Level of organochlorine pesticide residues in dry fruit nuts.

The use of pesticides on cash crops and exportable food commodities had always been a serious concern. Fruits form one of the important constituents of human diet, in that they give one third of the requirement of calories, vitamins, and minerals. This study has been carried out to determine the level of organochlorine pesticides namely HCH, DDT and Endosulfan in raw fruit nuts. Nuts have proteins and high level of fat content. These properties of nuts attract organochlorine pesticides to accumulate. The analysis of organochlorine pesticide residues in commonly used dry fruits like Cashew nut, Walnut, Coconut , Chilgoza , Chironji, Makhana, Resins, Apricot, Almonds, Date palm , Pistachio nut collected from local market of Lucknow. India has indicated presence of very low level of HCH (0.007-1.328 mg kg-1), DDT (ND-0.140 mg kg-1) and Endosulfan (ND-0.091 mg kg-1).There are no MRL values established for nuts in the country. This finding is based on a smaller number of samples, which however suggest that the presence of low level of DDT, HCH and Endosulfan might be due to environmental rather than direct exposure.

Characterization and changing minimum inhibitory concentration (MIC) of Acinetobacter species from a tertiary care setup.

128 isolates of Acinetobacter species from admitted and outdoor patients were subjected to biotyping and resistotyping. Resistance phenotype analysis included nine antibiotics and two betalactam inhibitor combination drugs. In 100 strains of Acinetobacter spp. ciprofloxacin, amikacin, cefotaxime and cefepime minimum inhibitory concentration (MIC) was done by agar dilution using NCCLS 2002 criteria. In forty-nine isolates MIC level was determined by E-strip also. Extended spectrum beta lactamase (ESBL) production was detected by double disc synergy technique. Inducible beta lactamases (IBL's) were detected by disc approximation method. The relationship between biotypes and resistance phenotype was analyzed. Majority of isolates (93.75%) were from admitted patients. The biotyping revealed Acinetobacter calcoaceticus-Acinetobacter baumannii complex (87.2%) to be the predominant species and they were isolated from tracheal aspirates of patients with ventilator associated pneumonia. By Kirby Bauer disc diffusion antimicrobial sensitivity testing Acinetobacter spp. were most sensitive to the combination of drug cefoperazone-sulbactam (95.6%) followed by meropenem (94.6%), piperacillin-tazobactam (92.6%). On screening incidence of Imipenem Nonsensitive Acinetobacter spp. (INSA) was (5.4%). Acinetobacter spp. were typable by six resistance phenotypes and six biotypes. Most common (66.6%) resistant phenotype of A. calcoaceticus-A. baumannii complex was susceptible to cefoperazone-sulbactam and or meropenem and or piperacillin-tazobactam. ESBL production was seen in 6% and IBL (Inducible Beta Lactamase) production was seen in 7% of Acinetobacter spp. The MIC90 for ciprofloxacin was =256 microg/ml, cefotaxime 512 microg/ml, cefepime 512 microg/ml, and amikacin 32 microg/ml. Multidrug resistance was seen in more than 90% of A. calcoaceticus-A. baumannii complex and 20% of Acinetobacter lwoffii. Acinetobacter spp. has other emerging novel mechanism of resistance that requires continuous research. Simpler, reproducible and reliable methods of biotyping and their subsequent correlation with resistotyping are more cost effective than molecular methods, which are available only in reference laboratories.

Defective interleukin-2 production and interleukin-2 receptor expression in pulmonary tuberculosis.

The evolution of Mycobacterium tuberculosis as an intracellular pathogen has led to a complex relationship between it and its host, the human mononuclear phagocyte. The products of M. tuberculosis-specific T lymphocytes are essential for macrophage activation for intracellular mycobacterial killing. However, dysfunction cell-mediated immune response to infection with M. tuberculosis may contribute to progressive primary infection or reactivation of endogenous foci of mycobacteria. Th1 cells produce IL-2, which is essential for proper cellular immunity. The aim of this study was to identify the variation in IL-2 activity and soluble IL-2 receptor (IL-2 R) in peripheral blood lymphocyte in patients suffering with pulmonary tuberculosis. A significant decrease in IL-2 and IL-2 receptor level was observed in patients with pulmonary tuberculosis when compared to normal controls. Our results suggested that patients with pulmonary tuberculosis had a defect in IL-2 production. Better understanding of these interactions will allow the development of increasingly specific immune-based interventions for prevention and treatment of tuberculosis.

