Melioidosis in Odisha: A clinico-microbiological and epidemiological description of culture-confirmed cases over a 2-year period

Melioidosis is an emerging infectious disease in India mostly reported from South-western coastal Karnataka and North-eastern Tamil Nadu. We speculate the existence of another major hidden focus in Odisha, one of the eastern coastal states. The clinico-epidemiological features of 47 culture-confirmed melioidosis at a tertiary care teaching hospital over a period of 2 years are reported. Septicaemia was the most common clinical presentation. Diabetes mellitus (DM) was present in 72.3% of our cases. The geo-climatic conditions of Odisha and other coastal states of India and the rise in the incidence of DM demand a nationwide surveillance of melioidosis and creation of melioidosis registry.

No evidence of association of xenotropic murine leukemia virus‑related virus with oral cancers: Experience from a tertiary care center in South India.

BACKGROUND: Development of oral cancer, a widely prevalent cancer in India, is multifactorial with increased risk in those habituated to smoking, consuming alcohol and chewing paan and tobacco. This does not preclude other etiological factors in the causation of this cancer. Exploratory studies on several oncogenic viruses have found varied associations with oral cancers. AIM: The aim of this study was to explore the association of xenotropic murine leukemia virus‑related virus, (XMRV) a retrovirus recently implicated in oncogenesis in humans, with oral cancers. SETTINGS AND DESIGN: The presence of XMRV proviral deoxyribonucleic acid (DNA) was evaluated by standard nucleic acid amplification from DNA extracted from representative bits of tumor tissues and adjacent normal tissues from surgically resected specimens sent post‑operatively for routine histopathological testing. MATERIALS AND METHODS: This prospective study comprised 109 patients with a provisional diagnosis of oral cancer who were operated at the Oral Oncology Department of Kidwai Memorial Institute of Oncology, over a period of 10 months. RESULTS: XMRV was not found in any of the tumor tissues (squamous cell carcinomas ‑ 98; verrucous carcinomas ‑ 4) nor in any of the normal tissues. It is thus important that the absence of this oncogenic virus in all the cases makes the association of XMRV with oral cancers very unlikely. CONCLUSIONS: There is a need to investigate potentially oncogenic viruses in other solid tumors and in larger sample sizes. Any such association could have implications in detecting, preventing and treating these cancers.

Clinical and microbiological profile of febrile neutropenia in solid tumors and hematological malignancies at a tertiary cancer care center in South India.

BACKGROUND: Febrile neutropenia (FN) is a common but serious complication of chemotherapy in patients with solid tumors (ST) and hematological malignancies (HM). The epidemiology of FN keeps changing. OBJECTIVE: The objective was to study the epidemiology of FN in adult patients with ST and HM at Kidwai Memorial Institute of Oncology, Bangalore – A tertiary cancer care center. MATERIALS AND METHODS: Data of all episodes of FN that occurred during the period July 2011 to December 2011 were collected prospectively and analyzed. RESULTS: A total of 75 episodes of FN was observed during study period involving 55 patients. Febrile neutropenic episodes were more frequent in HM than in ST (57% vs. 43%). The rate of bloodstream infection was 14.7%. Gram‑negative organisms were the predominant isolates (56.25%). Overall mortality rate was 13.3%. Presence of medical co‑morbidity and positive culture predicted high mortality. Mortality rate did not differ significantly between HM and ST (14% vs. 12.5%; P = 1.0). Gram‑positive bacteremia was associated with greater mortality than Gram‑negative bacteremia (P = 0.02). CONCLUSION: Empiric antibiotic treatment for FN should be tailored to the locally prevalent pathogens and their susceptibility patterns.

A preliminary molecular study on protein profile of vital organs: A new direction for post mortem interval determination.

