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   2011| July-September  | Volume 3 | Issue 3  
    Online since August 6, 2011

 
 
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SYMPOSIUM ON DIAGNOSIS, DRUGS AND DISEASES
An update on crimean congo hemorrhagic fever
Suma B Appannanavar, Baijayantimala Mishra
July-September 2011, 3(3):285-292
DOI:10.4103/0974-777X.83537  PMID:21887063
Crimean Congo hemorrhagic fever (CCHF) is one of the deadly hemorrhagic fevers that are endemic in Africa, Asia, Eastern Europe, and the Middle East. It is a tick-borne zoonotic viral disease caused by CCHF virus of genus Nairovirus (family Bunyaviridae). CCHF not only forms an important public health threat but has a significant effect on the healthcare personnel, especially in resource-poor countries. India was always a potentially endemic area until an outbreak hit parts of Gujarat, taking four lives including the treating medical team. The current review is an attempt to summarize the updated knowledge on the disease particularly in modern era, with special emphasis on nosocomial infections. The knowledge about the disease may help answer certain questions regarding entry of virus in India and future threat to community.
  11,472 163 45
Toxoplasmosis: A global threat
Joćo M Furtado, Justine R Smith, Rubens Belfort, Devin Gattey, Kevin L Winthrop
July-September 2011, 3(3):281-284
DOI:10.4103/0974-777X.83536  PMID:21887062
Toxoplasmosis, a disease described worldwide, which is caused by the protozoan Toxoplasma gondii, commonly involves the retina. The disease has a higher impact in immunocompromised individuals and in congenital infection because of the severity of central nervous system involvement. Although simple prophylactic measures could reduce transmission, T. gondii seroprevalence is still high, especially in South America. Educational campaigns and the development of new drugs to prevent primary infection could potentially reduce the burden of the disease.
  9,083 340 58
ORIGINAL ARTICLES
Clinical profile of chikungunya patients during the epidemic of 2007 in Kerala, India
Krishna Pillai Vijayakumar, Thekkumkara Surendran Nair Anish, Biju George, Tony Lawrence, Sujina C Muthukkutty, Reshmi Ramachandran
July-September 2011, 3(3):221-226
DOI:10.4103/0974-777X.83526  PMID:21887052
Background: The association of the present Chikungunya pandemic with a mutation in the Chik virus is already established in many parts of the world, including Kerala. Kerala was one of the worst-affected states of India in the Chikungunya epidemic of 2006-2007. It is important to discuss the clinical features of patients affected by Chikungunya fever in the context of this change in the epidemiology of the disease. Aim: This study tries to analyze the clinical picture of the Chikungunya patients in Kerala during the epidemic of 2007. Setting and Design: A cross-sectional survey was carried out in five of the most affected districts in Kerala, India. Materials and Methods: A two-stage cluster sampling technique was used to collect the information. Ten clusters each were selected from all the five districts, and the size of the clusters were 18 houses each. A structured interview schedule was used for data collection. Diagnosis based on clinical signs and symptoms was the major case-finding strategy. Results and Conclusion: Of the 3623 residents in the surveyed households, 1913 (52.8%) had Chikungunya clinically. Most of the affected were in the adult age group (73.4%). Swelling of the joints was seen in 69.9% of the patients, followed by headache (64.1%) and itching (50.3%). The knee joint was the most common joint affected (52%). The number of patients with persistence of any of the symptoms even after 1 month of illness was 1388 (72.6%). Taking bed rest till the relief of joint pain was found to be a protective factor for the persistence of the symptoms. Recurrence of symptoms with a period of disease-free interval was complained by 669 (35.0%) people. Older age (>40 years), a presentation of high-grade fever with shivering, involvement of the small joints of the hand, presence of rashes or joint swelling during the first week of fever and fever lasting for more than 1 week were the significant risk factors for recurrence of symptoms predicted by a binary logistic regression model. In conclusion, we found that there is substantial acute and chronic morbidity associated with the Chikungunya epidemic of 2007.
