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  Citation statistics : Table of Contents
   2008| October-December  | Volume 26 | Issue 4  
    Online since October 23, 2008

 
 
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REVIEW ARTICLE
Bio-aerosols in indoor environment: Composition, health effects and analysis
Padma Srikanth, Suchithra Sudharsanam, Ralf Steinberg
October-December 2008, 26(4):302-312
DOI:10.4103/0255-0857.43555  PMID:18974481
Bio-aerosols are airborne particles that are living (bacteria, viruses and fungi) or originate from living organisms. Their presence in air is the result of dispersal from a site of colonization or growth. The health effects of bio-aerosols including infectious diseases, acute toxic effects, allergies and cancer coupled with the threat of bioterrorism and SARS have led to increased awareness on the importance of bio-aerosols. The evaluation of bio-aerosols includes use of variety of methods for sampling depending on the concentration of microorganisms expected. There have been problems in developing standard sampling methods, in proving a causal relationship and in establishing threshold limit values for exposures due to the complexity of composition of bio-aerosols, variations in human response to their exposure and difficulties in recovering microorganisms. Currently bio-aerosol monitoring in hospitals is carried out for epidemiological investigation of nosocomial infectious diseases, research into airborne microorganism spread and control, monitoring biohazardous procedures and use as a quality control measure. In India there is little awareness regarding the quality of indoor air, mould contamination in indoor environments, potential source for transmission of nosocomial infections in health care facilities. There is an urgent need to undertake study of indoor air, to generate baseline data and explore the link to nosocomial infections. This article is a review on composition, sources, modes of transmission, health effects and sampling methods used for evaluation of bio-aerosols, and also suggests control measures to reduce the loads of bio-aerosols.
  58 25,409 1,809
ORIGINAL ARTICLES
Correlation between biofilm production and multiple drug resistance in imipenem resistant clinical isolates of Acinetobacter baumannii
R Srinivasa Rao, R Uma Karthika, SP Singh, P Shashikala, R Kanungo, S Jayachandran, K Prashanth
October-December 2008, 26(4):333-337
DOI:10.4103/0255-0857.43566  PMID:18974485
Purpose: To study the qualitative and quantitative methods for the investigation of biofilm formation and to examine the correlation between biofilm and antibiotic resistance among the clinical isolates of Acinetobacter baumannii . We also verified the association between biofilm and presence of extended spectrum β-lactamases, particularly, bla PER-1 . Methods: A total of 55 isolates were subjected to susceptibility testing by disc diffusion method for 13 clinically relevant antibiotics. Screening for biofilm production was done by both qualitative and quantitative methods through tube and microtitre plate assay respectively. The presence of bla PER-1 was checked by PCR. Results: A. baumannii isolates showed very high resistance (>75%) to imipenem, cephotaxime, amikacin and ciprofloxacin. Only cefoperazone, netillin and norfloxacin were found to be effective agents. Results of microtitre and tube methods were concordant with 34 isolates (62%) showing biofilm formation. Resistance to four antibiotics such as amikacin (82% vs. 17.6%, P <0.001), cephotaxime (88% vs. 11%, P P <0.001), ciprofloxacin (70% vs. 29%, P =0.005) and aztreonam (38% vs. 11%, P =0.039) was comparatively higher among biofilm producers than non-biofilm producers. Microtitre assay additionally detected 14 weakly adherent isolates. Only 11 isolates had bla PER-1 gene and among these two were strong biofilm producers, while remaining were weakly adherent isolates. Conclusion: Microtitre plate method was found to be a more sensitive method for biofilm detection. This study demonstrates a high propensity among the clinical isolates of A. baumannii to form biofilm and a significant association of biofilms with multiple drug resistance. Presence of bla PER-1 appears to be more critical for cell adherence than for biofilm formation.
