Differentiating Multisystem Inflammatory Syndrome in Children (MIS-C) and Its Mimics – A Single-Center Experience From a Tropical Setting

Objective: Identifying clinical and laboratory indicators that differentiate multisystem inflammatory syndrome in children (MIS-C) apart from other febrile diseases in a tropical hospital setting. Methods: Review of hospital records done in a tertiary care exclusive children’s hospital for children admitted from April, 2020 till June, 2021. Laboratory values, severe acute respiratory syndrome coronavirus (SARS-CoV-2) serological status, and clinical signs and symptoms of patients with MIS-C, and those with similar presentations were analyzed. Results: 114 children fulfilled the inclusion criteria (age group of 1 mo-18 y) for whom a diagnosis of MIS-C was considered in the emergency room based on the clinical features. Among them, 64 children had the final diagnosis of MIS-C, and the remaining 50 children had confirmatory evidence of infections mimicking MIS-C such as enteric fever, scrub typhus, dengue and appendicitis. Conclusion: Older age group, presence of mucocutaneous symptoms, very high C-reactive protein, neutrophilic leukocytosis, abdominal pain and absence of hepatosplenomegaly favor a diagnosis of MIS-C.

Anterior segment optical coherence tomography characteristics and management of a unique spectrum of foreign bodies in the cornea and anterior chamber

Purpose: To report anterior?segment optical coherence tomography (ASOCT) characteristics of different types of corneal and anterior chamber (AC) foreign bodies (FBs) and their usefulness in diagnosis and management. Methods: This is a retrospective descriptive clinical study involving 11 eyes of 11 patients who presented at the outpatient department of a tertiary ophthalmic care center from January 2017 to January 2022. All patients had a diagnosed or suspected corneal FB. All participants underwent a comprehensive ophthalmological examination, followed by slit?lamp photography and ASOCT. FB removal was done where required by an external, internal, or combined approach. Results: The mean age of patients was 28.2 (7–53) years. Ten were male, and one was female. Seven patients had a definitive positive history of injury; in one, there was a history suggestive of trauma, one had the post?operative complication of scleral buckling surgery, and two patients had a history of insect fall in the eyes. Three patients had acute, four had sub?acute, and four had chronic presentations. Descemet’s membrane (DM) breach was suspected in three cases of deep FB, which was later confirmed on ASOCT. In two cases, DM was presumed to be intact clinically, but ASOCT showed an AC penetration. The FB was removed in seven patients, one via slit?lamp, one via an external approach, two via an internal approach, and three via a combined approach. Conclusion: ASOCT facilitates non?invasive rapid imaging of ocular tissue at various depths, provides an accurate assessment of FB characteristics, and thereby serves as an additional tool in our armamentarium for diagnosis and management of deep corneal and AC Fbs

Cytomorphometry in Oral Lesions - An Objective Approach to Cytological Diagnosis.

Objectives: The present study focusses on cytomorphological evaluation of the scrapings and cytological appearance of a spectrum of lesions of the oral cavity, Morphometric nuclear and cytoplasmic parameters were used to distinguish between benign, premalignant and malignant lesions. Material and Methods: The samples were obtained by scraping the lesion firmly till tiny pin point bleeding points were seen to ensure adequate sampling. Adequate sampling was defined as 50 cells consisting of transepithelial cytology specimen (superficial, intermediate and basal cells). Results: A total of 80 patients were evaluated with predominance in males and mean age of presentation was 45.05± 12.8 years. Cytomorphomteric analysis revealed an increasing trend in nuclear parameters as the spectrum of oral lesion moved from benign to malignant category while a decline was observed in cellular parameters. A significant p value of <0.0001 was found between cytomorphometrical parameters and histopathological subtypes. Sensitivity and specificity of conventional exfoliative cytology in conjunction with cytomorphometry was 100% and 94.74% respectively. Negative predictive value and positive predictive value of cytology for malignant lesions was 100% and 93.75% respectively. Diagnostic accuracy of cytology in predicting malignancy taking histopathology as gold standard was 97.0. Conclusion: Grading and scoring of oral cytosmears according to morphology showed a positive correlation with histopathological diagnosis. In addition, cytomorphometry increases the diagnostic accuracy of oral conventional exfoliative cytology and hence is seen to have an impact on early detection of cellular alterations and prompt treatment. Therefore, it is a sensitive and useful adjunct to monitor the cellular transformation.