  8,811 65 21
Comparing absolute lymphocyte count to total lymphocyte count, as a CD4 T cell surrogate, to initiate antiretroviral therapy
Srirangaraj Sreenivasan, Venkatesha Dasegowda
July-September 2011, 3(3):265-268
DOI:10.4103/0974-777X.83533  PMID:21887059
Background: The high cost of CD4 count estimation in resource-limited settings is a major obstacle in initiating patients on highly active antiretroviral therapy (HAART). Thus, there is a need to evaluate other less expensive surrogate markers like total lymphocyte count (TLC) and absolute lymphocyte count (ALC). Objectives : To evaluate the correlation of TLC and ALC to CD4 count. To determine a range of TLC and ALC cut-offs for initiating HAART in HIV-infected patients in resource-limited settings. Materials and Methods: In a prospective observational cohort study of 108 ART-naive HIV-positive patients, Spearman correlation between ALC and CD4 cell count, and TLC and CD4 cell count were assessed. Sensitivity, specificity, positive and negative predictive values of various ALC and TLC cut-offs were computed for CD4 count <200 cells/cu.mm. Results: Good correlation was noted between ALC and CD4 (r=0.5604) and TLC and CD4 (r=0.3497). ALC of 1400 cells/cu.mm had a sensitivity of 71.08% and specificity of 78.26% for predicting CD4 cell counts less than 200 cells/cu.mm. Similarly, TLC of 1200 cells/cu.mm had a sensitivity of 63.41% and specificity of 69.57%. Conclusion: Either ALC or TLC may be helpful in deciding when to initiate antiretroviral therapy in resource-poor settings, though ALC is better than TLC as a surrogate for CD4 counts.
  8,420 65 8
Development of ASSURE® dengue IgA rapid test for the detection of anti-dengue IgA from dengue infected patients
Yun Ying Tan, Shamala D Sekaran, Seok Mui Wang, Firoz Ahmed, Anowar Hossain, Bijon Kumar Sil
July-September 2011, 3(3):233-240
DOI:10.4103/0974-777X.83528  PMID:21887054
Background: Rapid and early dengue diagnosis is essential for patient management and early disease intervention. MP Diagnostics ASSURE® Dengue IgA Rapid Test (Dengue IgA RT) was developed for the rapid detection of anti-dengue IgA in patients' biological samples. The performance of Dengue IgA RT was examined using multiple categories of well-characterized samples. Materials and Methods: Dengue IgA RT was designed and developed. Following characterization of samples by reference ELISAs, the performance of the kit was evaluated. Results: The overall sensitivity and specificity of Dengue IgA RT were 86.70% (n=233) and 86.05% (n=681) respectively; in which Dengue IgA RT detected 77.42% primary and 92.86% secondary cases; compared to 70.97% and 72.14% by IgM-Cap ELISA and 89.25% and 20% by Non-Structural Protein 1 (NS1) Ag ELISA respectively. Using 125 paired samples, Dengue IgA RT showed 84.80% sensitivity at acute phase and 99.20% sensitivity at convalescent phase; with 92% specificity at both phases. Dengue IgA RT also demonstrated a consistent performance (sensitivity: 85.53%, specificity: 80%) with 76 whole blood samples. In detecting all four serotypes of DENV (n=162), the performance of Dengue IgA RT was comparable with in-house IgM-Cap ELISA. Kinetics of anti-dengue IgA production was elucidated with 42.86% detection level as early as one-two days after fever onset, which increased to 83.33% between five and seven days after fever onset. Conclusion: Dengue IgA RT demonstrated a good performance and is applicable as one of the dengue early diagnostic tools at all levels of health care system.
  7,858 68 8
CASE REPORTS
Imaging findings of disseminated cysticercosis with unusual involvement of spleen and pancreas
Sandeep G Jakhere, Vipul C Chemburkar, Bhakti S Yeragi, Himanshu V Bharambay
July-September 2011, 3(3):306-308
DOI:10.4103/0974-777X.83547  PMID:21887068
In this study, we present a case of disseminated cysticercosis involving the brain, orbit, myocardium, muscle, subcutaneous tissues, pancreas, and spleen. Imaging studies are described with emphasis on pancreatic and splenic involvement which is a rare manifestation of a rather common disease and has been radiologically demonstrated only once previously. Although the involvement of the pancreas by parasites leading to pancreatitis has been described previously, in our case there was no clinical or biochemical evidence of pancreatitis due to infection by cysticerci.
