Preventive Health Checkup: Utilization, Motivators, and Barriers Among the General Population in a Rural District in Tamil Nadu, India.

BACKGROUND: The main goals of preventive health care include the early detection of disease by screening, identifying and reducing disease risk factors, and improving the current disease processes. Moreover, early disease discovery in the latent stage facilitates prompt intervention, reducing morbidity and death. OBJECTIVE: To estimate the proportion of people who have availed preventive health check-ups in Perambalur and to determine the motivators and barriers to health check-ups among adults (age group: 18 years and above). MATERIALS AND METHODS: We conducted a cross-sectional study among the general population from September 2021 to November 2021. A total of 436 participants were included in the study. A structured questionnaire was used to collect the socio-demographic characteristics and preventive health check-up details, along with the motivators and barriers. The data were entered in Microsoft Excel (Microsoft, Redmond, WA), and analysis was done using SPSS version 26 (IBM Corp., Armonk, NY). RESULT: The mean ± SD of the age of the general population was 52.27 ± 21.09. Out of 436 participants, only 130 (29.82%) had undergone preventive health check-ups in the past. The subjects with young age (p = 0.006), those who obtained COVID-19 vaccination (p = 0.001), subjects with stable occupation (p = 0.002), and those with higher education (p < 0.001) (chi-square test) had preventive health check-ups. A significant association was found between motivators and barriers for age, gender, education, occupation, marital status, the presence of comorbidities, and vaccination status against COVID-19. CONCLUSION: Preventive health check-up is still not up the ladder of health care for the general population. The health programmes should orient the public towards the concept of individual responsibility in health.

Strategies for enhancing the efficacy of anaerobic digestion of food industry wastewater: An insight into bioreactor types, challenges, and future scope.

Food waste have become a growing concern worldwide with raising population and economic growth. Wastewater discharged from food industries contains many valuable and toxic components that have a negative impact on the ecological system. Large amounts of wastewater are discharged from the food industry, which necessitates the creation of effective technologies. Wastewater from the food industry can be seen as a rich source of energy and a primary source for generating valuable products. Waste disposal and resource recovery are sustainably valued by anaerobic digestion of wastewater from the food sector. The characteristics, composition, and nature of wastewater produced from various food sectors are elaborated upon in this review. An overview of the anaerobic digestion process for wastewater treatment in the food industry is included. Enhancement strategies for the anaerobic digestion process have been discussed in detail. In addition, various types of reactors utilized for performing anaerobic digestion is illustrated. Though anaerobic digestion process possesses advantages, the challenges and future scope are examined for improving the outcome.

Socio-demographic study on extent of knowledge, awareness, attitude, and risks of zoonotic diseases among livestock owners in Puducherry region.

AIM: This study was conducted to assess the extent of knowledge, awareness, attitude, and risks of zoonotic diseases among livestock owners in Puducherry region. MATERIALS AND METHODS: A total of 250 livestock farmers were selected randomly from eight revenue villages. And each farmer was interviewed with a questionnaire containing both open- and close-ended questions on various aspects of zoonotic diseases, a total of 49 questionnaires were framed to assess the source and transmission of infection to the farmers and to test their knowledge and awareness about zoonotic diseases. The data collected were analyzed by chi-square test using software Graph pad prism, and results were used to assess the relationship between education level and zoonotic disease awareness; risk of zoonotic diseases and its relation with independent variables. RESULTS: The present survey analysis represents that most of the respondents are belonging to the age group of 41-60 years. About 42.8% of respondents' household having a graduate. The most of the respondent are small-scale farmers and their monthly income was less than Rs. 10,000. About 61.2% of farmers were keeping their animal shed clean. About 29.6% of the respondents were ignorant about cleaning the dog bitten wound. Only 16.4% of respondents knew that diseases in animals can be transmitted to humans. Only 4.8%, 3.6%, 6.8%, and 22.4% of respondents knew about the zoonotic potential of diseases such as brucellosis, tuberculosis (TB), anthrax, and avian flu, respectively. Only 18% of the respondents were aware about zoonotic diseases from cattle. Regarding the list of zoonotic diseases contracted, 37.7% reported respiratory infection, 31.1% digestive disturbances, 15.5% had dermatological problem, and 15.5% reported indiscrete disease such as fever, body pain, and headache joint pain. From the respondent got the zoonotic disease (n=45), 51.2% of the respondent reported chronic infection and 48.8% of the respondent reported acute form of zoonotic infection. About 30% of the respondents' farm had an incidence of abortion. Our analyses showed that there was significant in educational level of respondents and treatment of dog bitten animals. Furthermore, there was statistical significance in occurrence of hand and foot lesions in the respondent and occurrence of foot-and-mouth disease outbreak in their animals. CONCLUSION: From this study, it is concluded that involvement of educated family members in farming practices can create awareness and improve knowledge toward zoonotic disease. Further creation of awareness toward zoonotic diseases is of utmost important.

