Prevalence of Candida Species in ‘Thairu’ a Traditional Fermented Milk of Kerala, India

Aims: To determine the prevalence of Candida species in ‘thairu’, a traditional fermented milk prepared in the households of Kerala. Study Design: ‘Thairu’ samples collected randomly from the households in Wayanad, Kozhikode, Malappuram, Palakkad and Kannur districts of Kerala. This was followed by enumeration and identification of yeast using API 20CAUX Kit. Determination of pH and acidity of samples. Place and Duration of Study: Department of Dairy Microbiology, College of Dairy Science and Technology, Pookode, Wayanad, Kerala. September 2021- December 2021. Methodology: A total of 30 household ‘thairu’ samples were collected from households of Wayanad, Kozhikode, Malappuram, Palakkad and Kannur districts of Kerala in sterile bottles. The samples were serially diluted in normal saline and pour plated on to Yeast Extract Glucose Chloramphenicol Agar for isolation and enumeration. The pH was measured using pH meter by directly inserting the probe into the homogenized sample. Titratable acidity in per cent lactic acid was measured using N/10 NaOH. The isolates were identified based on the sugar fermentation pattern using API 20C AUX kit (Biomerieux, France). Results: The yeast count in the samples ranged from 5.0 to 6.7 log CFU/g with an average of 5.89±0.38 log CFU/g. Average acidity and pH of the samples were 1.92±0.34 % LA and 3.59±0.60 respectively. A total of 23 yeast isolates were identified based on morphology and carbohydrate fermentation pattern using API 20C AUX kit (Biomerieux, France). Exactly 86.95 per cent of isolates belong to Candida species. Conclusion: Observations of the study revealed the high prevalence of Candida species in traditional fermented milk ‘thairu’. Predominant Candida species were lactose fermenters, but the presence of a few species with spoilage and pathogenicity potential were also detected. The safety assessment of Candida species is essential before applying them as starter cultures for food fermentations.

Manifestaciones orales y disfunción olfativa y gustativa en el síndrome respiratorio agudo severo por corona virus 2 (VIRUS SARS-COV-2): una revisión sistemáticaA / Oral Manifestations and Olfactory and Gustatory Dysfunction in Severe Acute Respiratory Syndrome Corona Virus 2 (SARSCov-2 Virus) Disease: A Systematic Review

La enfermedad del corona virus 2 del síndrome respiratorio agudo severo (virus SARS-CoV-2) apareció por primera vez en diciembre de 2019 en Wuhan, China, y desde entonces se ha extendido rápidamente por todo el mundo. Desde entonces, el brote de esta grave enfermedad viral se ha convertido en una amenaza global para la humanidad. El diagnóstico precoz y el aislamiento son las medidas más importantes necesarias para prevenir su propagación. La evidencia anecdótica reciente ha sugerido manifestaciones orales con o sin deterioro olfativo y gustativo en asociación con la enfermedad por coronavirus (COVID-19). La enzima convertidora de angiotensina-2 (ECA-2) se expresa en la mucosa oral en grandes cantidades y, por tanto, puede contribuir a las primeras manifestaciones de esta enfermedad viral mortal. Las manifestaciones bucales de la enfermedad por coronavirus pueden presentarse en forma de lesiones ulcerativas irregulares en relación con diferentes partes de la cavidad oral y, en particular, en relación con la mucosa adherida en la región del paladar duro, así como inflamación y posterior atrofia de las diversas papilas de la lengua. La disfunción olfativa y gustativa asociada también puede conducir a una pérdida parcial y / o incluso completa de la capacidad para oler y saborear en las primeras etapas del inicio de la enfermedad. La evidencia también ha sugerido la presencia de ácido nucleico del SARS-CoV-2 en la saliva humana, lo que la convierte en portadora de la enfermedad viral infecciosa y ayuda en su diagnóstico. Hemos buscado sistemáticamente la base de datos médica para el mismo y hemos revisado toda la literatura disponible hasta el 29 de junio de 2020

Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2 virus) disease had first appeared in December 2019 in Wuhan, China and has been spreading quickly throughout the world since then. Since then, the outbreak of this severe viral disease has become a global threat to humanity. An early diagnosis and isolation are the most significant measures required to prevent its spread. Recent anecdotal evidence has suggested oral manifestations with or, without olfactory and gustatory impairment in association with corona virus disease (COVID-19). Angiotensin converting enzyme-2 (ACE-2) is expressed in oral mucosa in large amounts and can, thus, contribute in the early manifestations of this deadly viral disease. The oral manifestations of corona virus disease can occur in the form of irregular ulcerative lesions in relation to different parts of the oral cavity and particularly, in relation to the attached mucosa in the hard palate region as well as inflammation and subsequent, atrophy of the various tongue papilla. The associated olfactory and gustatory dysfunction can, also, lead to partial and/or, even a complete loss of the ability to smell and taste in the early stages of the disease onset. Evidence has, also, suggested the presence of SARS-CoV-2 nucleic acid in human saliva making it the carrier of the infectious viral disease as well as aiding in its diagnosis. We have systemically searched medical database for the same and have reviewed all the literature available up to 29th of June 2020.

