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   2007| January-March  | Volume 25 | Issue 1  
 
 
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ORIGINAL ARTICLE
Use of bactec 460 TB system in the diagnosis of tuberculosis
CS Rodrigues, SV Shenai, DVG Almeida, MA Sadani, N Goyal, C Vadher, AP Mehta
January-March 2007, 25(1):32-36
DOI:10.4103/0255-0857.31059  PMID:17377350
Purpose : To evaluate, the efficacy of BACTEC 460 TB system for the diagnosis of tuberculosis in a tertiary care hospital in Mumbai, India. Methods : We compared 12,726 clinical specimens using BACTEC 460 TB system and conventional method for detection of Mycobacterium tuberculosis over a period of six years. Result: The overall recovery rate was 39% by BACTEC technique and 29% using Lowenstein-Jensen (LJ) medium. An average detection time for B actec0 460 TB system was found to be 13.3 days and 15.3 days as against 31.2 days and 35.3 days by LJ method for respiratory and nonrespiratory specimens respectively. The average reporting time for drug susceptibility results ranged from 6-10 days for the BACTEC 460 TB system. Conclusions: The BACTEC system is a good system for level II laboratories, especially in the diagnosis of extrapulmonary and smear negative tuberculosis.
  24,346 1,095 15
CORRESPONDENCE
How safe is sugarcane juice?
K Subbannayya, GK Bhat, S Shetty, VG Junu
January-March 2007, 25(1):73-74
DOI:10.4103/0255-0857.31073  PMID:17377362
  18,998 701 1
REVIEW ARTICLES
An overview of human papillomaviruses and current vaccine strategies
M Gnanamony, A Peedicayil, P Abraham
January-March 2007, 25(1):10-17
DOI:10.4103/0255-0857.31055  PMID:17377346
Cervical cancer is one of the most common cancers in women worldwide, particularly in developing countries. The viral origin of cervical cancer has been proven beyond any reasonable doubt. Persistent infection with certain subsets of human papillomaviruses is recognized as a necessary cause for the development of cervical cancer. Persistence of oncogenic HPVs, immunodeficiency, high HPV viral load and cofactors like smoking, multiple sex partners and poor nutrition predispose to cervical cancer. Prophylactic vaccines using HPV virus-like particles containing capsid protein L1 have shown protection against disease in animals and are currently undergoing clinical trials. Therapeutic vaccines using HPV E6 and E7 proteins are also being investigated for their ability to remove residual infection.
  15,327 2,230 8
CASE REPORTS
Non-healing gastric ulcer associated with Candida infection
K Ramaswamy, M Correa, A Koshy
January-March 2007, 25(1):57-58
DOI:10.4103/0255-0857.31064  PMID:17377355
Candida bezoars of the stomach usually occur after gastric surgery. We report a small Candida mass occurring on a non-healing gastric ulcer in a 40-year-old male non-smoker. The ulcer healed with fluconazole and withdrawal of the proton pump inhibitor.
  15,577 709 4
BRIEF COMMUNICATIONS
Study of onychomycosis: Prevailing fungi and pattern of infection
P Veer, NS Patwardhan, AS Damle
January-March 2007, 25(1):53-56
DOI:10.4103/0255-0857.31063  PMID:17377354
A mycological study of onychomycosis was undertaken in 88 patients. The nails were judged to be infected by their clinical appearance. Direct microscopy of the nail clips in 20% KOH solution was positive in 72 (81.8%) and culture was positive in 43 (48.8%) cases. Out of the samples cultured, dermatophytes were grown in 26 cases (29.5%), non dermatophyte moulds in 12 (13.6%) and Candida spp. in 5 (5.6%) while 45 (51.1%) samples yielded no growth. Amongst dermatophytes, T. rubrum was found to be commonest etiological agent (57.6%) followed by T. mentagrophyte . Amongst the non-dermatophyte mould (NDM), Aspergillus spp. was the most prevalent species followed by Alternaria spp, Curvularia spp. and Fusarium spp. Commonest age group affected was above 31 years. Males were predominantly affected (65%), male to female ratio being 1.8:1. Fingernails were affected more frequently than toe nails with the ratio of 3:1. Distal and lateral subungual onychomycosis (DLSO) was more common (50%) than other clinical pattern followed by proximal subungual onychomycosis (PSO) (20.4%), white superficial onychomycosis (SWO) (2%), total dystrophic onychomysosis (TDO) (14%) and paronychia (10.2%).