A unified classification model for modeling of seismic liquefaction potential of soil based on CPT.

The evaluation of liquefaction potential of soil due to an earthquake is an important step in geosciences. This article examines the capability of Minimax Probability Machine (MPM) for the prediction of seismic liquefaction potential of soil based on the Cone Penetration Test (CPT) data. The dataset has been taken from Chi-Chi earthquake. MPM is developed based on the use of hyperplanes. It has been adopted as a classification tool. This article uses two models (MODEL I and MODEL II). MODEL I employs Cone Resistance (q c) and Cyclic Stress Ratio (CSR) as input variables. q c and Peak Ground Acceleration (PGA) have been taken as inputs for MODEL II. The developed MPM gives 100% accuracy. The results show that the developed MPM can predict liquefaction potential of soil based on q c and PGA.

Orthodeoxia syndrome: a rare complication of ASD in spinal cord injury.

STUDY DESIGN: This is a single-subject case report. OBJECTIVES: The objective is to describe and discuss a rare presentation of orthodeoxia after spinal cord injury in a previously healthy adult with an asymptomatic and undiagnosed atrial septal defect. SETTING: This study was conducted at the Tertiary Care Spinal Injuries Center in Sheffield, UK. METHODS: An 81-year-old woman who was otherwise healthy and active sustained a polytrauma following a road traffic collision. Her injuries were managed conservatively. As a complication of epidural analgesia, she developed a complete thoracic paraplegia secondary to an epidural hematoma. She was found to have repeated episodes of severe deoxemia, without any significant postural hypotension when attempts were made to sit her up in bed. Detailed investigations were done to ascertain the cause for this deoxemia. RESULTS: Echocardiography revealed an atrial septal defect; agitated saline contrast transesophageal ultrasound done in various positions revealed interatrial defect with reversal of shunting when the patient was made to sit up in bed. CONCLUSION: Orthodeoxia is an uncommon finding in spinal injury patients. Detailed investigations at an early stage of rehabilitation need to be done to rule out cardiac causes after ruling out the common medical complications seen in the acute and subacute phases following spinal cord injury.

Association of premature androgenetic alopecia and metabolic syndrome in a young Indian population.

CONTEXT: Although evidences for association of androgenetic alopecia (AGA) with metabolic syndrome (MetS) are accruing, inconclusiveness with respect to the gender specificity and differential association of MetS with increasing severity of AGA continues to persist. Furthermore, data specific to Indian settings are relatively sparse. AIMS: The present study aimed at assessing the frequency of MetS in individuals with early AGA in Indian settings. SETTINGS AND DESIGN: A case-control study was conducted at a trichology clinic in Bengaluru between April 2012 and September 2012 with a total of 85 cases of AGA and 85 age-matched controls. MATERIALS AND METHODS: The Norwood-Hamilton classification was used to assess the grade of AGA. MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Blood pressure, blood glucose, lipid parameters, and body mass index along with anthropometric measurements were assessed in all study participants. STATISTICAL ANALYSIS USED: Chi-square test was used to compare proportions between groups. Means were compared between groups using Student's t-test. RESULTS: MetS was seen in a higher proportion of patients with AGA (43.5%) as compared to the control group (2.4%) and the differences were statistically significant (P < 0.001). As compared to controls, patients with AGA had higher triglycerides (P < 0.001), systolic blood pressure (P < 0.001), diastolic blood pressure (P < 0.001) along with significantly lower high-density lipoprotein cholesterol levels (P < 0.001). Severity of AGA was not associated with MetS. CONCLUSIONS: AGA is associated with MetS in male Indian patients aged <30 years. Studies with large sample sizes may be required to conclusively define any putative associations between AGA grades and MetS.