  39 12,214 1,503
Antiviral activity of the Indian medicinal plant extract, Swertia chirata against herpes simplex viruses: A study by in-vitro and molecular approach
H Verma, PR Patil, RM Kolhapure, V Gopalkrishna
October-December 2008, 26(4):322-326
DOI:10.4103/0255-0857.43561  PMID:18974483
Purpose: The antiviral activity of Indian Medicinal plant extract Swertia chirata was tested against Herpes simplex virus (HSV) type-1, using multiple approaches both at cellular and molecular level. Methods: Cytotoxicity, plaque reduction, virus infectivity, antigen expression and polymerase chain reaction (PCR) assays were conducted to test the antiviral activity of the plant extract. Results: Swertia plant crude extract (1gm/mL) at 1:64 dilution inhibited HSV-1, plaque formation at more than 70% level. HSV antigen expression and time kinetics experiments conducted by indirect immunofluorescence (IFA) test, revealed a characteristic pattern of small foci of single fluorescent cells in Swertia extract treated HSV-1 infected cells at 4 hours post infection dose, suggested drug inhibited viral dissemination. Infected cell cultures treated with Swertia extract at various time intervals, tested by PCR, failed to show amplification at 12, 24-72 hours. HSV-1 infected cells treated with Acyclovir (antiviral drug) did not show any amplification by PCR. Conclusions: In this preliminary study, the Indian medicinal plant extract, Swertia chirata showed antiviral properties against Herpes simplex virus type-1.
  25 13,407 999
BRIEF COMMUNICATIONS
Increased prevalence of extended spectrum β lactamase producers in neonatal septicaemic cases at a tertiary referral hospital
A Bhattacharjee, MR Sen, P Prakash, A Gaur, S Anupurba
October-December 2008, 26(4):356-360
DOI:10.4103/0255-0857.43578  PMID:18974490
Emergence of extended spectrum β lactamases (ESBLs) producing strains of gram negative bacteria, as one of the leading cause of septicaemia often complicates the clinical and therapeutic outcome. The present study was undertaken to investigate the prevalence of ESBLs in bacteria isolated from neonatal septicaemic cases along with their antimicrobial sensitivity pattern. Blood samples were collected from 243 suspected cases of neonatal septicaemia. Apart from susceptibility testing, all the gram negative isolates were subjected to phenotypic tests for ESBL production. Amongst the positive test samples (n = 115), 84 were gram negative rods. ESBL was detected in 26 (32%) isolates. Results indicate that routine ESBL detection should be made imperative and empirical use of third generation cephalosporins must be discouraged.
  20 4,312 694
The utility of IS6110 sequence based polymerase chain reaction in comparison to conventional methods in the diagnosis of extra-pulmonary tuberculosis
B Sekar, L Selvaraj, A Alexis, S Ravi, K Arunagiri, L Rathinavel
October-December 2008, 26(4):352-355
DOI:10.4103/0255-0857.43575  PMID:18974489
IS6110 sequence based polymerase chain reaction (PCR) was compared with conventional bacteriological techniques in the laboratory diagnosis of extra-pulmonary tuberculosis (EPTB). One hundred and ninety one non-repeated clinical samples of EPTB and 17 samples from non-tuberculous cases as controls were included. All the samples were processed for Ziehl-Neelsen staining for acid fast bacilli (AFB) and 143 samples were processed by culture for M. tuberculosis . All the samples were processed for PCR amplification with primers targeting 123 bp fragment of insertion element IS6110 of M. tuberculosis complex. Of the total 191 samples processed, 34 (18%) were positive by smear for AFB. Culture for AFB was positive in 31(22%) samples among the 143 samples processed. Either smear or culture for AFB was found positive in 51(27%) samples. Of the total 191 samples processed 120 (63%) were positive by PCR. In 140 samples, wherein both the conventional techniques were found negative, 74 (53%) samples were positive by PCR alone. Among 51 samples positive by conventional techniques, 46 (90%) were found positive by PCR. PCR assay targeting IS6110 is useful in establishing the diagnosis of EPTB, where there is strong clinical suspicion, especially when the conventional techniques are negative.