Lateral Canals - Terminologies, Classification and Prevalence in Permanent and Deciduous Teeth : A 12 Comprehensive Review

A clear understanding of the intricate anatomy of human teeth is an essential prerequisite to all dental procedures especially in the case of root canal treatment. Anatomical relationship between the pulp and the periodontal structures plays a major role in the etiopathogenesis of the pulp or pulp periodontal lesions. Lateral canals may comprise of potential pathways through which bacteria or their products may reach the periodontal ligament and likewise. This, often overlooked aspect contribute to persistence of periapical lesion even after the completion of endodontic treatment. Therefore, this library dissertation attempts to present a comprehensive review on the origin, frequency, location and prevalence of lateral canals in primary and permanent dentition.

Development of transgenic cucumber mosaic virus (CMV) resistant gerbera plants expressing CMV coat protein gene

Gerbera (Gerbera jamesonii L.) has its immense importance to the floriculture industry worldwide. The gerbera flower production has been hampered by various viruses, among them cucumber mosaic virus (CMV) has shown considerable damage.As natural resistance to CMV is absent in gerbera, here, we have made an attempt to develop transgenic gerbera plants expressing coat protein (CP) gene of CMV via Agrobacterium mediated transformation of base petiole explants for genetic resistance to CMV infection. Among the 44 putative transgenic gerbera plant acclimatized, 39 were found positive for integration of CP gene by polymerase chain reaction and southern hybridization assay using their specific primer and probe respectively. Northern hybridization assay using CP gene specific probe confirmed the transcription of transgene in all 39 transgenic plants. These plants showed translation of CP during DAS-ELISA when tested with antiserum specific to CP of CMV. These 39 plants when challenged by mechanical inoculations with CMV gerbera isolate showed virus resistance in 53% (21 out of 39) plants, virus tolerance (delayed mild symptom) in 33% (13/39) plants, while rest 12.8% (5/39) plants showed severe disease symptoms. The CP mediated resistance of CMV in transgenic gerbera is being reported for the first time from India.

Intraocular pressure reduction in a spectrum of angle closure disease following cataract extraction

Purpose: The purpose is to study the effect of cataract extraction on intraocular pressure (IOP) in patients with angle closure disease (ACD). Methods: In this retrospective study, patients with ACD including medically uncontrolled and advanced primary angle closure glaucoma (PACG) who underwent only cataract surgery were included. The IOP trend was analyzed at postoperative day 1, day 7, 1 month, 3 months, 6 months, 1 year, and final follow-up along with requirement of antiglaucoma medication (AGM)/surgery. Results: A total of 110 eyes of 79 patients [primary angle closure suspect (PACS): 21, PAC: 34, PACG: 55 eyes] were analyzed. Of these patients, 31 eyes had advanced PACG and 20 eyes had medically uncontrolled glaucoma. Best-corrected visual acuity >6/12 was seen in 51 eyes at baseline and 87 eyes at final follow-up. After cataract surgery alone, there was significant reduction (median) in IOP [19.1 ± 18.00% (18.8) in PACS (P < 0.01), 8.55 ± 17.9% (10) in PAC (P = 0.04), 22.82 ± 15.45%(14.3) in PACG (P < 0.01), 18.27 ± 15.99% (14.5) in advanced PACG (P = 0.01) and 36.56 ± 14.58% (28.57) in medically uncontrolled glaucoma (P < 0.01)] and AGM [51.85% (1) in PAC, 32.35% (2) in PACG, 17.71% (2) in advanced PACG, and 40.74% (1.5) in medically uncontrolled PACD] at median follow-up of 1, 2.5, 1, 1.3, and 1 year. Eleven PACG patients, who were on systemic medication preoperatively, were off systemic therapy at final follow-up, while six other PACG eyes (10.9%) required glaucoma surgery. Conclusion: Cataract surgery leads to significant drop in IOP across the spectrum of ACD with visually significant cataract. Cataract surgery may be considered initially for IOP control even in advanced or medically uncontrolled PACG followed by glaucoma surgery later if required.

