Development & validation of a quantitative anti-protective antigen IgG enzyme linked immunosorbent assay for serodiagnosis of cutaneous anthrax.

Background & objectives: Anthrax caused by Bacillus anthracis is primarily a disease of herbivorous animals, although several mammals are vulnerable to it. ELISA is the most widely accepted serodiagnostic assay for large scale surveillance of cutaneous anthrax. The aims of this study were to develop and evaluate a quantitative ELISA for determination of IgG antibodies against B. anthracis protective antigen (PA) in human cutaneous anthrax cases. Methods: Quantitative ELISA was developed using the recombinant PA for coating and standard reference serum AVR801 for quantification. A total of 116 human test and control serum samples were used in the study. The assay was evaluated for its precision, accuracy and linearity. Results: The minimum detection limit and lower limit of quantification of the assay for anti-PA IgG were 3.2 and 4 μg/ml, respectively. The serum samples collected from the anthrax infected patients were found to have anti-PA IgG concentrations of 5.2 to 166.3 μg/ml. The intra-assay precision per cent CV within an assay and within an operator ranged from 0.99 to 7.4 per cent and 1.7 to 3.9 per cent, respectively. The accuracy of the assay was high with a per cent error of 6.5 - 24.1 per cent. The described assay was found to be linear between the range of 4 to 80 ng/ml (R2=0.9982; slope=0.9186; intercept = 0.1108). Interpretation & conclusions: The results suggested that the developed assay could be a useful tool for quantification of anti-PA IgG response in human after anthrax infection or vaccination.

Incidence and sero epidemiology of brucellosis from a tertiary care centre of rural Maharashtra.

Background: It is usually difficult to diagnose brucellosis clinically in the absence of specific clinical features. Hence serological testing forms the mainstay of diagnosing the disease. Seroepidemiological determinants of brucellosis in rural western Maharashtra have not been closely investigated. Aim: The present study was therefore conducted to determine the incidence and to analyze seroepidemiological determinants of Brucellosis in cases of pyrexia of unknown origin (POU) in rural western Maharashtra. Material and methods: The present hospital based cross sectional survey was carried out in Rural Medical College, Loni on 500 cases of PUO. SPSS version 20.0 was used for analysis. The serum samples were subjected to serological tests like Rose Bengal Plate Test (RBPT) and Standard Tube Agglutination Test (STAT). The inoculated agar plates were watched daily for the presence of growth Brucella on culture. Results: Males (51.6%) outnumbered females (48.4%) in the study sample. Out of 500 cases 10 samples showed the presence of Brucella agglutinins. The male female ratio in the seropositive cases was 2.33:1. Headache and joint pain was observed in 5 and 3 cases respectively. 50% samples yielded the growth of Brucella on culture. All the culture positive samples had titer of 640 IU or more. Conclusion: Agglutination test if properly performed can be used as a very dependable laboratory procedure for rapid diagnosis of Brucellosis.

Bioactivity of marine organisms: part X--screening of some marine fauna from the Indian coasts.

Methanolic and chloroform-methanol extracts of 25 identified species of marine fauna have been screened for a wide range of biological activities. Of these, 2 extracts exhibited diuretic activity, while antibacterial, antiviral, oxytocic and spasmolytic activities, were observed in 1 extract each.

Bioactivity of marine organisms: Part IX--screening of some marine flora from the Indian coasts.

Alcoholic extracts of 48 identified species of marine flora were screened for a wide range of biological activities. Of these, 3 extracts showed diuretic activity while 2 extracts showed hypotensive effect.

Screening of Indian plants for biological activity: Part XVI.

Alcoholic extracts of 288 of plant materials from 199 plant species have been tested for various biological activities including chemotherapeutic and pharmacological screening. Biological activities, ranging from moderate to good degree, have been observed in 61 plants extracts. Follow up studies have been carried out in these extracts and some of them have shown moderate degree of activities at this Institute. However, none of the extracts was found to be good enough for further development. Results of the present studies, along with chemical investigations on different species of similar genera which were screened earlier, are also discussed.

Symbiotic effectiveness of bacteriocin producing and non-producing strains of Rhizobium in green gram (Vigna radiata).

Rhizobium strains nodulating green gram [Vigna radiata (L.) Wilczek] were found to produce bacteriocin on modified Bergersen's medium and inhibited the growth of homologous Rhizobium strains. Four bacteriocin producing and four bacteriocin non-producing strains were compared for their effect on nodulation, in planta nitrogenase activity and plant dry weight of green gram. The bacteriocin producers formed more nodules in comparison to non-bacteriocin producers. However, the symbiotic effectiveness of bacteriocin producers was less in terms of plant dry weight in comparison to non-bacteriocin producers.

Bioactivity of marine organisms: Part VIII--Screening of some marine flora of western coast of India.

Methanolic extracts of 31 botanically identified species of marine flora, collected from Gujarat Coast, have been screened for a wide range of biological activities. Of these, 3 extracts showed anti-implantation, 2 had antiviral, 2 showed hypotensive, 1 had anti-inflammatory while 12 extracts showed diuretic activities. The antiviral activity; against EMCV, was confirmed in one alga. The active principles and results of these studies are reported.

Screening of Indian plants for biological activity: Part XV.