  7,427 24 4
Empyema caused by Eikenella corrodens
Joshy Maducolil Easow, Noyal Mariya Joseph, Rashmi Tuladhar, PG Shivananda
July-September 2011, 3(3):303-305
DOI:10.4103/0974-777X.83546  PMID:21887067
Eikenella corrodens is a fastidious, facultative anerobic, non-motile, gram-negative bacilli that is part of the normal flora of the mouth and upper respiratory tract. It is being increasingly recognized as a human pathogen and has been implicated in a variety of human infections, including, periodontitis, brain abscess, endocarditis, osteomyelitis, intra-abdominal infections, and pleuropulmonary infections. We report, for the first time, from the Himalayan Kingdom of Nepal, a case of left-sided empyema due to Eikenella corrodens, in an 83-year-old man. Eikenella corrodens was isolated as a pure growth from the pleural aspirate, proving its pathogenic potential. Surgical drainage and an appropriate antimicrobial therapy resulted in a therapeutic response. We have discussed the difficulties that can be encountered in isolating Eikenella corrodens and in choosing appropriate antibiotics for its treatment.
  6,704 32 2
ORIGINAL ARTICLES
Extended-spectrum beta-lactamase orthopedic wound infections in Nigeria
Olusolabomi J Idowu, Anthony O Onipede, Ayodele E Orimolade, Lawrence A Akinyoola, Gbolahan O Babalola
July-September 2011, 3(3):211-215
DOI:10.4103/0974-777X.83524  PMID:21887050
Background: Extended-spectrum beta-lactamase (ESBL)-producing Gram-negative bacteria are emerging and impacting significantly on the management of patients and hospital costs. Besides, they are not being routinely sought after in diagnostic laboratories thus contributing to treatment failure. Materials and Methods: Bacterial isolates from wounds of 45 patients were identified using commercial identification kits and antibiotic susceptibility was evaluated by the Bauer-Kirby method. Screening and phenotypic confirmation of ESBL production were done as prescribed by the Clinical and Laboratory Standards Institute. The conjugation experiment was performed by the mating assay in broth between the ESBL producers and E. coli ATCC 25922 as the recipient. Results: Out of 102 Gram-negative bacteria isolated, 36 were positive for ESBL mainly of the Enterobacteriaceae family (33) and the rest were oxidase-positive bacilli (3). The predominant bacteria were Klebsiella spp. and E. coli. Others were Serratia rubidae, Citrobacter freundii, Morganella morgannii, Proteus spp., Providencia stuartii, and Enterobacter spp. There was a significant association between treatment with third-generation cephalosporins (3GCs) and isolation of ESBLs ( p=0.0020 ). The ESBL producers were multiply resistant and moderately sensitive to colistin. The conjugation experiment showed that the ESBL gene was transferred horizontally and tetracycline, cotrimoxazole, nitrofurantoin, gentamicin, and aztreonam resistance genes were co-transferred. No mortality was recorded but the mean length of stay in the hospital was 82 days. Conclusion: The development and spread of ESBL among Gram-negative bacteria and possible horizontal transfer calls for concern, especially in view of treatment failure, high treatment cost, and consequent discomfort to patients.
  6,358 59 11
HIV, hepatitis B, and hepatitis C in Zambia
Kenneth C Kapembwa, Jason D Goldman, Shabir Lakhi, Yolan Banda, Kasonde Bowa, Sten H Vermund, Joseph Mulenga, David Chama, Benjamin H Chi
July-September 2011, 3(3):269-274
DOI:10.4103/0974-777X.83534  PMID:21887060
Objectives : Epidemiologic data of HIV and viral hepatitis coinfection are needed in sub-Saharan Africa to guide health policy for hepatitis screening and optimized antiretroviral therapy (ART). Materials and Methods: We screened 323 HIV-infected, ART-eligible adults for hepatitis B surface antigen (HBsAg) and hepatitis C antibody (HCV Ab) at a tertiary hospital in Lusaka, Zambia. We collected basic demographic, medical, and laboratory data to determine predictors for coinfection. Results: Of 323 enrolled patients, 32 (9.9%; 95% CI=6.7-13.2%) were HBsAg positive, while 4 (1.2%; 95% CI=0.03-2.4%) were HCV Ab positive. Patients with hepatitis B coinfection were more likely to be <40 years (84.4% vs. 61.4%; P=0.01) when compared to those who were not coinfected. Patients with active hepatitis B were more likely to have mild to moderately elevated AST/ALT (40-199 IU/L, 15.8% vs. 5.4%; P=0.003). Highly elevated liver enzymes (>200 IU/L) was uncommon and did not differ between the two groups (3.4% vs. 2.3%; P=0.5). We were unable to determine predictors of hepatitis C infection due to the low prevalence of disease. Conclusions: HIV and hepatitis B coinfection was common among patients initiating ART at this tertiary care facility. Routine screening for hepatitis B should be considered for HIV-infected persons in southern Africa.