Does moderate alcohol intake protect against coronary heart disease?

There is abundant epidemiological and clinical evidence to show that light-to-moderate drinking is associated with a reduced risk of coronary heart disease (CHD), total and ischemic stroke, and total mortality in middle-aged and elderly men and women. The evidence suggests a J- or U-shaped relationship between alcohol and CHD. Alcohol reduces the risk of coronary heart disease both by inhibiting the formation of atheroma and by decreasing the rate of blood coagulation. It appears that for most conditions, other than cardiovascular diseases and cholelithiasis, moderate alcohol consumption has either none or only an intermediate type of risk as compared with the risk of either abstinence or excessive drinking. It is now fully recognized and accepted that drinking alcohol regularly for years is toxic to almost every tissue of the body. However, most people who choose to drink alcohol have little or no problem limiting their consumption to amounts that do not generally cause serious health or social consequences. Moreover, a given dose of alcohol may affect different people differently. It is, therefore, imperative that a critical evaluation, based on the observations made hitherto, be done of both the harmful and the protective effects of alcohol consumption on various organs/systems of the body. This article reviews epidemiological evidence for the protective effects of alcohol on the cardiovascular system and discusses how alcohol might lower the risk of CHD.

Use of complement receptor 1 (CD35) assay in the diagnosis and prognosis of immune complex mediated glomerulopathies.

Complement Receptor 1 (CR1) is a polymorphic glycoprotein expressed on erythrocytes, leukocytes and glomerular podocytes and has a major role in immune complex processing. In addition, it regulates the complement cascade activation by preventing formation of classical and alternative pathway convertases and by acting as a cofactor for Factor I mediated cleavage of C3. In this study, we have examined the expression of erythrocyte CR1 (E-CR1) and glomerular CR1 (G-CR1) in different kinds of nephropathies using ELISA and immunofluorescence microscopy to understand their role in immune complex (IC) mediated renal diseases. E-CR1 was significantly reduced in all categories of lupus nephritis in comparison to normal subjects and non-IC renal diseases. However, other IC mediated diseases like IgA nephropathy and membranoproliferative glomerulonephritis had normal E-CR1 levels. G-CR1 showed distinct differences between IC and non-IC mediated diseases. G-CR1 was virtually absent in lupus kidneys. In other IC mediated diseases, there was a correlation of G-CR1 expression to the IC and complement fragment deposition. G-CR1 serves as a useful diagnostic marker for IC mediated diseases while E-CR1 is useful as a prognostic marker to monitor the course of disease after the treatment has initiated.

Role of oxygen free radicals in causing endothelial damage in acute myocardial infarction.

OBJECTIVES: This work was done in order to study the oxidant and anti-oxidant status in a disease resulting from endothelial injury. The disease selected for study was acute myocardial infarction. METHODS: Sixty patients of acute myocardial infarction were selected after being diagnosed in accordance to the guidelines laid down by the WHO. Thirty subjects were included as controls. Plasma levels of certain markers of oxidative stress and anti oxidant activity were measured in all the subjects. Malonaldehyde (MDA) and nitrite (NO2) were measured as markers of free radical mediated endothelial injury, and superoxide dismutase (SOD) enzyme as an indicator of antioxidant activity. RESULTS: It was found that the plasma levels of MDA and nitrite were significantly elevated in the patients of acute myocardial infarction compared to the control group (7.29 +/- 3.28 v/s 4.57 +/- 0.63 nmol/ml and 12.85 +/- 8.71 v/s 0.97 +/- 0.25 microM respectively), thereby indicating that oxygen free radicals cause endothelial damage in them. The superoxide dismutase levels were also found to be elevated in these patients (5.57 +/- 1.47 v/s 3.91 +/- 0.66 U/ml). CONCLUSION: These results indicate that acute myocardial infarction is a state of enhanced free radical activity, which causes endothelial damage. The elevated SOD levels may imply that the body attempts to combat this oxidative stress by raising it's level of anti-oxidants.

Apolipoprotein(a) polymorphism and its association with plasma lipoprotein(a) levels: a north Indian study.