Alcoholics extracts of 266 botanically identified plant materials from 222 plant species have been tested for various biological activities including chemotherapeutic and pharmacological screenings. Biological activities have been observed in 89 extracts. Follow-up studies have been carried out in some plants with confirmed activity. The active principles and results of these studies are reported.

Early oral feeding after elective colorectal surgery: is it safe.

The authors have carried out a prospective trial to assess the safety, tolerability and outcome of early resumption of oral feeding after elective abdominal surgery involving the small or the large bowel. Over the study period, 161 patients undergoing elective laparotomy and bowel resection were randomized to two groups. Patients undergoing laparoscopic surgery were not included. In both groups, the nasogastric tube was removed immediately after surgery. In group I, oral feeding was started on first postoperative day, beginning with clear fluids and gradually progressing to a normal diet over a period of 24 to 48 hours, as tolerated. In group II, oral feeding was started after resolution of postoperative ileus, starting again with clear fluids as in group I. The resolution of postoperative ileus was defined as having bowel movements with no abdominal distention or vomiting. In both groups, nasogastric tube was reinserted if the patient had two episodes of vomiting of more than 100 ml over 24 hours in the absence of bowel movements. Postoperative analgesia was similar in both groups and same criteria for discharge from the hospital were followed. Of the 161 patients, 80 were in the early feeding group and 81 in the other group. The age and sex distribution of the patients in both groups was similar. In both groups, segmental colonic, rectal or small bowel resection was the commonest surgery. In group I, 79% patients tolerated feeds compared to 86% in group II. The incidence of vomiting was thus 21% in group I and 14% in group II, the difference being statistically insignificant. Reinsertion of nasogastric tube was required only in 11% patients in group I and 10% patients in group II. Further, the length of postoperative ileus (3.8 + 0.1 vs 4.1 + 0.1 days), length of hospital stay (6.2 + 0.2 vs 6.8 + 0.2 days) and incidence of complications (7.5% vs 6.1%) were not significantly different between the two groups. However, regular diet was tolerated significantly earlier. (p <0.001) in group I as compared to group II (2.6 + 0.1 vs. 5.0 + 0.1 days). Further, there was no incidence of anastomotic leaks or aspiration pneumonia, complications which could be expected to occur secondary to early feeding. The authors have reviewed the literature which shows a trend towards decreasing use of routine postoperative nasogastric drainage. Based on the results of the current study, they suggest that there is no need to delay oral feeding till resolution of colonic ileus as early feeding is safe and well tolerated. They also suggest that early resumption of oral feeding may have a positive impact on the psychological state of the patient and may help the recovery.

Breast cancer presentation at a regional cancer centre.

BACKGROUND. Breast cancer accounts for 20% of all female cancers in India and most patients present with advanced disease. Many factors may be responsible for the late presentation including the prehospital diagnostic and therapeutic approach towards breast lumps which may be malignant. To evaluate these factors we carried out a prospective investigation at the Institute Rotary Cancer Hospital of the All India Institute of Medical Sciences. METHODS. We studied 100 new patients with breast cancer seen in a special clinic over a 12-week period, excluding patients who did not have a palpable lump and those who had had an operation in another hospital more than six months previously. RESULTS. Fifty-seven of the patients were from urban and 43 from rural areas. Only 20 patients were aware of breast cancer before the onset of their illness. They were mainly from an urban background, educated and had a family history of breast and other malignancies. The total duration of illness ranged from 1 week to 10 years (mean 11.3 months) and the time to first visit ranged from 1 day to 9.5 years (mean 6.7 months). The delay between the first contact with a doctor to the date seen in the Institute Rotary Cancer Hospital thus amounted to a mean of 4.6 months. The duration of illness as well as time to first visit was also significantly shorter in urban patients, those who were educated and those who were aware of the disease. Fine needle aspiration cytology was used in 50 patients and was diagnostic in 39. Thirty of the 100 patients had no diagnostic investigations. Of the 43 patients treated elsewhere, the operation had been inadequate in 17 and 27 of the 43 patients were found to have had faulty adjuvant therapy. Many patients did not carry their operation notes and histopathology reports and when these were available, they were often of poor quality. The use of staging investigations was incomplete so much so that in 22 patients the disease could not be staged at all because of poor records. CONCLUSION. Breast cancer is seen in our hospital in an advanced stage because most patients are unaware of the disease. However, the treating physician also contributes to delay in the diagnosis, uses the diagnostic and staging investigations improperly, performs inadequate surgery and prescribes inappropriate adjuvant treatment. Record keeping is also of a poor quality. We need to provide more information to both patients and doctors about breast cancer.

Esophageal bezoar: a rare but distinct clinical entity.

A 89 year old female patient presented with severe dysphagia and was suspected to have carcinoma of the esophagus. Endoscopy revealed an esophageal phytobezoar which passed down spontaneously after unsuccessful endoscopic extraction attempt. Barium swallow study revealed diffuse spasm of the esophagus. A review of English literature revealed only 17 previous cases of esophageal bezoar. Salient features of esophageal bezoars are discussed based on previous reports and the current case.

Bioactivity of marine organisms: Part VII--Effect of seaweed extract on central nervous system.

Alcohol extracts of marine algae (Rhodophyceae, Phaeophyceae and Chlorophyceae) were screened for their effect on central nervous system. Of 69 species investigated 8 appeared biologically active, 6 being CNS stimulant and two depressant, sites and dates of collection are given.