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Monitoring Microbiological Response to Antituberculosis Therapy by Real-Time PCR
Yadi Yasir,
Ressy Dwiyanti,
Muhammad Sabir,
Andini Febrianty,
Ahmad Adhyka,
Nur Indah Purnamasari,
Muhammad Reza Primaguna,
Nataniel Tandirogang,
Masyhudi Amir,
Syamsu Rijal,
Rosdiana Natzir,
SutjiPratiwi Rahardjo,
Mochammad Hatta
Issue:
Volume 3, Issue 1, January 2015
Pages:
1-5
Received:
19 October 2014
Accepted:
6 November 2014
Published:
19 January 2015
Abstract: Background: M. tuberculosis grows slowly and requires several weeks to detect in clinical specimens using standard culture techniques. Messenger RNA is more rapidly destroyed in cells than rRNA or genomic DNA, assays that target mycobacterial mRNA better reflect mycobacterial viability. Therefore we evaluated performance of mRNA for monitoring response to antituberculosis therapy using Real-Time PCR. Methods: Sputum specimens from 29 tuberculosis patients confirmed by positive culture were included in this study. Sputum specimens were collected before therapy, at 1st week, 4th week, 8th week and 16th week after initiating antituberculosis therapy to evaluate acid-fast bacilli (AFB), culture and mRNA level. Results: All 29 specimens were positive for culture and mRNA before initiating tuberculosis chemotherapy. Within 29 samples confirmed by positive culture, only 22 (75.9%) patients were positive by AFB. After 8 and 16 weeks of therapy, 27 (93.1%) and 28 (96.5%) were negative by culture, 26 (89.6%) and 28 (96.5%) were negative results for mRNA, and 15 (51.7%) and 29 (100%) were negative results for AFB. Conclusion: Rapidly decline of mRNA level correlated with rapid culture clearance after anti-tuberculosis therapy.
Abstract: Background: M. tuberculosis grows slowly and requires several weeks to detect in clinical specimens using standard culture techniques. Messenger RNA is more rapidly destroyed in cells than rRNA or genomic DNA, assays that target mycobacterial mRNA better reflect mycobacterial viability. Therefore we evaluated performance of mRNA for monitoring resp...
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Microbiology of Diabetic Foot Ulcer with Special Reference to ESBL Infections
Mohammad Zubair,
Abida Malik,
Jamal Ahmad
Issue:
Volume 3, Issue 1, January 2015
Pages:
6-23
Received:
7 December 2014
Accepted:
17 December 2014
Published:
26 January 2015
Abstract: Chronic foot wounds represent an increasing burden to healthcare systems as the age of the population increases. The deep dermal tissues of all chronic wounds harbor microorganisms, however, the precise interaction between microbes in the wounds and impaired healing is unknown. With regard to antibiotic therapy, there is a lack of evidence concerning its effectiveness, optimal regimens or clinical indications for treatment. Despite this lack of evidence, antibiotics are frequently a feature of the management of chronic wounds and these patients receive significantly more antibiotic prescriptions (both systemic and topical) than age and sex-matched patients. Current guidelines for antibiotic prescribing for such diabetic foot wounds are often based on expert opinion rather than scientific fact and may present difficulties in interpretation and implementation to the clinician. Although the increasing prevalence of antibiotic resistance is widely recognized, the relationships between antibiotic resistance, chronic wound microbiology and rationales for antibiotic therapy have yet to be determined. This review discusses the role of microbes in chronic diabetic foot wounds from a clinical perspective with particular focus on the occurrence of type bacteria and their impact on such wounds and resistance pattern, Extended Spectrum Beta Lactamases [ESBL] studies with special reference to Indian studies. The evidence and role of antibiotics in the treatment of such wounds are outlined and current practice of antibiotic usage for chronic wounds in the primary care setting described. The implications of antibiotic usage with regard to antibiotic resistance are also considered.
Abstract: Chronic foot wounds represent an increasing burden to healthcare systems as the age of the population increases. The deep dermal tissues of all chronic wounds harbor microorganisms, however, the precise interaction between microbes in the wounds and impaired healing is unknown. With regard to antibiotic therapy, there is a lack of evidence concerni...