  17 4,821 583
GUEST EDITORIAL
Nanotechnology: A new frontier in virus detection in clinical practice
AM Abraham, R Kannangai, G Sridharan
October-December 2008, 26(4):297-301
DOI:10.4103/0255-0857.43551  PMID:18974480
Researchers are expanding the applications of nanotechnology in the field of medicine since mid-2000. These technologies include nanoarrays, protein arrays, nanopore technology, nanoparticles as a contrivance in immunoassays and nanosensors, among others. Nanobiotechnologies are clinically applicable and possess the potential to be useful in laboratory diagnosis of infections in general and viral infections in particular. Nanotechnology is a significant advance in molecular diagnostics. The technology strengthens and expands the DNA and protein microarray methods. In particular, the waveguide technology is an emergent area with many diagnostic applications. Nanosensors are the new contrivance for detection of bioterrorism agents. All these new technologies would have to be evaluated in clinical settings before their full import is appreciated and accepted.
  10 13,986 1,812
CASE REPORTS
Meningitis due to Rhodotorula glutinis in an HIV infected patient
RS Shinde, BG Mantur, G Patil, MV Parande, AM Parande
October-December 2008, 26(4):375-377
DOI:10.4103/0255-0857.43579  PMID:18974495
Rhodotorula spp, though considered a common saprophyte, recently has been reported as causative agent of opportunistic mycoses. We present a case of meningitis in an immunocompromised human immunodeficiency virus infected patient who presented with longstanding fever. He was diagnosed as a case of chronic meningitis. Diagnosis was confirmed by cell cytology, India ink preparation, Gram staining and culture of cerebrospinal fluid (CSF) sample. CSF culture grew Rhodotorula glutinis . Therapy with amphotericin B was successful in eliminating the yeast from CSF and the patient was discharged after recovery.
  8 3,747 255
Fatal rhino-orbito -cerebral infection caused by Saksenaea vasiformis in an immunocompetent individual: First case report from India
VP Baradkar, M Mathur, S Taklikar, M Rathi, S Kumar
October-December 2008, 26(4):385-387
DOI:10.4103/0255-0857.43572  PMID:18974499
A 56-year-old female patient presented with history of nasal blockage, nasal bleeding, headache, since one month. On admission the patient developed severe headache, decreased vision of eyes and blindness. Clinical diagnosis of rhino-orbital involvement was confirmed by computerized tomography of the paranasal sinuses. The diagnosis of fungal infection was confirmed by KOH examination, haematoxylin and eosin examination and Gomori's methanamine silver stain of the biopsy material. Diagnosis was confirmed by culture on Sabouraud Dextrose agar, slide culture on Czapek Dox medium and the isolate was identified as Saksenaea vasiformis. The patient was started on intravenous amphotericin B (received only one dose before succumbing), but she did not respond to the treatment, developed hemiparesis, slurred speech, diminished reflexes and ultimately died. The involvement of the brain was confirmed by computerised tomographic scan. We believe this case to be the first case of rhino-orbito-cerebral infection due to Saksenaea vasiformis and that of second case in an immunocompetent patient in the world.
  8 3,154 233
ORIGINAL ARTICLES
An evaluation of saliva as an alternative to plasma for the detection of hepatitis C virus antibodies
M Moorthy, HD Daniel, G Kurian, P Abraham
October-December 2008, 26(4):327-332
DOI:10.4103/0255-0857.42116  PMID:18974484
Purpose: Seroepidemiological studies on the prevalence of Hepatitis C virus (HCV) in India have been hampered by reluctance of subjects to provide blood samples for testing. We evaluated the use of saliva as an alternate specimen to blood for the detection of antibodies to HCV. Methods: Chronic liver disease (CLD) patients attending the liver clinic were recruited for this study. A saliva and plasma sample (sample pair) was collected from each patient included in the study. Saliva samples were collected using a commercially available collection device - OmniSal. Sample pairs were tested with an in-use ELISA for the detection of antibodies to HCV (HCV-Ab), with a minor modification in the manufacturer's protocol while testing saliva. The cut-off absorbance value for declaring a sample as positive was determined by receiver operating curve (ROC) analysis. HCV-Ab positivity in saliva was compared with that in plasma as well as with viral load in plasma and infecting genotype of the virus. Sensitivity, specificity, positive and negative predictive values, and correlation coefficients were calculated using Medcalc statistical software. Results: The optimal accuracy indices were: sensitivity-81.6%; specificity-92.5%; PPV-85.1% and NPV-90.5%. No correlation was found between salivary positivity and HCV viral load in plasma or infecting genotype. Conclusions: The accuracy indices indicate that the assay must be optimized further before it can be recommended for routine use in epidemiological surveys for HCV-Ab.