Design, Synthesis, Molecular Docking, Admet Studies And Biological Evaluation Of Pyrazoline Incorporated 1, 2, 3-Triazole Benzene Sulphonamides

Objective: The main objective of this work was to design, synthesize and evaluate the novel pyrazoline incorporated 1,2,3-triazole benzene sulphonamides for cytotoxic and anti-gout activities also to perform Insilco molecular docking studies. Methods: Designed compounds were synthesized by condensation of different substituted chalcones (3a-i) with hydrazine hydrate and substituted phenylhydrazines. All the synthesized compounds were characterized on the basis of physical and spectral data. To predict the affinity and activity of the ligand molecule Libdock program was employed to generate different bioactive binding poses of designing molecules at the active site of protein Phosphatidylinositol 3-kinase (PI3Kα). Title compounds were evaluated for cytotoxic activity by using 3-(4, 5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and anti-gout activity by potassium oxonate induced assay. Results: All the synthesized compounds showed characteristic peaks in FTIR, 1H, 13C NMR and MASS spectral analysis. In molecular docking studies, compound 3i has shown good binding affinity to the active site of PI3Kα with a docking score of 145.031 and 4 hydrogen bonding interactions with least hepatotoxicity and good bioavailability when compared with that of reference ligand KKR exhibited a Libdock score of 88.35. Remaining compounds also have a good binding affinity with a minimum of 2 bonding interactions and having better absorption, distribution, metabolism, elimination and toxicity (ADMET) profile. The same compound (3i) exhibited the highest cytotoxic activity with an IC50 value of 4.54µg/ml. Compound 4d was evaluated for anti-inflammatory activity and it has significantly ameliorated against potassium oxonate induced gout in mice when compared with that of standard drug allopurinol due to its anti-inflammatory property. Conclusion: We designed and synthesized a novel series of title compounds in quantitative yields and performed docking studies. New derivatives have a good binding affinity towards PI3Kα enzyme, good bioavailability, least hepatotoxicity and significant cytotoxic activity.

Iridocorneal endothelial syndrome: Evaluation of patient demographics and endothelial morphology by in vivo confocal microscopy in an Indian cohort

Purpose: To evaluate the patient demographics and morphological characteristics of corneal endothelium by in vivo confocal microscopy (IVCM), in patients with Iridocorneal Endothelial (ICE) Syndrome. Methods: In this retrospective observational series, IVCM acquired endothelial images of patients with ICE syndrome were evaluated. 'ICE cells' morphology was classified as “?” or “+” if they were larger or smaller than contralateral normal endothelium. It was correlated with patient demographics and clinical manifestations. Results: IVCM was performed on 41 eyes of 21 patients, with 13 males (62%) and 8 females (38%). The disease was unilateral in 19 (90.5%) and bilateral but asymmetric in two (9.5%) patients. Total ICE was seen in 91% eyes. Eighty percent patients (12 out of 15) with ICE—cells were males while 83.3% (5 out of 6) patients with ICE + cells were females. Mean age of patients with ICE- cell type and ICE + cell type was 45.8 ± 17.8 years and 40.3 ± 9.2 years respectively (P = 0.02). Both ICE – and ICE + eyes had similar incidence (33.3%) of corneal edema. ICE + eyes had more severe (grades 2/3) glaucoma (n = 5/6 eyes, 83.3%) compared to ICE – eyes (n = 8/15 eyes, 53.3%). Conclusion: A male preponderance, predilection of ICE – and + cell variants for male and female gender respectively, lack of association of the endothelial cell morphology with corneal edema, and apparent association of ICE + phenotype with more severe glaucoma occurring at a relatively younger age, are some novel findings of the present study. In the clinical setting correlation of patient demographics with these IVCM findings may help in better long-term prognostication of eyes with ICE syndrome.

A prospective randomized controlled study of Aurolab aqueous drainage implant versus Ahmed glaucoma valve in refractory glaucoma: A pilot study