Synthesis and characterization of doxorubicin modified ZnO/PEG nanomaterials and its photodynamic action.

The aim of this study is to investigate a new strategy of combined application of ZnO/PEG nanospheres with anticancer drug of doxorubicin (DOX) in photodynamic therapy (PDT). We were able to fabricate ZnO/PEG nanospheres as the drug carrier of DOX in drug delivery system. The combination of DOX-ZnO/PEG nanocomposites induced the remarkable improvement in the anti-tumor activity, which has been demonstrated by antibacterial activity, drug release and DNA cleavage study. Furthermore, the possible mechanism was explored by optical spectroscopic studies and EPR - spin trapping technique. It was noted that the photodynamic activity of the non-cytotoxic DOX loaded ZnO/PEG nanocomposite could considerably increase cancer cell injury mediated by reactive oxygen species (ROS) under UV irradiation. In our observations demonstrated that ZnO/PEG nanosphere could obviously increase the intracellular concentration of DOX and enhance its potential anti-tumor efficiency, indicating that ZnO/PEG nanosphere could act as an efficient drug delivery carrier importing DOX into target cancer cells. Nearly 91% of loaded drug was released within 26 h of incubation of conjugates in vitro in an acidic environment. It suggests that there is an efficient drug release of DOX from DOX-ZnO/PEG nanocomposite. DOX loaded on ZnO/PEG nanomaterials showed antibacterial activity was more pronounced with Gram-positive than Gram-negative bacteria under visible light. DOX-ZnO/PEG nanocomposites were effective against HeLa cell lines under in vitro condition and photocleavage of DNA. This result indicated that ZnO/PEG nanomaterials can be used as a nanocarrier for drug delivery system for PDT.

Shape-from-focus by tensor voting.

In this correspondence, we address the task of recovering shape-from-focus (SFF) as a perceptual organization problem in 3-D. Using tensor voting, depth hypotheses from different focus operators are validated based on their likelihood to be part of a coherent 3-D surface, thereby exploiting scene geometry and focus information to generate reliable depth estimates. The proposed method is fast and yields significantly better results compared with existing SFF methods.

GSK3beta: role in therapeutic landscape and development of modulators.

Glycogen synthase kinase-3 beta (GSK3beta) is a multifunctional serine/threonine kinase which was originally identified as a regulator of glycogen metabolism. It plays a key role in the regulation of numerous signalling pathways including cellular process such as cell cycle, inflammation and cell proliferation. Over the last few years there is a considerable rise in the number of journals and patents publication by different workers worldwide. Many pharmaceutical companies are focusing on GSK3beta as a therapeutic target for the treatment of disease conditions. The present review is focused on signalling pathways of different disease conditions where GSK3beta is implicated. In this review, we present a comprehensive map of GSK3beta signalling pathways in disease physiologies. Structural analysis of GSK3beta along with molecular modelling reports from numerous workers are reviewed in context of design and development of GSK3beta inhibitors. Patent landscape of the small molecule modulators is profiled. The chemo space for small molecule modulators extracted from public and proprietary Kinase Chembiobase for GSK3beta are discussed. Compounds in different clinical phases of discovery are analysed. The review ends with the overall status of this important therapeutic target and challenges in development of its modulators.

