Impact of BMW Segregation Training Program on Hospital Infection Control in a South Indian Hospital

This study aimed to investigate anaerobic co-digestion of palm oil mill effluent (POME) with cassava peels (CP) and cabbage waste (CW) for biomethane production. The anaerobic digestion (AD) in 10L capacity bioreactors loaded separately with three different ratios (3L/ 520g, 3L/ 600g and 3L/ 680g) of POME/CP, POME/CW and POME only (control) was operated under ambient temperature (25 - 36?C) and pH range of 6.5 - 8.5 for 45 days. Standard methods were adopted in the characterization of the bioreactor feeds and microbiological study. The biomethane content of the biogas was determined using Gas Chromatography (GC). The results showed the presence of Escherichia coli, Staphylococcus, Pseudomonas sp, Bacillus sp Salmonella sp among others. Fungal isolates identified include Saccharomyces, Aspergillus, Rhizopus, Penicillum, and Geotrichum species. The mean cumulative biogas yield recorded in bioreactors charged with POME/ CP 520g, POME/ CP 600g, POME/ CP 680g and POME/CW 520g, POME/CW 600g, POME/CW 680g were 7.08, 5.18, 9.06, 9.13, 9.28 and 8.33 dm3, respectively, whereas POME alone (control) was 4.64 dm3. The best performance in biogas yield was exhibited by POME/CW 600g (9.28dm3), and the highest percentage biomethane content (68.80%). Analysis of variance (ANOVA) revealed a significant difference (P ? 0.05) in biogas yield in all the treatments compared to control (POME alone) except in POME/CP 3L: 520g and POME/CP 3L: 600g. The results have shown that biogas production and biomethane content could be efficiently improved via co-digestion process, depending on the substrates used as feedstock.

Neglected Bronchial Foreign Body in an Adult

Foreign body inhalation is a clinical emergency requiring prompt action to ensure speedy recovery and minimize the complications. This is common in children rather than in adults. We hereby report a case of a neglected foreign body which remained in the bronchus of an adult for more than 10 months before the diagnosis was made and appropriate treatment was given.

Testing of newly developed glycophospholipid antigen for the detection of P. falciparum malaria by laser light immunoassay in endemic and non-endemic areas.

A glycophospholipid (GPL) antigen isolated from Plasmodium falciparum culture supernatant has been tested for its antigenicity. Detection of malaria positive known blood samples and unknown field samples from endemic and non-endemic areas were compared. In this study laser light scattering immunoassay (LIA) was used for the detection of P. falciparum malaria. Test results of control (malaria negative samples from Surat) were compared with known positive samples and unknown malaria positive field samples. A positive correlation has been observed (97%) in falciparum positive samples from laboratory and unknown samples from endemic area (Haldwani) by LIA method using GPL antigen. From the results of the study it was found that GPL antigen has a better antigenic property and can detect almost all the cases of Pf malaria by LIA method.

Acute renal failure in Plasmodium vivax malaria.

OBJECTIVES: To analyze incidence, clinical feature and outcome of acute renal failure due to Plasmodium vivax malaria. MATERIAL & METHOD: This is retrospective analysis of smear positive Plasmodium vivax patients with acute renal failure between Jan 1995 to Dec 2000. RESULT: Out of 577 cases of ARF, 93 [falciparum 74 (79.61%); vivax 19 (20.4%)] were related to complicated malaria. 3.2% (19/577) patients, 16 males and three females with age range 17-72, mean 43.3 +/- 13.4 years were due to vivax malaria. Thirteen had only vivax and six had mixed falciparum and vivax infection. The presenting features were fever (100%), jaundice (36.8%), hypotension--eight (42%), encephalopathy--11 (57.9%), sepsis--five (26.3%) and DIC--four (21%). The probable contributory factors for ARF were heavy parasitemia--11 (57.9%), hypotension--six (31.5%), hyperbilirubinemia--seven (36.8%), hemolysis--eight (42%) and DIC--four (21%). Oliguria was present in 47.3%, 13 (68.4%) patients required dialysis. Mortality was noted in 15.7% (3/19) patients. CONCLUSIONS: P. vivax malaria can cause ARF, which occurs more commonly in P. falciparum malaria. Renal ischemia is the dominant pathogenic mechanism that results in acute tubular necrosis. The prognosis of ARF in P. vivax malaria is favorable.

