Agronomic characters and genomic markers based assessment of genetic divergence and its relation to heterotic performance in maize

Aim: The present study was undertaken to examine the relation between genetic divergence of some tropical inbred lines of maize and extent of heterosis manifestation in their single cross hybrids. Methodology: Fifteen inbred lines and three inbred testers along with 45 single cross hybrids were evaluated by adopting randomized complete block design during two seasons. The observations recorded on eight metric traits of the entries in each of three replications were utilized during statistical analysis across the seasons. Relative importance of classification variables was determined by principal component analysis and the phenogram was generated using average taxonomic distance. Molecular profiling of inbred lines was carried out by employing 28 SSR primer pairs covering all the chromosomes. Principal coordinate analysis was performed and similarity indices based dendrogram was constructed. Relationship between parental genetic divergence and heterosis was statistically tested. Results: Significant differences due to parents, hybrids and parent vs. hybrids were observed for all metric characters. Principal component analysis based diagram and average taxonomic distance based phenogram separated the inbred lines into five clusters. Amplification profiles based principal coordinate analysis and hierarchical cluster analysis differentiated the inbred lines into four major clusters. Statistically non-significant correlation of genomic data based genetic similarity or phenotypic data based genetic dissimilarity of inbreds was revealed with grain yield and heterosis of hybrid combinations. Significantly positive correlation was found between heterosis over mid parent or better parent and grain yield of hybrids. Interpretation: Parental genetic divergence was not linearly or additively related to heterosis manifestation in hybrid. Moderate genetic divergence together with high per se performance of inbreds seemed to be a better criterion than consideration of merely extreme genetic diversity as the basis for the choice of parental inbreds during heterotic single cross hybrid development in maize

Phenotypic detection of carbapenem resistance and metallo-beta-lactamase among Enterobacteriaceae from clinical samples in tertiary care hospital

Background: Carbapenems have the broadest activity spectra of any β-lactam antibiotic and are often the most appropriate agents for use in the treatment of infections caused by multi resistant gram negative bacteria. The recent worldwide emergence and dissemination of carbapenemase-producing Gram negative rods that are resistant to carbapenems is a significant concern with respect to patient care and infection control strategies. Hence this study was undertaken to study the magnitude of carbapenem resistance among routine clinical isolates of family Enterobacteriaceae so as to guide the clinicians in selection of appropriate antimicrobial chemotherapies and infection control measures.Methods: The present study was conducted in the Department of Microbiology over a period 18 months from January 2017 to July 2018. All the clinical isolates of Enterobacteriaceae were screened for carbapenem resistance as per CLSI guidelines. Such strains were then subjected to phenotypic confirmation of carbapenemase production by the Modified Hodge test. All isolates that gave a positive screening test were further evaluated for metallo-β-lactamase production. The technique used was the Combined Disk Test using a combination of Imipenem and Imipenem-EDTA.Results: Out of the 400 total clinical isolates of Enterobacteriaceae isolated in the laboratory,57 were found to be Meropenem resistant (14.25%) and were labelled 'Carbapenem resistant Enterobacteriaceae" or CRE. Modified Hodge test (MHT) performed on the 57 carbapenem resistant isolates showed 41 (71.93%) isolates to be carbapenemase enzyme producers. Combined disc test (CDT) conducted on the 57 isolates of CRE detected Metallo-β-lactamase (MBL) enzyme production in 39 isolates (68.42%).Conclusions: Since there is a high prevalence of carbapenemase resistance in our setting hence we need to be cautious with the indiscriminate use of broad spectrum antimicrobials, more so, the carbapenems.

Evaluation of BODE index as a predictor of Pulmonary Hypertension in COPD patients.

Background: The severity of COPD is usually assessed on the basis of a single parameter – forced expiratory volume in one second (FEV1). However, the patients with COPD have systemic manifestations that are not reflected by the FEV1. The present study was undertaken to determine the predictive value of BODE index (Body-mass index (B), the degree of airflow obstruction (O) ,dyspnea (D), and exercise capacity (E) for development of pulmonary hypertension and as a predictor of severity in COPD patients. The original BODE index is a simple multidimensional grading system which is superior to FEV1 alone for prediction of mortality and hospitalization rates among COPD patients. Methods: This study was done from January 2013 to December 2014.Total one hundred male patients who attended the chest medicine department, with the symptoms suggestive of COPD were included in this study and the study was done to evaluate the BODE index and correlated with echo-cardigraphic findings suggestive of pulmonary hypertension as a predictor of severity in patients with COPD. Result: Among patients with COPD, there were (21%) patients who had mild COPD with a BODE score between 0 – 2, Moderate COPD (BODE score of 3 – 5) were (23%), Severe COPD (BODE score more than or equal to 6) groups had (56%) patients. The study results showed that as the BODE index scores severity increases the incidence of pulmonary hypertension increases as identified by echocardiography RVSP (Right ventricular systolic pressure) findings. The average RVSP was 59.6 in severe COPD patients (BODE index more than 6) 47.2 in moderate severe COPD (BODE index 3-5), while it was less than 36 in mild groups. These values were found to be significant on comparison to other groups. Conclusion: BODE index may offer superior and alternative reliable method to predict severity in patients with COPD in terms of pulmonary hypertension and for following up after medications. Since the assessment of BODE index requires only a spirometer, which is relatively inexpensive and can easily be made available, this index could be of great practical value in a primary health care setup to identify individuals who are at need for further evaluation in a higher referral center. Thus, BODE index can be used for judicious referral of patients with COPD thereby preventing the wastage of the limited resources available.

