Role of non-H2O2 producing lactobacilli and anaerobes in normal and complicated pregnancy.

Lactobacilli (Doederlein's bacilli) are the most important predominant protective agents of the vaginal microbial ecosystem and alteration in vaginal pH directly speculates the concentration of lactobacilli. Currently, recognition of anaerobic lactobacilli (non-H2O2 producing lactobacilli) had further raised its significance. Therefore, the present study was aimed to explore the role of non-H2O2 lactobacilli and its association with other anaerobes in 100 cases of complicated pregnancy, 75 cases of normal pregnancy and 35 cases in non-pregnant women. Vaginal and cervical swabs were obtained and were inoculated in special and suitable media. Anaerobic lactobacilli (non-H2O2 producing) were more common genital microbes in women of complicated pregnancy (56.0%) than in normal pregnancy (34.7%) and in control group (14.2%). Rate of recovery of non-H2O2 producing lactobacilli increased when pathogenic bacteria especially anaerobes dominate the genital microflora. Anaerobic lactobacilli were seen in higher numbers when they were associated with bacteroides sp and other anaerobes. They were significantly reduced when aerobes predominated in flora; the correlation have been discussed.

Trichomonas vaginalis-An indicator for other sexually transmitted infecting agents.

The present study is based on 350 women having sexually transmitted diseases (STD) and 68 male counterparts. Trichomonas vaginalis was a significant contributor in 216 (61.7%) out of 350 female STD cases and 56 (82.3%) out of 68 male counterparts. Further, out of 126 (58.3%) out of 216 cases of T. vaginalis, 41 cases (32.5%) were associated with candida species; 29 cases (23%) were associated with Neisseria gonorrhoeae (N gonorrhoeae); Haemophilus ducreyi (H. ducreyi) 18 cases (14.3%) and Chlamydia trachomatis (C. trachomatis) 11 cases (8.7%). Treponema pallidium (T. pallidium) was observed in 8 cases (6.3%) which constitutes a low percentage. The present study highlights the importance of T. vaginalis by showing positivity in two-thirds of the STD cases which suggests that it can be an important indicator for other etiological STD agents in women.

Trichomonas vaginalis - an indicator for other sexually transmitted infecting agents.

The present study is based on 350 women having sexually transmitted diseases and 68 men counterparts. Trichomonas vaginalis was a significant contributor in 216 (61.7%) out of 350 female SID cases' and in 56 (82.3%) out of 68 male counterparts. Further, out of 216 cases of T.vaginalis, 41 cases (32.5%) were associated with infection with Candida species; 29 (23%) with Neisseria gonorrhoea. 18 cases (14.3%) with Haemophilus ducreyi and 11 cases (8.7%), Chlamydia trachomatis. Treponema pallidum was observed in 8 cases (6.3%) which constituted a low percentage. Present study highlighted the importance of T. vaginalis by showing positivity in two-third cases which suggested that it can be an important indicator for other etiological STD agents in women.

Determination of mycobacterial phylogeny on the basis of immunological relatedness of superoxide dismutases.

Sixteen strains of cultivable mycobacteria were grown in Sauton's medium, and Mycobacterium leprae was purified from armadillo liver. Cell extracts were prepared from log-phase growths of each of the cultivable mycobacterial strains. Superoxide dismutase (SOD) enzyme was purified from all cultivable mycobacterial strains included in the study, and antibodies against purified SOD enzyme were raised in rabbits. Immunological distances (ImDs) between these anti-SOD antibodies and SOD antigens were determined by a previously described immunoprecipitation method and by a recently developed enzyme-linked immunosorbent assay (ELISA) technique. The reciprocal ImDs among mycobacterial strains were constant, reproducible and consistent by these two methods. An evolutionary tree was constructed on the basis of estimated ImDs. Except for M. duvalii and M. terrae, slowly and rapidly growing mycobacterial species appeared to be separately grouped by this analysis. Rapid growers clustered into a group which is near that of some slow-growing mycobacteria. M. avium falls almost in the middle of the evolutionary tree and the position of M. leprae was found to be between those of M. avium and M. bovis BCG. Measurement of immunological relatedness of SODs provides an alternative system with which to study the taxonomical relatedness among mycobacteria.

Development of a SOD ELISA to determine the immunological relatedness among mycobacteria.

