Progressive Disseminated Histoplasmosis with Coomb's Positive Hemolytic Anemia in an Immunocompetent Host.

Progressive Disseminated Histoplasmosis (PDH) is mainly described in immuno-compromised individuals and rare in immuno-competent subjects. Here we report a case of progressive disseminated histoplasmosis with Comb's positive hemolytic anemia, which is infrequently reported from a country like India where histoplasmosis is not an endemic mycosis.

Methaemoglobinaemia as a result of nitrite poisoning.

Methaemoglobinaemia due to nitrite poisoning is rare. Awareness of this condition in the cyanosed patient not responding to oxygenation and timely administration of methylene blue may be life saving. We report a case of methaemoglobinaemia as a result of sodium nitrite poisoning.

Anti-nucleosome antibodies in patients with systemic lupus erythematosus: potential utility as a diagnostic tool and disease activity marker and its comparison with anti-dsDNA antibody.

OBJECTIVE: To compare the utility of anti-nucleosome antibodies and anti-dsDNA antibodies in diagnosis of Systemic Lupus Erythematosus (SLE) and as a marker of disease activity. METHODS: This is a hospital based observational study among 40 (37 females and 3 males) selected cases of SLE (> or = 4 ACR criteria) and 80 control. 40 cases of other systemic autoimmune disease (SAD) [e g. 29 cases of Rheumatoid arthritis, 4 cases of Systemic sclerosis/scleroderma, 4 cases of Sjögren syndrome, 3 cases of MCTD and 40 Healthy blood were taken as control. From each patient venous blood samples were collected and submitted for anti-nucleosome and anti-dsDNA antibodies assay by enzyme linked immunosorbent assay (ELISA). RESULTS: Anti-nucleosome antibodies were positive in 19 (47.5%) SLE, 02 (05%) other SAD and none of the healthy persons. Anti dsDNA antibodies were positive in 15 (37.5%) SLE patients, 07 (17.5%) other SAD and 01(2.5%) healthy persons. For diagnosis of SLE, sensitivity of anti-ds DNA and anti-nucleosome antibody was found to be 37.5% and 47.50% respectively. The specificity of anti-nucleosome was 100% and that of anti-dsDNA was 97.50%. So, anti-nucleosome antibody test is more specific and more sensitive for diagnosis of SLE than anti-dsDNA. When SLE cases were compared with SAD, sensitivity of anti-dsDNA and anti-nucleosome antibody, for diagnosis of SLE, found to be 37.50% and 47.50% respectively but the specificity of anti-nucleosome was 95% and that of anti-dsDNA was 82.50%. Both antibodies show positive correlation with SLEDAI score .The correlation coefficient was stronger for anti-dsDNA antibodies (r = +0.550, P = < .001) than anti-nucleosome antibodies (r = +0.332, P = < .05) CONCLUSIONS: Anti-nucleosome antibodies show higher positivity than anti-dsDNA antibodies among SLE than other SAD and healthy population. Anti-nucleosome antibodies are more sensitive and specific for the diagnosis of SLE than anti-dsDNA antibodies. Anti-nucleosome and anti-dsDNA both show positive correlation with SLEDAI. But anti-dsDNA antibodies show stronger correlation with SLEDAI than anti-nucleosome. So, anti-nucleosome antibodies can be used as an additional marker for diagnosis of SLE and SLE disease activity.

Effectiveness of a new granular formulation of biolarvicide Bacillus thuringiensis Var. israelensis against larvae of malaria vectors in India.

Control of vector(s) or mosquitoes, in general, through biolarvicide as an alternate biocontrol agent is a greatest desire. We evaluated a water-dispersible granular formulation biolarvicide Bacillus thuringiensis var. israelensis (Bti, H-14 serotype; VectoBac(®) WDG) in the laboratory and also in the field against two principal malaria vectors, Anopheles culicifacies and Anopheles stephensi. Laboratory evaluations against laboratory-reared immature of the two species were carried out at a temperature of 28°C ± 2°C and 70%-80% relative humidity. Field trials were conducted in a rural area and in Bangalore city, Karnataka, South India. First trial against the rural vector An. culicifacies was carried out in stone quarry pits at dosages of 0.05, 0.2, and 1 g/m(2). The second trial against urban vector An. stephensi was carried out in ring wells at 0.05, 0.1, 0.2, 0.5, and 1 g/m(2) dosages. Laboratory tests revealed increased efficacy against An. stephensi. The fifty percent lethal concentration (LC(50)) and LC(90) values against An. culicifacies and An. stephensi were 0.348 and 1.008 mg/L (χ(2) = 8.49; p > 0.05) and 0.245 and 0.533 mg/L (χ(2) = 4.67; p < 0.05), respectively. Based on the findings of no pupal production in the field, the formulation was effective up to 14 days at 0.2 g/m(2) or more appropriately at 0.25 g/m(2) dose for both the species under field conditions. We discuss how this new formulation was evaluated against An. culicifacies and An. stephensi under laboratory and field conditions. No adverse effects were observed on the nontarget species such as frogs, their tadpoles, small local fish, Notonectid bugs, and water scatters. We conclude that VectoBac WDG is effective at 0.25 g/m(2) and be recommended for its use in the vector-borne disease control program under integrated vector management concept.

Efficacy of culture filtrates of Metarhizium anisopliae against larvae of Anopheles stephensi and Culex quinquefasciatus.

Efficacy of culture filtrates of five strains of Metarhizium anisopliae isolated from insects were evaluated against Anopheles stephensi and Culex quinquefasciatus. The culture filtrates released from the strains of M. anisopliae in the YpSs and chitin broths were filtered and used for the bioassays after a growth of 7 days. Among the culture filtrates of five strains, M. anisopliae 892 was found to be more effective against both the mosquitoes. The LC(50) values of culture filtrates of M. anisopliae 892 in chitin broth was lower than the LC(50) of culture filtrates in YpSs broth against first and fourth instars of both the mosquitoes. The LC(50) values of culture filtrates were significantly different between first and fourth instars of A. stephensi (t test; P = 0.0001) and C. quinquefasciatus (t test; P = 0.02). The larvae of A. stephensi were more susceptible than C. quinquefasciatus except in two cases. This is the first report of efficacy of culture filtrates produced by M. anisopliae in chitin broth against mosquitoes and have potential as a biological control agent of mosquitoes.