Shell Vial culture Assay for the rapid diagnosis of Japanese encephalitis, West Nile and Dengue-2 viral encephalitis

BACKGROUND: Encephalitis caused by flaviviruses, Japanese encephalitis virus (JEV) and West Nile virus (WNV) is responsible for significant morbidity and mortality in many endemic countries. Dengue-2 (Den-2) virus is a recent addition to the list of encephalitogenic viruses, after its Central Nervous System (CNS) invasion capability has been established. There is a wide array of laboratory tools that have helped us not only in the diagnosis of these conditions but also in understanding their pathogenesis and pathology. However, there are no reports of Shell Vial Culture (SVC), a centrifuge enhanced tissue culture assay that has revolutionized viral culturing in terms of rapidity and sensitivity being optimized for these flaviviral encephalitic conditions. The present study is an attempt to standardize and evaluate the usefulness of SVC for the laboratory diagnosis of JE, WN and Den-2 encephalitis cases and to compare it with Indirect Immunofluorescence (IIF) technique that detects cell associated virus antigen. Analysis of the various clinical parameters with respect to viral etiology has also been carried out. RESULTS: Pediatric patients constituted the major group involved in the study (92%). Etiological diagnosis of viral encephalitis could be established in twenty nine (58%) patients. JE encephalitis was the commonest with 19 (39%) cases being positive followed by, WN (9 cases-18%) and Den-2 (one case). IIF test could detect antigens of JE, WN and Den-2 viruses in 16(32%), 7(14%) and 1 case respectively. Shell vial culture assay picked up all cases that were positive by IIF test. In addition, SVC assay could detect 3 and 2 more cases of JE and WN encephalitis respectively, that were negative by the IIF test. CONCLUSION: Shell vial culture is a rapid and efficient tool for the etiological diagnosis of JE, WN and Den-2 encephalitis cases. Early, prompt collection, transport and processing of the CSF samples, would make SVC a better method for the rapid diagnosis of these flaviviral infections

ORGANO PHOSPHORUS COMPOUND POISONING, COMPLICATED ACUTE RENAL FAILURE AND DELAYED POST HYPOXIC ENCEPHALOPATHY - A CASE REPORT

Organophosphorus compound (OPC) poisoning is one of the most common poisons in rural India. We present a 27 year old female patient who came to us in altered sensorium and froathing from mouth with an alleged history of OPC intake about 2 hours back. The patient was intubated, connected to a mechanical ventilator and atropinized. On day 3 of admission patient had elevated renal parameters and was diagnosed as Acute Renal Failure due to acute tubular necrosis probably poison induced. On day 4 of admission she suffered an acute cardiac arrest and was resuscitated; following this she gradually improved and after 3weeks of intensive management her sensorium deteriorated. MRI Brain showed Diffuse Cerebral White Matter Leukodystrophy due to DEMYELINATION (Hypoxia induced). KEYWORDS: Organophosphorus compound poisoning; Acute renal failure; Demyelination; Leukoencephalopathy

ORGANO PHOSPHORUS COMPOUND POISONING, COMPLICATED ACUTE RENAL FAILURE AND DELAYED POST HYPOXIC ENCEPHALOPATHY - A CASE REPORT

Organophosphorus compound (OPC) poisoning is one of the most common poisons in rural India. We present a 27 year old female patient who came to us in altered sensorium and froathing from mouth with an alleged history of OPC intake about 2 hours back. The patient was intubated, connected to a mechanical ventilator and atropinized. On day 3 of admission patient had elevated renal parameters and was diagnosed as Acute Renal Failure due to acute tubular necrosis probably poison induced. On day 4 of admission she suffered an acute cardiac arrest and was resuscitated; following this she gradually improved and after 3weeks of intensive management her sensorium deteriorated. MRI Brain showed Diffuse Cerebral White Matter Leukodystrophy due to DEMYELINATION (Hypoxia induced). KEYWORDS: Organophosphorus compound poisoning; Acute renal failure; Demyelination; Leukoencephalopathy

Collaborative multidisciplinary learning : quantity surveying students’ perspectives