  14,070 1,394 37
ORIGINAL ARTICLE
Diagnostic potential of IS6110, 38kDa, 65kDa and 85B sequence-based polymerase chain reaction in the diagnosis of Mycobacterium tuberculosis in clinical samples
SS Negi, R Anand, ST Pasha, S Gupta, SF Basir, S Khare, S Lal
January-March 2007, 25(1):43-49
DOI:10.4103/0255-0857.31061  PMID:17377352
Purpose: The correlation between the presence of specific gene sequence of M. tuberculosis and specific diagnosis of clinical tuberculosis is not known. This study compared the results of polymerase chain reaction (PCR) amplification of M . tuberculosis specific DNA sequences (IS6110, 65kDa, 38kDa and mRNA coding for 85 B protein) from different clinical samples of pulmonary and extrapulmonary tuberculosis. Methods: One hundred and seventy-two clinical samples from suspected tuberculosis patients were tested for smear examination, culture (LJ and rapid BACTEC 460 TB system) and PCR. PCR was performed with specific primers for the targets: IS6110, 65kDa, 38kDa and 85B. Results: Each PCR test was found to have a much higher positivity than conventional test and BACTEC culture ( P <0.05). Smear positive samples (56) and the samples (36) showing positive results by conventional methods (smear and LJ medium culture) and BACTEC were found to be positive by all PCR protocols. No significant difference was found between the four PCR protocols ( P >0.05). The primer specific for amplifying the 123bp IS6110 fragment gave the highest positivity (83%), followed by 65kDa, 38kDa and 85B RT-PCR in descending order. Conclusions: These data suggest that the presence of IS6110 correlates more closely with the diagnosis of clinical tuberculosis than that of 65kDa, 38kDa and 85B proteins.
  10,365 1,438 28
Brucellosis in high risk group individuals
AS Agasthya, S Isloor, K Prabhudas
January-March 2007, 25(1):28-31
DOI:10.4103/0255-0857.31058  PMID:17377349
Purpose: The purpose of this study was to investigate the seroprevalence of brucellosis among high-risk group individuals, consisting of veterinarians and para-veterinarians, shepherds, butchers and animal owners. Methods: The present work was carried out at Project Directorate on Animal Disease Monitoring and Surveillance, Bangalore, by using the recently developed indirect enzyme-linked immunosorbent assay (ELISA) for antibodies to Brucella abortus. Results: The results were compared with the conventional serological tests, Rose Bengal plate test and standard tube agglutination test. The result showed that the indirect ELISA was more sensitive than the conventional tests. Of 618 tested, the disease of prevalence was at 41.23% in veterinary inspectors, 30.92% in veterinary assistants, 12.37% in veterinary officers, 6.18% in veterinary supervisors, 6.18% in Group D workers, 2.06% in shepherds and 1.03% in butchers. Conclusions: This study results highlight the immediate necessity to institute control measures to control Brucellosis.
  9,801 1,181 34
CASE REPORTS
Lepromatous leprosy of histoid type
SR Annigeri, SC Metgud, JR Patil
January-March 2007, 25(1):70-71
DOI:10.4103/0255-0857.31069  PMID:17377360
Histoid leprosy is a variant of lepromatous leprosy, which develops as a result of resistance to dapsone monotherapy. Here we report two cases of lepromatous leprosy of histoid type, one with typical and another with atypical presentations.
  9,660 892 4
SPECIAL ARTICLE
Dedicated decontamination: A necessity to prevent cross contamination in high throughput mycobacteriology laboratories
C Rodrigues, D Almeida, S Shenai, N Goyal, A Mehta
January-March 2007, 25(1):4-6
DOI:10.4103/0255-0857.31053  PMID:17377344
Unrecognized cross-contamination has been known to occur in laboratories frequently, especially with sensitive recovery system like BACTEC 460 TB. In March 2001, we investigated a pseudo-outbreak of Mycobacterium tuberculosis isolates in three smear negative clinical specimens and would like to present our experience in this communication. Methods : All suspected cases were confirmed by checking the drug susceptibility and DNA fingerprints using spoligotyping as well as restriction fragment length polymorphism. Results: On investigation, the most likely cause was found to be the use of common decontamination reagents and phosphate buffer. Conclusions: To avoid erroneous diagnosis, we have devised a dedicated decontamination procedure, which includes separate aliquoting of phosphate buffer and decontamination reagents per patient. Timely molecular analysis and appropriate changes to specimen processing have been identified as useful measures for limiting laboratory cross contamination.
