Assessment of groundwater salinity using principal component analysis (PCA): a case study from Mewat (Nuh), Haryana, India.

In the present study, principal component analysis (PCA) is used to investigate the processes controlling groundwater salinity in the Mewat (Nuh) district, Haryana, India. Twenty groundwater samples were collected from salinity-affected areas in the March-April months of years 2018 and 2019 and were analyzed for chemical variables pH, EC, Ca2+, Mg2+, Na+, K+, [Formula: see text], Cl-, SO42-, [Formula: see text], TDS, and total hardness. Three principal components were selected based on the eigen value, which explains 79.58% and 85.08% of the total variation in the years 2018 and 2019, respectively. The first principal component (PC-1) is identified with salinity, the second principal component (PC-2) with alkalinity, and the third principal component (PC-3) described the pollution. When the yearly comparison was made, the samples collected in 2019 were found to have an increased salinity compared to 2018, which shows an increased vulnerability to the aquifer of Mewat on account of the decline in rainfall recharge. It was also evident that declining recharge also triggered the recharge from other sources; thus, the impact of pollution is more pronounced in 2019 compared to 2018.

Risk factors and predictors of mortality in acute invasive fungal sinusitis - a single-institution experience.

OBJECTIVE: To determine risk factors affecting mortality in acute invasive fungal sinusitis. METHOD: This observational cohort study was conducted over a five-year period. RESULTS: Of 109 recruited patients, 90 (82.6 per cent) had diabetes mellitus. Predominant fungi were zygomycetes (72.6 per cent) with Rhizopus arrhizus being most common. Of the patients, 12.8 per cent showed a positive biopsy report from radiologically normal sinuses. Factors affecting mortality on multivariate analysis were: female sex (p = 0.022), less than two weeks between symptoms and first intervention (p = 0.01), and intracranial involvement (p = 0.034). Other factors significant on univariate analysis were: peri-orbital swelling (p = 0.016), restricted ocular movements (p = 0.053), intracranial symptoms (p = 0.008), posterior disease (p = 0.058), imaging showing ocular involvement (p = 0.041), fungus being zygomycetes (p = 0.050) and post-operative cavity infection (p = 0.032). Bilateral, palatal and retromaxillary involvement were not associated with poor prognosis. CONCLUSION: Diagnosis of acute invasive fungal sinusitis requires a high index of clinical suspicion. Recognition of factors associated with poor prognosis can help when counselling patients, and can help initiate urgent intervention by debridement and antifungal therapy. Post-operative nasal and sinus cavity care is important to reduce mortality.

Electronic nose for detection of food adulteration: a review.

The food products may attract unscrupulous vendors to dilute it with inexpensive alternative food sources to achieve more profit. The risk of high value food adulteration with cheaper substitutes has reached an alarming stage in recent years. Commonly available detection methods for food adulteration are costly, time consuming and requires high degree of technical expertise. However, a rapid and suitable detection method for possible adulterant is being evolved to tackle the aforesaid issues. In recent years, electronic nose (e-nose) system is being evolved for falsification detection of food products with reliable and rapid way. E-nose has the ability to artificially perceive aroma and distinguish them. The use of chemometric analysis together with gas sensor arrays have shown to be a significant procedure for quality monitoring in food. E-nose techniques with numerous provisions are reliable and favourable for food industry in food fraud detection. In the present review, the contributions of gas sensor based e-nose system are discussed extensively with a view to ascertain the adulteration of food products.

Protein functionalised self assembled monolayer based biosensor for colon cancer detection.

We report results of the studies relating to the fabrication of a surface plasmon resonance (SPR) based label-free immunosensor for real-time monitoring of endothelin-1 (ET-1), a colon cancer biomarker. A gold disk modified with a self-assembled monolayer (SAM) of 11-mercaptoundecanoic acid (11-MUA) was functionalised via covalent immobilization of monoclonal anti-ET-1 antibodies using EDC-NHS (1-(3-(dimethylamine)-propyl)-3-ethylcarbodiimide hydrochloride, N-hydroxy succinimide) chemistry. This immunosensing platform (ethanolamine/anti-ET-1/11-MUA/Au) was characterized via atomic force microscopy (AFM), contact angle (CA) and Fourier transform infrared (FT-IR) spectroscopic techniques. The fabricated SPR electrode was further used to detect ET-1 in the broad concentration range 2-100 pg mL-1, with a detection limit of 0.30 pg mL-1 and remarkable sensitivity of 2.18 mo pg-1mL. The adsorption mechanism was studied using monophasic model and the values of association (ka) and dissociation (kd) constants for anti-ET-1 and ET-1 binding were calculated to be 4.4 ±â€¯0.4 × 105 M-1 s-1 and 2.04 ±â€¯0.0003 × 10-3 s-1, respectively. The results obtained via analysis of serum samples of colorectal cancer patients were found to be in good agreement with those obtained from enzyme-linked immunosorbent assay (ELISA) technique. Further, electrochemical studies were performed to prove the efficacy of the fabricated platform as a point of care device for the detection of ET-1.

