A cross sectional study on combined prevalence of allergic rhinitis (AR) and bronchial asthma (BA) among construction workers

Background: Asthma is a heterogeneous syndrome with multiple phenotypes, the most prevalent of which is allergic asthma in association with allergic rhinitis. Construction is one of the important industries, which employs a large number of people on its workforce. In India about 340 million (92%) workers are in unorganized sector and about half of them are in construction industry. The construction workers are one of the most vulnerable occupational groups, prone to wide range of illnesses especially to respiratory morbidities like Asthma and allergic rhinitis. Despite this high risk very few studies are available on extent of asthma and AR in construction workers. Viswambhar V, Reddy GMM, Ragulan R, N. Meenakshi, Aruna Shanmuganathan, Krishnaveni R. A cross sectional study on combined prevalence of allergic rhinitis (AR) and bronchial asthma (BA) among construction workers. IAIM, 2016; 3(5): 174-183. Page 175 Objectives: To assess the prevalence and factors influencing allergic rhinitis and bronchial asthma among construction workers and to assess the degree of disease control using CARAT questionnaire Materials and methods: The study was a cross sectional study conducted in sub urban areas of metropolitan city of Chennai. The participants were selected by multistage Cluster random sampling. World Health Organization (WHO)-sponsored Allergic Rhinitis and its Impact on Asthma (ARIA) guideline, Spirometry and CARAT scoring were used in the study. Results: A total of 231 participants were included in the final analysis. The prevalence of any respiratory morbidity was 39% among study population. Out of the diseased 11 (4.8%) had AR alone, 12 (5.2%) subjects had BA alone and remaining 67 (29%) had both AR and BA. The prevalence of respiratory morbidity gradually increased with increasing age and was more in males. Upper airway symptoms were poorly controlled in 100% of the affected patients, this proportion was 66.7% for lower airway symptoms and 83.58% for combined airway score Conclusion: Co-existence of Bronchial asthma and Allergic rhinitis is more common among construction workers compared to general population. Male workers in middle age group are more prone to airway allergy. Bronchial asthma is poorly controlled in workers with coexisting allergic rhinitis

Diagnostic appraisal of simultaneous application of two nested PCRs targeting MPB64 gene and IS6110 region for rapid detection of M. tuberculosis genome in culture proven clinical specimens.

Background: Early diagnosis of tuberculosis is critical for its effective management and prevention. Several gene amplifi cation methods are used in the detection of tubercle bacilli from clinical specimens. MPB64 gene and IS6110 region have been identifi ed as potential gene targets for the specifi c detection of Mycobacterium tuberculosis from direct clinical specimens. Objective: The present study was conducted to evaluate the diagnostic utility of simultaneous application of two nested polymerase chain reaction (nPCRs) targeting MPB64 and IS6110 region for the detection of M. tuberculosis genome. Materials and Methods: A total of 100 and 354 clinical specimens from the control group and clinically suspected tuberculosis patients, respectively, were included in the study. nPCRs targeting MPB64 and IS6110 region were performed. Results and Conclusion: All of the 100 clinical specimens from the control group were negative for both nPCRs. Out of the 354 clinical specimens, 339 were positive for both culture and nPCRs, 10 and 5 were positive for culture, and nPCR targeting IS6110 and MPB64 regions, respectively. To conclude, nPCRs targeting MPB64 and IS6110 region are reliable and specifi c targets when applied simultaneously on clinical specimens to attain 100% sensitivity for the detection of M. tuberculosis genome.

Detection of Mycobacterium tuberculosis directly from sputum specimens & phenotypic drug resistance pattern of M. tuberculosis isolates from suspected tuberculosis patients in Chennai.

Background & objectives: mRNA is more rapidly destroyed in cells than rRNA or genomic DNA, an assay targeting bacterial mRNA would provide a better guide to mycobacterial viability than amplification tests directed at DNA or rRNA targets. This study was carried out to standardize reverse transcriptase PCR (RT-PCR) targeting 85B gene for the rapid detection of viable Mycobacterium tuberculosis from sputum specimens of suspected TB patients at Chennai, South India and to detect MDR-TB circulating in this population. Methods: Sputum samples from clinically suspected tuberculosis patients (n=301) and 78 controls were included in the study. The sputum samples were collected in sterile diethyl pyrocarbonate (DEPC) treated containers and transported in ice to the laboratory within 2 h to prevent degradation of RNA. RT-PCR targeting 85B gene, mycobacterial culture and phenotypic drug susceptibility testing for the first line drugs streptomycin (S), isoniazid (H), rifampicin (R), ethambutol (E) and pyrazinamide (Z) were performed by BACTEC microMGIT culture system for all the sputum specimens. Results: All the 78 controls were negative for culture and RT-PCR. Among the 301 sputum specimens from patients, 231 (76.8%) were RT-PCR positive and 70 (23.2%) were negative. There were 166 M. tuberculosis isolates, of which 11 (2.9%) were MDR-TB, 33 (8.7%) were polyresistant, 31 (8.2%) were monoresistant and 91 (30.2%) were sensitive to all five first line anti-tuberculous drugs by phenotypic drug susceptibility testing. Monoresistance was higher with Z [20 (20.8%)], followed by S [6 (3%)]. Interpretation & conclusions: RT-PCR targeting 85B gene of M. tuberculosis was a specific, rapid, reliable technique to detect the M. tuberculosis directly from sputum specimens. Our results showed that 2.9 per cent of M. tuberculosis isolates in the study population of Chennai were MDR.

Rapid Detection of Viable M. tuberculosis Directly from Sputum by Reverse Transcriptase PCR Targeting 85B Gene.

This study was carried out to standardize reverse transcriptase PCR (RTPCR) targeting 85B gene for the rapid detection of viable Mycobacterium tuberculosis (M tuberculosis) from sputum specimens. 100 sputum samples from clinically suspected tuberculosis patients were included in the study. The sputum samples were collected in sterile diethyl pyrocarbonate (DEPC) treated containers and transported in ice to the laboratory within 2 hours to prevent degradation of RNA. The following microbiological analysis was performed on the sputum specimens: Ziehl Neelsen staining, Mycobacterial culture by BACTEC TB 460 reader and RT-PCR targeting 85B gene. Out of the 100 sputum samples, 40 sputum samples were Ziehl Neelsen stain positive, 58 sputum samples were culture and RT-PCR positive and 42 were culture and RT-PCR were negative. Among direct smear positive specimens, 3 specimens did not grow in culture and was RT-PCR negative indicating the non-viability of the acid-fast bacilli seen in the direct smear. The results of RT-PCR and culture against control group and clinically diagnosed tuberculosis patients were statistically significant by Chi square test (P<0.001). RT-PCR targeting 85B gene of M tuberculosis standardized in our laboratory for is a rapid, reliable and sensitive technique to detect the viable M tuberculosis directly from sputum specimens.

Multiple cardiovascular involvement in a case of relapsing polychondritis.

Relapsing polychondritis is a multisystem disease characterized by recurrent inflammation of the cartilaginous tissue. Cardiovascular manifestations of relapsing polychondritis are rare but are the second most common cause of death in these patients. We report a case of relapsing polychondritis who underwent aortic valve replacement uneventfully but presented six months later with myocardial infarction due to bilateral coronary ostial stenosis.