The construction industry is highly fragmented and is known for its adversarial culture, culminating in poor quality projects not completed on time or within budget. The aim of this study is thus to guide the design of QS programme curricula in order to help students develop the requisite knowledge and skills to work more collaboratively in their multi-disciplinary future workplaces. A qualitative approach was considered appropriate as the authors were concerned with gathering an initial understanding of what students think of multi-disciplinary learning. The data collection method used was a questionnaire which was developed by the Behaviours4Collaboration (B4C) team. Knowledge gaps were still found across all the key areas where a future QS practitioner needs to be collaborative (either as a project contributor or as a project leader) despite the need for change instigated by the multi-disciplinary (BIM) education revolution. The study concludes that universities will need to be selective in teaching, and innovative in reorienting, QS education so that a collaborative BIM education can be effected in stages, increasing in complexity as the students’ technical knowledge grows. This will help students to build the competencies needed to make them future leaders. It will also support programme currency and delivery

Chromosome-wide mapping of DNA methylation patterns in normal and malignant prostate cells reveals pervasive methylation of gene-associated and conserved intergenic sequences

RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are.Abstract Background DNA methylation has been linked to genome regulation and dysregulation in health and disease respectively, and methods for characterizing genomic DNA methylation patterns are rapidly emerging. We have developed/refined methods for enrichment of methylated genomic fragments using the methyl-binding domain of the human MBD2 protein (MBD2-MBD) followed by analysis with high-density tiling microarrays. This MBD-chip approach was used to characterize DNA methylation patterns across all non-repetitive sequences of human chromosomes 21 and 22 at high-resolution in normal and malignant prostate cells. Results Examining this data using computational methods that were designed specifically for DNA methylation tiling array data revealed widespread methylation of both gene promoter and non-promoter regions in cancer and normal cells. In addition to identifying several novel cancer hypermethylated 5' gene upstream regions that mediated epigenetic gene silencing, we also found several hypermethylated 3' gene downstream, intragenic and intergenic regions. The hypermethylated intragenic regions were highly enriched for overlap with intron-exon boundaries, suggesting a possible role in regulation of alternative transcriptional start sites, exon usage and/or splicing. The hypermethylated intergenic regions showed significant enrichment for conservation across vertebrate species. A sampling of these newly identified promoter (ADAMTS1 and SCARF2 genes) and non-promoter (downstream or within DSCR9, C21orf57 and HLCS genes) hypermethylated regions were effective in distinguishing malignant from normal prostate tissues and/or cell lines. Conclusions Comparison of chromosome-wide DNA methylation patterns in normal and malignant prostate cells revealed significant methylation of gene-proximal and conserved intergenic sequences. Such analyses can be easily extended for genome-wide methylation analysis in health and disease.Published versio

An Active Learning Approach for Rapid Characterization of Endothelial Cells in Human Tumors

Currently, no available pathological or molecular measures of tumor angiogenesis predict response to antiangiogenic therapies used in clinical practice. Recognizing that tumor endothelial cells (EC) and EC activation and survival signaling are the direct targets of these therapies, we sought to develop an automated platform for quantifying activity of critical signaling pathways and other biological events in EC of patient tumors by histopathology. Computer image analysis of EC in highly heterogeneous human tumors by a statistical classifier trained using examples selected by human experts performed poorly due to subjectivity and selection bias. We hypothesized that the analysis can be optimized by a more active process to aid experts in identifying informative training examples. To test this hypothesis, we incorporated a novel active learning (AL) algorithm into FARSIGHT image analysis software that aids the expert by seeking out informative examples for the operator to label. The resulting FARSIGHT-AL system identified EC with specificity and sensitivity consistently greater than 0.9 and outperformed traditional supervised classification algorithms. The system modeled individual operator preferences and generated reproducible results. Using the results of EC classification, we also quantified proliferation (Ki67) and activity in important signal transduction pathways (MAP kinase, STAT3) in immunostained human clear cell renal cell carcinoma and other tumors. FARSIGHT-AL enables characterization of EC in conventionally preserved human tumors in a more automated process suitable for testing and validating in clinical trials. The results of our study support a unique opportunity for quantifying angiogenesis in a manner that can now be tested for its ability to identify novel predictive and response biomarkers

Evidence of seasonality in the diagnosis of monocytic leukaemia

Evidence of seasonality in the diagnosis of monocytic leukaemia in England and Wales is presented, with a maximum diagnosis rate in February/March and a minimum in August/September. Previous published results for monocytic leukaemia are of small sample size yet appear consistent with this finding