Awareness of Thyroid Disorders among Nepalese Women: A Cross-Sectional Study.

Background Thyroid disorders are emerging public health issues. Clients' awareness is crucial for prevention, early diagnosis, and treatment of the thyroid disorders. Studies, assessing knowledge on thyroid disorders among Nepalese population, is lacking. Objective To assess the awareness of thyroid disorders among women, a susceptible subgroup, and find the correlates of poor knowledge. Method A cross-sectional study was conducted among 423 women at the gynecological outpatient department of Tribhuvan University Teaching Hospital. Eighteen-item scale, with a Cronbach's Alpha of 0.913, was developed to assess participant's knowledge on various constructs of thyroid disorder. A linear regression model with Bootstrap approach was used to identify the predictors of the total knowledge score. Result The mean (±SD) age of the participant was 29.2 ± 7.0 years. About 49% of the women had inadequate knowledge, defined at or below the mean cumulative knowledge score. In linear regression, the total knowledge score was significantly lower among participants who were Janajati (ß=-2.87, BCa 95%CI=-4.61, -1.11), illiterate (ß=- 6.37, BCa 95%CI =-9.14, -3.21), and low income (ß=-3.76, BCa 95%CI=-5.68, -1.83). Likewise, a university education (ß=5.94, BCa 95%CI=3.50, 8.26), working status (ß=4.04, BCa 95%CI=2.19, 5.81), urban residence (ß=2.06, BCa 95%CI=0.02, 3.96) and family history (ß=2.20, BCa 95%CI=0.71, 3.63) of thyroid disorder predicted higher knowledge score. Conclusion This study identified a poor level of knowledge on thyroid disorders among Nepali women and thus proposes them to be an important subgroup for an intervention or policy aimed at promoting awarenessof thyroid disorders. The findings also warrant increased awareness among these population through hospital and communitybased behavior change communication campaigns.

Antenatal Health Care Service Utilization in Slum Areas of Pokhara Sub-Metropolitan City, Nepal.

BACKGROUND: Half a million women die every year due to pregnancy and childbirth in the world. Among these death, 99% occur in the low and middle income countries. Antenatal care (ANC) provides an opportunity to deliver different services which are important in improving maternal survival. METHODS: A descriptive cross sectional study was conducted from September 2012 - February 2013 among 400 married women of reproductive age group. A pre-tested structured questionnaire were used and data were analyzed using Statistical Package for Social Science(SPSS) for windows version 18.0. Frequency, crude and adjusted odds ratios and confidence intervals were performed. RESULTS: Nearly 27% had four or more antenatal health care utilization(ANC) visits on appropriate time according to schedule of World Health Organization(WHO). In logistic regression, ANC users were found to be more/less likely to be in age group 20 - 35 years (AOR =2.825, 95% CI: 1.166-6.843), education of spouse (AOR 0.361, 95% CI : 0.130-1.000), occupation of spouse (AOR = 0.261, 95% CI: 0.093 -0.739), monthly income of family > 20,000Nrs (AOR = 2.190, 95% CI: 1.041-4.606), planned pregnancy (AOR = 2.417, 95% CI: 1.047 -5.609), death of child (AOR = 3.153, 95% CI: 1.112 -8.944). CONCLUSIONS: This study demonstrated low antenatal care service utilization. Hence, there is a need to increase the availability and accessibility of antenatal care to all women.

Optimization of continuous hydrothermal treatment for improving the dehulling of black gram (Vigna mungo L).