Estimation of the postmortem interval (PMI) is one of the most important tasks in Forensic Medicine. Six autopsy organ tissues such as brain, lungs, heart, liver, pancreas and kidney were taken at the time of forensic autopsy. All the proteins present in the tissues were extracted and the protein profile was analyzed on the sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) starting from 0 day to 10th day after death. The protein profiles showed a consistent degradation pattern which was consistent and reproducible in all the samples with respect to the time interval. In conclusion, the protein profile of the vital body organs appears to be a useful method for estimating the post mortem interval up to 10th day. Advantage of this approach over others is that it can detect the post mortem interval over a long interval (0 - 10 days) with an easily detectable pattern of protein profile.

Obesity attenuates formalin-induced tonic pain in British Angora Rabbits.

Obesity is known to alter various physiological parameters including the pain sensitivity. There are conflicting reports on the pain sensitivity in obesity. In this context, the present study was aimed to investigate the tonic pain response in obese rabbit model. To achieve this aim, two groups of adult male British Angora rabbits were used. One of the groups was fed with standard rabbit chow and served as control. The other group was fed high fat diet (HFD) for 10 weeks to produce obesity. The standard formalin test was performed at the start and after 10 weeks of dietary regimen in both the groups. Timed behavioral responses (limping, elevation of paw, licking, biting, grooming etc.) were categorized and quantified with the help of standard pain rating scale. The total average pain rating score decreased significantly from 2.01 ± 0.02 to 1.47 ± 0.08 (P<0.05) in HFD group after 10 weeks of dietary regimen, whereas there was no change in the control group. A significant negative correlation was observed between body weight and pain rating score in HFD group of rabbits (P<0.05, r=–0.62). Results suggest that obesity attenuates the tonic pain responses induced by formalin in British Angora rabbits.

High fat diet induces obesity in British Angora Rabbit : A model for experimental obesity.

A reliable and cost-effective animal model for human obesity with its manifested disorders is yet to be established in the context of increased morbidity and mortality due to obesity and its related problems. Therefore, an attempt was made to produce obesity in locally available British Angora Rabbits (BAR) and examine the effect on metabolic and cardiovascular parameters. Adult male BARs weighing nearly 2 kg were randomly divided into two groups, one of the groups was fed with high fat diet (HFD) ad libitum for 10 weeks and the control group received standard normal rabbit chow for same period. Body weight, skinfold thickness, serum cholesterol, serum glucose and resting heart rate were measured before and after the dietary regimens. After 10 weeks, HFD group of rabbits demonstrated significant (P<0.05) increase in body weight (+24%) and skinfold thickness (+37%). The gain in body weight was positively correlated to skinfold thickness (r=0.61). Serum cholesterol, serum glucose and resting heart rate were also increased by 46%, 52% and 15%, respectively. Whereas no such increases in any of these parameters were observed in control group of rabbits. Our results suggest that obesity can be produced in BARs by feeding HFD. The obesity manifests with cardiovascular and metabolic changes. It is proposed that this may serve as a valid and reliable model of experimental obesity.

Study of parental handling patterns in a primary school of Kolkata.

The intricate pattern of parenting in our socio-cultural context needs evaluation hence this study was done with the objective to reveal the parenting styles of school going children. 141 school children belonging to the age group 6-10 years were included in the study. The Parental Handling Questionnaire a 14-item scale consisting of 10 items of care and 4-items of control was administered to the mothers accompanying the children. Rating was done on a 3-point. The scale showed moderate internal consistency. 5 independent factors with overlapping items of care and control were deduced on factor analysis indicating multidimensional aspects of parenting in our society.

Oxidative stress in hypertension : Association with antihypertensive treatment.

