Clinical and bacteriological study of urethral discharge.

A clinics-bacteriological study of 52 patients with urethritis was carried out. All the patients were evaluated clinically and bacteriologically at the beginning and end of the treatment. Majority of the patients belonged to the age group 21-30 years (58%). Incidence of gonococcal urethritis was 65% and Non gonococcal Urethritis (NGU) 35%. The common organisms causing NGU were chlamydia (28%) ureaplasma (11%) and mycoplasma (11%). Neisseria gonorrhoea was resistant to penicillin in (38%), ciprolloxacin in 67, and to noriloxaein in 6% cases. High incidence of HIV positivity was found in gonorrhoea (21%).

Concurrent leprosy and HIV infection: a report of three cases.

Three cases of concurrent infection with HIV and leprosy are reported. One had developed borderline lepromatous leprosy one year after identifying HIV infection, while the other two had indeterminate leprosy and both conditions were identified at the same time in these two patients. All three cases showed satisfactory response to standard antileprosy multidrug therapy.

Membrane skeletal protein structure and interactions in human erythrocytes after their treatment with diamide and calcium.

To analyse the role of native structures of membrane proteins in their structural modifications induced by the elevated intracellular free Ca2+ levels, we have studied the Ca(2+)-mediated effects on membrane skeletal proteins in human erythrocytes that were loaded with Ca2+ using the ionophore A23187 after their pretreatment with the sulphydryl oxidizing agent, diamide. The diamide treatment not only induced polymerization of the major membrane skeletal protein, spectrin, in the erythrocytes, but it also promoted intersubunit crosslinking within the tetramers and dimers of this protein. Loading of these diamide-treated cells with Ca2+ failed to induce significant structural modifications of spectrin as well as polypeptide 4.1, another major membrane skeletal protein, as compared to the erythrocytes that were loaded with Ca2+ without the diamide pretreatment. These results have been interpreted to suggest that the Ca(2+)-induced membrane skeletal protein changes in erythrocytes depend on both the shape and relative orientation of these proteins within the membrane skeleton.

Tissue distribution and antileishmanial activity of liposomised Amphotericin-B in Balb/c mice§.

Antileishmanial activity and organ distribution of the antifungal drug Amphotericin-B in free and liposomised form have been studied in Balb/c mice infected with Leishmania donovani. Results indicate that Amphotericin-B in the liposomised form is significantly more active than the free form. This increase in the activity is perhaps related to the reduced drug toxicity rather than the altered drug distribution at the site of infection.

Chloroquine delivery to erythrocytes in Plasmodium berghei-infected mice using antibody-bearing liposomes as drug vehicles.

Suitability of anti-erythrocyte F(ab')2-bearing liposomes as vehicles for chloroquine in the treatment of chloroquine resistant Plasmodium berghei infections in mice has been examined. Free chloroquine or chloroquine encapsulated in antibody-free liposomes failed to show much effect on the resistant infections, but the same doses of this drug after being encapsulated in antibody-bearing liposomes exhibited a significant inhibitory effect on this infection. These results indicate that chloroquine delivery in antibody targeted liposomes may help in the successful treatment of the chloroquine resistant malarial infections.

Membrane-associated cytoskeleton and transbilayer phospholipid asymmetry.

Earlier studies have suggested that the membrane-associated cytoskeleton (membrane skeleton) in erythrocytes plays a major role in maintaining the transmembrane phospholipid asymmetry. But recently, it has been proposed that an ATP-dependent aminophospholipid pump is the sole determinant of this asymmetry in these cells. A critical analysis of the published data along with some unpublished results from the author's laboratory, however, indicate that both membrane skeleton and ATP-dependent aminophospholipid pump are required for maintaining the membrane phospholipid asymmetry in native erythrocytes.

Coupling of proteins to liposomes and their role in understanding delayed type of hypersensitivity in human and mice.

Liposome-coupled lepromin was found to elicit a 3-week skin reaction in leprosy patients similar to that elicited by whole Mycobacterium leprae. The present study suggests that the presentation of antigens in a specific orientation is necessary for evoking delayed type hypersensitivity response in humans.

Anti-stress activity in a muramyl-dipeptide.

N-Acetylmuramyl-L-alanyl-D-isoglutamine and some of its derivatives have been examined for anti-stress activity. Amongst these, N-palmitoylmuramyl-L-alanyl-D-isoglutamine is shown to considerably enhance the capacity of animals to endure various types of stress. This indicates that besides acting as immunomodulators and sleep regulators, muramyl dipeptides may also act as anti-stress agents.

Evaluation and aetiopathogenesis of hypercalcaemia. A study of 89 patients.

Eighty nine cases with hypercalcaemia were seen during the period 1975-87. Malignancy of nonparathyroid tissue was responsible in 72 cases (80.9%). The other causes were primary hyperparathyroidism (11 cases), hypervitaminosis D (5) and sarcoidosis (1). Every patient with hypercalcaemia needs careful evaluation to establish the aetiological basis so that specific treatment may be instituted.