Purpose: To study the efficacy of the Aurolab aqueous drainage implant (AADI) compared to Ahmed glaucoma valve (AGV) in patients with refractory glaucoma. Methods: This was a prospective, randomized controlled trial. Thirty-eight adult patients (>18 years) scheduled for a glaucoma drainage device (GDD) were randomized into two groups to receive either AGV or AADI. Primary outcome measures: intraocular pressure (IOP) control and requirement of antiglaucoma medications; secondary outcome measures: final best correct visual acuity (log MAR), visual field (Visual field index [VFI], mean deviation [MD] and pattern standard deviation [PSD]), postoperative complications and additional interventions. Complete success was defined as IOP ?5–?18 mmHg without antiglaucoma medications/laser/additional glaucoma surgery or any vision threatening complications. Results: There were 19 age and sex-matched patients in each group. Both groups had comparable IOP before surgery (P = 0.61). The AGV group had significantly lower IOP compared to AADI group (7.05 ± 4.22 mmHg vs 17.90 ± 10.32 mmHg, P = <0.001) at 1 week. The mean postoperative IOP at 6 months was not significantly different in the two groups (13.3 ± 4.2 and 11.4 ± 6.8 mmHg respectively; P = 0.48). At 6 months, complete success rate according to antiglaucoma medication criteria was 78.94% in AADI and 47.36% in AGV groups. AGV group required 1.83 times more number of topical medications than AADI group. There was no significant difference in early (P = 0.75) and late (P = 0.71) postoperative complications in the AADI and AGV group. The complete success rate was higher in AADI group (68.42%) than AGV group (26.31%) (P = 0.034). Conclusion: In this study, AADI appears to have comparable efficacy versus AGV implant with higher complete success rate at 6 months follow-up.

Evaluation of macular ganglion cell analysis compared to retinal nerve fiber layer thickness for preperimetric glaucoma diagnosis

Purpose: To compare the diagnostic ability of the ganglion cell analysis (GCA) and retinal nerve fiber layer (RNFL) protocol on optical coherence tomography (OCT), to diagnose preperimetric glaucoma. Methods: A prospective, cross-sectional study of 275 adult patients including 47 early glaucoma (mean deviation better than -6.0 D), 150 glaucoma suspects (106 with suspicious discs and 44 ocular hypertensive (OHT), and 78 normal controls was done. Eligible participants were scanned with the spectral domain CirrusTM OCT (Carl Zeiss Meditec, Dublin, CA). Average peripapillary RNFL thickness and GCA measurements were obtained. Area under receiver operating characteristic (AROC) curves were used to evaluate discriminant value of both protocols to diagnose likely preperimetric glaucoma among glaucoma suspects. Results: Average RNFL and GCA were significantly thinner in glaucoma patients compared to glaucoma suspects and normal controls (P < 0.001). The RNFL was 92.26 ± 8.8 ? in normal controls, 87.9 ± 12.12 ? in glaucoma suspects and significantly thinner in POAG (70.29 ± 10.18 ?; P < 0.001). The GCA was 81.94 ± 6.17 ? in normal controls, 77.69 ± 9.03 ? in glaucoma suspects, and significantly thinner in POAG (69.36 ± 11.06 ?; P < 0.001). AROCs for discriminating glaucoma suspects from normal were modest, with no difference in AROC of average RNFL or GCA measurements (DeLong; P = 0.93). Average RNFL thickness had significantly greater AROC values than average GCA for discriminating glaucoma suspects (both suspicious discs and OHT) from glaucoma (P = 0.03 and 0.05, respectively. AROC for diagnosing glaucoma was significantly better (P = 0.02) for RNFL (0.88 ± 0.03) than GCA (0.77 ± 0.04). Conclusion: In the present time, GCA measurements, as provided by the SD-OCT, do not appear to outperform RNFL measurements in the diagnosis of preperimetric glaucoma.

Natural Sources of Gooseberry Component used for Microbial Culture Medium (NSM).

Gooseberry are plagued by a number of bacterial and fungi pathogens including Mucor sps, Rhizopus sps, Fusarium sps, Trichoderma sps and Klebsiella pneumonia, Staphylococcus aureus, Streptococcus pneumonia, Shigella sps ,and proteus. We developed a semi solid media, termed natural source medium (NSM), to selectively and rapidly isolate fungi and bacteria pathogenic to and associated with gooseberry and some other fruits. Most strains of interest grow sufficiently on NSM in 24h at 37⁰C for bacteria and 48h at room temperature for fungi tentative identification based on colony morphology, Gram staining and Biochemical characteristic.

Survey on Halophilic microbial diversity of Kovalam Saltpans in Kanyakumari District and its industrial applications.

