Changing patterns and trends of multidrug-resistant tuberculosis at referral centre in Northern India: a 4-year experience.

Purpose: India has a high burden of drug-resistant tuberculosis (TB), although there is little data on multidrug-resistant tuberculosis (MDR-TB). Although MDR-TB has existed for long time in India, very few diagnostic laboratories are well-equipped to test drug sensitivity. The objectives of this study were to determine the prevalence of MDR-TB, first-line drug resistance patterns and its changing trends in northern India in the 4 years.

Inducible mouse models illuminate parameters influencing epigenetic inheritance.

Environmental factors can stably perturb the epigenome of exposed individuals and even that of their offspring, but the pleiotropic effects of these factors have posed a challenge for understanding the determinants of mitotic or transgenerational inheritance of the epigenetic perturbation. To tackle this problem, we manipulated the epigenetic states of various target genes using a tetracycline-dependent transcription factor. Remarkably, transient manipulation at appropriate times during embryogenesis led to aberrant epigenetic modifications in the ensuing adults regardless of the modification patterns, target gene sequences or locations, and despite lineage-specific epigenetic programming that could reverse the epigenetic perturbation, thus revealing extraordinary malleability of the fetal epigenome, which has implications for 'metastable epialleles'.

Penetrating injury of pelvis, abdomen and thorax in a child with a trident (trishula).

Penetrating abdominal injuries are uncommon in the pediatric age group and are associated with a high mortality. A seven year old girl suffered penetrating injury to perineum when she fell onto the trident (trishula - traditional three pronged spear) implanted alongside Lord Shiva's idol. The rod caused perforations of the transverse mesocolon, ileum at 3 places, right lobe of liver, diaphragm, parietal pleura, and exited from 7th intercostal space.

Trends of anti-tuberculosis drug resistance pattern in new cases and previously treated cases of extrapulmonary tuberculosis cases in referral hospitals in northern India.

Background: Drug-resistant tuberculosis is one of major current challenges to global public health. The transmission of resistant strains is increasing as a burden of multidrug-resistant tuberculosis (MDR-TB) patients in extra pulmonary tuberculosis (EPTB) cases in India.

Aim And Objectives: The aim was to study trends of anti-tuberculosis drug resistance pattern in new cases and previously treated cases of EPTB in referral hospitals in northern India.

Complete right lung agenesis presenting with bronchial asthma and allergic rhinitis.

A 26 year-old lady presented with episodic breathlessness, chest tightness, recurrent nasal obstruction and excessive sneezing, mainly during change of season along with opacity of the right hemithorax on chest x-ray. Further detailed work-up including spirometry, high-resolution CT scan of the thorax and fibre-optic bronchoscopy confirmed complete right lung agenesis in patients with bronchial asthma and allergic rhinitis. Complete control of symptoms was achieved with formeterol 6 μg and mometasone 200 μg (via dry powder inhaler) and intranasal fluticasone 50 μg (nasal spray) 2 puffs twice daily and oral montelukast 10 mg with levocetirizine 5 mg once daily.

Identification of Late Embryogenesis Abundant (LEA) protein putative interactors using phage display.

Arabidopsis thaliana seeds without functional SEED MATURATION PROTEIN1 (SMP1), a boiling soluble protein predicted to be of intrinsic disorder, presumed to be a LATE EMBRYOGENESIS ABUNDANT (LEA) family protein based on sequence homology, do not enter secondary dormancy after 3 days at 40 °C. We hypothesized that SMP1 may protect a heat labile protein involved in the promotion of secondary dormancy. Recombinant SMP1 and GmPM28, its soybean (Glycine max), LEA4 homologue, protected the labile GLUCOSE-6-PHOSPHATE DEHYROGENASE enzyme from heat stress, as did a known protectant, Bovine Serum Albumin, whether the LEA protein was in solution or attached to the bottom of microtiter plates.

Evaluation of an immunochromatographic test for discrimination between Mycobacterium tuberculosis complex & non tuberculous mycobacteria in clinical isolates from extra-pulmonary tuberculosis.