Black gram kernels with three initial moisture contents (10, 14 & 18 % w.b.) were steam treated in a continuous steaming unit at three inlet steam pressures (2, 3 & 4 kg/cm(2)) for three grain residence times (2, 4 & 6 min) in order to determine best treatment condition for maximizing the dhal yield while limiting the colour change in acceptable range. The dhal yield, dehulling loss and the colour difference (Delta E*) of the dehulled dhal were found to vary respectively, from 56.4 to 78.8 %, 30.8 to 8.6 % and 2.1 to 9.5 with increased severity of treatment. Optimization was done in order to obtain higher dhal yield while limiting the colour difference (Delta E*) within acceptable range i.e. 2.0 to 3.5 using response surface methodology. The best condition was obtained with the samples having 13.1 % initial moisture treated with 4 kg/cm(2) for about 6 min to achieve a dhal yield of 71.2 % and dehulling loss of 15.5 %.

Chronic social defeat stress increases dopamine D2 receptor dimerization in the prefrontal cortex of adult mice.

The present study aimed to examine the effects of chronic social defeat stress on the dopamine receptors and proteins involved in post-endocytic trafficking pathways. Adult mice were divided into susceptible and unsusceptible groups after 10 days of social defeat stress. Western blot analysis was used to measure the protein expression levels of dopamine D2 receptors (D2Rs), a short (D2S) and a long form (D2L) and, D2R monomers and dimers, dopamine D1 receptors (D1Rs), neuronal calcium sensor-1 (NCS-1) and G protein-coupled receptor-associated sorting protein-1 (GASP-1), and reverse transcription-polymerase chain reaction (RT-PCR) was used to measure the mRNA expression levels of D2S, D2L, D2R monomers and dimers, and D1Rs in different brain areas. We observed increased expression of D2S, D2L and D2Rs dimers in the prefrontal cortex (PFC) of susceptible and/or unsusceptible mice compared with controls. The only significant findings with regard to mRNA expression levels were lower expression of D2S mRNA in the amygdala (AMYG) of susceptible and unsusceptible mice compared with controls. The present study demonstrated that chronic social defeat stress induced increased expression of D2S, D2L, and D2R dimers in the PFC of susceptible and/or unsusceptible mice.

Microwave assisted dehulling of black gram (Vigna mungo L).

This article summarises the results of the investigation of application of microwave exposure on the dehulling characteristics of the black gram and the properties of the dehulled grains. Black gram was exposed to 3 microwave power levels, viz., 450, 630 and 810 W for 7 different exposure, ranging from 60 to 150 s at an interval of 15 s with a view to determine the suitable combination of dosage in order to get the maximum yield with little change in colour. Related changes in properties were also studied. It was observed that the surface temperature of the grain increased with the increase in microwave power level from 450 to 810 W as well as exposure time from 60 to 150 s in the range from 58 to 123 °C while the dehulling time reduced from 445 to 170 s. The dehulling yield increased with increasing microwave dosage in the beginning and reached to the maximum value followed by decreasing trend. The colour of the dehulled grain changed slowly up to a microwave dosage of 972 J/g after that it changed vividly darker than the control. The dehulling and dhal yields and colour change were polynomial functions of microwave dosage. The highest yield of 73.7 % was achieved at about 972 J/g with a little change in colour (CIELAB ΔE* value of 2.58). The corresponding dehulling time, cooking time and losses during dehulling were respectively 185 s, 10 min and 15.1 % as compared to 492 s, 20 min and 31.5 % for control respectively. It is concluded that a dosage of about 972 J/g was the best for the black gram dehulling at a rate of 630 W or higher power level.

The effects of social defeat on behavior and dopaminergic markers in mice.

The present study investigated the effects of chronic social defeat stress on several behavioral parameters, and the expression of dopaminergic markers, i.e., dopamine D1 receptors (D1Rs), dopamine D2 receptors (D2Rs), and dopamine and cyclic adenosine 3',5'-monophosphate-regulated phosphoprotein-32 (DARPP-32), in the prefrontal cortex (PFC), amygdala (AMY), and hippocampus (HIP) of mouse brains. After 10days of social defeat stress, the defeated mice were divided into two groups: one group underwent a series of behavioral tests. The other group was sacrificed on the 11th day and tissue samples were collected for Western blotting. The behavioral tests comprised tests of locomotion, light/dark preference, social interaction, as well as the novel object recognition test (NORT), Morris water maze, and forced swimming test (FST). We measured the expression of D1Rs, D2Rs, total DARPP-32, phospho-Thr34 or Thr75-DARPP-32 using Western blotting. The defeated mice showed increased anxiety- and depression-like behaviors, and impaired cognition. No significant differences in D1Rs and D2Rs expression were shown between defeated and control mice in any area studied. A significantly increased expression in total DARPP-32, and phospho-DARPP-32 was observed in the PFC or AMY of defeated mice. These data suggest that alterations in dopaminergic markers may be involved in anxiety- and depression-like behaviors, and cognitive impairment induced by social defeat stress.