Halophilic microorganisms are organisms that grow optimally in the presence of NaCl at least 0.2 M. The applications of halophilic bacteria include food and pharmaceutical industries, production of enzymes, polymers and various cosmetic products. The objective of the study was isolation and its characterization of potentially important microorganisms from saltpans. In this preliminary investigation, the total microbial counts were studied from the salt sample at three month intervals for one year. Totally 9 organisms were identified based on standard cultural, physiological and biochemical studies. These strains were subjected to screening of potential enzymes such as; amylase, protease, gelatinase, etc. The organisms Natranobacterium sp-1, Staphylococcus epidermidis, Staphylococcus intermedius and Staphylococcus citreus showed positive for amylase; Halo bacillus salinus, Halococcus salifodinae, Staphylococcus epidermidis and Staphylococcus intermedius showed positive for protease; Halobacillus salinus, Halobacterium salinarum, Natranobacterium sp-1, Staphylococcus intermedius and Staphylococcus citreus showed positive for gelatinase activity.

Coat protein-mediated resistance against an Indian isolate of the Cucumber mosaic virus subgroup IB in Nicotiana benthamiana.

Coat protein (CP) -mediated resistance against an Indian isolate of the Cucumber mosaic virus (CMV) subgroup IB was demonstrated in transgenic lines of Nicotiana benthamiana through Agrobacterium tumefaciens-mediated transformation. Out of the fourteen independently transformed lines developed, two lines were tested for resistance against CMV by challenge inoculations. The transgenic lines exhibiting complete resistance remained symptomless throughout life and showed reduced or no virus accumulation in their systemic leaves after virus challenge. These lines also showed virus resistance against two closely related strains of CMV. This is the first report of CP-mediated transgenic resistance against a CMV subgroup IB member isolated from India.

Comparison of the clinical and pathologic staging in patients undergoing radical cystectomy for bladder cancer

PURPOSE: Radical cystectomy (RCx) is perhaps the most effective therapeutic approach for patients with muscle-invasive bladder cancer. Unfortunately, clinical staging is imprecise and the degree of understaging remains high. This study retrospectively evaluated patients undergoing RCx with regard to pathologic outcomes and degree of upstaging to better identify features that may lessen clinical understaging. MATERIALS AND METHODS: 141 consecutive patients with urothelial bladder carcinoma who were candidates for RCx with curative intent were retrospectively evaluated. Preoperative clinical and pathological (i.e. TURBT) features were compared to pathological outcomes in the cystectomy specimen. Patients were also evaluated as to whether cystectomy was performed as their primary (n = 91) versus secondary (n = 50) treatment for recurrent/progressive disease. Date of cystectomy (< 5 years vs. > 5 years prior to study) was also analyzed. RESULTS: Of the 141 patients, 54 percent were upstaged on operative pathology. The greatest degree of upstaging occurred in those with invasive disease preoperatively (cT2-T3). Twenty-six percent of all patients had node-positive disease, and 75 percent of cT3 patients were node-positive. Seven of 101 (7 percent) patients with clinical T2 disease were unresectable at the time of surgery. In the primary (vs. secondary) RCx group, more patients were upstaged (63 percent vs. 40 percent), non-organ confined (62 percent vs. 38 percent), and LN positive (31 percent vs. 20 percent). In the more modern cohort, the degree of upstaging was not improved. CONCLUSIONS: Pathologic findings after RCx often do not correlate with preoperative staging. Over half of patients undergoing cystectomy are upstaged on their operative pathology. An improved understanding of the relative frequency of upstaging in cystectomy patients may have important implications in the decision-making and selection for neoadjuvant and adjuvant therapies ...

Comparison of shear bond strength of composite, compomer and resin modified glass ionomer in primary and permanent teeth: an in vitro study.

The aim of this study was to determine the difference in shear bond strength between Composite, Compomer and Resin modified glass ionomer cement in primary and permanent teeth. Thirty extracted primary molars and thirty premolars were selected and buccal surfaces of all the teeth were made smooth with the help of 300 grit silicon carbide paper. These specimens were then divided into 6 groups. Restorative materials were placed on the buccal surfaces of respective specimens with the help of acrylic template. All the specimens were subjected to thermocycling and shear bond strength was tested under the Honsfield testing machine and results were recorded in megapascals (MPa). The resultant scores were tabulated and statistically analysed. It was observed that in case of primary teeth resin modified glass ionomer exhibited significantly higher shear bond strength as compared to composite and compomer, where as on permanent teeth composite demonstrated a significantly higher shear bond strength than that of the resin modified glass ionomer and compomer, where as compomer gave poor shear bond strength in both primary and permanent teeth.

