Pulmonary leptospirosis: an excellent response to bolus methylprednisolone.

BACKGROUND: This case series analyses the beneficial effect of methylprednisolone in pulmonary leptospirosis, which usually has an aggressive course and grave outcome. METHODS: 30 patients of pulmonary leptospirosis were evaluated. The initial 13 patients did not receive corticosteroids while the remaining 17 all received bolus methylprednisolone one gram intravenously for three days followed by oral prednisolone 1 mg/kg for seven days, on the basis of occasional case reports of benefit in pulmonary leptospirosis. APACHE III and lung injury scores of similar severity were considered while comparing outcomes in those who received methylprednisolone with those who did not. RESULTS: Dyspnoea and haemoptysis were the commonest symptoms in those with pulmonary manifestations. Overall mortality was 18% (3 of 17) in patients who received methylprednisolone, as compared with 62% (8 of 13 patients) in those who did not (p<0.02). In patients with established acute lung injury (ALI score >2.5), five of eight patients survived in the subgroup with corticosteroids (37% mortality) while only one of nine patients survived in the group that did not receive corticosteroids (89% mortality). Corticosteroids affected outcome only if given within the first 12 hours after the onset of pulmonary manifestations. Mortality seemed to correlate with the APACHE scores, and number of quadrants affected on chest radiographs, more than with blood gas pressures. CONCLUSIONS: Corticosteroids reduce mortality and change outcome significantly when used early in the management of pulmonary leptospirosis.

Recurrent Kimura's disease: excellent response to cyclosporine.

Kimura's disease is a chronic inflammatory disorder involving the skin, subcutaneous tissues and lymph nodes, predominantly in the head and neck region. Though surgery, intralesional or systemic steroids or radiation therapy have been the mainstay of treatment recurrence is a common problem. On the basis of occasional case report of Kimura's disease responding to cyclosporine, we attempted oral cyclosporine in our patient with dramatic improvement.

Enhancing plant phosphorus use efficiency for sustainable cropping.

Phosphorus (P) is one of the least available mineral nutrients to the plants in many cropping environments. Sub-optimal P nutrition can lead to yield losses in the range of 10% to 15% of the maximal yields. P deficiency is more critical in highly withered soils as well as in calcareous and alkaline soils. Amelioration attempts by addition of phosphatic fertilizers are economically and ecologically unsound as the efficiency of added phosphatic fertilizers is very low. Inoculation with the mineral phosphate solubilizing microbes has not helped much due to inconsistent performance of the inoculants under field conditions. These factors have led to examine the opportunities for developing genetically enhanced plants with better P use efficiency (PUE) through efficient P absorption, transportation and internal utilization. In order to improve the PUE in crop plants, it is important to explore genetic variation for all its associated traits. Inter- and intra-specific variations for these traits are known to exist and are shown to be under genetic and physiological controls, but modified by the plant-environment interactions. A more comprehensive understanding of the molecular and physiological basis of P uptake, transportation and utilization is leading to formulation of strategies aimed at developing better P efficient cultivars suited for sustainable cropping with less P fertilizer inputs. Issues relating to enhancing PUE through genetic manipulations of crop cultivar parameters are discussed.

Kaposi's sarcoma with thrombocytopenia in a heterosexual Asian Indian male.

A 45-year-old heterosexual male patient with retroviral disease since 12 years presented with hyperpigmented lesions, misdiagnosed initially as purpura due to an associated thrombocytopenia, but was biopsy proven to be Kaposi's sarcoma (KS). Bone marrow examination revealed excess megakaryocytes. Low CD4 count and absence of platelet specific IgG reduced the likelihood of immune thrombocytopenia (ITP). However after 6 weeks of antiretroviral therapy the patient's lesions have reduced and platelet counts are improving, possibly suggesting a sequestration thrombocytopenia in the abnormal tumor vessels of KS.

Pulmonary hydatid cyst in HIV-1 disease.

A 36-year-old male patient, a known case of retroviral disease, presented with clinical features suggestive of pneumonia and was found to have bilateral lower zone lung consolidation which on resolution showed a cystic change on the chest radiograph. A subsequent CT scan revealed the true nature of these cysts to be ruptured pulmonary hydatid cysts showing a 'water lily sign'. The rare association of pulmonary hydatid cyst and HIV from India is described.

Plus minus lid syndrome with ataxia.

Plus minus lid syndrome is an ocular syndrome characterized by unilateral ptosis and contralateral lid retraction. Also when the ipsilateral lid is raised manually, the contralateral retracted lid does not revert. This patient presented with features of plus minus lid syndrome with ataxia due to a vascular mesencephalic lesion.

Identification of flanking SSR markers for a major rice gall midge resistance gene Gm1 and their validation.

Host-plant resistance is the preferred strategy for management of Asian rice gall midge (Orseolia oryzae), a serious pest in many rice-growing countries. The deployment of molecular markers linked to gall midge resistance genes in breeding programmes can accelerate the development of resistant cultivars. In the present study, we have tagged and mapped a dominant gall midge resistance gene, Gm1, from the Oryza sativa cv. W1263 on chromosome 9, using SSR markers. A progeny-tested F2 mapping population derived from the cross W1263/TN1 was used for analysis. To map the gene locus, initially a subset of the F2 mapping population consisting of 20 homozygous resistant and susceptible lines each was screened with 63 parental polymorphic SSR markers. The SSR markers RM316, RM444 and RM219, located on chromosome 9, are linked to Gm1 at genetic distances of 8.0, 4.9 and 5.9 cM, respectively, and flank the gene locus. Further, gene/marker order was also determined. The utility of the co-segregating SSR markers was tested in a backcross population derived from the cross Swarna/W1263//Swarna, and allelic profiles of these markers were analysed in a set of donor rice genotypes possessing Gm1 and in a few gall midge-susceptible, elite rice varieties.

Isozyme polymorphism and virulence of Indian isolates of the rice sheath blight fungus.

Inadequate information about the genetic structure of the polyphagous Rhizoctonia solani has made sheath blight resistance breeding a difficult task. To assess the variability in the Indian populations of sheath blight fungus, 18 isolates were collected from different rice growing regions of India and analyzed for virulence and electrophoretic profiles of 13 isozymes. The virulence spectrum of all 18 isolates was examined on susceptible IR50 and tolerant Swarnadhan varieties, based on which the isolates could be grouped as highly virulent, moderately virulent or avirulent. A total of 11 enzyme systems with 153 electrophoretic phenotypes were applied to characterize the genetic variation among the isolates. Cluster analyses based on isozyme patterns resulted in one major cluster comprising 16 virulent isolates, with two avirulent isolates loosely linked to this at 0.13 similarity. Isozyme systems of esterases (both alpha and beta) and 6-phosphogluconic dehydrogenase could be used to fingerprint the individual isolates.