A New Begomovirus Species in Association with Betasatellite Causing Tomato Leaf Curl Disease in Gandhinagar, India.

In December 2012, tomato leaf curl disease (ToLCD) (2) was observed in tomato-growing areas of Gandhinagar District of Gujarat, a state in northwestern India. Incidence of ToLCD was estimated to be between 40 and 70% depending on the cultivars used. Infected plants exhibited symptoms consisting of leaf rolling, leaf curling, and yellowing typical of begomoviruses. Total DNA was isolated from a single affected tomato plant (2). Begomovirus infection in this sample was established by amplification of the expected-size 550-bp DNA fragment from this extract by PCR with degenerate DNA-A primers (3). Rolling circle amplification (RCA) using ϕ29 DNA polymerase was carried out on the total DNA, followed by digestion with Bam HI. An amplicon of ~2.8 kb was gel-eluted and cloned into Bam HI linearized pBluescript II KS(+). Restriction enzyme digestion of plasmid DNA from the resulting clones indicated the presence of one type of molecule. Using PCR and universal betasatellite primers, the expected 1.3-kb fragment was amplified from the DNA extract (1). An amplicon of ~1.3 kb was gel-eluted and cloned into pTZ57RT vector. Sequence analysis revealed that DNA-A (GenBank Accession No. KC952005) is composed of 2,753 nt and showed the highest identity (87.8%) with Tomato leaf curl Kerala virus[India:Kerala:2008] (GenBank Accession No. EU910141). An analysis for recombination showed this begomovirus DNA likely to have originated by recombination between Tomato leaf curl Kerala virus and Tomato leaf curl Karnataka virus. The satellite DNA-ß (GenBank Accession No. KC952006) is composed of 1,365 nt and showed the highest identity (75.6%) with Tomato leaf curl betasatellite[India:Ludhiana:2004] (ToLCB-[IN:Lud:04]) (GenBank Accession No. AY765255). On the basis of DNA-A sequence analysis, the ICTV species demarcation criteria of 89% DNA-A sequence identity, and genome organization, the present isolate was considered as a new begomovirus species and named Tomato leaf curl Gandhinagar virus (ToLCGNV). The betasatellite shares less than 78% identity with (ToLCB-[IN:Lud:04]), it is considered a new species of betasatellite and the name, Tomato leaf curl Gandhinagar betasatellite (ToLCGNB) is proposed. Multimeric clones of the begomovirus and betasatellite DNAs were generated in a binary vector and these plasmids transformed into Agrobacterium tumefaciens. Nicotiana benthamiana and tomato plants agroinoculated with the cloned begomovirus DNA developed leaf curl symptoms, whereas plants co-agroinoculated with the cloned begomovirus and betasatellites developed more severe symptoms, including leaf rolling, leaf curling, and yellowing. The symptoms induced by the begomovirus and betasatellite DNAs were indistinguishable from those observed in the field. Thus, ToLCGNV is a new monopartite begomovirus which, in association with a new species of betasatellite, causes ToLCD in Gandhinagar, India. The presence of ToLCGNV needs to be considered, along with the already reported begomoviruses infecting tomatoes in this state, e.g., Tomato leaf curl Gujarat virus (2), in studies aimed to developing tomato cultivars with stable resistance to these tomato-infecting begomoviruses in India. References: (1) R. W. Briddon et al. Mol. Biotechnol. 20:315, 2002. (2) C. Reddy et al. Arch Virol. 150:845, 2005. (3) S. D. Wyatt and J. K. Brown. Phytopathology 86:1288, 1996.

Prevalence of metabolic syndrome in chronic kidney disease: a hospital based cross-sectional study.

