ABSTRACT
Cholera has been a recurrent epidemic disease in human populations for the past 200years. We present herein a comparative characterization of clinical Vibrio cholerae strains isolated from two consecutive cholera outbreaks in 2012 and associated environmental strains from western India. The clinical and toxigenic environmental isolates were identified as hybrid V. cholerae O1, serotype Ogawa, biotype El Tor carrying the variant ctxB7 allele. Partial sequences of SXT integrase from the isolates revealed 100% identity to ICEVchInd5 (Sevagram, India, 1994) and VC1786ICE (Haiti, 2013). The full clonal relationship of the strains established by RAPD, Box PCR, ERIC PCR and MLST (pyrH, recA and rpoA) analyses, and the short time between the two outbreaks, strongly supported that both outbreaks were due to a single strain. The study corroborated that faecal contamination of the potable water supply was the main reason for the first outbreak, which further spread to other areas and resulted in the second outbreak. The study concluded that the circulating El Tor variant strains of epidemic potential in the region can be a serious concern in the future.
Subject(s)
Bacterial Proteins/genetics , Cholera/epidemiology , Drinking Water/microbiology , Integrases/genetics , Vibrio cholerae O1/classification , Vibrio cholerae O1/isolation & purification , Cholera/microbiology , Disease Outbreaks , Humans , India/epidemiology , Multilocus Sequence Typing , Phylogeny , Sequence Analysis, DNA , Vibrio cholerae O1/geneticsABSTRACT
Vibrio cholerae O1 biotype El Tor producing Haitian variant Cholera Toxin (HCT) and showing reduced susceptibility to ciprofloxacin caused a cholera outbreak associated with a high case fatality rate (4.5) in India. HCT-secreting strains responsible for severe cholera epidemics in Orissa (India), Western Africa and Haiti were associated with increased mortality. There is a pressing need for an integrated multidisciplinary approach to combat further spread of newly emerging variant strains. The therapeutic effect of ciprofloxacin was diminished whereas use of doxycycline in moderate to severe cholera patients was found to be effective in outbreak management.
Subject(s)
Bacterial Proteins/genetics , Cholera/epidemiology , Cholera/microbiology , Disease Outbreaks , Vibrio cholerae O1/drug effects , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Cholera/drug therapy , Cholera Toxin/genetics , Ciprofloxacin/pharmacology , DNA Gyrase/genetics , DNA Topoisomerase IV/genetics , Disk Diffusion Antimicrobial Tests , Doxycycline/therapeutic use , Drug Resistance, Bacterial/genetics , Humans , India/epidemiology , Vibrio cholerae O1/geneticsABSTRACT
Majority of patients with prostate cancer develop bone metastases which lead to serious skeletal complications. Prostate cancer guidelines recommend the use of bisphosphonates for men with bone metastases. The objective of this study was to determine the best treatment options for prostate cancer with bone metastases. Patients with clinically confirmed bone metastases were identified and the efficacy of bisphosphonates of second generation was studied. Findings from this study show that pamidronate in dose 90 mg is effective in treatment of different stages of bone metastases. All above mentioned confirms implementation of bisphosphonates of II generation into clinical practice in palliation of prostate cancer patients with bone metastases along with other treatments.
Subject(s)
Bone Neoplasms/drug therapy , Bone Neoplasms/secondary , Diphosphonates/therapeutic use , Prostatic Neoplasms/pathology , Diphosphonates/administration & dosage , Humans , Male , Pamidronate , Treatment OutcomeABSTRACT
Application of retroperitoneoscopy improved diagnosis of regional metastases urinary bladder cancer because it provided relevant morphological verification. Fifty patients were examined for urinary bladder cancer. Factors influencing the frequency of lymphogenic dissemination were studied. A comparative evaluation of the results of direct contrast lymphography and of retroperitoneoscopy suggests that a complex of procedures including retroperitoneoscopy should be used for diagnosis of regional metastases of urinary bladder cancer (T3-4).
Subject(s)
Laparoscopy/methods , Lymphatic Metastasis/diagnosis , Urinary Bladder Neoplasms/pathology , Adult , Aged , Humans , Lymphography , Middle Aged , Urinary Bladder Neoplasms/diagnostic imagingABSTRACT
According to the data of literature intermuscular lipomas are observed in children, but rarely. The diagnosis of intermuscular lipomas presents certain difficulties since these tumors are frequently taken for sarcomas. Biopsy seems to be an important diagnostic method. From 1967 to 1972 the authors observed intermuscular lipomas in 3 children. One case report of a large intermuscular lipoma of the femur in a 2 year-old child is described. Surgery is considered to be the principal method of treatment for intermuscular lipomas. Recurrent intermuscular lipomas should be regarded as a warning against liposarcoma.