  8,281 813 5
ORIGINAL ARTICLE
Significance of the hepatitis C virus (HCV) core antigen as an alternative plasma marker of active HCV infection
HDJ Daniel, P Vivekanandan, S Raghuraman, G Sridharan, GM Chandy, P Abraham
January-March 2007, 25(1):37-42
DOI:10.4103/0255-0857.31060  PMID:17377351
Purpose: To evaluate the role of core antigen (Ortho trak-C assay) as a marker of active HCV infection in comparison to HCV RNA as detected by reverse transcription polymerase chain reaction (RT-PCR). Methods: This evaluation was carried out during January 2000 to December 2003 in HCV infected individuals who were treatment naοve or were on anti-viral therapy. Additionally, sequential plasma samples from patients on clinical follow-up were included in this study. A total of 167 samples from 61 patients were tested by trak-C and RT-PCR. HCV RNA detection was achieved by a RT-PCR. Trak-C assay results were also compared in a limited proportion of these samples with known HCV viral load and genotype. Results: Of 167 samples tested, 56.9% were RNA positive and 43.1% were RNA negative while 50.3% were trak-C positive and 49.7% were trak-C negative, yielding a sensitivity of 85.3% and a specificity of 95.8% for the trak-C assay (Kappa co-efficient = 0.8). The concentration of HCVcAg and HCV RNA showed significant correlation (n=38, r=0.334, P =0.04). The trak-C assay detected the most prevalent HCV genotypes in India without significant difference ( P =0.335). The difference between mean absorbance values of HCV RNA positive samples compared to HCV RNA negative samples in the trak-C assay was highly significant ( P <0.000). Qualitative results of trak-C assay and RT-PCR were comparable in 93% of follow-up samples. Conclusions: Trak-C assay can be recommended for confirmation of HCV infection and follow-up in laboratories with resource-poor facilities.
  7,925 910 4
REVIEW ARTICLES
An insight into the Leishmania RNA virus
V Gupta, A Deep
January-March 2007, 25(1):7-9
DOI:10.4103/0255-0857.31054  PMID:17377345
Leishmania RNA virus is an ancient virus that has coevolved with its protozoan host. The purpose of this article is to convey current understanding of Leishmania RNA virus as it has emerged over the past decade. The potential of the virus to play a role in modulating parasite virulence is also discussed.
  7,911 858 1
CASE REPORTS
Invasive trichosporonosis due to Trichosporon asahii in a non-immunocompromised host: A rare case report
VL Rastogi, PS Nirwan
January-March 2007, 25(1):59-61
DOI:10.4103/0255-0857.31065  PMID:17377356
A case of invasive Trichosporonosis due to Trichosporon asahii in an otherwise healthy young adult male presenting as meningoencephalitis and pneumonia is reported here. T. asahii was isolated from cerebrospinal fluid and sputum of the patient and morphologic forms of organism was also demonstrated on direct Gram stain of sputum. The isolate was identified as T. asahii. The patient partially responded to fluconazole therapy. Our case suggests that T. asahii can no longer be linked with Trichospronosis in immunocompromised patient alone and any case of meningitis needs thorough mycological workup for its correct etiological identification and appropriate management.
