (hMPV) has been recently discovered as an etiological agent of acute respiratory infections (ARTI) in infants and children. The aim of this study was to determine the prevalence of hMPV and its potential role as causative agent of ARTI in Ahwaz children. Methods: In the present study, we examined 124 nasal swabs from infants affected by ARTI for the presence of hMPV by RT-PCR technique. Results: Sixty-eight out of 124 (54.4%) cases were positive for hMPV which is the highest incidence of hMPV ever reported in the world, 94.1% of positive cases belonged to genotype A; whereas no B genotype was detected. Our positive hMPV children were affected by upper (URTI) as well as lower respiratory tract infection (LRTI); however, LARTIs had higher prevalence. Conclusions: We suggest a probable role of F protein alteration as the causative agent for the highest prevalence of hMPV infection among Ahvaz children.
  4,964 290 7
BRIEF COMMUNICATIONS
Genotypic resistance profile of HIV-1 protease gene: A preliminary report from Vellore, south India
AJ Kandathil, R Kannangai, OC Abraham, TD Sudarsanam, SA Pulimood, G Sridharan
April-June 2008, 26(2):151-154
DOI:10.4103/0255-0857.40530  PMID:18445952
HIV-1 subtypes other than B are responsible for most new HIV infections worldwide; virus sequence data for drug resistance is described only from a limited number of non-B subtype HIV-1. This study is on mutations and polymorphisms of HIV-1 protease gene that can predict drug resistance in subtype C. The genotypic resistance assay was carried out on 38 HIV-1 strains with their plasma RNA and in nine, the proviral protease gene was sequenced. The treatment naοve strains showed minor resistance mutations, there were no major resistance mutations in the protease gene. We suggest the use of resistance testing to monitor individuals on therapy and also before initiation of therapy, gathering more sequence information for a data bank of Indian strains.
  4,798 315 5
Emergency department based HIV screening: An opportunity for early diagnosis in high prevalent areas
VD Teja, T Sudha, V Lakshmi
April-June 2008, 26(2):167-171
DOI:10.4103/0255-0857.40535  PMID:18445957
The Emergency Medicine Department (EMD) is an ideal place for public health interventions and provides ready access to the health care system, offering a great opportunity for HIV testing and counselling. Between 2003 and 2005, rapid test was requested for 59.39% of 10,752 cases from EMD, where as ELISA was requested for 40.61%. Of the 317 HIV reactive cases, available medical records of 249 were reviewed for epidemiological and clinical information. Nearly 42% of total reactive cases detected in our Institute were from EMD. Three percent (317/10,752) were diagnosed as HIV reactive, 1.52% of the total samples were reactive by rapid test and the other 1.43% by ELISA. Two and half percent (163/6386) of those who had rapid testing and 3.53% (154/4366) who had ELISA testing, were identified as HIV reactive. All these cases were diagnosed within a mean EMD stay of 2.5 days. Eighty-five percent of HIV reactive individuals were unaware of their reactive status. Additional 53 cases of asymptomatic spouses were diagnosed as HIV reactive, thus making it possible to seek early treatment for HIV infection. The study emphasizes the importance of offering HIV testing to all patients who present to emergency department.
  4,595 332 2
CORRESPONDENCE
Bacteriological and molecular studies of group A streptococcal pharyngitis in a south Indian hospital
C Sindhulina, S Geethalakshmi, PR Thenmozhivalli, JM Jose, KN Brahmadathan
April-June 2008, 26(2):197-198
DOI:10.4103/0255-0857.40545  PMID:18445967
  4,358 317 1
BRIEF COMMUNICATIONS
Molecular characterization of genes encoding the quinolone resistance determining regions of Malaysian Streptococcus pneumoniae strains
N Kumari, G Subramaniam, P Navaratnam, SD Sekaran
April-June 2008, 26(2):148-150
DOI:10.4103/0255-0857.40529  PMID:18445951
Genes encoding the quinolones resistance determining regions (QRDRs) in Streptococcus pneumoniae were detected by PCR and the sequence analysis was carried out to identify point mutations within these regions. The study was carried out to observe mutation patterns among S. pneumoniae strains in Malaysia. Antimicrobial susceptibility testing of 100 isolates was determined against various antibiotics, out of which 56 strains were categorised to have reduced susceptibility to ciprofloxacin (≥2 μg/mL). These strains were subjected to PCR amplification for presence of the gyrA, parC , gyrB and parE genes. Eight representative strains with various susceptibilities to fluoroquinolones were sequenced. Two out of the eight isolates that were sequenced were shown to have a point mutation in the gyrA gene at position Ser81. The detection of mutation at codon Ser81 of the gyrA gene suggested the potential of developing fluoroquinolone resistance among S. pneumoniae isolates in Malaysia. However, further experimental work is required to confirm the involvement of this mutation in the development of fluoroquinolone resistance in Malaysia.
  4,131 291 -
Identification of weak points prone for mutation in ferredoxin of Trichomonas vaginalis
V Wiwanitkit
April-June 2008, 26(2):158-159
DOI:10.4103/0255-0857.40532  PMID:18445954
Trichomonas vaginalis , the causative agent for human trichomoniasis, is a problematic sexually transmitted disease mainly in women. At present, metronidazole-resistant trichomoniasis is an infrequent but challenging problem with no universally successful treatment. Genetic mutation is believed to be an important factor leading to increasing drug resistance. Understanding the mutation status will help to design accurate strategies of therapy against mutant strains of T. vaginalis . The author performed a bioinformatic analysis to determine positions that tend to comply peptide motifs in the amino acid sequence of ferridoxin of T. vaginalis . Based on this study, the weak linkages in the studied protein can be identified and can be useful information for prediction of possible new mutations that can lead to drug resistance. In addition, the results from this study can be good information for further research on the diagnosis for mutants and new effective drug development.
  3,890 246 4
CORRESPONDENCE
Seroprevalence of HIV, hepatitis C and hepatitis B in multitransfused thalassemics
M Mathur, K Wanjari, D Turbadkar
April-June 2008, 26(2):205-206
DOI:10.4103/0255-0857.40552  PMID:18445974
  3,395 314 2
Microscopy for cryptosporidiosis screening in remote areas
P Barua, NK Hazarika, N Barua, E Rasul, N Laskar
April-June 2008, 26(2):203-204
DOI:10.4103/0255-0857.40550  PMID:18445972
  3,170 240 2
An explanation in nanostructure level based on the view of energy change for G333d mutation relating to drug resistance in HIV-1 reverse transcriptase
V Wiwanitkit
April-June 2008, 26(2):202-203
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2004 - Indian Journal of Medical Microbiology
Published by Wolters Kluwer - Medknow

Online since April 2001, new site since 1st August '04