Physiological and biochemical alterations in Anabaena 7120 under iron stress.

Various physiological and biochemical process like growth, NO3- -uptake, nitrate reductase, glutamine synthetase and ATPases (Mg2+ and Ca2+ dependent) in the cyanobacterium Anabaena 7120 were observed under iron stress. Growth was found to be maximum in 50 microM Fe3+ added cells however, 20 microM Fe3+ (the Fe3+ concentration generally used for routine culturing of cyanobacterial cell in Chu 10 medium) incubation resulted in lower growth. Fe3+ starvation on the other hand showed very poor growth up to 4th day but once the growth started it reached at significant level on 7th day. Higher Fe3+ concentration reflected reduced growth with lethality at 500 microM Fe3+. Chlorophyll a fluorescence under Fe3+ stress reflected almost the similar results as in case of growth. However, the pigment was found to be more sensitive as compared to protein under Fe3+ stress. Similar results have been observed in case of NO3-uptake with only 80% reduction in nutrient uptake in 500 microM Fe3+ incubated cells. Nitrate reductase activity was lower in Fe3+ starved cells as compared to significant enzyme activity in 20 and 50 microM Fe3+ incubated cells. Similar to nitrate reductase, glutamine synthetase also showed maximum level in 50 microM Fe3+ added cells, however, higher Fe3+ concentration (300-500 microM ) resulted in reduced enzymatic activity. Glutamine synthetase activity was less sensitivity as compared to nitrate reductase activity under Fe3+ stress. ATPase (Mg2+ and Ca2+ dependent) always showed higher level with increasing Fe3+ concentration.

Acute renal failure complicating rifampicin therapy.

BACKGROUND : Since 1971, 55 case-reports of rifampicin-induced acute renal failure (ARF) have been published. Covic et al described 60 consecutive cases of rifampicin-induced ARF during a period of eight years (1987-1995) from Iasi Dialysis Centre, Romania. The systenic data on this condition are not available, in view of the anecdotal nature of the observation from our country. OBJECTIVE: The aims of study were to analyze clinical features, course and outcome of ARF complicating rifampicin therapy at our centre. METHODS: We retrospectively studied prevalence, clinical presentations and renal histology and outcome of 11 cases (eight males, three females, aged 42-72 years) who were referred to Nephrology Unit of University Hospital, Varanasi for acute renal failure following retreatment with rifampicin between period of 1994-1999. RESULTS: The gastrointestinal symptoms (abdominal pain, nausea and vomiting) and 'flu like' (fever, weakness and body ache) syndrome were the most frequent presenting features. The clinical signs of intravascular hemolysis were observed in four cases. The commonest laboratory findings included: Anaemia (7), leukocytosis (5), thrombocytopenia (3) and toxic hepatitis in (2) patients. Toxic hepatitis, hemolysis and ARF was seen in one patient in combination. The typical clinical features of allergic interstitial nephritis and acute tubular necrosis were seen in six and two patients respectively. Renal biopsy in three cases revealed; crescentic GN (1) and ATN in (2) patients. Acute renal failure complicating rifampicin accounted for 1.8% (11/607) of all ARF cases hospitalized in our centre during the study period. Renal function returned to normal in nine cases and one patient died on account of hepatic failure (toxic hepatitis). The patients with crescentic GN remained anuric and became dialysis dependent. Thus, clinical course of rifampicin induced ARF was favourable; with only one mortality, compared to a 18% mortality rate among all ARF patients. CONCLUSION: Acute renal failure complicating rifampicin therapy is not an uncommon condition, and typically occurs after reintroduction of rifampicin. The renal prognosis is usually favourable. Intermittent or interrupted therapy appears to be a significant risk factor for the development of acute renal failure.