Disjoint and Overlapping Process Changes: Challenges, Solutions, Applications

Adaptive process–aware information systems must be able to support ad–hoc changes of single process instances as well as schema modifications at the process type level and their propagation to a collection of related process instances. So far these two kinds of (dynamic) process changes have been mainly considered in an isolated fashion. Especially for long-running processes, however, it must be possible to adequately handle the interplay between type and instance changes as well. One challenge in this context is to determine whether concurrent process type and process instance changes have the same or overlapping effects on the original process schema or not. Information about the degree of overlap is needed, for example, to determine whether and – if yes – how a process type change can be propagated to individually modified process instances as well. This paper provides a formal framework for dealing with overlapping and disjoint process changes and presents adequate migration strategies depending on the particular degree of overlap. In order to obtain a canonical representation of changes an algorithm is introduced which purges change logs from noisy information. Finally, a powerful proof-of-concept prototype exists

Prevalence of Chlamydia trachomatis infection among women in a Middle Eastern community

BACKGROUND: Common vaginal infections that manifest in women are usually easily diagnosed. However, Chlamydia infection is often asymptomatic, leading to infertility before it is detected. If it occurs in pregnancy, it could lead to significant neonatal morbidity. It may also play a role with other viral infections for e.g. Human Papilloma Virus in the development of cervical cancer. The objective of this study was to determine the prevalence of Chlamydia infection in women undergoing screening for cervical abnormalities as a part of a research project in primary and secondary care institutions in the United Arab Emirates. METHODS: In this cross sectional study married women attending primary and secondary care participating in a large nationwide cervical abnormalities screening survey were offered Chlamydia testing using a commercially available test kit. This kit uses a rapid immunoassay for the direct detection of Chlamydia trachomatis antigen in endocervical swab specimens. As this study was performed in a traditional Islamic country, unmarried women were excluded from testing, as the management of any positive cases would create legal and social problems. All married women consenting to take part in the study were included irrespective of age. RESULTS: Of 1039 women approached over a period of eight months 919 (88.5%) agreed to participate. The number of women in the 16 to 19 years was small (0.01%) and 30% were aged over 40 years. The prevalence of Chlamydia infection in this study was 2.6% (95% confidence interval 1.2–3.3%), which was marginally higher in women screened in secondary care (p = 0.05). CONCLUSION: This is one of the few reports on the prevalence of Chlamydia infection in women from the Middle East. Due to cultural and social constraints this study excluded a large proportion of women aged less than 19 years of age. Hence no direct comparisons on prevalence could be made with studies from the West, which all included younger women at high risk of Chlamydia. However this study emphasizes the importance of cultural factors while interpreting results of studies from different cultures and communities

EPHA2 Polymorphisms and Age-Related Cataract in India

Objective: We investigated whether previously reported single nucleotide polymorphisms (SNPs) of EPHA2 in European studies are associated with cataract in India. Methods: We carried out a population-based genetic association study. We enumerated randomly sampled villages in two areas of north and south India to identify people aged 40 and over. Participants attended a clinical examination including lens photography and provided a blood sample for genotyping. Lens images were graded by the Lens Opacification Classification System (LOCS III). Cataract was defined as a LOCS III grade of nuclear >= 4, cortical >= 3, posterior sub-capsular (PSC) >= 2, or dense opacities or aphakia/pseudophakia in either eye. We genotyped SNPs rs3754334, rs7543472 and rs11260867 on genomic DNA extracted from peripheral blood leukocytes using TaqMan assays in an ABI 7900 real-time PCR. We used logistic regression with robust standard errors to examine the association between cataract and the EPHA2 SNPs, adjusting for age, sex and location. Results: 7418 participants had data on at least one of the SNPs investigated. Genotype frequencies of controls were in Hardy-Weinberg Equilibrium (p > 0.05). There was no association of rs3754334 with cataract or type of cataract. Minor allele homozygous genotypes of rs7543472 and rs11260867 compared to the major homozygote genotype were associated with cortical cataract, Odds ratio (OR) = 1.8, 95% Confidence Interval (CI) (1.1, 3.1) p = 0.03 and 2.9 (1.2, 7.1) p = 0.01 respectively, and with PSC cataract, OR = 1.5 (1.1, 2.2) p = 0.02 and 1.8 (0.9, 3.6) p = 0.07 respectively. There was no consistent association of SNPs with nuclear cataract or a combined variable of any type of cataract including operated cataract. Conclusions: Our results in the Indian population agree with previous studies of the association of EPHA2 variants with cortical cataracts. We report new findings for the association with PSC which is particularly prevalent in Indians