BACKGROUND: The components of metabolic syndrome (MetS) are the established risk factors of chronic kidney disease (CKD). Therefore, MetS and interplay of its various components, have deleterious effects on patients with chronic kidney disease. The aims of our study was to find out the prevalence of MetS in chronic kidney disease patients and to find out the association of each component of MetS with chronic kidney disease. METHODS: A Hospital based cross-sectional study was carried out from February 2008 to August 2009. One hundred and sixty confirmed chronic kidney disease diagnosed patients were included in this study. Chronic kidney disease was defined from national kidney foundation guidelines. Anthropometric measurements of subjects were noted in a semi-structured pro-forma. Fasting blood sample was collected for the estimation of fasting blood glucose, triglyceride and HDL-cholesterol. Chronic kidney disease patients were diagnosed as having the metabolic syndrome by using the modified National Cholesterol Education Program Adult Treatment Program III criteria. Data were assessed by the t-test and Chi Square Test. RESULTS: Sixty (37.5%) of the chronic kidney disease patients had MetS according to modified National Cholesterol Education Program Adult Treatment Program III criteria. The prevalence of hypertension, high fasting blood glucose, high triglyceride, low HDL Cholesterol and high waist circumference in chronic kidney disease patients was 112 (70.0%), 36 (22.5%), 74(46.25%), 98 (61.25%) and 30 (18.75%) respectively. Among the five components of the metabolic syndrome, waist circumference has the highest positive predictive value (73.34%) for chronic kidney disease. CONCLUSIONS: MetS occurs in more than one-third of chronic kidney disease patients. The prevalence of individual components of MetS is higher in chronic kidney disease patients.

Dyslipidaemia in chronic kidney disease in Nepalese population.

Patients having chronic kidney disease (CKD) are at higher risk for cardiovascular disease (CVD). Dyslipidaemia is a potential risk factor for CVD in CKD cases. In this study our aim was to find out the dyslipidaemia in patients with different stages of CKD. This hospital based cross-sectional study was conducted in department of biochemistry, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Total of 163 CKD cases and 163 non-CKD healthy controls were enrolled. CKD was defined and classified as per national kidney foundation guidelines. We analyzed fasting lipid profile including total cholesterol, HDL-C, LDL-C and TG. Significant difference in mean value of serum total cholesterol, HDL-C, LDL-C and TG were found in different stage of CKD and non-CKD groups (p value <0.05). CKD cases 33.75% and 21.47% of non-CKD controls had hypercholesterolemia (Odds ratio 1.86, p value 0.013). CKD cases 32.5% and 17.18% of non-CKD controls had low HDL-C (Odds ratio 2.32, P-value 0.001). CKD cases 38.03% and 33.13% of non-CKD controls had high LDL-C (Odds ratio 1.24, p value 0.297). CKD cases 35.58% and 19.01% of non-CKD controls had hypertriglyceridemia (Odds ratio 2.35, P-value 0.001). CKD had a higher prevalence of dyslipidaemia compared to non-CKD controls. Dyslipidaemia was also found in early stages of CKD.

Spectrum of thyroid dysfunction in patients visiting Kantipur Hospital, Kathmandu, Nepal.

Thyroid disorder is most common endocrine abnormality in the general population and its prevalence increases with age. The screening of thyroid disorder is advised in high risk population. This hospital based cross-sectional study was conducted in Department of Biochemistry, Kantipur Hospital, Kathmandu, Nepal. Patients having complains of thyroid disease from February 2010 to January 2011 were enrolled in this study. Thyroid parameters such as FT3, FT4 and TSH were measured by ELISA technique. Among total 472 subjects 393(83.27%) were female whereas 79(16.73%) were male. The prevalence of thyroid dysfunction was 36.0% (n=170). The different patterns of thyroid dysfunction in Kathmandu valley were: hypothyroid (11.6%), subclinical hypothyroid (16.9%), hyperthyroid (4.0%), and subclinical hyperthyroid (3.6%) respectively. Subjects having all thyroid parameters normal i.e. euthyroid were 63.9%. In conclusion, this study reveals a higher prevalence of thyroid dysfunction in Kathmandu region. This study recommends community based nationwide epidemiological studies on a regular basis to monitor thyroid dysfunction in Nepalese populations.

Worm infestation among the school children of Dhankuta District.