  5,801 50 7
Acute Chlamydia trachomatis respiratory infection in Infants
Kamal Narain Mishra, Pankaj Bhardwaj, Anuradha Mishra, Anil Kaushik
July-September 2011, 3(3):216-220
DOI:10.4103/0974-777X.83525  PMID:21887051
Objectives: This designed was designed to estimate the prevalence of Chlamydia trachomatis infection in infants of up to 6 months of age and to assess clinical and laboratory indicators as predictors of Chlamydia etiology. Materials and Methods: A hospital-based study was conducted in Department of Pediatrics, Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India, where infants up to 6 months of age (n=50) with features of lower respiratory tract infection of at least 1 week duration and fulfilling the inclusion criteria were assessed clinically and underwent laboratory investigations using hemogram, Chest X-ray, and IgM ELISA. Results: Out of 50 infants, 12 (24%) were tested positive by IgM ELISA test for C. trachomatis infection. In age group of up to 2 months 25% positivity was seen whereas it was found to be 31.81% in age group of 2-4 months and 15% in age group 4-6 months. With the 'P' value less than 0.05, it was found that there may be an association of seropositivity of C. trachomatis with duration of cough and absolute eosinophil count. Conclusion: Chlamydia trachomatis is an important cause of lower respiratory tract infection in infants below six months of age. The prolonged duration of cough and increased absolute eosinophil count may be good indicator of its etiology.
  5,065 71 4
GLOBAL HEALTH REPORT
Dermatology and HIV/AIDS in Africa
Jenny Hu, Karen McKoy, Art Papier, Sidney Klaus, Terence Ryan, Henning Grossman, Elisante J Masenga, Aisha Sethi, Noah Craft
July-September 2011, 3(3):275-280
DOI:10.4103/0974-777X.83535  PMID:21887061
Human immunodeficiency virus and the acquired immunodeficiency syndrome (HIV/AIDS) have greatly complicated dermatologic disease and the required care in most regions of Africa. Opportunistic infections, ectoparasites, Kaposi sarcoma, and skin manifestations of systemic infections are exceedingly common in patients with HIV/AIDS. Dermatologists have contributed significantly to our knowledge base about HIV/AIDS and have played an important educational role regarding the clinical manifestations historically. Because of the increased burden of skin disease in Africa due to the HIV/AIDS epidemic we must redouble our efforts to provide dermatology education to care providers in Africa. We review the burden of skin disease in Africa, how it relates to HIV/AIDS and global infectious disease, current educational strategies in Africa to address this need, and suggest potential solutions to move these efforts forward.
