The presence of dsRNA virus in Trichomonas vaginalis isolates from symptomatic and asymptomatic Indian women and its correlation with in vitro metronidazole sensitivity.

Purpose: Trichomonas vaginalis, a protozoan parasite, is the causative agent of human trichomoniasis, the most common non-viral sexually transmitted disease. The infection encompasses from a complete asymptomatic presentation to severe sequelae; yet, the virulence markers have been poorly understood. It is suggested that the presence of Trichomonas vaginalis virus (TVV) in T. vaginalis may have an impact on its virulence, and its relatedness to in vitro metronidazole resistance has been reported. The aim of the study was to assess the presence of TVV in fresh and Long -Term Cultivated ( LTC) maintained T. vaginalis isolates from symptomatic (S) and asymptomatic (AS) Indian women and its relatedness, if any, with symptomatology and in vitro drug sensitivity. Materials and Methods: One thousand women (537 S and 463 AS) were screened for the presence of T. vaginalis by wet smear and culture examination of vaginal swab and urine sample. Fresh and LTC (6 months-2 years) maintained 15 isolates each from 15 S and 15 AS women were subjected to agarose gel electrophoresis following total cellular RNA extraction to evaluate the presence of double stranded (ds) RNA viral infection. The susceptibility of isolates to metronidazole was determined in vitro. Results: On agarose gel electrophoresis, three bands (5.5, 2.5 and 1.5 kb) were observed in all the 30 fresh isolates from 15 S and 15 AS women and only in 7 LTC isolates from 3 S and 4 AS women. All the fresh isolates harbouring TVV were found to be sensitive to metronidazole in vitro irrespective of the symptomatology of subjects, and out of seven LTC isolates harbouring TVV, six were sensitive to metronidazole and one showed borderline resistance. Conclusions: The results suggest that the presence of TVV alone may not be a virulence marker and loss of TVV on LTC appears to be related to drug resistance. The T. vaginalis Indian isolates are sensitive to metronidazole.

CD46 polymorphism: A probable risk factor for recurrent spontaneous abortion in a northern Indian population.

Background. CD46 is a complement regulatory glycoprotein. Certain polymorphic forms of the CD46 gene have been associated with recurrent pregnancy loss in the Caucasian population. We assessed the role of CD46 polymorphism in recurrent spontaneous abortion in our setting, as this has not been done on Indian subjects till date. Methods. Polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP) was carried out on 44 samples each from women with recurrent spontaneous abortion and normal pregnancy. Genotyping of the CD46 gene was done using 2.5% agarose gel. Statistical analysis was done using the TFPGA software. Results. The absence of CD46H*1 homozygosity was more pronounced in women with recurrent spontaneous abortion in the Indian population. Of recurrent aborters, 9% had the H*1/*1 genotype as compared to 30% of normal pregnant women. Conclusion. Although our data did not fit the Hardy– Weinberg equilibrium, this pilot study indicates that further increasing the sample size might clarify whether polymorphism in the first intron of the CD46 gene can be regarded as a risk factor for recurrent spontaneous abortion.

Influence of metal ions on structure and catalytic activity of papain.

Papain is an endoprotease belonging to cysteine protease family. The catalytic activity of papain in presence of two different metal ions namely zinc and cadmium has been investigated. Both the metal ions are potent inhibitors of the enzyme activity in a concentration dependent manner. The enzyme loses 50% of its activity at 2 x 10(-4) M of CdCl2 and 4 x 10(-4) M of ZnCl2. It is completely inactivated above 1 x 10(-3) M concentration of either ZnCl2 or CdCl2. Of the two metal ions zinc with a ki value of 5 x 10(-5) M is a more potent inhibitor than cadmium which has a ki value of 8 x 10(-5) M. Both the metal ions have higher affinity for active site than the substrate. At concentrations above 1 x 10(-2) M of metal ions the inhibition is not reversible. Calorimetric studies showed decreased thermal stability of papain upon binding of these metal ions. Far UV circular dichroic spectral data showed only small changes in the beta-structure content upon binding of these metal ions. These data are also supported by decrease in the apparent thermal transition temperature of papain by 5 degrees C upon binding of metal ions indicating destabilization of the papain molecule. The mechanism of both partial and complete inactivation of papain in presence of these two metal ions both at lower and higher concentration has been explained.

Clinical profile of klebsiella septicemia in neonates.

A detailed clinical study of 51 consecutive cases of neonatal klebsiella septicemia was carried out prospectively over a 20 months period. The incidence was 6.27 per 1000 live births. Majority (85.5%) were either preterms or small for date. Almost fifty percent babies had associated perinatal risk factors. Mean age of onset was 5.7 +/- 2.2 days. General symptoms were the earliest to occur at mean age of 5.7 days followed by respiratory, alimentary, hematological and neurological symptoms at 6.2, 6.3, 6.6 and 7.9 days respectively. About half of the neonates had associated complications; commoner being meningitis (20%), bleeding manifestations and sclerema (17.6% each) and pneumonia (15.7%). Cefatoxime was found to be the drug of choice (86% sensitivity). Nine babies (17.6%) died during the study period at a mean age of 9.1 +/- 3.2 days. Mean duration of hospital stay in rest of neonates was 27.9 +/- 12.1 days. Neurological symptoms were commoner in late onset disease. Bleeding manifestations, sclerema and granulocytopenia were seen exclusively in preterms. Presence of respiratory symptoms, bleeding, sclerema, shock and granulocytopenia were identified as poor prognostic factors in neonatal klebsiella septicemia.

Aortic valve replacement with concomitant open mitral valvotomy--early results and long term followup in 72 consecutive patients.

Experience with 72 consecutive subjects, who underwent aortic valve replacement with open mitral valvotomy is presented. Mean age was 30 years and history of rheumatic fever was forthcoming in 80%. 91.7% patients had aortic regurgitation--with or without aortic stenosis. 45% patients had pulmonary hypertension. Starr Edwards (51.4% and Bjork Shiley valves (45.8%) were commonly used. There were no early deaths. All patients were followed up for 1 to 19 years (mean = 9 years). There were 4 (5.5%) late deaths. 4.1% patients developed mild restenosis of the mitral valve over a mean period of 8 years and 1.04% developed mitral regurgitation mandating mitral valve replacement. A notable feature of this series is the low incidence of thromboembolism-free lives at upto 10 years followup despite receiving only aspirin in place of coumarin anticoagulation. We believe aortic valve replacement and open mitral valvotomy is a worthy alternative to double valve replacement in view of its zero hospital mortality, low late mortality, low incidence of restenosis, low thromboembolic episodes and the avoidance of coumarin anticoagulation.

Effect of eltroxine and neomercazol on monoamine oxidase from rat tissues.

The paper describes the effect of two drugs, (Eltroxine and Neomercazol) on the nature and activity of monoamine oxidase (MAO) in albino rats. Four organs namely liver, kidney, brain and heart were examined from this point of view. Biological activity measurements were done using tyramine hydrochloride as the substrate. The liver MAO from normal as well as the drug treated rats were subjected to DEAE gel filtration studies. These investigations show that there is a significant difference in the biological activity as well as in the actual nature of the enzyme as a result of treatment with the drugs mentioned above.