Intestinal parasitic infections (IPI) cause serious public health problem in Nepal. They are more prevalent in the poor segments of the population with low household income, poor handling of personal and environmental sanitation, overcrowding and limited access to clean water. The objective of the study is to assess knowledge and practice about worm infestation and to find out the relation of knowledge and practice with the selected variables. A cross-sectional study was conducted in 200 students of Grade 9 and 10 in Government and private schools of Dhankuta. The chi-square test was used to measure the association of knowledge and practice about worm infestation. The knowledge regarding risk factors of worm infestation due to unhygienic pig farming practices is significantly higher in female (66.4%) than male (44.8%). All the risk factors were found to be significantly higher in knowledge among the private school as compared to Government school. Regarding Fathers occupation, unemployed (100.0%) believe it is due to poor personal hygiene and very less of labor (50%) which is significantly associated. Regarding Mother Group, students never eat raw meat and vender food whose mothers have skilled worker. The school going students of Dhankuta were aware of the knowledge regarding the worm infestation but had less knowledge among the school children of Government as compared to private.

Status of pathology professionals.

BACKGROUND: The status of basic, general and specialist workforces in pathology services in Nepal needs to be defined and explored for better pathology services. The objective of the study was to find out the status of laboratory medicine professionals (pathology workforces) and the regulation of ethics and limitations of the different level of workforces. METHODS: A cross-sectional descriptive study was conducted by observing and taking interview with the head of the clinical private institutions from August 2008 to January 2009. A total of 373 private pathology laboratories and the workforces working over there were included in the study. RESULTS: The workforces heading private pathology services showed that 153 (41%) of laboratories were headed by laboratory assistant, 79 (21%) by laboratory technician, 90 (24%) by (medical technologist) pathology officer, 30 (8%) by histocytopathologist and 21 (6%) by non pathology professionals. Officer level Pathology workforce (eligible to work independently) was 113 (30%) whereas 260 (70%) of laboratories had no such workforces. Intermediate level Pathology workforce (eligible to work dependently and for some investigation independently) was 34% (127/373) where as 66% (246/373) of laboratories were lacking such workforces. Specialist level (MD/M. Sc) workforces in histocytopathology, clinical microbiology and cytopatholgy & hematology were 43 (11%), 10 (3%) and 3 (1%) respectively. CONCLUSIONS: The workforces heading the private laboratories were not according to the norms of good laboratory practices. The workforces had crossed their limitations and ethical barrier in performing pathological investigations which did not abide by the rules and regulations made by respective councils of Nepal by pathology workforces. There was intervention of non medical/clinical workforce in laboratory services especially in microbiology and biochemistry.

Assessment of chronic kidney disease in Nepalese people with hypertension.

Hypertension is one of the leading causes to develop chronic kidney disease (CKD) and could be a risk factor for progression of CKD to end stage renal disease (ESRD).Uncontrolled hypertension worsens CKD. Hypertension control may contribute to prevent CKD in early stages and retards the progression of CKD stages to ESRD. Prevalence of CKD in people with diagnosed and chronic hypertension is known to be high, but little is known about the prevalence of CKD in those with newly diagnosed Hypertension. Present work was undertaken to see the prevalence of CKD among people with newly diagnosed hypertension. In this cross-sectional study, we accessed the CKD in newly diagnosed hypertensive patients and determined the association between hypertension and CKD. CKD was defined as either kidney dysfunction or kidney damage or both as per National Kidney Foundation Guidelines. 106 of newly diagnosed patients and 106 of normotensive controls were recruited in the study. 51.9% of newly diagnosed hypertensive patients and 23.6% of normotensive controls had CKD which was statistically significant (p-value <0.001). Difference in the mean value in eGFR and spot urine ACR (mg/mmol) between hypertensive patients and normotensive controls was statistically significant (p-Value <0.001). Both systolic BP and diastolic BP negative significantly correlated with eGFR (p-Value < 0.001 and 0.024 respectively) and positive significantly correlated with ACR (p-Value 0.003 and 0.003 respectively). The prevalence of CKD is high among people with newly diagnosed hypertension. Those, people might benefit from interventions aimed at preventing development and/or progression of both CKD and hypertension.

In-vitro assessment of cell-mediated immunity by demonstrating effector-t cells for diagnosis of tuberculosis in Nepalese subjects.