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Computed Tomography Assessment of the Vascularization Degree of Hepatocellular Carcinoma in the Noncirrhotic Liver
Ulyana N. Tumanova,
Grigoriy G. Karmazanovsky,
Alexander I. Shchyogolev
Issue:
Volume 3, Issue 1, January 2015
Pages:
24-31
Received:
31 December 2014
Accepted:
15 January 2015
Published:
28 January 2015
Abstract: An important CT-characteristic at a diagnostic of liver tumors is the determination of its vascularity. To study the characteristics of blood tissue of hepatocellular carcinoma (HCC) with different degrees of differentiation by CT. The work is based on the clinical and morphological comparisons performed in 55 patients (34 men and 21 women aged 15-83 years) with hepatocellular carcinoma (HCC) without accompanying liver cirrhosis. In the preoperative stage all patients was carried spiral computed tomography (CT) with bolus contrast enhancement (on the four phases of the study). Was evaluated parameters of CT density and degree of nodes HCC vascularization. Morphologic study of histological preparations of operation material from 16 patients was diagnosed high-differentiated, 33 - moderately differentiated, and 6 - poorly differentiated HCC. At the immunohistochemical preparations with reaction to CD34 was determined by the number and the total cross-sectional area of vessels in sight of HCC tissue. The maximum values of CT density in the arterial phase were observed at the nodes moderately differentiated HCC. In the venous phase the greatest values of density as well as the venous increase was registered in high-differentiated HCC. The most vascularised (hypervascular) tumor is high-differentiated HCC, and the least vascularized - poorly differentiated HCC by CT. At morphometric study of the maximum values of the number and the total cross-sectional area of the blood vessels are installed in high-differentiated HCC tissues, the minimum - in the tissue of low-grade HCC. CT with bolus contrast enhancement allows studying the characteristics of blood supply of HCC varying degrees of differentiation. Determine the true measure of total CT-vascularization of the tumor tissue must be done with consideration of the increase concentration difference coefficient (ICDC).
Abstract: An important CT-characteristic at a diagnostic of liver tumors is the determination of its vascularity. To study the characteristics of blood tissue of hepatocellular carcinoma (HCC) with different degrees of differentiation by CT. The work is based on the clinical and morphological comparisons performed in 55 patients (34 men and 21 women aged 15-...
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Rabbit Snake-Bite Model to Assess Safety and Efficacy of Anti Viper Chicken Antibodies (IgY)
Lissy Kalliyana Krishnan,
Juliet Baby Saroja,
Madhumati Rajalingam,
Vimala John,
Mohanan Parayathala Valappil,
Harikrishnan Vijayakumar Sreelatha
Issue:
Volume 3, Issue 1, January 2015
Pages:
32-38
Received:
17 October 2014
Accepted:
28 October 2014
Published:
2 February 2015
Abstract: Infusion of mammalian antivenom is considered to be the best available treatment for snake bites; but, production of cost-effective IgG in pure form is challenging. Purification of egg yolk immunoglobulins (IgY) raised against various toxins has been found to be relatively easier. But to use IgY for therapeutic purpose its efficacy and safety need to be experimentally proven which is hardly done due to lack of an appropriate model. In this study, pure IgY against viper venom was isolated and its efficacy and safety for intravenous infusion was tested in rabbits. Rabbit snake bite model was created by subcutaneous injection of 2x lethal dose50 (LD50) venom. Animals were given intravenous infusion of pure anti-viper IgY and recovery was monitored. Isolated chicken immunoglobulin (IgY) was >90% homogenous and showed 1:32 titre in immunodiffusion experiment. The minimum hemorrhagic dose (MHD) of viper venom was 0.2mg and antihaemorragic dose (AHD) of IgY was 4x concentration (0.8 mg) of native venom. Subcutaneously injected venom at LD50 resulted in severe local reaction, coagulation abnormality and mortality in rabbits. When anti viper IgY was infused within 2 h of envenomation, the animals survived, clotting parameters were reversed to normal and animals showed steady weight gain like healthy animals. No adverse effect of IgY was noticed on renal or hepatic function. The efficacy of commercially available mammalian IgG was lower than that of anti-viper IgY. Long term stability of the purified and lyophilized IgY was demonstrated. The effective IgY dose required to prevent mortality in the envenomed rabbits was found to be 4x of the injected venom estimated by Lowry’s protein assay. It has been demonstrated that rabbit model of snake bite is successfully cured by anti-snake IgY infusion at a specific dose.
