Opportunistic Intestinal Protozoan Parasitic Infection in HIV Positive Patient in Jamnagar, Gujarat

The case definition of AIDS encompasses a spectrum of infections and malignancies, labelled as opportunistic infections. In recent years, numerous studies have outlined the emergence of opportunistic gastrointestinal protozoa that have caused diarrhoeal illness among HIV - AIDS patients. Purpose of present study was to determine the prevalence of opportunistic intestinal protozoal parasites in HIV positive patients with or without diarrhoea. A total of 100 stool samples of HIV positive patients were examined for protozoal parasites by microscopy. Protozoal parasites were detected in 25 HIV positive patients; in 41.37 % of patients with diarrhoea and in 2.38% of patients without diarrhoea. Isospora belli appeared to be a predominant parasite associated with diarrhoea among HIV patients. Cryptosporidium revealed of its asymptomatic carriage along with its association with acute and chronic diarrhoea. Prevalence of Microsporidia and Cyclospora cayetenensis was found to be very low. Key words: HIV; diarrhoea; opportunistic protozoa. DOI: 10.3126/saarctb.v5i1.3079 SAARC J. Tuber. Lung Dis. HIV/AIDS 2008 Vol.5(1) 21-24

Age trends of sibling resemblance for height, weight and BMI during growth in a mixed longitudinal sample from Sarsuna-Barisha, India

BACKGROUND

Even though some studies have considered that sibling resemblance remains constant throughout the life cycle, several investigations emphasize the importance of age and its interactions with genetic and environmental factors in determining sibling similarity in several bodily traits. In fact, the study of age changes in familial resemblance is of great importance for the analysis of certain sources of variation observed in growth processes.

AIM

The study examined sibling resemblance for height, weight and body mass index (BMI) in a mixed longitudinal sample from West Bengal, ages 2-19 years, in order to analyse the variations with age of the sibling resemblance for these phenotypes during growth.

SAMPLE AND METHODS

Two hundred and forty-five brothers and 213 sisters from 138 middle-class nuclear families living in a semi-urban area of South Kolkata, India were analysed. The analysis of sibling resemblance was performed through correlations estimated by the maximum-likelihood method. The patterns of different trends of sibling resemblance with age were examined by fitting a cubic non-linear regression to the observed correlations.

RESULTS

The results show clear variations with age in the sibling resemblance for the traits height and weight, though to a lesser extent for BMI. In general, we found the highest correlation values during the period of infancy, a remarkable decrease during puberty, and a trend of increase towards the end of the growth cycle.

CONCLUSION

The study confirms the effect of age on the degree of similarity among siblings for height, weight and BMI in the sample. The sharp decline of correlation at adolescence can be interpreted in terms of the individual variation in age of reaching the adolescent growth spurt.

Adaptation of the Hall-Findlay technique for simultaneous contralateral reduction in delayed breast reconstruction with extended latissimus dorsi flap

In the past we have validated Hall-Findlay technique of breast reduction with our independent results. The technique combines the safety of the superomedial pedicle with advantages of a vertical scar in a quick but safe manner ensuring adequate resection and sound healing with less scars and faster recovery for the patient. We now report our experience of using an adaptation of the same in simultaneous contralateral reduction in delayed breast reconstruction with extended latissimus dorsi flap.

METHOD

Thirty consecutive patients underwent simultaneous contralateral balancing reduction. The modifications consisted of wider upper pole reduction with smaller, thinner pedicle reducing the projection.

RESULTS

All patients had an uneventful recovery with no haematoma, infection or seroma. Two patients (6.66%) wished further reduction and one (3.33%) required dog-ear revision.

CONCLUSION

The modifications allow the reduction of the contralateral breast with a lower projection to match the extended latissimus dorsi (ELD) flap reconstruction. We have found the modified technique to be reliable and versatile with a shorter operative and recovery time adding minimal morbidity of simultaneous contralateral reduction and effectively reducing the need of a delayed balancing reduction.

