Verotoxic Escherichia coli (STEC) from beef and its products.

In the present investigation, out of 27 (24.10%) strains of Escherichia coli isolated from 112 beef samples comprising raw meat (45), kabab (36) and kofta (31), 9 (33.33%) belonging to 7 different serotypes were verotoxic as tested by vero cell cytotoxic assay. Serotype O145 was the predominant STEC in raw meat. Interestingly, one STEC-O157 strain was also detected. All the STEC strains were positive for Stx genes by polymerase chain reaction showing stx2 (77.78%) to be most predominant followed by stx1 (22.22%). Phenotypic enterohaemolysin production on washed sheep blood agar supplemented with CaCl2 revealed 6 (66.67%) STEC strains to be positive. Presence of STEC in cooked beef products, viz., kabab and kofta appeared to be a matter of concern and potential threat to public health.

Effect of growth medium on hydrophobicity of Staphylococcus epidermidis.

The present study was undertaken to evaluate the effect of growth medium on expression of hydrophobicity of Staphylococcus epidermidis. A total of 24 hydrophobic isolates of S. epidermidis, determined by n-hexadecane adherence assay (HAA) earlier were included. Five different growth media: horse blood agar (HBA), brain heart infusion agar (BHIA), brain heart infusion broth (BHIB), tryptic soy broth (TSB) and proteose peptone broth (PPB) were used. All 24 isolates exhibited the reproducible hydrophobicity when grown on HBA; however, 20 (83.33%), 19 (79.16%), 15 (62.50%) and 13 (54.16%) isolates were found to be hydrophobic when grown in BHIA, BHIB, TSB and PPB, respectively. HBA was found to be the most suitable medium for detection of hydrophobicity of S. epidermidis followed by BHIA or BHIB.

Incidence of intracranial aneurysms in north-west Indian population.

One thousand human brains of both sexes were examined. Aneurysms were found in 10 specimens (1%). The incidence of aneurysms was 1.6% in females and 0.8% in males. All the aneurysms were saccular. The aneurysms varied in size. In 5 specimens the aneurysms were minute bulbous dilatations. In the rest of the cases it varied from 0.2 to 2.5 cm. In 7 specimens the aneurysms were present at the junction of anterior cerebral artery with the anterior communicating artery, in 2 on the anterior communicating artery and in one specimen it was seen at the origin of posterior communicating artery. The youngest subject with saccular aneurysm was an 18-years-old male and the oldest was a 55-years-old male. No aneurysm was found in the brains of 94 children (1-17 years).

Comparative evaluation of hydrophobicity measures for virulence determination of Staphylococcus epidermidis from hospitalized patients & healthy individuals.

BACKGROUND & OBJECTIVES: Hydrophobicity is one of the recognized markers for identifying pathogenic strains of Staphylococcus epidermidis. A number of tests are available for measuring the hydrophobic character but three tests viz., salt aggregation test (SAT), n-hexadecane adherence assay (HAA) and xylene adherence assay (XAA) are in common practice with different degrees of sensitivity. However, in the Indian context, no systematic study has been reported on the hydrophobicity of S. epidermidis. Hence, the present study was undertaken to compare the three methods for hydrophobicity measurement for identifying the pathogenic isolates of S. epidermidis. METHODS: Of the 597 samples obtained from milker's and butcher's (hand and nose), hospitalized pre-operative patients (hand, nose, ear), and post-operative patients (blood) examined, 212 isolates of S. epidermidis were recovered using established laboratory procedures. The isolates were screened by the three tests viz., SAT, HAA and XAA. The identified hydrophobic isolates were further tested by mouse inoculation method. RESULTS: Of the 212 S. epidermidis isolates studied, 24 (11.32%), 23 (10.84%) and 4 (1.88%) were found to be hydrophobic as detected by HAA, XAA and SAT, respectively. No isolates from apparently healthy individuals were found to be hydrophobic by SAT while 13 (8.76%) and 10 (8.24%) strains from apparently healthy individuals were detected to be hydrophobic by HAA and XAA, respectively. Seven (33.38%) isolates each were hydrophobic by HAA and XAA and 4 (22.22%) by SAT among the isolates from hospitalized post-operative patients. INTERPRETATION & CONCLUSION: The results suggested that there was no difference in the number of strains detected as hydrophobic by HAA and XAA, and any of the two tests may be used for screening the hydrophobic strains of S. epidermidis from healthy individuals and patients.