Heterogeneity of immune responses to various Aspergillus species in patients with allergic respiratory diseases.

In the present study, allergenic significance of thirteen species of Aspergillus and their allergenic and antigenic relationship was studied. Of the 3025 ID tests performed with the 13 species of Aspergillus on 289 patients suffering with allergic respiratory diseases, 627 (20.7%) were positive (1+ to 4+), 386 (12.8%) being significantly positive (2+ to 4+) . Of the 64 patients eliciting a positive cutaneous response to at least one species, 42(65.6%) were positive to 5 or less number of species while others showed a broad spectrum of positive skin reactivity to different Aspergillus extracts. In RAST inhibition assays using pooled sera ofpatients sensitive to A. tamarii dose related inhibition was produced by homologous as well as 5 of the 12 heterologous species. Similarly, in A. terreus RAST inhibition was observed with homologous and A. tamarii extracts only. Our results suggested the presence of both species specific as well as shared allergenic components among different Aspergillus species. In TDIEP experiments using rabbit antisera to A. tamarii and A. terreus extracts multiple precipitin bands were observed with the homologous extracts. However, only 1-2 bands were produced by 6 heterologous Aspergillus species in each system. Collectively, these results gave evidence that there is heterogeneity of immune response in the patients with allergic respiratory diseases to different species of Aspergillus and also in rabbits immunized with Aspergillus extracts.

Effect of serum dilution in diagnosis of malaria in community.

Recently, it has been shown that immunological methods can be used for the diagnosis of malaria other than sero-epidemiology. A study has been done to investigate optimum binding capacity of antigen-antibody (Ag-Ab) at different serum dilutions. For validating antigen-antibody (Ag-Ab) reaction at 1:100, 1:1000 and 1:1000 serum dilutions, have been tested in two different laboratories to establish validation of the ELISA method. Inter laboratory test on synthetic peptide (RI) ELISA was found comparable and meaningful for assessing malaria transmission in defined locality at 1:100 dilution. Results also showed that 1:1000 serum dilution can be useful for diagnostic purpose.

Interplay of matrices in cartilage synovial fluid combine under moderate & high loadings.

Interplay of the constituents of the articular cartilage synovial fluid combine and its role was examined through the biochemical and rheological studies on bovine joints. The results showed an inverse relationship between the changes in the hyaluronic acid of synovial fluid and the proteoglycans content in articular cartilage together with alterations in the rheological properties of synovial fluid. The study indicated that the inter-movement of fluid solutes across the cartilage and synovial fluid may have an important role in the pathophysiology of osteoarthritis.

Partial purification and characterization of a novel human factor that augments the expression of class I MHC antigens on tumour cells.

A cytokine which augments the expression of major histocompatibility complex (MHC) I antigens on K562 and gastric carcinoma tumour (HR) cells, has been isolated from the culture supernatant of Concanavalin-A (Con-A) activated human peripheral blood mononuclear cells. The factor, termed MHC augmenting factor (MHC-AF) has been partially purified by Sephadex G-100 column chromatography, preparative isoelectric focusing and HPLC with ion-exchange as well as sizing columns. MHC-AF activity is associated with a 35 kDa molecule which has pI of 6·0. Interferon (IFN)-α, ß, tumour necrosis factor (TNF), Interleukin (IL)-2, IL-4, IL-5 and IL-7 had no significant effect in MHC-AF bioassay, but IFN-γ had significant MHC-AF activity. Antibodies to IFN-α, IFN-ß and TNF-α did not block the activity of MHC-AF, but anti-IFN-y antibodies could partially neutralize the activity. However, unlike IFN-γ, MHC-AF activity was resistant to pH 2·0 treatment. Purified MHC-AF preparations did not have any activity in WISH cell/encephalo myocarditis virus (EMC) IFN bioassays. In addition, anti-IFN-y affinity column did not retain MHC-AF activity. These results indicate that a MHC-AF distinct from IFN-γ, is produced by activated human mononuclear cells.