  7,699 773 26
ORIGINAL ARTICLE
Serological evaluation of leptospirosis in Hyderabad, Andhra Pradesh: A retrospective hospital-based study
S Velineni, S Asuthkar, P Umabala, V Lakshmi, M Sritharan
January-March 2007, 25(1):24-27
DOI:10.4103/0255-0857.31057  PMID:17377348
Purpose : Leptospirosis is a zoonotic disease with humans getting the infection either from rodent hosts or from domestic animals. Urine contaminated environment is the common source of infection. This is an under-reported disease in Andhra Pradesh. We report a retrospective hospital-based study on 55 patients with suspected leptospirosis. Methods : A total of 55 serum samples were collected from patients with suspected leptospirosis and subjected to serological testing by LeptoTek Dri-dot, microscopic agglutination test (MAT) and IgM enzyme-linked immunosorbent assay (ELISA). Identification of the predominant infecting serotype was done using a panel of 12 serovars. Results: MAT analysis of all the 55 samples identified all cases to be positive. The predominant serogroup was Icterohaemorrhagiae (68%) followed by Australis (22%), Autumnalis (8%) and Javanica (2%). LeptoTek Dri-dot showed a sensitivity of 96% as compared to MAT. IgM ELISA done on 32 samples showed a sensitivity of 86.7% compared to MAT. Conclusions : MAT helped to identify Icterohemorrhagiae as the predominant serovar in this study. Despite the small number of samples analyzed, the data obtained establishes a need for a prospective study in this region.
  6,936 887 5
Differential T helper cell response in tuberculous pleuritis
C Prabha, KV Jalapathy, RP Matsa, SD Das
January-March 2007, 25(1):18-23
DOI:10.4103/0255-0857.31056  PMID:17377347
Purpose: This study was conducted to understand the in vivo and in vitro immune responses and to find whether there exists any difference in the systemic and localized immune responses in tuberculous pleuritis. Methods: The in vivo levels of IFN-γ and IL-4 were compared in plasma (BL) and pleural fluid (PF) of 47 tuberculous (TB) and 31 nontuberculous pleuritis (Non-TB) patients. In vitro cytokine response to various mycobacterial antigens was studied in 19 TB patients by ELISA . Both ex vivo and in vitro cytokine responses were further ascertained by intracellular cytokine staining on purified CD4+ T cells from pleural fluid mononuclear cells (PFMC) of 10 TB patients. Results: The ex vivo results showed a significant increase in IFN-γ levels and higher IFN-γ + T cells in PF. On the other hand, in vitro results showed simultaneous increase in both IFN-γ and IL-4 levels in the supernatants of antigen stimulated PFMC. Similarly antigen specific increase was observed in both IFN-γ + and IL-4+ T cells in all cultured conditions. However, the percentile increase was more in IL-4 secreting T cells, significant for PPD stimulation ( P <0.05), indicating that in vitro cellular response was dominated by Th2 type. Conclusions: These results showed a differential T-helper response in TB pleuritis suggestive of predominant Th1 in vivo and mixed response (Th1 and Th2) under in vitro conditions.
  6,922 749 16
CASE REPORTS
Neuroaspergillosis in an immunocompetent patient
S Sood, R Sharma, S Gupta, D Pathak, S Rishi
January-March 2007, 25(1):67-69
DOI:10.4103/0255-0857.31068  PMID:17377359
Aspergillosis of the central nervous system (CNS) is an uncommon infection, mainly occurring in immunocompromised patients. We report a case of neuroaspergillosis caused by Aspergillus flavus in an immunocompetent patient presenting as a space-occupying lesion of the CNS. The patient was responding favorably to voriconazole at the time of this report.
  6,791 730 12
A case of poly-parasitism involving a trematode and four different nematodes in a migrant from Bihar
S Rai, V Wadhwa, P Kharbanda, B Uppal
January-March 2007, 25(1):62-63
DOI:10.4103/0255-0857.31066  PMID:17377357
Reported is a case of seven-year-old, migrant from Bihar state, infested with Fasciolopsis buski Strongyloides stercoralis Ascaris lumbricoides , Trichuris trichiura and Ankylostoma duodenale in feces. Patient responded to treatment with piperazine, thiabendazole and albendazole, the importance of considering multiple and non-endemicparasite infestations in migrant of poor socio-economic background is emphasized.
  6,861 656 1
Late prosthetic valve endocarditis due to Cardiobacterium hominis, an unusual complication
S Shivaprakasha, K Radhakrishnan, P Kamath, PMS Karim
January-March 2007, 25(1):64-66
DOI:10.4103/0255-0857.31067  PMID:17377358
We report a case of prosthetic valve endocarditis caused by Cardiobacterium hominis in a patient who had undergone atrial septal defect closure and mitral valve replacement of the heart in 1978. He presented with pyrexia of unknown origin and congestive cardiac failure. Investigations revealed infective endocarditis of prosthetic valve in mitral portion. Blood culture samples grew C. hominis . The patient was empirically started on vancomycin and gentamicin intravenously and ceftriaxone was added after isolation of the organism. Though subsequent blood cultures were negative, patient remained in congestive cardiac failure and died due to complications.