  8 4,979 613
Chronic Chlamydia pneumoniae infection and bronchial asthma: Is there a link?
A Agarwal, Y Chander
October-December 2008, 26(4):338-341
DOI:10.4103/0255-0857.43567  PMID:18974486
Purpose: Besides well-defined environmental causes, accumulating evidence suggests that respiratory tract infections play an important role in the pathogenesis of asthma. Among these Chlamydia pneumoniae infection has been discussed as possibly inducing the development of asthma. Methods: This study was designed to investigate the presence of anti chlamydial IgG, IgA, and IgM antibodies by ELISA in serum samples of 60 adults with a clinical history of asthma and 100 healthy age and sex matched controls. All the samples positive for Chlamydial genus specific IgG antibodies were then subjected to Chlamydia pneumoniae species specific IgG antibody ELISA. Results: The IgG anti chlamydial antibody-positivity rate in the patients with bronchial asthma (80%) was significantly higher in all age groups than that in the healthy age and sex matched controls (59%). No significant association was observed for IgA and IgM anti chlamydial antibodies. C. pneumoniae species specific IgG antibody seroprevalence was also found to be significantly higher in all age groups in comparison to controls (61.66% vs 38%). Conclusions: Serological evidence of chronic infection with C. pneumoniae was more frequent in patients with asthma compared with control subjects. Our results support the correlation of bronchial asthma and chronic infection with C. pneumoniae in Indian population.
  7 5,638 393
BRIEF COMMUNICATIONS
Status of high level aminoglycoside resistant Enterococcus faecium and Enterococcus faecalis in a rural hospital of central India
DK Mendiratta, H Kaur, V Deotale, DC Thamke, R Narang, P Narang
October-December 2008, 26(4):369-371
DOI:10.4103/0255-0857.43582  PMID:18974493
Considering the emergence of high level aminoglycoside resistance (HLAR) in enterococci this study was undertaken to determine their status in a rural setting. HLAR by disc diffusion and agar dilution, β lactamase by nitrocefin disc and vancomycin resistance by agar dilution was determined in 150 enterococcal isolates, as per NCCLS guidelines. Only two species, Enterococcus faecalis (85.5%) and Enterococcus faecium (14.7%) were recovered, mostly from blood. Forty six percent showed HLAR. Multi drug resistance and concomitant resistance of HLAR strains to β lactams were quite high. None showed β lactamase activity or vancomycin resistance.
  6 4,169 526
CASE REPORTS
Cerebral phaeohyphomycosis due to Cladophialophora bantiana
V Lakshmi, C Padmasri, P Umabala, C Sundaram, M Panigrahi
October-December 2008, 26(4):392-395
DOI:10.4103/0255-0857.43569  PMID:18974502
Cladophialophora bantiana a dematiaceous fungus and a member of the family Phaeohyphomycetes , is primarily a neurotropic fungus causing central nervous system (CNS) infection. We report a case of a well preserved, young adult male presenting with a capsuloganglionic abscess caused by C. bantiana , a rare entity. Diagnosis was made based on the mycology and histopathology findings of the aspirate from the abscess through a burr hole. The patient responded clinically to amphotericin B.