Zoonoses and bats: a look from human health viewpoint.

Bats are the most abundant and most widely distributed mammals on the Earth after humans. Except Antarctica and some small remote islands, they are prevalent worldwide. Although the actual role played by bats as reservoir or in disseminating zoonoses is still enigmatic a multitude of zoonotic diseases are known to be associated with bats. Such diseases including viral, bacterial, parasitic, fungal and rickettsial diseases, reported from all over the world including India have been briefed in this article as an informative approach because dramatically increased and diversified human activities during the last few decades perturbing natural ecosystems are enough to compel public health personnel to have an investigative look at these flying mammals.

Isolation of verotoxin producing Escherichia coli from diarrhoeal and urinary tract infection patients.

Fourty nine Escherichia coli strains, isolated from diarrhoeal and urinary tract infection (UTI) patients, attending Bareilly district hospital, Uttar Pradesh during October to December, 1998 were screened for verotoxin (VT) production by Vero cell assay. Five strains produced characteristic cytopathic effect on Vero cell line, of which 4 were from diarrhoeal and one was from UTI-patient. The level of VT-production varied widely. Antibiotic sensitivity tests revealed that the VT-producing E. coli (VTEC) were mostly sensitive to kanamycin, norfloxacin and nalidixic acid but resistant to ampicillin and tetracycline.

Virulence factors of aeromonads--an emerging food borne pathogen problem.

Aeromonas spp. possess a number of virulence properties which are considered responsible for intestinal and extra-intestinal infections in human beings and also for a wide variety of infections in animals. The paper discusses current status of colonization and toxic factors of Aeromonas spp., especially in relation to food and biochemical markers. Future research needs are also identified.

Testicular biopsy in cases of male infertility: a retrospective study.

One hundred testicular biopsies performed during the period of 1983-90 were reviewed to reappraise the value and utility of testicular biopsy in cases of male infertility. All the biopsies were categorised into the following 7 types and their relative incidences were determined. There were 16% normal cases. Hypospermatogenesis was found in 42% cases, maturation arrest in 18% cases, Sertoli cell-only syndrome in 17% cases, Klinefelter's syndrome in 3% cases, orchitis in 3% cases and tubular sclerosis in 1% case. Testicular biopsy findings were correlated with semen analysis reports. Azoospermia was represented by all the above 7 types whereas oligospermia was represented hypospermatogenesis and maturation arrest varieties. Testicular biopsy is most useful in azoospermia but its value is limited in oligospermia.

Clinico-therapeutic profile of pyogenic liver abscess.

Nineteen consecutive patients of pyogenic liver abscess (13 males, 6 females, mean age 45.2 +/- 6, 5 years) were studied over a period of 5 years for the clinical profile and therapeutic efficacy of percutaneous aspiration. Majority of them presented with spiking fever (94.7%), pain over right upper quadrant of abdomen (53.8%) and often with prostration and shock (31.6%). The onset has been rather acute in patients with multiple abscesses (7 cases). Ascites (10.5%), clubbing of fingers (15.8%) and splenomegaly (10.5%) were observed in cases with long duration of illness. There has been the polymorphonuclear leucocytosis (89.5%) and mild to moderate anaemia (52.6%). Jaundice (42.1%) was usually mild degree (serum bilirubin 4.6 +/- 2.4 mg/dl). The serum transaminases and alkaline phosphatase were raised in 94.9% of cases. Ultrasonography revealed predominantly hypoechoic (54.1%) areas with frequent distal acoustic enhancement and internal echoes (21.6%). Seven patients had multiple abscesses with 25 lesions (size 5.2 +/- 4.6 cms) situated mainly over antero-inferior segment of the right lobe (45.9%) of the liver. The blood and pus cultures demonstrated the micro-organisms (positive in 63.9% and 86.6% respectively) predominantly of bowel flora including facultative gram negative rods and anaerobes. Mortality was 26.5% and pleuro-pulmonary complications were the commonest (26.4%) one. 15 cases were treated by percutaneous aspiration, proper antibiotic and metronidazole with encouraging results (only two deaths). Complete resolution of abscess took place in 14.2 +/- 1.2 weeks (range 6 weeks to 7.5 months). It is emphasized that percutaneous needle aspiration is useful both for diagnosis and treatment of pyogenic liver abscess.