Elevated levels of lipoprotein(a) has been regarded as an independent risk factor for coronary, peripheral and cerebral atherosclerosis. The enormous intra-personal variation in the plasma concentration of lipoprotein(a) is almost entirely controlled by the apolipoprotein(a) i.e. gene locus on the chromosome 6q 26-27. The apolipoprotein(a) molecule is highly polymorphic and is known to exist in multiple, genetically determined isoforms. These polymorphisms may be responsible for difference in promoter activity, variable size of apolipoprotein(a) and thereby variation in plasma lipoprotein(a) concentration. We studied the effect of two types of polymorphisms, (i) variation in length of the pentanucleotide repeat in the 5' flanking region starting -1373 bp upstream of AUG codon, and (ii) the Kringle-4 type 2 size polymorphism, on plasma lipoprotein(a) levels in North Indian population. The study group consisted of 88 angiographically assessed male coronary artery disease patients (age range 30-70 years) and 83 age- and sex-matched healthy controls. The pentanucleotide repeat polymorphism was analysed using polymerase chain reaction. In all, 8/11 pentanucleotide repeat isoforms were observed. Using SDS-agarose gel electrophoresis and immunoblotting isoforms having 12-50 Kringle-4 type 2 repeats were detected. Our study indicates a strong association of elevated plasma lipoprotein(a) concentration with coronary artery disease. An inverse correlation was seen between lipoprotein concentration and isoform size for both the pentanucleotide repeat polymorphism and the Kringle-4 type 2 polymorphisms; statistically significant difference (p = 0.001) was, however, observed only for the later.

Fasciolopsiasis--a persisting problem in eastern U.P.--a case report.

Fasciolopsiasis, or infection by the intestinal fluke, Fascilopsis buski, is endemic in the eastern states of our country. While it is by no means a rarity, especially in the rural set up, awareness regarding this common parasitic infestation is still a much-needed entity. The importance of a strong degree of suspicion and early diagnosis cannot be over emphasised, if a successful campaign is to be launched in its control. With this as our central theme, we proceed to report a case of and unsually heavy Fasciolopsis buski infection in our hospital, which had failed to be diagnosed in a semi urban setup in UP.

Detection of mycobacterial antigen in circulating immune complexes in patients with childhood tuberculosis.

The presence of both components (antigen and antibody) in circulating immune complexes (CIC) were detected in tuberculosis in children. Fifty two patients with pulmonary and extrapulmonary tuberculosis showed the presence of either components or both. CIC--antigen was present in 92.3% (48/52) and CIC antibody in 88.96% (46,52). Out of these 52 patients, 20 were proved cases, CIC antigen (ag) and CIC--antibody (ab) were present in 100% (20/20). In the control group both CIC-ag and CIC-ab and CIC = ab can be taken as an additional marker in diagnosis of tuberculosis.

Macronutrient and energy content of breast milk of mothers delivering prematurely.

The protein, lactose, fat and energy contents of the fore-milk of mother with term (n = 23) and preterm (n = 29) infants were estimated on postpartum days 3, 7, 14 and 21. During the first 4 weeks of lactation, the mean (+/- SD) energy (Kcal/dl), protein (g/dl), fat (g/dl) and lactose (g/dl) levels of the preterm milk were: 56.39 (+/- 7.99), 2.17 (+/- 0.66), 2.30 (+/- 0.48) and 5.78 (+/- 0.99), respectively. The same for term milk were: 59.39 (+/- 8.30), 1.99 (+/- 0.70), 2.48 (+/- 0.53) and 6.24 (+/- 1.08), respectively. The differences in composition between the term and preterm milk were not significant. The composition of breast milk showed changes over the first 3 weeks of lactation. With increasing post-partum days, there was a decline in protein content while fat, lactose and energy contents increased. These trends were more pronounced for preterm milk than term milk. The macronutrient composition and energy estimates of preterm breast milk of Indian mothers in this study may be useful for calculation of nutritional intake by premature neonates fed on expressed breast milk.

Release of superoxide anion from activated mouse peritoneal macrophages during Mycobacterium tuberculosis infection.

Mouse peritoneal macrophage monolayers infected with M. tuberculosis were cultured in RPMI up to 7 days. Release of superoxide was assayed on different days in presence or absence of Phorbol myristate acetate (PMA), a known stimulator of NADPH oxidase which is involved superoxide production. Basal level of superoxide release was significantly higher in M. tuberculosis infected peritoneal mouse macrophages (P < 0.01) as compared to normal mouse macrophages. When normal and tuberculoid macrophage cultures were stimulated with PMA, increased superoxide anion release was observed in both the cultures but the increase of superoxide was significantly higher in normal macrophages as compared to tuberculoid stimulated macrophages. Superoxide release was maximum in 4 day old cultured macrophages and gradually it declined in older cultures by day 7, both in vitro and in vivo. A defective macrophage function in killing of M. tuberculosis bacilli was observed after 4 days of in vitro and in vivo cultures.