  5 3,517 284
Prostatic abscess by Staphylococcus aureus in a diabetic patient
VP Baradkar, M Mathur, S Kumar
October-December 2008, 26(4):395-397
DOI:10.4103/0255-0857.43568  PMID:18974503
Prostatic abscess is uncommon and difficult to diagnose because the clinical presentation may mimic symptoms of lower urinary tract infection. We report here a case of prostatic abscess in a 50-year-old known diabetic male patient, who presented with urinary retention. Clinical diagnosis was done by clinical presentation and ultrasonography. The causative agents i.e., Staphylococcus aureus was isolated from the aspirate and the patient responded to intravenous Ciprofloxacin therapy. No other surgical intervention was required to treat the patient.
  5 4,933 319
CORRESPONDENCE
A preliminary study on prevalent serovars of leptospirosis among patients admitted to teaching hospital, Kandy, Sri Lanka
SB Agampodi, V Thevanesam, H Wimalarathna, T Senarathna, MH Wijedasa
October-December 2008, 26(4):405-406
DOI:10.4103/0255-0857.43557  PMID:18974510
  5 3,454 231
BRIEF COMMUNICATIONS
Validation of multiplex PCR strategy for simultaneous detection and identification of methicillin resistant Staphylococcus aureus
S Rallapalli, S Verghese, RS Verma
October-December 2008, 26(4):361-364
DOI:10.4103/0255-0857.43580  PMID:18974491
Multiplex polymerase chain reaction (PCR) strategy is described for rapid identification of clinically relevant methicillin resistant Staphylococcus aureus (MRSA) that targets mecA and coag ulase genes. In this study, 150 staphylococcal clinical isolates were used that included 40 isolates of MRSA, 55 isolates of methicillin susceptible S. aureus (MSSA), 44 isolates of methicillin susceptible coag ulase negative Staphylococcus spp. (MS-CoNS) and 11 isolates of methicillin resistant coag ulase negative Staphylococcus spp. (MR-CoNS). Out of 55 S. aureus strains, three strains demonstrated mecA gene, which appeared to be oxacillin sensitive by disc diffusion. When (MS-CoNS) were evaluated, 10 isolates classified as oxacillin sensitive phenotypically, yielded positive results in PCR method. The results for mecA detection by PCR were more consistent with disk susceptibility tests in case of MRSA (100%) and MSSA (95%) isolates. In contrast to above results with MRSA and MSSA, mecA detection by PCR in MS-CoNS showed less correlation with disk susceptibility tests (77%). The results for coag detection by PCR were consistent with phenotypic tests in all isolates.
  4 5,112 693
CASE REPORTS
A successful management of dengue fever in pregnancy: Report of two cases
N Singh, KA Sharma, V Dadhwal, S Mittal, AS Selvi
October-December 2008, 26(4):377-380
DOI:10.4103/0255-0857.43577  PMID:18974496
In the most recent outbreak of degue fever in India, we encountered at least seven cases of fever with thrombocytopenia in pregnancy but only two were seropositive for dengue. In one of the cases there was postpartum hemorrhage while in the other case there was perinatal transmission to the neonate requiring platelet transfusions. The diagnostic difficulties in pregnancy and the management are discussed.
  4 36,128 615
Cutaneous infection with Mycobacterium fortuitum : An unusual presentation
S Sarma, R Thakur
October-December 2008, 26(4):388-390
DOI:10.4103/0255-0857.43571  PMID:18974500
Cutaneous infection with rapidly growing mycobacteria is uncommon and its diagnosis can be missed unless there is strong clinical suspicion coupled with microbiological confirmation. We report a case of localized recurrent soft tissue swelling of the foot by Mycobacterium fortuitum in a healthy adult male. The case is being reported for its uncommon clinical presentation and the associated etiological agent. The patient recovered completely following therapy with amikacin and clarithromycin.