Prevalence and Risk Factors for Allergic Bronchopulmonary Aspergillosis in Indian Children with Cystic Fibrosis.

Objectives: Allergic bronchopulmonary aspergillosis (ABPA) is a common complication in patients with cystic fibrosis. This crosssectional study was planned to determine the prevalence and risk factors for ABPA in Indian children with cystic fibrosis. Methods: Clinical evaluation, spirometry, chest radiograph, sputum, total IgE, specific IgE for Aspergillus fumigatus, IgG precipitins and skin prick tests were done in 33 CF patients. Results: Prevalence of allergic bronchopulmonary aspergillosis was 18.2% (95% CI 6.9% - 35.4%): allergic bronchopulmonary aspergillosis was higher in patients with low cystic fibrosis score, age >12 years, atopy, and eosinophilia. Conclusion: Prevalence of ABPA is higher in Indian children with cystic fibrosis.

Knowledge, Awareness, and Practices Among Patients with Thyroid Swelling Attending Cytology Clinic in a Medical College, Meerut.

Background: Thyroid disorders are believed to be a common health issue in India, as it is worldwide. However, there is a paucity of data on the knowledge, awareness, and practices (KAP) among these patients. Materials and methods: A crosssectional study was conducted in a medical college of Meerut, Uttar Pradesh. Total 200 patients were evaluated during the period from 2011 to 2012. Results: Total 200 patients with thyroid swelling were evaluated. Sixty percent patients did not know that thyroid is a normal gland in body while 50% did not knew about hyper/hypothyroidism. There are many misconceptions regarding thyroid disorders, such as 79.5% patients thought that hypothyroidism causes excessive weight gain. Conclusion: This study shows that patients with thyroid disorders lack knowledge. Education should take place at all levels and should include doctors and decision makers, health workers, and citizen groups. The results of this study will help the physician to concentrate on these specific issues during their interaction with the patients.

Emergence of decreased susceptibility to extended-spectrum cephalosporins in Neisseria gonorrhoeae in India.

Background. In the past, Neisseria gonorrhoeae has developed resistance to antimicrobial agents used for its treatment. Consequently, extended-spectrum cephalosporins form the mainstay of treatment for gonorrhoea. Methods. Samples from 88 patients attending the sexually transmitted diseases clinics from December 2009 to January 2011 in two referral hospitals in New Delhi were studied. Antimicrobial susceptibility testing was done using the disc diffusion method as per the calibrated dichotomous sensitivity technique against the following antibiotics: penicillin (0.5 i.u.), tetracycline (10 μg), nalidixic acid (30 μg), ciprofloxacin (1 μg), spectinomycin (100 μg), ceftriaxone (0.5 μg) and cefpodoxime (10 μg) (Oxoid UK). Azithromycin (15 μg) (Oxoid, UK) was tested as per the guidelines of the Clinical and Laboratory Standards Institute. Minimum inhibitory concentrations were determined using the Etest for penicillin, tetracycline, ciprofloxacin, ceftriaxone, spectinomycin and azithromycin as per the manufacturer’s instruction (Biomerieux, France). Results. Eighteen isolates of Neisseria gonorrhoeae were obtained. Three of these had decreased susceptibility to ceftriaxone and cefpodoxime by the disc diffusion method. The minimum inhibitory concentrations of ceftriaxone for two isolates were 0.064 μg/ml and for one isolate it was 0.125 μg/ml. Conclusion. Higher minimum inhibitory concentrations to extended-spectrum cephalosporins is of concern as it has been shown to precede treatment failure. This may warrant its use in increased/multiple dosages alone or possibly in combination (dual therapy), thereby complicating effective disease control. Our report is in accordance with earlier reports from different parts of the world. Therefore, a continuous surveillance of antimicrobial resistance is crucial to tailor treatment schedules for Neisseria gonorrhoeae in a particular geographical region.

The role of a commercial enzyme immuno assay antigen detection system for diagnosis of C. trachomatis in genital swab samples.

In the present pilot study, endocervical and urethral swabs collected from 100 patients attending sexually transmitted disease (STD) clinics and regional centre for STD in two referral hospitals in New Delhi were analyzed by enzyme immune assay (EIA), polymerase chain reaction (PCR) and direct fluorescent antibody (DFA) for detection of C. trachomatis. It was found that EIA could detect a very low number of cases (3/100) as against DFA (11/100) and PCR (9/100). Thus, in spite of the widespread availability, lower cost and ease of performance of the enzyme-linked-immunosorbent serologic assay, the present study highlights the need to employ sophisticated diagnostic tools like DFA and PCR for detection of Chlamydia trachomatis in STD patients.

