ABSTRACT
Enterococcus, considered a normal commensal of intestinal tract, is fast emerging as a pathogen causing serious and life threatening hospital borne infections. This is attributed to acquisition of multi drug resistance and virulence factors of the organisms. The sequencing of Enterococcus faecalis has given a lot of insight into its genetic makeup. The E. faecalis strain V583, which has been sequenced, contains a total of 3182 open reading frames (ORFs) with 1760 of these showing similarity to known proteins and 221 of unknown functions. Strikingly unique to this genome is the fact that over 25% of the genome is made up of mobile and exogenously acquired DNA which includes a number of conjugative and composite transposons, a pathogenicity island, integrated plasmid genes and phage regions, and a high number of insertion sequence (IS) elements. This review addresses the genomic arrangement and the study of virulence factors that have occurred since the sequencing of the genome.
ABSTRACT
OBJECTIVE: To evaluate the utility of an indigenously developed nitrite kit for the rapid diagnosis of urinary tract infection (UTI) METHODS: 1018 urine specimens were collected from all cases where there was clinical suspicion of UTI. Samples were cultured as per standard microbiological protocol. Presence of nitrites was indicated by the development of purple color on addition of color developing solution and compared with the set of graded positive and negative controls also provided in the Kit. RESULTS: The results of the nitrite kit were compared with the semi-quantitative urine culture as the gold standard. The sensitivity, specificity, positive predictive and negative predictive values were 47%, 87%, 31% and 93%, respectively. CONCLUSION: Nitrite kit as a screening test can decrease the work load in the clinical bacteriology laboratory. More importantly in a field set up that is devoid of culture facilities, it can be used to correctly predict the absence of UTI.
Subject(s)
Adult , Bacterial Infections/diagnosis , Child , Humans , India , Nitrites/urine , Observer Variation , Reagent Kits, Diagnostic/economics , Sensitivity and Specificity , Urinary Tract Infections/diagnosisABSTRACT
Till forty years ago infants and children with hydrocephalus had a bleak future. Most of them used to die. Those who survived lived with mental retardation, spasticity and blindness. With the advent of an effective shunting device in 1957, a new era was ushered in the history of hydrocephalus. Today an infant with hydrocephalus has a good chance of symptom-free survival into adulthood. This landmark achievement divides the past from the present. Although CSF shunts bring about a dramatic improvement in symptoms, the long term results reveal a high incidence of shunt related problems and therefore, the search for a competent and long lasting surgical treatment continues. The purpose of this communication is to review the contributions of the past, to critically evaluate the achievements of the present and to predict the advances expected to come through in the future.
Subject(s)
Adult , Cerebrospinal Fluid Shunts/adverse effects , Disease-Free Survival , Forecasting , Humans , Hydrocephalus/complications , Incidence , Infant, Newborn , Longevity , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Ventriculostomy/instrumentationABSTRACT
The clinical and myelographic evaluation in 24 children with spina bifida occulta has been correlated with the operative findings. Myelograms were done using Myodil in 11 patients and Metrizamide in 13 patients. The diagnostic quality of myelograms done with Metrizamide was comparatively better. Myodil myelography failed to demonstrate diastematomyelia in one case and a dural sac in 3 cases of lipomeningomyelocele, whereas, Metrizamide failed to demonstrate a sac in one case of lipomeningomyelocele only. Worsening of the neurological status was observed in only 3 cases in whom myelography was done with Myodil. The radiographic and operative correlation has been discussed.