Clinical profile of giardiasis and comparison of its therapeutic response to metronidazole and tinidazole.

Seventy five cases (50 males, 25 females; mean age 20.2 +/- 5.8 years), whose stools were positive for cysts and/or trophozoites of Giardia lamblia, were studied for their clinical profile and therapeutic response to metronidazole and tinidazole. Maximum frequency of cases (41.2%) was noted upto 20 years of age, and it declined with advancing age. A majority of them (41.3%) presented with non-specific symptoms while 38.6% were asymptomatic parasite carriers. Features of malabsorption were observed in 12% of cases and 8% presented with acute illness, having explosive, watery, foul smelling diarrhoea along with crampy upper abdominal discomfort. Most of them (62.5%) had blood group A. Tinidazole (97.5%) was more efficacious (P less than 0.01) than metronidazole (54%) in a single dose of 50 mg/Kg, with good tolerance. Tinidazole can be recommended for the treatment of giardiasis in individual cases as well as in families and close communities.

Clinical profile of herpes zoster ophthalmicus.

Herpes zoster ophthalmicus was seen in 22 cases out of 195 cases of herpes zoster (11.3% incidence). It was affecting mainly adults (90.9%). Oedema over the lids (81.8%) was invariably present and lead to ptosis. Mucopurulent conjunctivitis, predominantly mucoid (72.7%) was the commonest manifestation associated with vesicles over the lid margins. Sectorial (22.7%) and diffuse (9.1%) episcleritis appeared in later part of first week, while nodular episcleritis was observed in one case only on 12th day of the disease. Nummular keratitis was seen in 31.8% of cases between 8-10 days. Iritis and iridocyclitis was seen in 45.4% of cases out of which 36.3% had secondary ocular hypertension (glaucoma). Neuroparalytic keratitis and internal ophthalmoplegia were detected in one patient each. Postherpetic neuralgia occurred in 22.7% of cases and was uncommon in younger age group (below 40 years, 4.5%). Carbamazepine was effective in relieving the herpetic pain.

Enterotoxigenic Escherichia coli from an outbreak with cholerigenic syndromes of gastroenteritis.

In an outbreak of food-poisoning, 76 out of 200 students who had dined in an Institute mess experienced acute cholerigenic syndromes of gastroenteritis. Processing of the seven stool samples of affected students and remnants of 4 out of 5 type of food for isolation of bacterial pathogen(s) revealed only the presence of Escherichia coli which were serotyped as 020, 026, 045, 053 and one untypable (UT). Enterotoxigenicity testing of these isolates revealed serotypes 020, 026 of E. coli to be heat-labile enterotoxin producer when subjected to Biken test, Latex agglutination test and co-agglutination test. Based on the laboratory findings there are good reasons to believe that serotype 020 was responsible for this episode.

Male gonads in leprosy--a clinico-pathological study.

Sixty male leprosy patients (mean age 27.2 +/- 5.04 years) selected at random, were studied for gonadal involvement with the mean duration of illness 4.17 +/- 3.27 years. Only lerpomatous and borderline leprosy cases developed testicular and epididymal changes. Testicular pain and/or swelling (lepromatous 62.5%, borderline 30%) was the main presenting feature. Altered sexual function was observed in 34(56.6%) cases, and 11 patients revealed altered sexual hair pattern. Gynecomastia was seen in 9 cases. Reduced testicular size along with its soft feeling was present in 25% of cases while no testicular sensation was felt in 8 (13.3%) cases, and impaired testicular sensation in 9 (15%) of them. Spermogram revealed azoospermia in 19 (35%) and oligospermia in 16 (26.6%) cases. Histo-pathology revealed evidences of leprous pathology irrespective of testicular size, semen picture and clinical manifestations. There was marked variation in histopathological findings in testes and hence it was difficult to categorise them into vascular, interstitial and obliterative phase.