Enhanced MHC I antigen expression on tumour target cells is inversely correlated to lysis by allogenic but not by xenogenic NK cells.

Relationship between the levels of MHC class 1 antigen expressed on tumour cells and their susceptibility to allogenic and xenogenic NK cells was investigated. Mouse and human natural killer-resistance inducing factor (NK-RIF) preparations were used for augmenting/inducing MHC 1 antigen expression on murine YAC and human K562 tumour cells, respectively YAC cells with augmented MHC I antigen expression became relatively resistant to lysis by murine NK cells but not to rat NK cells. Similarly, induction of MHC I antigens on K562 cells reduced their susceptibility to human NK cells but not to monkey NK cells. These results indicate that the inverse correlation of MHC I antigen expression and NK susceptibility does not hold true for xenogenic pairs of NK effector and target cells.

Effect of moderate & high loadings on the proteoglycans & water content of bovine knee joint articular cartilage.

Variations in proteoglycans and water content of the knee joint cartilage were found to occur when the joint was subjected to articulating motion under moderate and high loadings. It was found that at a moderate load of 150 kg there were an increase in the percentage of proteoglycans but the percentage decreased when the joint was articulated at a high loading of 300 kg. It has also been observed that the ratio of water content and the proteoglycans decreased at moderate load, whereas the ratio increased at high load. The observed changes in proteoglycans and water content in extracellular matrix with moderate and high loadings suggested that articular cartilage properties respond to mechanical stresses.

Effect of gamma interferon on the expression of class I MHC antigens on fresh leukemic cells and their susceptibility to lysis by lymphokine activated killer cells.

Relationship between MHC class I antigen expression on PBLs from leukemia patients and their susceptibility to lysis by LAK cells was investigated. LAK cells induced small yet significant lysis of leukemic cells. In nine out of 14 cases studied, treatment with Interferon gamma (200 U/ml for 48 hours) resulted in a decrease in the LAK susceptibility of leukemic cells. In six of these cases, there was a concomitant increase in the expression of class I MHC antigen expression. In three samples, the increase in MHC class I antigen expression was not accompanied by a decrease in LAK susceptibility. IFN treatment had no effect on the binding of leukemic cells to LAK effector cells.

Immune status of children suffering from minimal change nephrotic syndrome.

Twenty five children suffering from minimal change nephrotic syndrome were studied for immunological alterations at different stages of this disease i.e., onset, relapse and remission. Changes were found mainly at onset and during relapse in the form of altered helper and suppressor cell ratio, depressed delayed cutaneous hypersensitivity reaction, decreased S-IgG bearing lymphocytes with low serum IgG concentration, and increased S-IgM bearing lymphocytes with high serum IgM concentration. Majority of these parameters returned to normal values during remission. Serum IgE was found high at all stages of this. These alterations suggest defects in cell mediated immunity resulting in secretion of some substance which modifies the glomerular anionic charges.

Quantitative estimation of major histocompatibility complex antigens on live tumour cells.

Quantitation of major histocompatibility complex (MHC) antigens on cells can accurately be done by using a flowcytometer. Since flowcytometer is not freely accessable an alternate, simple method for relative quantitation of MHC antigens has been devised. In this procedure, YAC lymphoma cells were first treated with a monoclonal anticlass I MHC antibody and then with a rabbit anti mouse Ig-antibody coupled to peroxidase, followed by colour development using a substrate of peroxidase enzyme. Various assay parameters have been optimized. The validity of the procedure was examined by assessing the enhanced MHC expression on YAC cells treated with a soluble rat spleen derived factor, by the new procedure as well as by the flowcytometer. Comparable results were obtained by using both techniques.