  5,059 47 4
ORIGINAL ARTICLES
Anti-infective potential of hot-spring bacteria
Pallavi Pednekar, Roopesh Jain, Girish Mahajan
July-September 2011, 3(3):241-245
DOI:10.4103/0974-777X.83529  PMID:21887055
Aim and Background: Antibiotic resistance currently spans most of the known classes of natural and synthetic antibiotics; limiting our options for treatment of infections and demanding discovery of new classes of antibiotics. Much effort is being directed towards developing new antibiotics to overcome this problem. Success in getting novel chemical entities from microbial sources depends essentially on novelty of its habitat. The diversity of geographical location decides the type of micro-flora. In the past various terrestrial and aqueous microorganisms have provided several novel bioactive secondary metabolites of pharmaceutical importance. Hot-springs have not been as extensively exploited as other terrestrial resources. However, perseverance with such microbes augment the probability of getting novel bioactive compounds. Materials and Methods: Hot-springs soil samples were collected from Hot-springs in Maharashtra. Actinomycetes and other eubacteria were isolated from these soil samples by selective methods and purified. They were classified based on gram's nature and morphology. Six representative morphological strains were screened for their anti-infective potential by agar well diffusion method as reported by Nathan P. et al (1974). The bioactivity of the active microbes was confirmed. Results: Seventy three strains of bacteria encompassing eight actinomycetes, and 65 eubacteria were isolated and purified. Among the actives eubacteria PPVWK106001 showed broad spectrum antibacterial activity encompassing both gram positive and gram negative bacterial test models. The extract was active against resistant bacteria such as MRSA and VREs. Activity was very specific as there was no activity against fungi even at 100 fold concentration. The active principle was extractable in butanol. Conclusions: The study showed that Hot-springs exhibit diverse bacteria and it serves as potential reservoirs for bacteria of antimicrobial importance with diverse facet of activities. Thus Hot-springs microbes have ability to address issue of resistant bugs.
  4,710 50 4
Minimal inhibitory concentration of ceftazidime and Co-trimoxazole for Stenotrophomonas maltophilia using E-test
Firoozeh Jamali, Mohammad Ali Boroumand, Farzad Yazdani, Maryam Sotoudeh Anvari, Leila Pourgholi, Saeede Mahfouzi, Mohammad Khak
July-September 2011, 3(3):254-258
DOI:10.4103/0974-777X.83531  PMID:21887057
Background : Stenotrophomonas maltophilia, previously named as Pseudomonas or Xanthomonas maltophilia, is an important nosocomial pathogen . Aim : The purpose of the present study was to investigate the prevalence of S. maltophilia in Iranian hospitals and its susceptibility to available antimicrobial agents. Setting and design: A cross-sectional study in Imam Khomeini Hospital affiliated to Tehran University of Medical Sciences. Materials and Methods : All blood specimens were sent to the laboratory for blood culture and biochemical analysis. One hundred samples were positive for S. maltophilia. We used disk diffusion and E-test in order to determine minimal inhibitory concentration (MIC) of ceftazidime and co-trimoxazole as the first line antibiotics for S. maltophilia. The tests were performed and interpreted according to the guidelines of Clinical Laboratory Standards Institute (CLSI). Statistical analysis: Chi-square test and Kappa measurement of agreement were applied as appropriate. Results : S. maltophilia was the most frequent pathogen (895 specimens; 38.9%) isolated from the samples which were mostly from emergency ward (780 specimens; 33.9%). Ceftazidime MIC 50 and MIC 90 were 2 and 32 μg/ml, respectively (sensitive ≤8 μg/ml and resistant ≥32 μg/ml according to CLSI guideline). MIC 50 and MIC 90 for co-trimoxazole were 0.5 and 2 μg/ml, respectively (sensitive ≤2 μg/ml and resistant ≥4 μg/ml according to CLSI guideline). Conclusion : S. maltophilia is the most frequent pathogen in our hospital with a high susceptibility to both ceftazidime and co-trimoxazole.
  4,361 66 2
Impact of basic lymphedema management and antifilarial treatment on acute dermatolymphangioadenitis episodes and filarial antigenaemia
HA El-Nahas, AM El-Shazly, M Abulhassan, NA Nabih, N Mousa
July-September 2011, 3(3):227-232
DOI:10.4103/0974-777X.83527  PMID:21887053
Background: A major factor in the progression of lymphedema is acute dermatolymphangioadenitis (ADLA). Aims : To study ADLA episodes and antigenaemia in patients with different grades of filarial lymphedema at pre- and two years post-treatment. Setting and Design: A prospectively conducted study from May 2008 through May 2010. Patients and Methods: Forty five patients complaining of limb swelling with present or past history of limb redness suggestive of ADLA attacks were included. Patients were clinically examined for lymphedema grading, detection of potential entry points and diagnosis of microfilaraemia. Wuchereria bancrofti antigen titer was estimated by "Trop-Ag W. Bancrofti" ELISA kit. Basic lymphedema management and treatment with antifilarial drugs were applied. Statistical Analysis : Mann−Whitney test and Chi-square test were used. Results: The number of ADLA attacks in the pretreatment period, ranged from one to three per year. Mean duration of the attacks was 3.87±0.79 days. Entry points were detected in 82% of cases. The study revealed statistical significance between extension and grade of lymphedema and number of ADLA attacks per year (P=0.018 and 0.022, respectively). Microfilaraemia was detected in four cases and positive filarial antigenaemia were detected in 29 patients (64.4). The number of ADLA attacks per year significantly decreased from the pre-treatment period (mean: 2.05±0.560) to be 1.23±0.706 after one year and 0.89±0.575 after two years post treatment. There was a significant decrease in the mean antigen titer one year and two years after treatment. Conclusion: Basic lymphedema management is effective for controlling ADLA attacks in areas where lymphatic filariasis is endemic.