Community reintegration of spinal cord-injured patients in rural south India.

STUDY DESIGN: Cross sectional follow-sup survey. OBJECTIVE: To ascertain the factors influencing community reintegration, of individuals with spinal cord injury living in rural environment, and to suggest measures to enhance community participation. SETTING: Bangalore, Karnataka, India. METHODS: Thirty-five individuals who were admitted under Physical Medicine and Rehabilitation Department of St Johns Medical College Hospital and rehabilitated to their functional level based on their level of injury; individuals living in rural environment were included in the study. The study was conducted by means of a standardized questionnaire and environmental and home assessments carried out during follow-up home visits after 12 months of discharge from the hospital. The main outcome measures were Craig Handicap Assessment and Reporting Technique (CHART) and Craig Hospital Inventory of Environmental Factors (CHIEF). The home visits and assessments were carried out by a rehabilitation team, which consisted of community-based rehabilitation worker, medico-social worker, physiotherapist and occupational therapist, and headed by a physiatrist. RESULTS: The findings of the study indicate a general decline in community re integration in terms of physical independence, mobility, occupation and social integration. Mobility issues were the greatest perceived barrier and economic issues also significantly influenced the community participation. CONCLUSION: Our study showed significant decline in community reintegration in subjects living in rural south India. Architectural and environmental barriers, poor socio-economic status and comorbidities significantly affected the level of community participation.

A prospective, parallel group, open-labeled, comparative, multi-centric, active controlled study to evaluate the safety, tolerability and benefits of fixed dose combination of acarbose and metformin versus metformin alone in type 2 diabetes.

OBJECTIVE: The present study was a prospective, parallel group, open-labeled, comparative, multicentric, active controlled study to evaluate the safety, tolerability and benefits of fixed dose combination of acarbose and metformin versus metformin alone in type 2 diabetic patients. METHODS: A total of 229 patients with type 2 diabetes were enrolled at 5 medical centers across India. They received either acarbose (50 mg) + metformin (500 mg) bid/tid (n=115) or metformin monotherapy (500 mg) bid/ tid (n=114) for 12 weeks. Primary objective was to evaluate safety and tolerability based on the adverse events reported. Secondary objective was efficacy assessment based on changes in fasting, post prandial blood glucose and HbA1c values. RESULTS: In the acarbose + metformin group 10 patients reported 14 adverse events while in metformin group 9 patients reported 10 adverse events. No patient reported any serious adverse event or was withdraw from study because of adverse events. In the acarbose plus metformin group fasting blood glucose (FBG) decreased from a baseline of 158.85 +/- 18.14 mg/dl to 113.55 +/- 19.38 mg/dl (p < 0.0001) (decrease of 45.30 +/- 15.30 mg/dl) at 12 weeks, while in the metformin group fasting blood glucose decreased from a baseline of 158.31 +/- 26.53 mg/dl to 130.55 +/- 28.31 mg/dl (p < 0.0001) (decrease of 27.76 +/- 22.91 mg/dl) at 12 weeks. In the acarbose plus metformin group postprandial blood glucose (PPBG) decreased from a baseline of 264.65 +/- 34.03 mg/dl to 173.22 +/- 31.40 mg/dl (p < 0.0001) (decrease of 91.43 +/- 28.65 mg/dl) at 12 weeks, while in the metformin group PPBG decreased from a baseline of 253.56 +/- 36.28 mg/dl to 205.36 +/- 39.49 mg/dl (p < 0.0001) (decrease of 48.20 +/- 32.72 mg/dl) at 12 weeks. In the acarbose plus metformin group glycosylated haemoglobin (HbA1c) decreased from a baseline of 9.47 +/- 0.69% to 7.71 +/- 0.85% (p < 0.0001) (% decrease of 1.76 +/- 1.11) at 12 weeks, while in the metformin group HbAlc decreased from a baseline of 9.32 +/- 0.65% to 8.26 +/- 0.68% (p < 0.0001) (% decrease of 1.06 +/- 0.66) at 12 weeks. The combination of acarbose and metformin was found to be significantly superior in lowering the FBC (p < 0.0001), PPBG (p < 0.0001) and HbA1c (p < 0.0001) at 12 weeks as compared to metformin monotherapy. CONCLUSIONS: Fixed dose combination of acarbose and metformin was well tolerated and it was superior to metformin monotherapy in controlling FBG, PPBG and HbA(1C) levels in Type 2 Diabetes Mellitus patients.