  4 3,603 299
BRIEF COMMUNICATIONS
Study of metallo-β-lactamase production in clinical isolates of Pseudomonas aeruginosa
G Agrawal, RB Lodhi, UP Kamalakar, RK Khadse, SV Jalgaonkar
October-December 2008, 26(4):349-351
DOI:10.4103/0255-0857.43573  PMID:18974488
A study of metallo-β-lactamase (MBL) production was done in clinical isolates of Pseudomonas aeruginosa . Isolates resistant to ceftazidime and imipenem were screened for MBL production by double disc synergy test (DDST) and minimum inhibitory concentration reduction test. There was complete correlation between two methods for imipenem. For ceftazidime, there was correlation between the two methods in all except four strains. In the screening test for MBL, ceftazidime - EDTA combination was better than imipenem - EDTA combination. 8.05% strains were MBL producers. Presence of MBL producer P. aeruginosa is a cause of concern. Simple DDST can be helpful for monitoring of these emerging resistant determinants.
  3 3,478 793
CASE REPORTS
Neonatal septicaemia in a premature infant due to Candida dubliniensis
VP Baradkar, M Mathur, S Kumar
October-December 2008, 26(4):382-385
DOI:10.4103/0255-0857.43574  PMID:18974498
Candida dubliniensis is a recently described species that shares many features with Candida albicans. There are very few reports of isolation of this species from bloodstream in adults and paediatric population. Here we report a case of neonatal septicaemia produced by C. dubliniensis in a premature infant admitted to neonatal intensive care unit. The preterm male neonate with a gestational age of 30 weeks and a birth weight of 1.2 kg presented with respiratory distress syndrome for which mechanical ventilation was provided. In spite of receiving antibiotics, the patient developed fever. C.dubliniensis was repeatedly isolated from the blood culture of the patient collected aseptically from different sites. The patient was successfully treated with amphotericin B.
  3 3,570 433
CORRESPONDENCE
Ciprofloxacin breakpoints in enteric fever: Time to revise our susceptibility criteria
LK Gupta, VS Randhawa
October-December 2008, 26(4):406-406
DOI:10.4103/0255-0857.43556  PMID:18974511
  3 2,220 250
BRIEF COMMUNICATIONS
Molecular characterization of nosocomial CTX-M type β-lactamase producing Enterobacteriaceae from a tertiary care hospital in south India
SA Jemima, S Verghese
October-December 2008, 26(4):365-368
DOI:10.4103/0255-0857.43581  PMID:18974492
CTX-M group of extended spectrum β lactamases (ESBLs) represents a rapidly emerging problem in many countries. The prevalence of nosocomial bla CTX-M-1 producing Enterobacteriaceae strains has not been reported earlier in Indian hospitals. This study describes molecular subtyping of nosocomial bla CTX-M producing strains of Enterobacteriaceae . Polymerase chain reaction with primers specific for bla CTX-M-1 coding genes was used to identify 95 Enterobacteriaceae strains producing bla CTX-M positive isolates. Of the 95 bla CTX-M producing isolates, 45 strains were positive for bla CTX-M-1 . bla CTX-M-1 was found to be most prevalent in Klebsiella strains.
  2 3,054 464
High rate of mutation K103N causing resistance to nevirapine in Indian children with acquired immunodeficiency syndrome
S Sehgal, N Pasricha, S Singh
October-December 2008, 26(4):372-374
DOI:10.4103/0255-0857.43583  PMID:18974494
In north India the number of paediatric cases with acquired immunodeficiency syndrome (AIDS) is on the rise. Most drug combinations used for treatment of AIDS incorporate nevirapine, resistance to which develops very fast if given singly or because of unplanned interruptions. This paper investigates presence of mutations at codon 103 and codon 215 of the HIV pol gene causing resistance to nevirapine and zidovudine (AZT) respectively in 25 children with AIDS. Mutations T215Y and K103N were detected by a nested cum amplification refractory mutation system polymerase chain reaction (ARMS PCR) and the results were confirmed by direct sequencing in five randomly selected cases. Nineteen patients had received nevirapine containing regimen and six were drug naive. Mutation K103N was observed in 56% (14/25) of the children while mutation T215Y was found in none. Two of the six drug naοve children also showed K103N mutation. Thus, Indian children drug naοve or treated with nevirapine containing regimens show a high rate of mutation conferring resistance to nevirapine which calls for a judicious use of nevirapine both in antenatal and postnatal setting.
