Cowitch seed agar medium--a simple new medium for identification and melanin production of Cryptococcus neoformans.

A simple medium for identification and melanin production of Cryptococcus neoformans was developed using cowitch (Mucuna pruriens) seeds.

Is moderation of protease production an adaptation of well-defined anthropization in dermatophytes?

The protease activity of different isolates of dermatophytes representing different ecological groups namely geophilic, zoopahilic and anthropophilic, in their vegetative and sporulation growth phases were compared. Unlike their geophilic and zoophilic counterparts, all the isolates of anthropophilic dermatophytes viz. Trichophyton rubrum, T. mentagrophytes, T. tonsurans, T. violaceum and Epidermophyton floccosum recorded reduced protease activity during artificially induced sporulation phase in comparison to their vegetative growth phase. Even among the anthropophilic group, a classical moderation of protease activity was recorded in Trichyphyton rubrum which also correlates to its clinical manifestation. This enzyme moderation could also be an evolutionary adaptation of the anthropization of these species.

Solanum trilobatum in the management of atopy: Through inhibition of mast cell degranulation and moderation of release of interleukins.

Solanum trilobatum is a widely used plant in the Indian indigenous systems of medicine. It is mainly used in the treatment of respiratory diseases like bronchial asthma. In our present study, we report that the aqueous and alcoholic extracts of S. trilobatum exhibited inhibition of mast cell degranulation. Further, aqueous and alcoholic extracts of S. trilobatum significantly decreased the release of IL1α and increased the release of IL8 from the cultured keratinocytes. Oral administration of the aqueous and alcoholic extracts of S. trilobatum stabilized mast cells in experimental rats.

Extensively drug resistant tuberculosis (XDR-TB): A potential threat.

Emergence of extensively drug resistant tuberculosis (XDR-TB) has been reported by more than 55 countries. XDR-TB is considered as untreatable and highly fatal disease. In developing countries like India, number of cases of multi-drug resistant tuberculosis (MDR-TB) and XDR-TB are increasing. Emergence of resistance to Isoniazid and Rifampicin, the two most effective and well tolerated agents, coupled with resistance to second line agents pose limited treatment options for XDR-TB. The present minireview provides information about the seriousness of XDR-TB and the drugs available for its treatment. Although considered a fatal disorder, judicious use of combination of drugs, retaining their antimycobacterial activity, can improve the clinical outcome of XDR-TB. Only such an approach can provide some hope for the patients of XDR-TB.

Kawasaki disease in south India: a prospective, case-control study.

AIM: To describe the clinical and laboratory profile of Kawasaki disease in south India and compare patients with normal and abnormal cardiac status. METHODS: This was a nested case-control study. All patients admitted to Kanchi Kamakoti CHILDS Trust Hospital, Chennai with Kawasaki disease between January 2002 and March 2006 were included. They were stratified into two groups: cases, who had abnormal echocardiography (ECHO), and controls, who had normal ECHO. All clinical and laboratory investigations, results of echocardiography and management were recorded and follow-up was organised. RESULTS: Of 56 patients, 36 (64.3%) were boys and 58.9% were under 3 years of age. Only 17.9% had an atypical presentation. Oral cavity changes and cervical lymphadenopathy were the most common clinical parameters and were detected in 85.7%. Thrombocytosis and elevated CRP on admission were seen in 41% and 100%, respectively. Echocardiography was abnormal in 27 (48.2%). Apart from raised CRP, which was higher in those with cardiac abnormality, the clinical and laboratory profiles were similar in the two groups. CONCLUSION: Kawasaki disease is not uncommon in south India. The clinical and laboratory profiles were similar between those with and without cardiac echocardiographic abnormality.

Role of Chrysosporium keratinophillum in the parasitic evolution of dermatophytes.