Keratoderma hereditarium mutilans (Vohwinkel syndrome)

Keratoderma hereditarium mutilans, or Vohwinkel syndrome, is a very rare genetic skin condition which causes palmoplantar hyperkeratosis and constricting rings of the fingers and toes. Approximately 50 cases have been reported in the literature with only three having been managed surgically. All three had a high rate of recurrence and unfavourable results in the long term. We report two more cases managed surgically with a follow up of 5 and 8 years respectively. Our experience suggests that the use of full thickness grafts to line the released contractures does not work in the long term as the grafts become raised and painful, requiring multiple revisions. Surgical correction was easy to achieve but difficult to maintain and achieved poor outcomes in general. We therefore feel that the indication for surgical treatment should be a neurovascular compromise.

High fat diet induces obesity in British Angora rabbit: a model for experimental obesity

A reliable and cost-effective animal model for human obesity with its manifested disorders is yet to be established in the context of increased morbidity and mortality due to obesity and its related problems. Therefore, an attempt was made to produce obesity in locally available British Angora Rabbits (BAR) and examine the effect on metabolic and cardiovascular parameters. Adult male BARs weighing nearly 2 kg were randomly divided into two groups, one of the groups was fed with high fat diet (HFD) ad libitum for 10 weeks and the control group received standard normal rabbit chow for same period. Body weight, skinfold thickness, serum cholesterol, serum glucose and resting heart rate were measured before and after the dietary regimens. After 10 weeks, HFD group of rabbits demonstrated significant (P < 0.05) increase in body weight (+24%) and skinfold thickness (+37%). The gain in body weight was positively correlated to skinfold thickness (r = 0.61). Serum cholesterol, serum glucose and resting heart rate were also increased by 46%, 52% and 15%, respectively. Whereas no such increases in any of these parameters were observed in control group of rabbits. Our results suggest that obesity can be produced in BARs by feeding HFD. The obesity manifests with cardiovascular and metabolic changes. It is proposed that this may serve as a valid and reliable model of experimental obesity.

Obesity attenuates formalin-induced tonic pain in British Angora rabbits

Obesity is known to alter various physiological parameters including the pain sensitivity. There are conflicting reports on the pain sensitivity in obesity. In this context, the present study was aimed to investigate the tonic pain response in obese rabbit model. To achieve this aim, two groups of adult male British Angora rabbits were used. One of the groups was fed with standard rabbit chow and served as control. The other group was fed high fat diet (HFD) for 10 weeks to produce obesity. The standard formalin test was performed at the start and after 10 weeks of dietary regimen in both the groups. Timed behavioral responses (limping, elevation of paw, licking, biting, grooming etc.) were categorized and quantified with the help of standard pain rating scale. The total average pain rating score decreased significantly from 2.01 +/- 0.02 to 1.47 +/- 0.08 (P < 0.05) in HFD group after 10 weeks of dietary regimen, whereas there was no change in the control group. A significant negative correlation was observed between body weight and pain rating score in HFD group of rabbits (P < 0.05, r = -0.62). Results suggest that obesity attenuates the tonic pain responses induced by formalin in British Angora rabbits.

Study of parental handling patterns in a primary school of Kolkata

The intricate pattern of parenting in our socio-cultural context needs evaluation hence this study was done with the objective to reveal the parenting styles of school going children. 141 school children belonging to the age group 6-10 years were included in the study. The Parental Handling Questionnaire a 14-item scale consisting of 10 items of care and 4-items of control was administered to the mothers accompanying the children. Rating was done on a 3-point. The scale showed moderate internal consistency. 5 independent factors with overlapping items of care and control were deduced on factor analysis indicating multidimensional aspects of parenting in our society.

Prelaminated free radial forearm flap for a total nasal reconstruction

A prelaminated osteocutaneous radial forearm flap has previously been described for total nasal reconstruction, but achieving good aesthetics at the dorsum and tip tends to be difficult with a flap that can be too bulky. We present a case of total nasal reconstruction in a burns patient where a tight adherent scar at the forehead precluded the use of a forehead flap, ideal for such reconstructions. We successfully used a prelaminated free radial forearm flap, with a non-vascularised bone graft. The existing scarred skin at the dorsum was turned down as pedicled flaps for the lining. We were able to achieve a successful total nasal reconstruction which was aesthetically pleasing and made a tremendous impact on the quality of life of the patient.