  2 2,476 244
CASE REPORTS
An unusual seroconversion profile in a pregnant woman infected with the human immunodeficiency virus-1: Need for using later generations HIV screening assays
R Kannangai, AJ Kandathil, HD Daniel, S Prasannakumar, J Lionnel, P Abraham
October-December 2008, 26(4):390-392
DOI:10.4103/0255-0857.43570  PMID:18974501
The first HIV-1 marker that appears in blood following infection is HIV-1 RNA and usually the load is in millions of copies/ ml preceding seroconversion. A 24-year-old pregnant woman, gravida 2, parity 1 was tested for HIV as part of antenatal screening. Three samples were collected and tested from this individual over a period 70 days. The HIV-1 RNA level during seroconversion phase was very low contrary to the well understood natural history of HIV infection. The reactivity rate in the ELISA and the Western Blot profile showed a gradual increase over the 70 days with a weak reactivity in a second generation assay (detects IgG only) for the third sample. This case illustrates the uncertainties regarding the serological window period in HIV infection and the need to use at least a third generation assay in testing centres for early detection of HIV infection.
  2 3,725 253
CORRESPONDENCE
Concurrent infection by two dengue virus serotypes among dengue patients
E Gupta, L Dar, S Broor
October-December 2008, 26(4):402-403
DOI:10.4103/0255-0857.43560  PMID:18974508
  2 2,814 462
CASE REPORTS
Cytological diagnosis of pulmonary nocardiosis in an immunocompromised patient
R Kumar, DK Chhina, V Kaushal, R Mahajan, H Kaur
October-December 2008, 26(4):380-382
DOI:10.4103/0255-0857.43576  PMID:18974497
We report a case of pulmonary nocardiosis in an immunosuppressed patient having vasculitis who presented with fever, cough and chest pain. A suspicion of nocardiosis was made on auramine O staining of material procured by CT guided fine needle aspiration cytology right lung. Modified Ziehl-Neelsen staining was useful in confirming the diagnosis. The patient showed remarkable recovery after treatment with co-trimoxazole. Quick identification of this uncommon pathogen in the cytological material using special stains helped in timely diagnosis and successful treatment of the patient.
  1 4,806 274
CORRESPONDENCE
Rubella in Delhi: In-utero infection and congenital rubella syndrome
I Gandhoke, R Aggarwal, S Lal, S Khare
October-December 2008, 26(4):403-405
DOI:10.4103/0255-0857.43559  PMID:18974509
  1 3,003 348
Comparison of weber green and ryan blue modified trichrome staining for the diagnosis of microsporidial spores from stool samples of HIV-positive patients with diarrhoea
K Patil, A De, M Mathur
October-December 2008, 26(4):407-407
DOI:10.4103/0255-0857.43554  PMID:18974512
  1 2,836 248
Presence of anti- Toxocara antibodies in children population of district Anantnag and Pulwama of Kashmir valley
ZA Dar, S Tanveer, GN Yattoo, BA Sofi, PA Dar, SA Wani
October-December 2008, 26(4):400-402
DOI:10.4103/0255-0857.43562  PMID:18974507
  1 2,036 154
Imipenem resistant metallo β lactamse producing Pseudomonas aeruginosa
B Chacko, A Varaiya, B Dedhia
October-December 2008, 26(4):398-398
DOI:10.4103/0255-0857.43565  PMID:18974504
  1 2,472 455
SPECIAL ARTICLE
Comparative analysis of codon usage patterns and identification of predicted highly expressed genes in five Salmonella genomes
UK Mondal, S Sur, AK Bothra, A Sen
October-December 2008, 26(4):313-321
DOI:10.4103/0255-0857.43558  PMID:18974482
Purpose: To anlyse codon usage patterns of five complete genomes of Salmonella , predict highly expressed genes, examine horizontally transferred pathogenicity-related genes to detect their presence in the strains, and scrutinize the nature of highly expressed genes to infer upon their lifestyle. Methods: Protein coding genes, ribosomal protein genes, and pathogenicity-related genes were analysed with Codon W and CAI (codon adaptation index) Calculator. Results: Translational efficiency plays a role in codon usage variation in Salmonella genes. Low bias was noticed in most of the genes. GC3 (guanine cytosine at third position) composition does not influence codon usage variation in the genes of these Salmonella strains. Among the cluster of orthologous groups (COGs), translation, ribosomal structure biogenesis [J], and energy production and conversion [C] contained the highest number of potentially highly expressed (PHX) genes. Correspondence analysis reveals the conserved nature of the genes. Highly expressed genes were detected. Conclusions: Selection for translational efficiency is the major source of variation of codon usage in the genes of Salmonella . Evolution of pathogenicity-related genes as a unit suggests their ability to infect and exist as a pathogen. Presence of a lot of PHX genes in the information and storage-processing category of COGs indicated their lifestyle and revealed that they were not subjected to genome reduction.