Background & Objectives: Accurate diagnosis of tuberculosis (TB) is crucial to facilitate early treatment of the patients, and to reduce its spread. Clinical presentation of Mycobacterium tuberculosis complex (MTBC) and non tuberculous mycobacteria (NTM) may or may not be the same, but the treatment regimen is always different for both the infections. Differentiation between MTBC and NTM by routine laboratory methods is time consuming and cumbersome.

Bone cement/layered double hydroxide nanocomposites as potential biomaterials for joint implant.

Poly(methyl methacrylate)-based bone cement and layered double hydroxide (LDH) nanocomposites have been used as a grouting material for total joint arthroplasty. Few weight percentage of nanoLDH was uniformly dispersed in the bone cement matrix to have adequate interaction with matrix polymer. Mechanical strength, stiffness, toughness, and fatigue resistance of the nanocomposites are found to be higher than that of pure bone cement.

Detection of 123 bp fragment of insertion element IS6110 Mycobacterium tuberculosis for diagnosis of extrapulmonary tuberculosis.

Purpose: Extrapulmonary tuberculosis (EPTB) is emerging problem in developing and developed countries. The diagnosis of EPTB in its different clinical presentations remains a true challenge. IS6110-based polymerase chain reaction (PCR) is used for rapid identification and positivity rate of the Mycobacterium tuberculosis complex in clinical isolates of different sites of EPTB.

Steatohepatitis in laboratory opossums exhibiting a high lipemic response to dietary cholesterol and fat.

Plasma VLDL and LDL cholesterol were markedly elevated (>40-fold) in high-responding opossums, but moderately elevated (6-fold) in low-responding opossums after they had consumed a high-cholesterol and high-fat diet for 24 wk. In both high- and low-responding opossums, plasma triglycerides were slightly elevated, threefold and twofold, respectively. Dietary challenge also induced fatty livers in high responders, but not in low responders.

Comparative evaluation of IS6110 PCR via conventional methods in rapid diagnosis of new and previously treated cases of extrapulmonary tuberculosis.

In developing countries the diagnosis of extrapulmonary tuberculosis (EPTB) is a major burning challenge. EPTB encounters many problems like pauci-bacillary nature, inadequate specimen volume. All the limitations reflect in the poor contribution of conventional bacteriological technique in the establishment of diagnosis of EPTB.

The advantage of using IS6110-PCR vs. BACTEC culture for rapid detection of Mycobacterium tuberculosis from pleural fluid in northern India.

Pleural tuberculosis is an extra-pulmonary disease which poses a diagnostic dilemma. The detection of mycobacterial DNA by IS6110 polymerase chain reaction (PCR) in clinical samples is a promising approach for the rapid diagnosis of pleural tuberculosis infections. The aim of the present study is to evaluate the advantage of using IS6110 PCR for rapid detection of Mycobacterium tuberculosis (M.

Factors affecting podophyllotoxin yield in the ex situ grown Podophyllum hexandrum, an endangered alpine native of the western Himalayas.

This study reports an appreciable yield of podophyllotoxin (PDT) in P. hexandrum plants grown ex situ under polyhouse conditions of a temperate locale. The PDT content of below-ground parts was affected by both plant age and growth period.

Differential expression of intestinal genes in opossums with high and low responses to dietary cholesterol.

High and low responding opossums (Monodelphis domestica) differ in their plasma very low density lipoprotein and low density lipoprotein (VLDL+LDL) cholesterol concentrations when they consume a high cholesterol diet, which is due in part to absorption of a higher percentage of dietary cholesterol in high responders. We compared the expression of a set of genes that influence cholesterol absorption in high and low responders fed a basal or a high cholesterol and low fat (HCLF) diet. Up-regulation of the ABCG5, ABCG8, and IBABP genes by the HCLF diet in high and low responders may reduce cholesterol absorption to maintain cholesterol homeostasis.

Multifocal renal angiomyolipoma presenting as massive intraabdominal hemorrhage.

Angiomyolipomata of the kidney are unusual lesions composed of abnormal thick walled blood vessels, smooth muscle and adipose elements. These are asymptomatic and occasionally present with flank pain, a palpable mass or gross hematuria. They may be associated with tuberous sclerosis.