  4,299 47 5
CASE REPORTS
Acute pulmonary schistosomiasis
SA Baharoon, HH Al-Jahdali, HS Bamefleh, AM Elkeir, NM Yamani
July-September 2011, 3(3):293-295
DOI:10.4103/0974-777X.83539  PMID:21887064
Acute pulmonary schistosomiasis affects non-immune individuals returning from endemic areas. Pathogenesis is not well understood. We report a case of acute pulmonary schistosomiasis in which lung biopsy was done 10 weeks after exposure and it identified the presence of schistosomal ovum surrounded by granuloma.
  4,215 28 1
ORIGINAL ARTICLES
T-cell epitopes identified by BALB/c mice immunized with vaccinia expressing HIV-1 gag lie within immunodominant regions recognized by HIV-infected Indian patients
Ashwini V Shete, Madhuri R Thakar, Srikanth P Tripathy, CG Raut, Sekhar Chakrabarti, Ramesh S Paranjape
July-September 2011, 3(3):246-253
DOI:10.4103/0974-777X.83530  PMID:21887056
Background: Human immunodeficiency virus (HIV) antigens from transmitted strains of HIV would prove crucial in vaccine designing for prevention of HIV infection. Immune response generated by Vaccinia construct expressing the HIV-1 gag gene from transmitted Indian HIV-1 subtype C strain (Vgag) in BALB/c mice is reported in the present study along with the identification of epitopes responsible for induction of the immune response. Aims: The aim of this study was to determine immune response generated by the constructs in a mouse model and to understand the epitope specificities of the response. Settings and Design: This was an observational study carried out in BALB/c mice. Materials and Methods: The immunogenecity of Vgag construct was evaluated in BALB/c mice after multiple immunizations. T-cell response was monitored by the interferon-γ ELISPOT assay using HIV-1 C Gag overlapping peptides and anti-P24 antibodies were estimated by ELISA. Statistical Analysis Used: Graphpad prism software was used for statistical analysis and for plotting graphs. Results: IFN-γ-secreting T cells and antibodies were detected against HIV Gag in mice after immunization. Although after repeated immunizations, antibody-mediated immune response increased or remained sustained, the magnitude of IFN-γ-secreting T cell was found to be decreased over time. The Gag peptides recognized by mice were mainly confined to the P24 region and had a considerable overlap with earlier reported immunodominant regions recognized by HIV-infected Indian patients. Conclusion: Vaccinia construct with a gag gene from transmitted HIV-1 virus was found to be immunogenic. The Gag regions identified by mice could have important implications in terms of future HIV vaccine designing.
  4,112 36 3
CASE REPORTS
Bilateral parotid tuberculosis
JS Thakur, A Thakur, NK Mohindroo, S Mohindroo, DR Sharma
July-September 2011, 3(3):296-299
DOI:10.4103/0974-777X.83543  PMID:21887065
Tuberculosis of parotid is a rare clinical entity, and cases of bilateral tubercular parotitis are even rarer. We present a case of bilateral primary parotid tuberculosis in a 49-year-old female. The patient received anti-tuberculosis treatment for six months, resulting in complete resolution of the disease. We also review the theories related to the pathogenesis of tubercular parotitis, and propose a novel hypothesis about greater involvement of parotid gland as compared to other salivary glands in primary tuberculosis.