Rapidly progressive (crescentric) glomerulonephritis in erythema nodosum leprosum: case report

A autora faz a introduçäo do trabalho uma abordagem sobre o tabagismo como importante fator associado a doenças respiratórias, cardiovasculares e a alguns cânceres. Lembra também sobre as implicaçöes do tabagismo na gravidez e descreve alguns estudos sobre fumante passivo e refere algumas informaçöes epidemiológicas. Propöe-se a: 1- Estudar a prevalência de tabagismo entre estudantes da Universidade de Säo Paulo, campus de Ribeiräo Preto, em 1988. 2- Analisar a tendência desta prevalência no perído de 1980-1988. 3. Analisar a relaçäo entre escolhas das marcas e o custo das mesmas. Foi feito um levantamento em 1988, com questionário padronizado e com a mesma metodologia utilizada em 1980, 1981 e 1986. As principais conclusöes foram: 1- A prevalência do tabagismo nas diferentes unidades da USP, em dezembro de 1988 foi: FMRP, 11,9% EERP, 21,2%, FFRP, 8,7; FORP, 8,9%; e prevalência de extabagista foi respectimente: 6,8%; 9,3%; 7,5% e 6,5%. 2- As mulheres fumam tanto quanto os homens em 1988 entre os alunos inqueridos. 3- Até 1986, há tendência geral de declínio em todas as escolas; em 1988, esta tendência näo tem significado estatístico. 4- A tendência segundo o gênero alterou-se no período estudado, em 1980 e 1981 os homens fumam mais que as mulheres e em 1986 e 1988, homens e mulheres fumam igualmente. Foram levantadas e discutidas várias hipóteses no sentido de tentar explicar esta tendência geral de declínio e as mudanças ocorridas neste período quanto a prevalência nos dois gêneros

Histo-functional status of kidney in leprosy.

A study of 64 cases of leprosy (44 lepromatous and 20 nonlepromatous) revealed that the duration of the disease has a significant relationship with renal involvement (chi 2 = 16.9, P less than 0.001). Proteineuria, microscopic haematuria, granular and hyaline casts are mainly seen in lepromatous cases and specially with lepra reaction (100%) while few of the non-lepromatous (2%) cases may show these abnormalities. Impaired renal functions are mostly observed in lepromatous leprosy (62.9%) specially those with lepra reaction (100%) while 2% nonlepromatous cases have these impaired renal functions. Histo-pathological studies revealed non-specific changes in 44.4% of cases and those of chronic pyelonephritis in 15.5% of the cases. Renal amyloidosis is less common occurrence (4.4%). The specific lesion, that is 'leproma kidney', is rare and seen in one patient only. Acid fast bacilli could not be seen in any of the kidney tissue. It is therefore, concluded that the renal involvement in the form of inflammatory lesions and non-specific changes in the glomeruli and tubules are very common in lepromatous leprosy specially during the reactive phase.

Serum cations (calcium and magnesium) in leprosy.

Serum cations (calcium and magnesium) were studied in 80 leprosy patients and 40 normal healthy individuals to find out the correlation between the clinical status of leprosy with these cations levels in the serum. There was significant decrease of serum calcium in lepromatous leprosy (7.42 +/- 0.7 mg%, t = 14.12, P less than 0.001), which seems to be related with the extent of leprosy lesions and duration of illness as few patients (22.2%) with minimal lesions and shorter duration of illness had serum calcium within normal range. Serum magnesium was significantly decreased in all types of leprosy cases and lepromatous leprosy patients showed highly significant decrease in serum magnesium level (1.02 +/- 0.2 mEq/L, t = 14.54, P less than 0.001).