Hypolipidemic and antioxidant activity of Anthocephalus indicus (Kadam) root extract.

The present study was carried out to explore the anti-diabetic, anti-dyslipoproteinemic and anti-oxidant activities of Anthocephalus indicus root extract in alloxan-induced (150 mg/kg body wt.) diabetic rats. A marked increase in plasma levels of glucose and lipid peroxides accompanied with an elevation in the lipids and apoprotein levels of serum very low density lipoprotein (VLDL) and low density lipoprotein (LDL) following decrease in lipid and protein constituents of high density lipoprotein (HDL) were observed.

ABCB4 mediates diet-induced hypercholesterolemia in laboratory opossums.

High-responding opossums are susceptible to developing hypercholesterolemia on a high-cholesterol diet, but low-responding opossums are resistant. The observation of low biliary cholesterol and low biliary phospholipids in high responders suggested that the ABCB4 gene affects response to dietary cholesterol. Two missense mutations (Arg29Gly and Ile235Leu) were found in the ABCB4 gene of high responders.

Multi-drug resistant tuberculosis: an iatrogenic problem.

The occurrence of resistance to drugs used to treat tuberculosis (TB), and particularly multi-drug resistant TB (MDR-TB) defined as resistance to at least rifampicin and isoniazid, has become a significant public health dilemma in a number of countries and an obstacle to effective global TB control. HIV-associated MDR-TB understanding is vital in providing strategies for treatment of HIV and drug-resistant TB. Better understanding on the basis of drug action and resistance is a key to development of diagnostic strategies, novel drugs, and treatment programs, and to find an approach to study the pathogenicity of drug resistant strains.

A study of skin sensitivity to various allergens by skin prick test in patients of nasobronchial allergy.

Objective: To study skin sensitivity to various allergens in patients of nasobronchial allergy.

Materials And Methods: 2880 skin prick tests with 60 allergens were performed in 48 patients of nasobronchial allergy.

Results: Most common offending allergens were insects (21.

Pulmonary and nodal multiple myeloma with a pleural effusion mimicking bronchogenic carcinoma.

Multiple myeloma (MM) is a hematological malignancy characterized by the occurrence of plasma cell tumor within the bone marrow. Extramedullary plasmacytomas form a small percentage of plasma cell tumors, and although 80-90% of extramedullary lesions occur in the head and neck, pulmonary plasmacytomas are found to be a very uncommon clinical entity. Hereby, we describe a case of a patient with pulmonary plasmacytoma, who developed nodal and pulmonary MM with a pleural effusion, the radiological appearance of which mimicked bronchogenic carcinoma.

Neurological complications of miliary tuberculosis.

Introduction: The symptomatic central nervous system involvement is often seen in patients with miliary tuberculosis.

Materials And Methods: In this study, we evaluated 60 consecutive miliary tuberculosis patients, who presented with some neurological manifestations. Evaluation included neurological examination, a battery of blood tests, HIV serology, sputum examination, cerebrospinal fluid (CSF) examination along with imaging of the brain and spinal cord.

Objective measures of disordered sleep in fibromyalgia.

Objective: Patients with fibromyalgia syndrome (FM) complain of inadequate sleep, which could contribute to common symptoms including sleepiness, fatigue, or pain. However, measures that consistently and objectively distinguish FM patients remain elusive.

Methods: Fifteen women with FM and 15 age- and gender-matched controls underwent 3 nights of polysomnography; Multiple Sleep Latency Tests to assess sleepiness; testing of auditory arousal thresholds during non-REM stage 2 and stage 4 sleep; overnight assessment of urinary free cortisol; and analysis of 24-hour heart rate variability.

Dermatophytes, related keratinophilic and opportunistic fungi in indoor dust of houses and hospitals.

Dermatophytes, related keratinophilic and opportunistic fungi were isolated from indoor dust samples of 46 hospitals and 47 houses in Kanpur. A total of 19 fungi represented by 11 genera were isolated by the hair-baiting technique from 230 and 235 samples from hospitals and houses respectively. The isolated fungi are Acremonium implicatum (Indian Type Culture Collection) ITCC 5266, A.