Clinical and bacteriological profile and outcome of sepsis in dermatology ward in tertiary care center in New Delhi.

Background: There is paucity of data regarding the clinical and bacteriological profile of sepsis in dermatology in-patients. Aims: To study the frequency, etiology, and outcome of sepsis dermatology in-patients. Methods: The study was conducted in a 30-bedded dermatology ward of a tertiary care center. Sepsis was defined by presence of ≥2 SIRS (systemic inflammatory response syndrome) criteria along with evidence of infection (clinically obvious/culture proven infection of skin or internal organs). Patients were also assessed for known (common) risk factors of sepsis. In suspected sepsis patients, at least two samples of blood cultures by venepuncture were taken. Pus, skin swab, urine, and sputum samples were also collected for culture as needed with avoidance of contamination. Results: Among 860 admitted patients studied from November 2004 to July 2006, 103 (12%) fulfilled SIRS criteria. Of these, 63 had nonsepsis causes of SIRS positivity, while 40 (4.65%) had sepsis. Majority of the sepsis patient had vesicobullous diseases (42.5%), erythroderma (25%), toxic epidermal necrolysis (TEN) (22.5%). Severe sepsis developed in 17 (42.5%) patients, while 15 (37.5%) died. Methicillin-resistant Staphylococcus aureus (MRSA) was the commonest organism isolated (99; 25.9%) in all culture specimens followed by Acinetobacter spp. (52; 13.6%), Pseudomonas spp. (40; 10.5%), Methicillin-sensitive S. aureus (MSSA: 33; 8.7%), and Klebsiella spp. (22; 5.8%). Various risk factors affecting mortality and sensitivity patterns for various isolates were also analyzed. Conclusion: Sepsis occurred in 40 (4.65%) inpatients in dermatology ward. The frequency of sepsis was highest in TEN (90%), followed by drug-induced maculopapular rash (20.0%), erythroderma (17.5%), and vesicobullous diseases (8.5%). MRSA, acinetobacter, pseudomonas, MSSA, and Klebsiella were important etiological agents involved in sepsis in dermatology in-patients.

Standard guidelines of care: Keloids and hypertrophic scars.

Keloids and hypertrophic scars (HTS) are the result of overgrowth of fibrous tissue, following healing of a cutaneous injury, and cause morbidity. There are several treatment modalities which are useful for the management of keloids, though no single modality is completely effective. The most commonly used modalities are pressure, silicone gel sheet, intralesional steroids, 5-fluorouracil (5 FU), cryotherapy, surgical excision, and lasers. They may be used either singly or, as is done more commonly, in combinations. Any qualified dermatologist who has attained postgraduate qualification in dermatology can treat keloids and HTS. Some procedures, such as cryosurgery and surgical excision, may require additional training in dermatologic surgery. Most modalities for keloids, including intralesional injections and mechanical therapies such as pressure and silicone gel based products, can be given/prescribed on OPD basis. Surgical excision requires a minor operation theater with the facility to handle emergencies. It is important to counsel the patient about the nature of the problem. One should realize that keloid will only improve and not disappear completely. Patients should be informed about the high recurrence rates. Different modalities carry risk of adverse effects and complications and the treating physician needs to be aware of these and patients should be informed about them.

Primary tuberculosis of glans penis after intravesical Bacillus Calmette Guerin immunotherapy.

A 55-year-old male with carcinoma in situ of urinary bladder was treated with weekly intravesical injections of Bacillus Calmette Guerin (BCG) vaccine. Three days after the sixth injection, he developed low grade fever and multiple grouped punched out, 2-3 mm ulcers around meatus and corona glandis. In addition, multiple, firm, indurated, nontender papules and few deeper nodules were present on the proximal part of glans penis, along with bilateral enlarged, matted and nontender inguinal lymph nodes. There was no history suggestive of sexually transmitted diseases and high risk behavior. Chest X-ray was within normal limits, and Mantoux, Venereal Disease Research Laboratory (VDRL) and HIV antibody tests were negative. The biopsy from the penile ulcer revealed epithelioid cell granuloma with Langhans giant cells. Fine needle aspiration cytology from the lymph node also revealed epithelioid cell granuloma and acid fast bacilli on Ziehl Neelsen's stain. The tissue biopsy grew Mycobacterium tuberculosis. The BCG immunotherapy was stopped and patient was treated with four drug antitubercular therapy with isoniazid, rifampicin, ethambutol, and pyrazinamide in standard daily doses along with pyridoxine. The edema resolved and the ulcers started healing within 2 weeks, and at 6 weeks after starting antitubercular therapy almost complete healing occurred. To the best of our knowledge, we describe the first case of an Indian patient with BCG induced primary tuberculosis of penis after immunotherapy for carcinoma urinary bladder and review the previously described cases to increase awareness of this condition in dermatologists and venereologists.