Addressing healthcare needs of people living below the poverty line: A rapid assessment of the Andhra Pradesh Health Insurance Scheme.

Background. Families living below the poverty line in countries which do not have universal healthcare coverage are drawn into indebtedness and bankruptcy. The state of Andhra Pradesh in India established the Rajiv Aarogyasri Community Health Insurance Scheme (RACHIS) in 2007 with the aim of breaking this cycle by improving the access of below the poverty line (BPL) families to secondary and tertiary healthcare. It covered a wide range of surgical and medical treatments for serious illnesses requiring specialist healthcare resources not always available at district-level government hospitals. The impact of this scheme was evaluated by a rapid assessment, commissioned by the government of Andhra Pradesh. The aim of the assessment was to explore the contribution of the scheme to the reduction of catastrophic health expenditure among the poor and to recommend ways by which delivery of the scheme could be improved. We report the findings of this assessment. Methods. Two types of data were used for the assessment. Patient data pertaining to 89 699 treatment requests approved by the scheme during its first 18 months were examined. Second, surveys of scheme beneficiaries and providers were undertaken in 6 randomly selected districts of Andhra Pradesh. Results. This novel scheme was beginning to reach the BPL households in the state and providing access to free secondary and tertiary healthcare to seriously ill poor people. Conclusion. An integrated model encompassing primary, secondary and tertiary care would be of greater benefit to families below the poverty line and more cost-effective for the government. There is considerable potential for the government to build on this successful start and to strengthen equity of access and the quality of care provided by the scheme.

Cryptosporidium and isospora belli diarrhoea in immunocompromised hosts.

Cryptosporidium and isospora, two of the intestinal coccidian parasites known to be the causative agents of acute diarrhoea in animals, have now emerged as one of the main causes of prolonged life threatening diarrhoea in immunocompromised patients particularly so in patients with AIDS. Between June 1996 and December 1997, a total of 75 immunocompromised patients presenting with diarrhoea were investigated both for Cryptosporidium and Isospora. The study group consisted of cancer and AIDS patients with history of diarrhoea. Cryptosporidium oocysts were detected in 35 patients (46.7%). One of the faecal samples from an AIDS patient with diarrhoea showed the presence of both Cryptosporidium and Isospora oocysts. To the best of our knowledge, this is the second documented report of Isospora associated diarrhoea in an AIDS patient from India. The various techniques used for demonstration of these parasites were modified acid fast staining, Safranine Methylene-blue staining and direct immunofluorescence test.

Shigella and the fluorinated quinolones.

Between July 1996 to June 1997 a total of 531 Stool samples from cases of acute diarrhoea, dysentry, colitis admitted to Kasturba Medical College Hospital, Manipal were investigated. Shigella were isolated from 29 samples (5.46%). Out of them, Shigella flexneri were 16 (55.17%), Shigella boydii 8 (27.58%), Shigella dysentriae 3 (10.34%) and Shigella sonnei 2 (6.89%). Five strains of Shigella flexneri and one strain of Shigella dysentriae were found to show resistance to Nalidixic acid and the newer fluoroquinolones viz., Ciprofloxacin, Norfloxacin and Ofloxacin. The in vitro 'R' factor transfer study showed that the resistance was not transferable.

Clinical, hematological and electrophysiologic study of megaloblastic anemias.

Thirty one cases of megaloblastic anaemia were studied clinically and electrophysiologically. Eight patients had clinical evidence of peripheral neuropathy. MNCV, distal sensory latency, la fibre conduction velocity, proximal conduction velocity and H-reflex amplitude and latency were compared with fourteen age and sex matched healthy controls. MNCV, proximal conduction velocity and H-reflex amplitude were significantly decreased in anaemic subjects while distal sensory latency was increased. No change was seen in la fibre conduction velocity and H-reflex latency. There was no correlation between severity of anaemia and the electrophysiologic abnormalities. MNCV and la fibre conduction velocity improved after correction of anemia.

Role of H-reflex latency studies in the diagnosis of subclinical diabetic neuropathy.

Motor conduction velocity (MCV) in the median, ulnar and peroneal nerves and H-reflex studies have been conducted in 50 diabetics aged 20-65 years and 25 controls. MCV in the upper limb was below the normal range in 16% of diabetics. 28% diabetics showed abnormal MCV in the peroneal nerve. H-reflex abnormality consisting of either prolonged latency or its complete absence could be observed in 54% of diabetics. The results indicate the greater sensitivity of H-reflex in the detection of sub-clinical diabetic neuropathy. Greater prevalence of neuropathy in the early onset diabetes than in the late onset type is also suggested.