  1 4,958 440
BOOK REVIEW
Arthropod borne viral infections: Current status and research
R Kanungo
October-December 2008, 26(4):408-408
  - 3,358 408
CORRESPONDENCE
Prolonged fever in HIV disease due to Salmonella enetritidis
KE Vandana, I Bairy, PS Rao, B Kabir
October-December 2008, 26(4):399-400
DOI:10.4103/0255-0857.43563  PMID:18974506
  - 2,409 167
Phenotypic expression of methicillin resistance in nosocomial Staphylococcus aureus
GK Bhat, LS Jathana, A Kumar
October-December 2008, 26(4):398-399
DOI:10.4103/0255-0857.43564  PMID:18974505
  - 2,269 423
EDITORIAL
Eight years and 2500 manuscripts later…
S Sharma
October-December 2008, 26(4):295-296
DOI:10.4103/0255-0857.43550  PMID:18974479
  - 2,478 363
ORIGINAL ARTICLES
Progression of chronic pulmonary tuberculosis in mice intravenously infected with ethambutol resistant Mycobacterium tuberculosis
S Srivastava, A Ayyagari, TN Dhole, N Krishnani, KK Nyati, SK Dwivedi
October-December 2008, 26(4):342-348
DOI:10.4103/0255-0857.42124  PMID:18974487
Purpose: Ethambutol (EMB) is an important first line drug, however little information on its molecular mechanism of resistance and pathogenicity of resistant isolates is available. Present work was designed to study virulence of the EMB resistant M. tuberculosis strains and the host responses in-vivo on infection of EMB resistant M. tuberculosis using Balb/c mouse model of infection. Methods: Three groups of Balb/c mice (female, age 4-6 wk; 21 mice in each group) were infected intravenously with 106 CFU of M. tuberculosis H37Rv and two EMB resistant clinical isolates. Age and sex matched control animals were mock inoculated with Middlebrook 7H9 broth alone. At 10, 20, 30, 40, 50, 60, and 70 days post-infection three animals from each group were sacrificed by cervical dislocation and lung tissue was collected for further analysis. Results: Infection with EMB resistant M. tuberculosis led to progressive and chronic disease with significantly high bacillary load (p=0.02). Massive infiltration and exacerbated lung pathology with increased expression of IFN-γ and TNF-α was observed in lungs of mice infected with EMB resistant strains. The present study suggests that infection with EMB resistant M. tuberculosis leads to chronic infection with subsequent loss of lung function, bacterial persistence with elevated expression of TNF-α resulting in increased lung pathology. Conclusion: These findings highlight that EMB resistant M. tuberculosis regulates host immune response differentially and its pathogenicity is different from drug sensitive strains of M. tuberculosis.
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SNIPPETS
Research snippets from the world of medicine
P Desikan
October-December 2008, 26(4):409-410
DOI:10.4103/0255-0857.43552  
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