There is growing evidence that oxidative stress contributes to the pathogenesis of hypertension. Our aim was to measure oxidative stress in hypertensive subjects, and assess the potential confounding influences of antihypertensive therapy. Serum malondialdehyde and antioxidant levels were estimated in patients at the time of presentation and also after a antihypertensive therapy for 3 months. During the period of study no antioxidant/s was given to the patients and control subjects. Mean blood pressure values were altered in the hypertensive patients following antihypertensive therapy from their respective values observed at the time of presentation. Serum malondialdehyde levels were significantly higher in the hypertensive patients in comparison to control cases. The antioxidant activity of enzymes super oxide dismutase, glutathione and non enzymatic antioxidant levels of vitamins E and C were significantly lower in patients compared to controls. After 3 months of antihypertensive treatment all the above parameters showed reversal in the respective levels of serum malondialdehyde and antioxidant activity. Antihypertensive medications lower the blood pressure and thereby results in reduced oxidative stress which indicates that oxidative stress is not the cause, but rather a consequence, of hypertension.

Mechanisms of resistance to carbapenems in meropenem- resistant Acinetobacter isolates from clinical samples.

PURPOSE: To analyze the resistance mechanisms in Acinetobacter species by phenotypic methods. METHODS: Antibiotic susceptibility profile for 150 clinical isolates of Acinetobacte r was determined by the standard disk diffusion method. Isolates detected to be meropenem resistant were tested further by broth microdilution minimum inhibitory concentration (MIC) for meropenem. The resistant isolates were also tested for metallo beta -lactamase (MBL) production by the double-disk approximation test, for AmpC beta-lactamase production and efflux pump detection by agar microdilution MIC with and without reserpine. RESULTS: Twenty-one isolates were found resistant to meropenem by the standard disk diffusion method. Nine samples were from patients admitted in intensive care units (ICUs). Broth microdilution MICs of the isolates revealed low-level resistance to meropenem. MBL was not produced by any of these isolates. AmpC beta -lactamases were produced by nine (43%) isolates. 'Efflux pump'-mediated resistance to meropenem was detected in two out of nine random isolates tested for the same. CONCLUSIONS: Carbapenem resistance is not uncommon in Acinetobacter isolates. AmpC production may cause carbapenem resistance. MBL and efflux pump may not be important causes of carbapenem resistance.

Use of RAPD fingerprinting for delineating populations of hilsa shad Tenualosa ilisha (Hamilton, 1822)

RAPD was used to delineate the hilsa populations sampled from the Ganga, Yamuna, Hooghly, and Narmada Rivers at six different locations. Six degenerate primers were used to generate the fragment patterns from the samples collected. All primers were highly polymorphic and generated high numbers of amplification products. Nei's genetic distances were calculated between locations. The overall average genetic distance among all the six locations was 0.295. The Fst value within the Ganga was 0.469 and within the Hooghly it was 0.546. The overall Fst value for the six populations analyzed was 0.590. The UPGMA dendrogram clustered the hilsa into two distinct clusters: Ganga and Yamuna populations and the Hooghly and Narmada populations.

Oxidative stress in patients with essential hypertension.

BACKGROUND: Free oxygen radicals react with membrane lipids to form lipid hydroperoxides, a destructive process known as lipid peroxidation. Lipid hydroperoxides decompose to form a variety of products including malondialdehyde, which is used as an indicator of the oxidative damage of cells and tissues. Endogenous antioxidant enzymes such as superoxide dismutase counteract the oxidative damage from oxidative stress. There is increasing evidence that free radicals are involved in the pathogenesis of hypertension by altering endothelial function. We evaluated the oxidative stress and endogenous enzymatic antioxidant status in patients with essential hypertension before and 3 months after treatment with antihypertensives. METHODS: Fifty patients with essential hypertension attending the outpatient services of the Department of Medicine, Institute of Medical Sciences, Banaras Hindu University and 20 age- and sex-matched healthy controls were studied. The serum malondialdehyde and superoxide dismutase levels were measured in patients at the time of presentation and after 3 months of antihypertensive treatment. No antioxidants were given to the patients during the period of the study. RESULTS: The mean (SD) serum malondialdehyde level was found to be significantly higher (0.33 [0.07] mmol/L) in patients with hypertension compared with controls (0.21 [0.05] mmol/L; p < 0.001). This showed a significant decrease following antihypertensive therapy (0.23 [0.06] mmol/L; p < 0.001) compared with pre-treatment values. The serum superoxide dismutase activity was significantly lower in patients (6.93 [1.35] mg protein/ml of serum) compared with controls (20.12 [3.65] mg protein/ml serum; p < 0.001) at the time of presentation and, compared with the pre-treatment values, increased significantly after 3 months of treatment (10.66 [2.91] mg protein/ml of serum; p < 0.001). CONCLUSION: Our study shows that essential hypertension is associated with increased oxidative stress and reduced antioxidant status. Adequate control of blood pressure with antihypertensive therapy decreases oxidative stress and improves the antioxidant status in these patients.

