Resistance to amoxicillin‑clavulanate and its relation to virulence‑related factors in Yersinia enterocolitica biovar 1A.

Recent studies have reported that the virulence factors (VFs) were detected more frequently in amoxicillin‑clavulanate (AMC) susceptible clinical isolates of Escherichia coli. Here, we have evaluated the relationship between VFs and AMC‑resistance phenotype in clinical isolates of Y. enterocolitica biovar 1A. The presence/absence of VFs was compared with their minimum inhibitory concentrations for AMC in strains of two serovars. We observed that the strains of the serovar O: 6, 30‑6, 31 showed a similar relationship between the number of VFs and resistance to clavulanic acid as in E. coli but not of serovar O: 6, 30. Variations in the promoters/complete coding sequences (CCDSs) of β‑lactamase gene (blaA) or the serological characteristics could not account for unusual susceptibility to AMC displayed by the strains of the serovar O: 6, 30. Therefore, we speculate that since the clinical strains of serovar O: 6, 30‑6, 31 originated from the environment they were less exposed to antibiotics compared to clinical strains of serovar O: 6, 30. Thus, AMC susceptibility seems to be influenced by factors other than serotypes or promoters/CCDS of β‑lactamase genes.

Serum zinc levels in celiac disease.

This study was done to determine the zinc levels in 30 children with celiac disease. Serum zinc level was estimated at inclusion and zinc supplementation was given for 3 months. Zinc levels were repeated at 3 and 6 months after inclusion. The serum zinc levels of newly diagnosed CD cases (0.64+/-0.34 microg/mL) versus controls (0.94+/-0.14 microg/mL) were significantly lower (95% CI -0.44 to -1.4), whereas in the old cases this difference was non-significant. The serum zinc level among severely malnourished and stunted celiac cases was also significantly lower irrespective of their treatment status. We conclude that serum zinc levels are low in newly diagnosed and severely malnourished children with celiac disease.

Waldenstrom's macroglobulinemia.

Waldenstrom's macroglobulinemia is an uncommon lymphoplasmacytic lymphoma presenting with hyperviscocity and autoimmune phenomenon. Disease is characterized by bone marrow infiltration by lymphoplasmacytic cells and raised IgM. Bone marrow morphology and immunohistochemistry is important for diagnosis. Course is indolent and anemia and age are most important prognostic factors. Treatment options include alkylating agents, anti-purine anti-metabolites, which though not curative but offer valuable responses. Newer agents like Rituximab and autologous transplant are being tried.

Chronic myeloid leukemia.

Chronic myeloid leukemia is one of the commonest hematological malignancies seen in clinical practice. It is the result of abnormal and excess cell proliferation due to de-regulated bcr-abl tyrosine kinase activity as a result of Philadelphia chromosome. The present article discusses the various options available to treat the disorder. Allogeneic stem cell transplant remains the gold standard and the only curative option. Hydroxyurea and Busulfan helps in controlling the total leukocyte count but fail to impact on survival. Interferon especially when combined with cytarabine is curative in minority of patients though a substantial number of patients achieve functional cure. Imatinib, a molecular targeted oral therapy, against bcr-abl tyrosine kinase is the latest addition to various treatment options. Early results appear very promising and can be considered as non- transplant standard of care.

Lipid profile in rheumatoid arthritis and its relation to disease activity.

AIM OF THE STUDY: To ascertain whether--1. Serum lipids are altered in rheumatoid arthritis (RA) patients and 2. Disease activity has any role in altering lipid profile. METHODOLOGY: Lipid profiles of 25 RA cases were compared with age and sex matched controls. RESULTS: Serum triglycerides (STG) and total cholesterol (TC) were found to be significantly lower in RA patients. In patients with very active disease, activity index (AI) > 80, STG, TC and low-density lipoprotein (LDL-C) were significantly lower as compared to controls. For TG 'r' value of -0.483 indicated negative correlation between disease activity and TG values, though the correlation is not significant (p > 0.05). For TC 'r' value (-0.0551) indicates negative correlation between disease activity and serum TC.

Mitochondrial diseases: an overview of genetics, pathogenesis, clinical features and an approach to diagnosis and treatment.

Defects in structures or functions of mitochondria, mainly involving the oxidative phosphorylation, mitochondrial biogenesis and other metabolic pathways have been shown to be associated with a wide spectrum of clinical phenotypes. The ubiquitous nature of mitochondria and their unique genetic features contribute to the clinical, biochemical and genetic heterogenecity of mitochondrial diseases. This article focuses on the recent advances in the field of mitochondrial disorders with respect to the consequences for an advanced clinical and genetic diagnostics. In addition, an overview on recently identified genetic defects and their pathogenic molecular mechanisms are given.