Biochemical alterations in macrophages by interaction with immune complexes.

The mouse peritoneal cells (MPS) were stimulated under in vitro and in vivo conditions with different compositions of bovine serum albumin (BSA)-anti BSA immune complexes (IC). The aim was to monitor the biochemical changes that may occur in macrophages and this activation was indicated by an increase in the number and protein content of the cells. The role of these complexes in inducing lysosomal hydrolases release from elicited as well as during an in vitro interaction with ICs was also studied. The insoluble immune complex at equivalence (IC-Eq) and immune complex-antibody excess (IC-Ab) registered a significant increase in number of cells and protein content as compared to soluble immune-complex antigen excess (IC-Ag) complexes. The IC elicited cells showed lesser secretory activity as compared to MPM cells stimulated in vitro. Stimulating capacity of ICs in causing hydrolase release was time and dose dependent. The complement coated complexes were the most effective in inducing enzyme release (4.5-5-fold).

Effect of corticosteroid treatment on various serological & bronchoalveolar lavage abnormalities in patients with sarcoidosis.

Effect of daily oral prednisolone treatment was studied in 29 patients with pulmonary sarcoidosis. Twenty normal control subjects were also studied. Pretreatment absolute lymphocyte counts and proportion of lymphocytes in peripheral blood were significantly lower in patients with sarcoidosis as compared to normal controls. Total cell count and the proportion of lymphocytes in bronchoalveolar lavage (BAL) fluid were significantly higher in sarcoidosis. The proportion of CD3+ and CD4+ was significantly lower in peripheral blood and higher in BAL fluid in patients with sarcoidosis. Immunoglobulins (IgG, A and M) and complements (C3, C4 and CH50) were significantly higher both in peripheral blood and BAL fluid. Patients with sarcoidosis were treated with daily oral prednisolone (30 mg/day). Repeat studies were performed after an interval of 4-6 months in 20 patients with sarcoidosis. A significant increase in absolute lymphocyte counts in peripheral blood and decrease in the proportion of lymphocytes in BAL fluid occurred with prednisolone treatment. Proportion of CD3+, CD4+ and B cells increased in peripheral blood and decreased in BAL fluid. Complement and immunoglobulin levels revealed a significant reduction in peripheral blood and BAL fluid. It is concluded that patients with sarcoidosis have peripheral blood lymphopaenia and lymphocytic alveolitis. They have increased levels of complement and immunoglobulins both in the peripheral blood and BAL fluid. All these abnormalities show significant improvement with prednisolone treatment.

Diagnosis of tuberculous meningitis by ELISA test.

Detection of IgG antibodies to Mycobacterium tuberculosis H37 Ra antigen in cerebrospinal fluid (CSF), by ELISA test appears to be highly sensitive. In 90 per cent (18/20) of proven cases of tuberculous meningitis (TBM), antibodies were present in CSF; in 75 per cent (15/20) antibodies were also present in the sera. In the patients clinically suspected to have TBM, antibodies in CSF and sera were present in 87.5 per cent (42/48) and 70.8 per cent (34/48) respectively, whereas in the control group antibodies were present in only one serum sample and in none of the CSF samples. The results indicate that ELISA test using sonicated M. tuberculosis H37 Ra as antigen is a sensitive and specific test for diagnosis of TBM.

Inherited structural and quantitative polymorphisms of C3b receptor (CR1) in normals and patients with glomerular diseases.