Anti-dermatophytic activity of Chrysosporium keratinophillum against species of the genera Trichophyton, Microsporum and Epidermophyton floccosum was tested in vitro. When C. keratinophillum and different species of dermatophytes were inoculated on Sabouraud's dextrose agar plates 2 cm apart, no antagonistic effect of C. keratinophillum on the mycelial growth of dermatophytes was observed. However, conidia production was not observed on the hyphae of Trichophyton rubrum, Trichophyton tonsurans and E. floccosum grown near C. keratinophillum. The secretory substances released by C. keratinophillum inhibited the growth of T. rubrum, T. tonsurans, Trichophyton mentagrophytes var. interdigitale and E. floccosum at a concentration of 2,000 microg ml(-1) when tested by broth dilution technique. No inhibition of the growth was observed for Microsporum gypseum and Microsporum nanum. The anti-fungal activity of secretory substances released by C. keratinophillum was recorded to be heat stable. Results of the present study suggest that the anti-dermatophytic activity of the secretory substances of C. keratinophillum on T. rubrum, T. mentagrophytes var. interdigitale, T. tonsurans and E. floccosum may be responsible in part, for the absence of these dermatophyte species in soil. Considering the global prevalence of C. keratinophillum in soil one may speculate that the anti-dermatophytic activity of C. keratinophillum is one of the early events for the evolutionary divergence of saprophytic archi-dermatophytes to obligate parasitic dermatophyte species.

Prevalence, serotypes and mating patterns of Cryptococcus neoformans in the pellets of different avifauna in Madras, India.

A total of 887 pellets of different avifauna were screened for the presence of Cryptococcus neoformans. One hundred and six of 887 samples (12%) yielded Cr. neoformans in culture. The report on the isolation of Cr. neoformans from the pellets of the crow appears to be new and of greater significance because of the ubiquitous prevalence of this bird in India. The prevalence of both MAT a and MAT alpha mating types were recorded. The serotype D was predominant over serotype A. The findings of the present study reveal the growing diverse ecological niche of Cr. neoformans in a the pellets of various avifauna in India.

Did earthworms contribute to the parasitic evolution of dermatophytes?

The survival of dermatophyte species in the gut of four species of earthworms was studied by feeding the fungi to the earthworms. Recovery of the dermatophyte species in culture from the guts was only possible for Microsporum gypseum and Chrysosporium keratinophilum. In the light of these findings, we presume that earthworms could have influenced the parasitic evolution of certain dermatophytes.

False aneurysm following modified Blalock-Taussig shunt.

A 3 1/2-year-old female child presented with massive hemoptysis 5 months after a modified Blalock-Taussig (BT) shunt for double-outlet right ventricle with pulmonary stenosis. Computerized tomographic scan and angiography showed a false aneurysm of the subclavian artery at the insertion of the shunt. Successful surgical management is discussed.

Surgical experience with congenital heart disease in Down's syndrome.

Children with Down's syndrome and congenital heart defects have multiple problems. The role of cardiac surgery in the management of these patients was investigated by reviewing the clinical data, hospital course and follow-up of 21 patients (9 males and 12 females, age range 1 month to 14 years) with Down's syndrome and congenital heart defects operated in our institute. Twelve (57%) of these were infants and nine (43%), older children. Five were in congestive cardiac failure, four were hypothyroid. The heart lesions ranked in incidence as follows: atrioventricular septal defect 7 (33.3%), tetralogy of Fallot 3 (14.3%), tetralogy of Fallot & atrioventricular septal defect both 2 (9.5%), double outlet right ventricle with pulmonary stenosis 1 (4.8%), patent ductus arteriosus 2 (9.5%), patent ductus arteriosus plus coarctation 1 (4.8%), ventricular septal defect 2 (9.5%), atrial septal defect plus ventricular septal defect 1 (4.8%), atrial septal defect plus patent ductus arteriosus plus right pulmonary artery stenosis 1 (4.8%) and transposition of great arteries with multiple ventricular septal defect 1 (4.8%). Four (19%) patients had palliative procedures while the rest (81%) underwent primary repair. All survived the operation. The post-operative period was complicated in 6 (28.5%), with respiratory infections in 3, pulmonary hypertensive crisis in 2 and complete heart block in 1. The early mortality was 0, while there were 2 (9.5%) late deaths. The number of hospitalisations was markedly reduced according to the parents. Follow-up showed near normal pulmonary artery pressure in 50 percent children with large shunts and a good developmental spurt was seen in 60 percent. From a purely surgical viewpoint, the prognosis for children with Down's syndrome and congenital heart disease is good.