Molecular variants of HPV-16 associated with cervical cancer in Indian population.

Human papilloma virus is a causative factor in the etiology of cervical cancer with HPV16 being the most prevalent genotype associated with it. Intratype variations in oncogenic E6/E7 and capsid L1 proteins of HPV 16 besides being of phylogenetic importance, are associated with risk of viral persistence and progression. The objective of this multicentric study was to identify HPV-16 E6, E7 and L1 variants prevalent in India and their possible biological effects. Squamous cell cervical cancer biopsies were collected from 6 centres in India and examined for the presence of HPV 16. Variants of HPV-16 were characterized by full length sequence analysis of L1, E6 and E7 genes in 412 samples. Similar distribution of the variants was seen from the different centres/regions, with the European variant E350G being the most prevalent (58%), followed by American Asian variant (11.4%). Fifty six changes were seen in E6 region, 31 being nonsynonymous. The most frequent being L83V (72.3%), Q14H (13.1%) and H78Y (12.1%). Twenty-nine alterations were seen in E7 region, with 12 being nonsynonymous. The most frequent being F57V (9%). L1 region showed 204 changes, of which 67 were nonsynonymous. The most frequent being 448insS (100%), and 465delD (100%), H228D (94%), T292A (85%). The identified variants some new and some already reported can disrupt pentamer formation, transcriptional regulation of the virus, L1 protein interface interaction, B and T cell epitopes, p53 degradation, and thus their distribution is important for development of HPV diagnostics, vaccine, and for therapeutic purpose.

Efficacy, safety, and tolerability of Epalrestat compared to Methylcobalamine in patients with diabetic neuropathy.

OBJECTIVE: To compare the efficacy, safety, and tolerability of Epalrestat with Methylcobalamine in patients with diabetic neuropathy. MATERIALS AND METHODS: This prospective, open-labeled, comparative, and multicentric study was conducted on an outpatient basis by qualified investigators at four different centers. A total of 242 patients with diabetic neuropathy were enrolled in the study. The enrollment of patients was as per inclusion/exclusion criteria. After obtaining their informed consent, they were individually interviewed, examined, investigated, and treated as per the study protocol. Each patient was administered with one tablet containing Epalrestat 50 mg thrice daily or Methylcobalamine 500 microg thrice daily for 12 weeks. They were followed up at the end of weeks 4, 8, and 12 for their examination. Therapeutic success was assessed in terms of clinical symptoms, physical examinations, and electrophysiological assessments. RESULTS: A significant improvement in all the efficacy parameters was observed with Epalrestat treatment compared to Methylcobalamin treatment. The efficacy parameters assessed were loss of sensation, burning sensation, numbness, muscle cramps, spontaneous pain, weakness, mean score of isometric muscle strength, tendon reflexes, and sensation. Epalrestat treatment is associated with very few adverse events. The tolerability to Epalrestat treatment was also reported to be excellent in the majority of the study population compared to tolerability to Methylcobalamine. Patients as well as physicians reported that the Epalrestat treatment is superior in efficacy and safety parameters compared to Methylcobalamin. CONCLUSION: The present study concludes that Epalrestat has better efficacy and safety profile than Methylcobalamine in the treatment of diabetic neuropathy.

Evaluation of an intermittent six-month regimen in new pulmonary tuberculosis patients with diabetes mellitus.