Abstract: Infusion of mammalian antivenom is considered to be the best available treatment for snake bites; but, production of cost-effective IgG in pure form is challenging. Purification of egg yolk immunoglobulins (IgY) raised against various toxins has been found to be relatively easier. But to use IgY for therapeutic purpose its efficacy and safety need ...
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Serum Angiopoietin-2 as Marker of Plasma Leakage in Dengue Viral Infection
Novie Homenta Rampengan,
Dasril Daud,
Sarah Warouw,
Idham Jaya Ganda
Issue:
Volume 3, Issue 1, January 2015
Pages:
39-43
Received:
6 January 2015
Accepted:
18 January 2015
Published:
2 February 2015
Abstract: Background. The immunopathology of DHF/DSS is yet completely understood. Angiopoietin-2 (Ang-2) produced by endothelial cell could promote vascular leakage by disrupting endothelial junction. Few studies reported the role of Ang-2 in dengue viral infection. Objective. To study the role of Ang-2 in promoting vascular leakage in dengue viral infection. Methods. Prospective cohort study conducted at Prof. Dr. R.D. Kandou, Pancaran Kasih and R.W. Mongonsidi General Hospitals in Manado, from March 2013 to October 2014. Children, aged 1-15 years old, with the diagnosis of dengue viral infection according to 1997 World Health Organization (WHO) criteria [Dengue Fever (DF), Dengue Hemorrhagic Fever (DHF), Dengue Shock Syndrome (DSS)],were recruited consecutively. Written informed consent was obtained from parents or legal guardian. Blood samples were obtained at the time of diagnosis and 48 hours after, evaluated for complete blood counts, albumin, NS-1, Ig M, Ig G anti-dengue, and Ang-2. Results. During the study period, there were 119 children with dengue viral infections (39 DF, 39 DHF, 41 DSS). Patient’s characteristics: female predominance, age between 1.5-8.5 years old, well nourished, and mean albumin level were less than ≤3.5 gr% in the DHF and DSS group. Ang-2 level at admission were 2,486.21 pg/dl, 3,194.95 pg/dl and 4,005.32 pg/dl in DF, DHF and DSS group, respectively. Anova test analyses shows significant differences in serum Ang-2 level at admission between DF, DHF and DSS group (p<0.0001). Between those groups, DSS group had the highest level of Ang-2, followed with DHF and DF. Discussion. Mean albumin level were 3.88 gr%, 3.39 gr% and 2.63gr% in DF, DHF and DSS group, respectively. This results shows increasing plasma leakage with increasing severity of dengue viral infection. Increasing level of Ang-2 can promote blood vessels instability therefore causing increased vascular permeability and subsequent plasma leakage. In this study, we found significant elevation of serum Ang-2 in patiens with DSS compared to DHF and DF but the difference was not significant between DF and DHF group. Conclusions. Angiopoietin-2 contributes in transient systemic vascular leak in dengue viral infection.
Abstract: Background. The immunopathology of DHF/DSS is yet completely understood. Angiopoietin-2 (Ang-2) produced by endothelial cell could promote vascular leakage by disrupting endothelial junction. Few studies reported the role of Ang-2 in dengue viral infection. Objective. To study the role of Ang-2 in promoting vascular leakage in dengue viral infectio...