Association of cucumovirus and potyvirus with betelvine (Piper betle L.) as evidenced by ELISA and RT-PCR.

An attempt was made to detect various viruses of Piper betle grown at Mahoba and Banthara in India. DAC-ELISA and RT-PCR tests were performed in leaf sap samples of betelvine for detection of a cucumovirus (Cucumber mosaic virus) and potyvirus (Bean yellow mosaic virus) using specific antibodies and universal primers of respective viruses. DAC-ELISA could detect only CMV. However, RT-PCR detected both cucumovirus and potyvirus infection in betelvine samples. Association of CMV with betelvine was observed for the first time in the present study.

Trichuriasis: localized inflammatory responses in the colon.

Most patients with trichuriasis have light worm burdens. Data regarding the inflammatory response to Trichuris worms in the colon of lightly infected persons are scant. Nine patients whose Trichuris infection was found by colonoscopy had biopsies taken from a site adjacent to visible worms and from a second site some 20 cm distally. The biopsies were studied by routine and immunohistochemical methods. None of the biopsies showed mucosal ulceration, significant congestion, fibrosis, gland distortion or goblet cell mucin depletion. There was no difference between worm and worm-free sites in terms of edema, lymphoid follicles or epithelial slough. Worm sites had higher numbers of eosinophils, neutrophils and total inflammatory cells and lower numbers of plasma cells. However there was no difference in lymphocyte, mast cell, and B- and T-cell counts between the two sites. This suggests that the T. trichiura worm incites a local inflammatory response involving eosinophils and neutrophils, even when the colon has only a light burden of worms.

Modulation of feeding and drinking behaviour by catecholamines injected into nucleus caudatus in rats.

Lesions of nucleus caudatus have been documented to produce adipsia and aphasia in rats. Injection of dopamine into this nucleus has been shown to facilitate water intake in rats. But, reports are not available on the effects of intracerebral injection of epinephrine and norepinephrine on feeding and drinking behaviour in animal models. Therefore, in the present study the effect of adrenaline and noradrenaline injected into nucleus caudatus on food and water intake in rats was assessed. 24 h basal food and water intakes were recorded in Wistar rats and were found to be 12.37 +/- 0.20 g and 22.04 +/- 0.27 ml respectively. Stainless steel cannulae were implanted stereotaxically into the nucleus caudatus. Four different doses (0.1 microgram, 0.5 microgram, 1 microgram, and 2 micrograms) of adrenaline and noradrenaline were injected into the nucleus caudatus through the implanted cannulae in separate groups of animals and their 24 h food and water intakes were recorded following these injections. No change in food and water intake was observed following the administration of different doses of adrenaline. A significant increase in 24 h food intake reaching a maximum of 16.03 +/- 0.15 g at 2 micrograms dose, without change in water intake was observed following administration of different doses of noradrenaline. The noradrenaline-facilitated food intake was blocked when noradrenaline was injected following injection of phentolamine, an alpha-receptor blocker. The bilateral lesions of nucleus caudatus resulted in a significant and sustained inhibition of food (8.98 +/- 0.17 g) and water intake (19.12 +/- 0.16 ml). These observations suggest that nucleus caudatus is involved in regulation of food and water intakes in rats. Noradrenaline-facilitated food intake is mediated by alpha-receptors. Adrenaline does not affect these ingestive behaviours when injected into the nucleus caudatus in rats.

Role of satellite RNA of an Indian isolate of cucumber mosaic virus in inducing lethal necrosis of tobacco plants.

Lethal necrosis or systemic stem necrosis followed by death of Nicotiana benthamiana, severe leaf deformations of N. tabacum cv. white burley and blister formations on N. tabacum cv. samsun NN symptoms were induced by experimental inoculations of CMV RNA preparations containing satellite RNA (sat-RNA). Inoculations of RNA preparations without sat-RNA did not induce that severe symptoms on these plants, only late mild mosaic was observed. It is suggested that sat-RNA of CMV isolate has a certain role for enhancing severity of symptoms in tobacco plants. Local and systemic lethal necrosis of N. benthamiana is due to sat-RNA present with genome of CMV isolate. It is the first report of lethal necrosis induced in N. benthamiana by CMV satellite.