BACKGROUND: The treatment of tuberculosis (TB) with category I regimen of the Revised National Tuberculosis Control Programme (RNTCP) for patients with diabetes mellitus (DM) needs evaluation. OBJECTIVE: To assess the cure and relapse rates in 3 years, among the new smear-positive TB patients with Type-2 DM (DMTB) treated with CAT-I regimen (2E3H3R3Z3/4R3H3) of RNTCP. METHODOLOGY: TB suspects attending the diabetology units and the TB research centre (TRC) Chennai, were investigated. Eligible DMTB cases were enrolled. Baseline estimation of cardiac, renal, liver function tests and glycosylated-HBA1c were undertaken. All patients received 2E3H3R3Z3/4R3H3 under supervision at TRC. Clinical and sputum (smear and culture) examinations and monitoring of diabetic status were undertaken every month up to 24 months, then once in 3 months up to 36 months. RESULTS: Of 100 patients admitted, 7 were excluded for various reasons from analysis. Of 93 patients, 87 (94%) had a favourable response at the end of treatment. Pre and post treatment mean glycosylated-HBA1c were 9.7% and 8.4% (>7% poor control). During follow-up period, 6 died and one lost to follow-up. Of the remaining, four relapsed. CONCLUSION: Category-I regimen, recommended for all the new smear-positive patients in the Indian TB programme, is effective in the treatment of DMTB patients, despite poor control of diabetes.

Molecular characterization and expression of interferon-gamma of Asian elephant (Elephas maximus).

Tuberculosis (TB) caused by Mycobacterial organisms has emerged as one of the major diseases in captive elephants. In vitro Interferon-gamma (IFN-gamma) assay is being used as an ancillary test for early detection of TB in domestic and captive wild animals. In the present study, basic sequence information and immunological cross-reactivity of this major cytokine of Asian elephants were explored. At predicted amino acid level, IFN-gamma of Asian elephant showed maximum identity to that of horse (73%). Other IFN-gamma amino acid sequences that showed high level identity were that of giant panda (72%), dog (71%), nine-banded armadillo (69%), cattle (63%) and human (62%). IFN-gamma promoter sequences of Asian elephant, human, cattle and mouse showed high level conservation of the putative transcription factor binding sites, TATA box and transcriptional start site. The functionally important human IFN-gamma promoter elements, such as AP-2IRE-BE, YY1-gammaIFN-BED, ATFCS and AP-1gammaINF binding sites, were absolutely conserved in the corresponding elephant sequence. There was only a single nucleotide variation in the other two important elements, NFAT-gammaINF and IFN-gammaPE, indicating the highly conserved regulation of IFN-gamma expression across different species. Phylogenetic analysis based on IFN-gamma protein sequences revealed a closer relation of Asian elephants and nine-banded armadillo. This shows a closer evolution of these members of Afrotheria and Xenarthra, respectively; and supports the previous reports based on mitochondrial DNA studies. In Western blot analysis, IFN-gamma of Asian elephant expressed in Escherichia coli was detected using an anti-bovine IFN-gamma monoclonal antibody, indicating immunological cross-reactivity.

A pilot study for evaluation of the efficacy and safety of telmisartan in reducing microalbuminuria in hypertensive patients with type 2 diabetes mellitus.