The erythrocyte C3b receptor (CR1) has been studied for its structural and quantitative polymorphisms in normal Indian individuals and in patients with glomerular diseases. In the normal Indian population, purification of CR1 by immunoprecipitation or C3b-Sepharose affinity column and subjecting it to electrophoresis showed the existence of two types of structural polymorphic patterns with M(r) of 190 kDa and 220 kDa, and with gene frequencies of 0.975 and 0.025, respectively. The gene frequencies of these alleles remain unaltered in the patient population. Evaluation of CR1 levels in the normal Indian population revealed a trimodal distribution of CR1 number suggesting a co-dominant allelic pattern (L and H alleles) for the quantitative expression of CR1 with gene frequencies of 0.523 and 0.477, respectively. In our earlier study we have shown that there is a decreased expression of CR1 on the erythrocytes of patients with acute glomerulonephritis. Since this decrease in the CR1 level in patients is an acquired characteristic, it may not be the level controlled by the LL homozygous alleles. The discrepancy in the gene frequencies of the structural and quantitative polymorphic alleles in normal individuals show that they are not linked to each other. In our earlier study, we showed that the affinity constant of C3b-CR1 binding in different individuals remains the same irrespective of the number of CR1 on the erythrocyte surface. Comparison of this result with the present investigation shows that there is no functional difference among various structural polymorphic forms of CR1 and the susceptibility to glomerular diseases is not associated with any of the CR1 polymorphic patterns.

Effect of alcohol on serum lipids & lipoproteins in male drinkers.

The evaluation of the effect of moderate and high doses of ethanol on the serum levels of triglyceride (TG), total cholesterol (TC), cholesterol content of very low density lipoprotein (VLDL), low density lipoprotein (LDL), high density lipoprotein (HDL), HDL2, HDL3 subfractions and apoproteins: apo-AI and apo-B was undertaken in 45 (25 controls, 10 moderate and 10 high dose drinkers) healthy males. The results of this preliminary study showed a significant rise in total HDL-cholesterol and apo-AI levels of alcoholics of both the groups. Out of the two subfractions, HDL2 appeared to be induced more. Increased levels of atherogenic lipids (TG, VLDL-chol., LDL-chol. and apo-B) were found in high as well as moderate drinkers. Our results suggest that the benefit of alcohol intake need to be weighed carefully against its considerable risks.

Association between incidence of lipoprotein(a) positivity and coronary heart disease.

Serum samples from 167 (109 male, 58 female) hospital based staff as controls and 760 (596 male and 164 female) clinically documented patients of coronary heart disease (CHD) were subjected to 3.75% polyacrylamide gel electrophoresis for lipoprotein profile and the presence of lipoprotein(a) [LP(a)], which is reported to be an independent risk factor for CHD. Serum total cholesterol, triglyceride and ratio of the electrophoretically separated LDL/HDL lipoprotein fractions were also evaluated. The significant observations are (i) a large proportion of both male and female CHD patients showed the presence of LP(a) as compared to controls, (ii) The incidence of LP(a) positivity was found to be independent of sex and age in controls. Female patients however showed marginal increase (p < 0.05) with age. Male patients of < 40 years demonstrated three times higher incidence of LP(a) presence as compared to their female counterparts, (iii) Comparison of LP(a)+ and LP(a)- patients for serum lipid levels did not show any significant difference. It is inferred that LP(a) positivity may be independent of these lipid variables.

Coagulase negative staphylococcal septicemia in newborns.

The case records of 2177 newborn infants admitted in the Neonatal Intensive Care Unit (NICU) from January, 1989, through July, 1990, with positive blood cultures for coagulase-negative staphylococci (C-NS) were evaluated. Seventy four (3.4%) neonates yielded C-NS in blood cultures during the study period. Of these, 58 (2.7%) infants had clinical and hematological features compatible with the diagnosis of septicemia. Remaining 16 babies with positive cultures had no evidence of sepsis, and were designated as "C-NS bacteremia". The age at which positive cultures were obtained differed between the bacteremic and septicemic groups. In bacteremic group, the onset occurred between one to four days of age. In contrast, in septicemic group the range was 6-20 days, with a mean of 10.22 (+/- 3.53) days. More than two third of total cases of C-NS sepsis were premature and low birth weight (LBW). Prominent clinical features included lethargy, poor feeding and fever. Besides this apneic spells were seen predominantly in babies weighing less than 1500 g. Further, before the diagnosis of C-NS sepsis, more than half of neonates had received prolonged intravenous fluid therapy, a quarter had undergone umbilical catheterization and a further quarter needed a ventilator support. Overall mortality in C-NS sepsis was 17.24%, distinctly higher in neonates with RDS and those requiring mechanical ventilation (p less than 0.05). Only 1.34% C-NS isolates were resistant to all routinely used antibiotics and sensitivity was maximum with newer cephalosporins, ciproflox and amikacin.