Identification of human metapneumovirus-induced gene networks in airway epithelial cells by microarray analysis

Human metapneumovirus (hMPV) is a major cause of lower respiratory tract infections in infants, elderly and immunocompromised patients. Little is known about the response to hMPV infection of airway epithelial cells, which play a pivotal role in initiating and shaping innate and adaptive immune responses. In this study, we analyzed the transcriptional profiles of airway epithelial cells infected with hMPV using high-density oligonucleotide microarrays. Of the 47,400 transcripts and variants represented on the Affimetrix GeneChip Human Genome HG-U133 plus 2 array, 1601 genes were significantly altered following hMPV infection. Altered genes were then assigned to functional categories and mapped to signaling pathways. Many up-regulated genes are involved in the initiation of pro-inflammatory and antiviral immune responses, including chemokines, cytokines, type I interferon and interferon-inducible proteins. Other important functional classes up-regulated by hMPV infection include cellular signaling, gene transcription and apoptosis. Notably, genes associated with antioxidant and membrane transport activity, several metabolic pathways and cell proliferation were down-regulated in response to hMPV infection. Real-time PCR and Western blot assays were used to confirm the expression of genes related to several of these functional groups. The overall result of this study provides novel information on host gene expression upon infection with hMPV and also serves as a foundation for future investigations of genes and pathways involved in the pathogenesis of this important viral infection. Furthermore, it can facilitate a comparative analysis of other paramyxoviral infections to determine the transcriptional changes that are conserved versus the one that are specific to individual pathogens.

Molecular characterization of bovine group A rotavirus G3P[3] strains

During a surveillance study, four of 130 group A rotavirus strains, detected from diarrheic calves in Eastern India, exhibited G3P[3] specificities. Molecular characterization of VP7 and VP8(*) genes of one such strain [named as RUBV3 (RU: ruminant and BV: bovine)] revealed genetic relatedness to a G3P[3] simian strain, RRV, and RRV-related caprine strain GRV. Strain RUBV3 had VP6, NSP4 and NSP5 genes of bovine origin. Therefore, the present study provides evidence for multiple reassortment events involving ruminant and simian strains and, to our knowledge, is the first report of detection of bovine group A rotavirus strains with G3P[3] specificities.

Mechanisms of resistance to carbapenems in meropenem- resistant Acinetobacter isolates from clinical samples

PURPOSE

To analyze the resistance mechanisms in Acinetobacter species by phenotypic methods.

METHODS

Antibiotic susceptibility profile for 150 clinical isolates of Acinetobacte r was determined by the standard disk diffusion method. Isolates detected to be meropenem resistant were tested further by broth microdilution minimum inhibitory concentration (MIC) for meropenem. The resistant isolates were also tested for metallo beta -lactamase (MBL) production by the double-disk approximation test, for AmpC beta-lactamase production and efflux pump detection by agar microdilution MIC with and without reserpine.

RESULTS

Twenty-one isolates were found resistant to meropenem by the standard disk diffusion method. Nine samples were from patients admitted in intensive care units (ICUs). Broth microdilution MICs of the isolates revealed low-level resistance to meropenem. MBL was not produced by any of these isolates. AmpC beta -lactamases were produced by nine (43%) isolates. 'Efflux pump'-mediated resistance to meropenem was detected in two out of nine random isolates tested for the same.

CONCLUSIONS

Carbapenem resistance is not uncommon in Acinetobacter isolates. AmpC production may cause carbapenem resistance. MBL and efflux pump may not be important causes of carbapenem resistance.

Squamous cell carcinoma of penis presenting as groin metastasis 3 years before the primary

A 78-year-old patient who developed bilateral inguinal node metastatic squamous cell carcinoma, more than 3 years before the primary penile carcinoma declared itself, is presented. An exhaustive multispeciality search for the primary including a circumcision proved fruitless. A review of the relevant literature is summarised.