To evaluate efficacy and tolerability of telmisartan, an angiotensim II receptor blocker, in reducing microalbuminuria in adult Indian hypertensive patients with type 2 diabetes mellitus, a prospective, open-label, non-comparative, assessor-blind, multicentric, pilot study was conducted in 60 eligible hypertensive patients with type 2 diabetes mellitus and microalbuminuria after obtaining their informed consent. The study was approved by the respective institutional review boards. Each patient received telmisartan 40 mg initially once daily for first 4 weeks which was titrated upwards to 80 mg once daily for the next 8 weeks. Blood pressure was assessed at the end of every 2 weeks and urinary albumin excretion and creatinine clearance were measured at baseline and after 12 weeks of therapy. Safety outcome measures included monitoring of physical examination, laboratory parameters and monitoring treatment-emergent adverse events. Fifty-five patients completed the study while 5 cases were lost to follow-up. The mean age of the patients was 48.27 years. Of the total patients 63.6% were males and 46.4% were females. At baseline the mean urinary albumin excretion rate was 131.81 +/- 38.82 mg/minute. A statistically significant (p < 0.05) reduction (32.96%) in urinary albumin excretion rate occurred after 12 weeks of therapy (118.36 +/- 37.22). The mean pre-study systolic blood pressure was 165.05 +/- 15.24 mmHg which was significantly (p < 0.05) reduced to 123.72 +/- 5.88 mmHg at the end of 12 weeks. At baseline the mean diastolic blood pressure was 103.55 +/- 9.84 mmHg which was significantly (p < 0.05) reduced to 84.71 +/- 8.54 mmHg. The JNC-VII goal of blood pressure below 130/80 was achieved in 34 (61.8%)of the 55 patients at the end of 12 weeks. Both fasting and postprandial blood sugar levels were well-controlled at the end of the study. Telmisartan was well tolerated with only 9.09% of the patients reported mild and transient adverse events like fatigue, dizziness, nausea and diarrhoea. No abnormalities were detected in the laboratory parameters. The results of this pilot study indicate that telmisartan is effective, safe and well tolerated while reducing microalbuminuria in adult Indian hypertensive patients with type 2 diabetes mellitus.

Polypurine.polypyrimidine sequences in complete bacterial genomes: preference for polypurines in protein-coding regions.

The genomes of Methanococcus jannaschii, Mycoplasma genitalium, Haemophilus influenzae, Archaeoglobus fulgidus, Helicobacter pylori, Treponema pallidum, Borrelia burgdorferri, Rickettsia prowazekeii, Mycobacterium tuberculosis, Methanobacterium thermoautotrophicum, Synechocystis sp. PCC6803, Bacillus subtilis, Chlamydia trachomatis, Pyrococcus horikoshii, Aquifex aeolicus, Mycoplasma pneumoniae and Escherichia coli have been analysed for the presence of polypurine.polypyrimidine tracts, in order to understand their distribution in these genomes. We observed a variation in abundance of such sequences in these bacteria, with the archaeal genomes forming a high-abundance group and the canonical eubacteria forming a low-abundance group. The genomes of M. tuberculosis and A. aeolicus are unique among the organisms analysed here in the abnormal underrepresentation and overrepresentation of polypurine.polypyrimidine, respectively. We also observe a strand bias, i.e., a preferential occurrence of polypurines in coding strands. It varies widely among the bacteria, from the very high bias in M. jannaschii to the slightly inverse bias in the parasitic genomes of T. pallidum and C. trachomatis. The extent of strand bias, however, cannot be explained on the basis of the GC-content of the genome, use of all-purine codons or an excess in the amino acids that are encoded by such codons. The probable causes and effects of this phenomenon are discussed.

Utility of serial rectal swab cultures for detection of ceftazidime- and imipenem-resistant gram-negative bacilli from patients in the intensive care unit.

Forty-four patients receiving intensive care were studied prospectively to assess the utility of serial rectal swab cultures and clinical correlates of resistance for Pseudomonas aeruginosa, Enterobacter spp., Citrobacter spp., Morganella morganii, and Serratia marcescens strains resistant to ceftazidime or imipenem. Strains of Pseudomonas aeruginosa, Enterobacter spp., Citrobacter spp., or Morganella morganii were found in 26 of 44 (59%) patients: 17 (65%) in clinical sites (11 with concomitant rectal isolates) and nine (35%) in a rectal site only. Of 49 total isolates, 13 (26.5%) were resistant: 10 (20.4%) to ceftazidime and three (6.1%) to imipenem. Surveillance rectal swabs from 27 patients without a clinical isolate identified two patients with resistant organisms (15% of all resistant isolates). The majority of resistance to ceftazidime or imipenem among Pseudomonas or Enterobacter can be detected by the use of clinical specimens alone.