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Mean Values, Normal Limits and Sex Differences of Anthropometry of Young Adults in a University Community in Nigeria
Oluwadare Ogunlade,
Olusoji Adeola Adalumo
Issue:
Volume 3, Issue 1, January 2015
Pages:
44-47
Received:
28 December 2014
Accepted:
26 January 2015
Published:
2 February 2015
Abstract: This study assessed the weight, height, body mass index (BMI) and body surface area (BSA) of young adults at Ile-Ife with a view of determining the mean values, normal limits and sex differences in the anthropometric parameters. Four hundred and eighty four (242 males and 242 females) subjects aged between 18-41 years (inclusive) were recruited for the study. The participants were age and sex-matched (mean age: 22.81±3.83years). The weight and height of the subjects were obtained using standard techniques while BMI and BSA were calculated as derivatives of height and weight. Data were analyzed using descriptive and inferential statistics. Normal limits for height, weight and BSA were determined using 5th and 95th percentiles while normal limits for BMI were determined using 5th and 85th percentiles. The mean ± SD and normal limits of weight, height, BMI and BSA for the 484 participants were 60.94 ± 9.60kg (47.00-79.75kg), 1.67± 0.85m (1.54-1.82m), 21.82±3.02kg/ m2 (17.80-24.83 kg/ m2) and 1.68 ± 0.15m2 (1.45-1.96 m2). Among males and females respectively, the mean weight [63.43± 9.11kg and 58.46 ± 9.46kg (p <0.001, t =5.9)], height [1.72 ± 0.07m and 1.62 ± 0.07 m2 (p < 0.001, t = 15.03)], BMI [21.43 ± 2.62 and 22.20 ± 3.33(p =0.01, t = -2.83)] and BSA [1.75±0.14m2 and 1.62 ±0.13m2 (p< 0.001, t =10.34] showed significant statistical differences. The normal limits for weight, height, BMI and BSA in males and females respectively were; 50.56-82.00kg and 45.56-75.00kg; 1.61-1.85m and 1.53-1.73m; 17.80-26.90 and 17.80-28.79 and 1.53-2.00m2 and 1.41-1.87m2. BMI was significantly higher in females while other anthropometric parameters were significantly higher in males. This study provides data on anthropometric parameters among young adult Nigerians as reference values for physiological and pathophysiological evaluation and clinical management. Significant sex differences exist among young adult Nigerians with regards to weight, height, BMI and BSA. So, sex should be taken into consideration in classification of young adult Nigerians using anthropometry.
Abstract: This study assessed the weight, height, body mass index (BMI) and body surface area (BSA) of young adults at Ile-Ife with a view of determining the mean values, normal limits and sex differences in the anthropometric parameters. Four hundred and eighty four (242 males and 242 females) subjects aged between 18-41 years (inclusive) were recruited for...
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Correlation of Serum IL-4 Levels in New and MDR Tuberculosis Patients
Nazish Fatima,
Mohammad Shameem,
Nabeela,
Parvez A. Khan,
H. M. Khan
Issue:
Volume 3, Issue 1, January 2015
Pages:
48-51
Received:
24 November 2014
Accepted:
17 December 2014
Published:
6 February 2015
Abstract: Mycobacterium tuberculosis (Mtb) infects approximately one third of world population. Many cytokines are produced during tuberculosis, with predominance of Th1 cytokines during the early stage and Th2 cytokines in the later stages of the infection. Most studies on cytokines during TB are from ‘in vitro’-stimulated lymphoid cells with few reports on in vivo plasma levels. The high expression of IL-4 has been implicated as a virulence factor. In the present study we examined the level of IL-4 in the serum of active tuberculosis in new cases, during anti-tubercular therapy and MDR cases. This Study was conducted at Department Of Microbiology, JNMC, AMU, Aligarh. A total 76 blood samples of Pulmonary & Extra-Pulmonary tuberculosis patients were tested by ELISA (Diaclone France) along with 10 healthy controls. The test was carried out according to the manufacturer instructions. O.D. was taken at 450 nm. There was no stastical difference in age and sex in our study. The level of IL-4 show significant changes in MDR TB cases (P<0.05) but not significant during the anti-tubercular therapy (ATT) and new TB cases (P>0.05). An understanding of the development of the cellular immune response may lead to insight into pathogenesis and novel therapies for TB. Further studies are needed to address the role of cytokines in immunity to TB under natural conditions.
Abstract: Mycobacterium tuberculosis (Mtb) infects approximately one third of world population. Many cytokines are produced during tuberculosis, with predominance of Th1 cytokines during the early stage and Th2 cytokines in the later stages of the infection. Most studies on cytokines during TB are from ‘in vitro’-stimulated lymphoid cells with few reports on...
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