Antithrombin III activity in cerebrovascular accidents.

Cerebrovascular accidents are commonly due to occlusive or haemorrhagic lesions. The present prospective study was planned to find out role of antithrombin in possible etiopathological process, which might predispose an individual for stroke. METHOD: Biological activity of antithrombin III was done by the method as described by Innerfield et al (1976). Immunological estimation of an antithrombin III was done by single radial immunodiffusion by the technique of Mancini et al modified by Fahey and Mckelvey. RESULTS: The biological and immunological activity of antithrombin III was measured in 98 patient of occlusive and 56 patients of haemorrhagic strokes. Significant depression in biological as well as immunological activity (p<0.001) was observed in occlusive stroke. In haemorrhagic stroke both, biological and immunological activity was increased. In follow up study, there was progressive normalization of both, biological as well as of immunological activity in both group. CONCLUSION: Decrease of antithrombin III in occlusive and increase in haemorrhagic stroke indicates that these changes have at least an additive role in the pathogenesis of stroke.

Influence of dietary vitamin A deficiency on rat digestive & absorptive functions during diabetes mellitus.

Intestinal absorption of glucose and activities of amylases of intestinal and pancreatic origin were measured in animals vitamin A deficient, diabetic and combined state of vitamin A deficiency with diabetes. The vitamin A deficient diet caused a significant reduction in intestinal digestive and absorptive functions. On the other hand the digestive and absorptive functions were increased in the diabetic state. The combination of diabetes with vitamin A deficient diet caused a decrease in the digestive and absorptive functions along with blood glucose level in comparison to diabetic state alone. These findings suggest that the inhibition of digestive and absorptive functions observed in the combined state of vitamin A deficiency and diabetes may be due to the presence of vitamin A deficient diet.

Effect of hypervitaminosis A on intestinal digestive & absorptive functions in rat.

Oral administration of large doses of retinol to young rats significantly accelerated glucose and galactose uptake in small intestinal segments. It also augmented both total and specific activities of brush border membrane associated disaccharidases and blood glucose level. For this investigation the intestine was examined in three segments viz., proximal, mid and distal portion and also as a whole. In comparison with matched controls, total enzymic activities in with hypervitaminosis A animals were nearly double for lactase, sucrase and maltase in all segments. With specific enzymic activities, the change in enzymic activities were greater for lactase and maltase, but less for sucrase.

Control of zoopathogenic fungi in vitro by polyamine biosynthesis inhibitors.

Effect of inhibitors of polyamine (PA) biosynthesis, alpha-difluoromethylornithine (DFMO), methylglyoxal bis (guanylhydrazone)--MGBG and bis (cyclohexylammonium) sulphate (BCHA) on mycelial growth of three clinically important fungi-Trichophyton mentagrophytes, Microsporum gypseum and Aspergillus flavus was examined in vitro. All inhibitors at concentrations 1 to 50 mM produced greater inhibition of mycelial growth in all fungi tested in a dose-dependent manner. MGBG was the most effective inhibitor, and T. mentagrophytes was the most sensitive fungus to all inhibitors followed by M. gypseum and A. flavus. The results suggested that control of fungal diseases in animals and human beings with specific inhibitors of PA biosynthesis is possible.