Evaluation of two multidrug regimen in hospitalised multibacillary cases.

Fifty three multibacillary leprosy cases were treated with two regimens of MDT L1 consisting of Rifampicin, Dapsone and Ethionamide and L2 consisting of Rifampicin, Dapsone and clofazimine. The results were compared at regular intervals and at the end of the study (24 months). Clinical inactivity, bacteriological negativity, ENL reactions, upgrading reactions were seen in L1 group in 65%, 4.54%, 50% and 41% of cases respectively while 65%, 25.8%, 30% and 45% respectively in L2 regimen group. Zero percent morphological Index was achieved in all cases in L1 regimen 90% in L2 regimen cases. No viability was found on mouse foot pad inoculation after 6 months in L1 while after 18 months in L2 cases.

Primary hyperpigmented cutaneous lesions in tuberculoid leprosy.

Two cases of tuberculoid leprosy with primary hyperpigmented anaesthetic lesions are reported and subject is reviewed.

Abnormal erythrocyte membrane phospholipid organisation in chronic myeloid leukaemia.

The membrane phospholipid organisation in the red cells of humans suffering from chronic myeloid leukaemia has been analysed using the amino-group labelling reagent trinitrobenzenesulphonic acid and the fluid-sensing fluorophore, Merocyanine 540. Unlike the normal human erythrocytes, trinitrobenzenesulphonic acid in intact chronic myeloid leukaemia erythrocytes modified about 30% phosphatidylserine, under controlled conditions. Also, the chronic myeloid laukaemia red cells, but not the normal cells, were found to bind the fluorescent dye Merocyanine 540. These results demonstrate that loss of the transmembrane phospholipid asymmetry in chronic myeloid leukaemia erythrocytes is accompanied by an enhancement in the outer surface fluidity and, therefore, suggest that the red cells membrane phase-state asymmetry originates probably from the asymmetric arrangements of phospholipids across the membrane bilayer.

A study of palmar ridge malformation in leprosy.

Palmar ridge malformation of 150 male leprosy patients (50 multibacillary and 100 paucibacillary) were compared with matched controls. Significantly high incidence of ridge malformation was found on the palms of multibacillary leprosy patients. The acquired ridge atrophy was found in 32% multibacillary leprosy, 4.5% paucibacillary leprosy and 0% controls. The congenital ridge dissociation was found in 46% multibacillary leprosy, 20% paucibacillary leprosy and 22% controls. The difference is statistically significant.

Clinico-histopathological evaluation of modified pilocarpine test in early diagnosis of leprosy.

Modified pilocarpine test was done in 112 patients of which 89 cases were under investigation (Group I) and 23 cases were confirmed tuberculoid leprosy cases (Group II). In group I, 70 cases (78.6%) showed deficient sweating of varying degree and 36 cases (40.4%) showed definite histopathological changes of paucibacillary leprosy in skin. 22 cases (95.6%) in Group II showed deficient sweating. 24 cases under investigation who had deficient sweating but did not show definite histopathological changes of leprosy initially were followed up for one year and at the end of one year 10 cases (41.6%) showed confirmatory changes of leprosy on histopathological examination. The modified pilocarpine test has been found to be a simple and very useful test in early diagnosis of leprosy.

An evaluation of palmar flexion creases and dermatoglyphics in leprosy.

The palmar flexion creases and dermatoglyphics of 150 male leprosy patients (100 paucibacillary and 50 multibacillary leprosy) were compared with 50 matched controls. Among palmar dermatoglyphics a significantly high frequency (P less than 0.001) of palmar pattern in thenar/1st interdigital area was noticed on left palm of multibacillary leprosy patients. Slight increase in frequency of distal axial triradii (t' and t'') was also seen on palms of leprosy patients. No difference in values of atd angle and C-line types were observed between patients and controls. Among palmar flexion creases a significantly high frequency of Single Radial Base Crease (SRBC) and lower frequency of Double Radial Base Crease (DRBC) was noticed on palms of leprosy patients as compared to controls (P less than 0.001). The difference mainly exist on left palm. A significantly high frequency of Simian Crease was also observed on palms of multibacillary leprosy patients (P less than 0.001) and paucibacillary leprosy patients (P less than 0.05) as compared to controls.

Experience with multidrug therapy in paucibacillary leprosy.

Eighty paucibacillary leprosy cases were randomly put on two different multidrug regimens for 6 months followed by dapsone monotherapy. Regimen I was according to WHO (1982) recommendations consisting of Dapsone and six once a month rifampicin. In regimen II in addition to above two constituents, clofazimine was added 100 mg on alternate days. Dapsone thereafter was continued in both the regimens upto one year. The efficacy, acceptability and side effects of multidrug regimens were observed for a period of one year. Histopathological assessment was done on completion of multidrug therapy in all cases. A comparative evaluation of effect of two multidrug regimens in paucibacillary leprosy patients is reported. Addition of clofazimine over WHO (1982) recommended regimen appears to have no added benefit. The duration of WHO (1982) recommended regimens was found to be inadequate in many cases.