  6,493 619 5
BRIEF COMMUNICATIONS
In vitro activity of antimicrobial agents against oxacillin resistant staphylococci with special reference to Staphylococcus haemolyticus
A Chaudhury, AG Kumar
January-March 2007, 25(1):50-52
DOI:10.4103/0255-0857.31062  PMID:17377353
One hundred and sixty seven isolates of staphylococci isolated from the inpatients of a tertiary care referral hospital in South India were speciated and activity of oxacillin, glycopeptides, linezolid and quinupristin/dalfopristin against these isolates was tested by broth microdilution method. Of the 114 coagulase negative staphylococci (CoNS), 49.1 % were S. haemolyticus, isolated predominantly from urine (64.6%), while the rest belonged to 11 other species. More than half the isolates of S. aureus (52.8%) and 68.4% of the CoNS were oxacillin resistant. All the strains were uniformly susceptible to vancomycin, linezolid and quinupristin/dalfopristin; but 25.6% isolates of S. haemolyticus showed reduced susceptibility to teicoplanin (MIC: 8-16 mg/L). Our study demonstrates the high prevalence of oxacillin resistance among hospital isolates of S. aureus and CoNS in India. Vancomycin, along with the newer agents like linezolid and quinupristin/dalfopristin remains the drug of choice for treating multi drug resistant staphylococcal infections.
  5,837 1,007 5
CORRESPONDENCE
Screening for vancomycin intermediate - resistant Staphylococcus aureus among clinical isolates of MRSA
A Sonavane, A De, M Mathur
January-March 2007, 25(1):79-80
DOI:10.4103/0255-0857.31078  PMID:17377368
  5,422 965 2
Efficacy and acceptability of chlorine dioxide water disinfectant
A Jacob, S Ramani, I Banerjee, G Kang
January-March 2007, 25(1):74-75
DOI:10.4103/0255-0857.31074  PMID:17377364
  5,567 622 3
GUEST EDITORIAL
Genetic diversity of pathogenic microorganisms and its medical and public health significance
JS Virdi, P Gulati, M Pai
January-March 2007, 25(1):2-3
DOI:10.4103/0255-0857.31052  PMID:17377343
  5,342 796 -
CORRESPONDENCE
An outbreak of cholera in the Sangli District of Maharashtra
RD Kulkarni, SA Patil, VA Kulkarni, M Ramteerthakar, V Kumbhar, SR Shah, PA Joshi, VL Jahagirdhar
January-March 2007, 25(1):76-78
DOI:10.4103/0255-0857.31076  PMID:17377366
  5,246 631 3
A sudden rise in occurrence of Salmonella paratyphi a infection in Rourkela, Orissa
SS Bhattacharya, Usha Dash
January-March 2007, 25(1):78-79
DOI:10.4103/0255-0857.31077  PMID:17377367
  4,297 591 19
Intrafamilial transmission of hepatitis C virus
MK Celen, C Ayaz, B Dikici, S Hosoglu, MF Geyik
January-March 2007, 25(1):73-73
DOI:10.4103/0255-0857.31072  PMID:17377363
  4,262 540 1
EDITORIAL
Getting what you need from medical research
S Sharma
January-March 2007, 25(1):1-1
DOI:10.4103/0255-0857.31051  PMID:17377342
  4,056 666 -
CORRESPONDENCE
Human thelaziasis in India
AM Khan
January-March 2007, 25(1):72-72
DOI:10.4103/0255-0857.31070  PMID:17377361
  3,864 534 -
Changing serotypes and phage types of Vibrio cholerae in Ludhiana (Punjab) during 2001-2005
A Oberoi, A Aggarwal
January-March 2007, 25(1):75-76
DOI:10.4103/0255-0857.31075  PMID:17377365
  3,681 570 4
Authors' reply
A Sharma
January-March 2007, 25(1):72-72
DOI:10.4103/0255-0857.31071  
  2,680 458 -

2004 - Indian Journal of Medical Microbiology
Published by Wolters Kluwer - Medknow

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