This study reports on the standardization of an enzyme-linked immunosorbent assay (ELISA) system for the measurement of immunological distances (ImDs) of the superoxide dismutase (SOD) molecule among the cultivable mycobacteria, namely, Mycobacterium vaccae, M. phlei, M. smegmatis, M. avium, M. scrofulaceum, M. tuberculosis H37Ra, M. tuberculosis H37Rv, and M. bovis BCG, and M. leprae. SODs from cultivable mycobacteria were purified, antibodies were raised against these molecules, and ImDs between these anti-SOD antibodies and antigen (SODs) were determined by an immunoprecipitation technique standardized earlier and by the ELISA technique developed in this study. The ELISA system developed in this study showed higher sensitivity and consistent and reproducible ImDs among various mycobacteria, including pathogens such as M. tuberculosis, M. leprae and M. avium. These values were comparable with the values derived by the immunoprecipitation technique. Our ELISA technique appears to be a sensitive and rapidly reproducible method with the additional advantage of the stability of reagents, and holds promise in the taxonomy as well as in the development of diagnostics for leprosy and other mycobacterial infections.

Comparative study of immunoglobulin G and immunoglobulin M among neonates in caesarean section and vaginal delivery.

The present study comprised 50 cases of normal vaginal delivery and 50 cases of caesarean section. The cord blood level of immunoglobulin G was significantly higher in normal vaginal delivery cases than in caesarean section cases (mean level is 1653.2 +/- 443.1 mg/dl and 898.3 +/- 415.6 mg/dl respectively). The immunoglobulin G was low in cord blood but had higher concentration in all the 7 cases in study group who had fever with rigor in antenatal period. Thus the babies delivered with caesarean section had lower immunoglobulin level than normal vaginal delivery.

PIP: In India, data on 50 newborns delivered vaginally and data on 50 other newborns delivered by cesarean section for cephalopelvic disproportion were analyzed to compare the maternal and cord blood levels of immunoglobulin G (IgG) and immunoglobulin M (IgM). The mothers were 21-33 years old. Hemoglobin levels ranged between 10 and 12 g/dl. For cord blood, normal delivery cases had a higher IgG level than cesarean section cases (1653 vs. 898.3 mg/dl). For maternal blood, however, the IgG level was not significantly different (1310 mg/dl for vaginal and 1275 mg/dl for cesarean section). Seven of the 50 mothers who delivered by cesarean section had a severe fever. All their newborns had higher IgG levels than other cesarean section cases and vaginal delivery cases (1060 vs. 896 mg/dl). IgM maternal and cord blood levels were not significantly different between the two groups. These findings suggest a need for prophylactic measures to prevent complication of neonatal sepsis.

Correlation between inhibitory effect of quinolones and mycolic acid metabolism in mycobacteria.

Mycolic acids are important components having a significant role in maintaining the rigidity of mycobacterial cell wall. They could also be the barrier for penetration of certain drugs into the bacterial cell. A novel in vitro model system was established for assessing the effect of Ciproflaxacin on mycolic acid metabolism in pathogenic mycobacteria M. Kansasii (which has similar mycolic acid pattern to that from M. leprae) and the effect of norfloxacin in M. intracellulare. These test mycobacteria were exposed in their midlogarithmic phase of growth to 0.5, 1, 2, 3, 4, 5 and 6 micrograms ml of ciprofloxacin and norfloxacin respectively for 1, 2 and 24 hours. Ciprofloxacin completely inhibited the synthesis of mycolates in M. kansasii at 3, 4 and 5 micrograms/ml; whereas norfloxacin exhibited its maximum inhibitory action on mycolic acids in M. intracellulare at 6 micrograms/ml for all the durations of exposure. Inhibition of mycolates directly correlated with bacterial viability which was estimated by colony forming units. The effect of quinolones on mycolic acid metabolism appears to be direct and not secondary to DNA gyrase. The results obtained from this study and our previous findings show that mycolic acid metabolism is affected by various groups of drugs, whose primary sites of activity may be different. The findings of the present study may have significant therapeutic implications in leprosy and other mycobacterial diseases.

Amebic necrosis of bowel.

Ten cases of amebic necrosis of bowel have been presented. The pathology of amebic bowel necrosis has been discussed in detail, and diagnostic criteria have been mentioned. The treatment of choice in these cases is wide excisional surgery.