The immune response against mycobacterium tuberculosis (MTB) is cell mediated. T-cells become sensitized when they encounter MTB antigens and subsequently activated effector T-cells produce a number of cytokines including interferon- gamma (INF-gamma) to fight the infecting organisms. Demonstration of either production of INF-gamma or presence of effector T-cells sensitized to MTB specific antigens in vitro can be diagnostic for TB infection. Aim of this study was to determine the efficacy of commercially available T-SPOT.TB kit which is used for the in vitro diagnosis of TB infection and to determine if this test has any cross reactivity in leprosy patients. Blood sample was taken from 30 sputum AFB positive, 30 sputum AFB negative healthy controls and 10 cases of paucibacillary leprosy patients. The blood samples were processed to separate peripheral blood mononuclear cells. The final cell suspensions were cultured along with MTB specific antigens namely- Early Secretory Antigenic Target (ESAT-6) and Culture Filtrate Protein (CFP 10) along with negative and positive controls. The production of INF-gamma was demonstrated by enzyme linked immunospot (ELISPOT) assay technique. All AFB positive samples produced INF-gamma after exposure to MTB specific antigens. 4 (16.6%) of healthy controls were also found reactive for INF-gamma. The sensitivity and "specificity" for active disease of the ELISPOT (T-SPOT.TB) in respect to AFB microscopy was 100% and 85.7% respectively. Assessment of CMI against tuberculosis, by demonstrating effector T-cell sensitized to MTB antigens can be use to aid the diagnosis of tuberculosis. T-SPOT.TB has no cross reactivity with leprosy patients.

Estimation of serum uric acid in cases of hyperuricaemia and gout.

INTRODUCTION: Gout is crystal deposit arthritis and is an ancient disease. The biologic precursor to gout is hyperuricaemia. The prevalence of hyperuricaemia and gout has an increasing trend all over the world including the developing countries. The purpose of this study is to estimate serum uric acid level in hyperuricaemic and gout patients attending a medical college hospital. METHODS: A consecutive 150 hyperuricaemics and 150 gout patients attending Tribhuwan University Teaching Hospital from June to September 2007 were included in this study. The serum uric acid level was measured by the enzymatic (PAP- Uricase) method. The patients with acute gout were interviewed and relevant information was obtained. RESULTS: Males comprised 84% of gout cases. Hyperuricaemia was common in both sexes. The mean age for gout was 47.49 and 56.65 years in males and females respectively. The mean age for the first gout attack was 42.1 +/- 14.0 years. Family history was positive in 22% of cases. The overall mean serum uric acid level in hyperuricaemics was 7.2 +/- 0.7 mg/dL and 8.4 +/- 1.1 mg/dL in acute gout (p 0.0001). The mean serum uric acid level was significantly (p 0.0001) high among males both at the asymptomatic phase and at acute gout. Gout was more common in non-vegetarians (95%) and alcoholics (65.3%). Serum uric acid level was inversely related with the amount of daily water intake (p 0.0001). CONCLUSIONS: Serum uric acid level is significantly high among the male gouty arthritic patients. However, it is also high among asymptomatic hyperuricaemic cases of both sexes.

Association of cardiovascular risk factors in hypertensive subjects with metabolic syndrome defined by three different definitions.

INTRODUCTION: Different authorities have put forward their criteria to define metabolic syndrome (MetS). The aim of this study was to find the prevalence of MetS in hypertensive individuals by the available three different definitions from National Cholesterol Education Program (NCEP), International diabetes Federation (IDF) and WHO and their association with other cardiac risk factors. METHODS: After anthropometric measurements fasting blood was analyzed for glucose, lipids, high sensitivity C-reactive protein (hsCRP) and anti-oxidized LDL antibody in 150 hypertensive individuals. A ten-year coronary heart disease risk was predicted using the Framingham risk score (FRS). RESULTS: The prevalence of MetS was 54.7 % by NCEP, 42.0 % by IDF) and 18.7 % by WHO. As many as 63.4 % had MetS by any definition, while only 9.4 % fulfilled all the criteria of the three definitions. The association of cardiac risk factors also varied according to the definition used. hsCRP was significantly elevated in MetS compared to non-MetS. Body mass index, waist circumference and HDL-C were associated in MetS defined by NCEP and IDF. FRS was higher in MetS defined by Adult Treatment Panel and WHO definitions. An increase in urine albumin and a decrease in eGFR were associated with MetS individuals defined by WHO only. CONCLUSION: There is a wide variation in the prevalence of MetS and associated cardiac risk factors according to three different definitions used. The different cardiac risk factors among MetS also vary with the definitions used. However, hsCRP and emerging risk factor are significantly elevated in hypertensive individuals with MetS as defined by all definitions.