  3,945 22 4
ORIGINAL ARTICLES
Evaluation of Aro-Tal-AST complex protein as a marker for differential diagnosis of Mycobacterium avium Infection
Kapil Gupta, Indu Verma, Gopal K Khuller, Rajiv Mahajan
July-September 2011, 3(3):259-264
DOI:10.4103/0974-777X.83532  PMID:21887058
Purpose: Conventional diagnostic techniques for detecting Mycobacterium avium infection are far from satisfactory. As serodiagnostic tests for M. avium infection have been shown to be simple and rapid, the present study was carried out to identify and evaluate M. avium secretory protein(s) of diagnostic potential. Materials and Methods: Initially, by differential immunoblotting, a specific protein band of 45-50 kDa was recognized. Anion exchange column chromatography was used for purification of proteins. After fractionation, blast search was carried out. Further immunoreactivity studies were done with M. avium and Mycobacterium tuberculosis infected mice sera. Clinical utilization was confirmed by conducting indirect enzyme-linked immunosorbent assay (ELISA) with serum samples from mycobacterial infected patients. Results: A complex of three proteins (Aro-Tal-AST) of molecular weight ~48 kDa, shown to be Aro A homologue (Aro), transaldolase (Tal) and aspartate transaminase (AST) by blast search was separated. Immunoreactivity studies of purified complex protein with mice sera confirmed it to be specific for M. avium infection. Indirect ELISA with patient samples further confirmed it to be M. avium infection specific. Conclusion: Aro-Tal-AST protein is specifically recognized by patients infected with M. avium and can be used as a marker for simple and rapid ELISA based tests for differential diagnosis of M. avium infection in patients with M. avium complex (MAC).
  3,830 23 -
EDITORIAL
State of the Globe: The Immunological Quest for an HIV/AIDS Vaccine Continues
NK Ganguly
July-September 2011, 3(3):209-210
DOI:10.4103/0974-777X.83523  PMID:21887049
  3,241 32 2
CASE REPORTS
Vibrio vulnificus diarrhea in a child with respiratory infection
Anuradha De, M Mathur
July-September 2011, 3(3):300-302
DOI:10.4103/0974-777X.83544  PMID:21887066
Vibrio vulnificus is a rare cause of disease and it is often unrecognized and underreported. It is a lactose-fermenting, halophilic vibrio causing severe disease in immunocompromised patients, but causing a mild type of gastroenteritis in healthy people, usually associated with consumption of seafood. We report here a case of diarrhea due to V. vulnificus in a male child who was admitted for fever, loose motions and productive cough. There was no history of consumption of any seafood; so, the source of infection could not be traced. As V. vulnificus is a rare entity, clinicians should have a high index of suspicion for the bacteria, when patients present with gastrointestinal illness, fever or shock, with or without ingestion of raw seafood. Pediatricians should also be alert as the bacterium causes a potentially fatal disease in children.
  3,066 24 5
LETTERS TO EDITOR
A rare case of nosocomial urinary tract infection due to Trichosporon asahii
Simit Kumar, Maitreyi Bandyopadhyay, Soma Mondal, Nupur Pal
July-September 2011, 3(3):309-310
DOI:10.4103/0974-777X.83541  PMID:21887069
  2,833 23 7
"Air - Bubble" Sign - An uncommon presentation of a common disease
Anirban Das, Sibes Kumar Das
July-September 2011, 3(3):310-312
DOI:10.4103/0974-777X.83542  PMID:21887071
  2,547 20 3
The New Delhi Metallo-Beta-Lactamases: Their origins and implication for the intensivist
Binila Chacko, John Victor Peter, Veeraraghavan Balaji
July-September 2011, 3(3):309-309
DOI:10.4103/0974-777X.83540  PMID:21887070
  2,326 18 2
Polymicrobial sepsis in an immunocompetent host due to self injection of urine
Subramanian Senthilkumaran, Shah Sweni, Namasivayam Balamurugan, Ponniah Thirumalaikolundusubramanian
July-September 2011, 3(3):312-313
DOI:10.4103/0974-777X.83545  PMID:21887072
  2,165 27 -
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