A study of hip arthroplasty using bipolar endo-prothesis for fracture neck of femur

Background: The purpose of this study is to analyze 20 cases of bipolar hip arthroplasty done for fracture neck of femur from August 2011 to January 2013. The technique, overall functional results were tabulated in a proforma and analyzed, complications if any were noted and analysed. A conventional Austin Moore and Thompson device has been routinely deployed, however in long term follow-up, unsatisfactory results remained high due to femoral stem loosening, acetabular erosion, intrusion of prosthesis into the pelvis and difficulties with total hip revisions. These factors led to the development of bipolar prosthesis.Methods: 20 patients were operated by cemented bipolar hemiarthraoplasty for fracture neck of femur. All the patients had displaced fracture neck of femur and were in the elderly age group.Results: 20% of the patients had excellent results and 80% had good results. There was a significant incidence on the postoperative functional out come. There was a significant increase in the postoperative score by 4 grades.Conclusions: For elderly patients with fracture neck of femur cemented bipolar hemiarthroplasty gives good functional outcome, except for some difficulties in routine daily activities like sitting cross legged and squatting.

A study of body mass index and nasal mucociliary clearance in healthy South Indian adult volunteers

Background:Overweight and obesity are associated with a variety of diseases including respiratory disorders like asthma, COPD and breathing disorders which can reduce the quality of life. Nasal mucociliary clearance (NMC) is a defence mechanism of the upper airways whereby mucus secreted by the mucociliary apparatus traps inhaled particulate matter and transports it to the pharynx where it is swallowed. The nasal mucociliary epithelium is a mirror image of the bronchial mucosa and is affected by various factors. Little is known about the effect of Body Mass Index (BMI) on respiratory epithelium function. Aim of the study was to evaluate the effect of BMI on nasal mucociliary clearance.Methods: NMC was measured in 60 healthy adult volunteers of age ranging from 20 - 35 years. The time taken to experience sweet taste at posterior nasopharynx following the placement of saccharin crystal in the nostril was recorded as NMC time. The height and weight of the subjects was recorded and BMI computed.Results: Average NMC time (STTav) was 7.00 mins in the normal BMI category. However, we could not demonstrate much of a difference between this value and the mean in the overweight and obese categories, which were 7.16 and 5.81minutes respectively. Consistently, we observed faster clearance in the obese category compared to the normal and overweight, though the difference was not found to be statistically significant.Conclusions: Our study did not demonstrate appreciable increase in NMC time among the overweight and obese compared to the normal BMI group.

Luciferase reporter phage phAE85 for rapid detection of rifampicin resistance in clinical isolates of Mycobacterium tuberculosis

AbstractObjectiveTo evaluate luciferase reporter phage (LRP) phAE85 in rapid detection of rifampicin resistance in a region where TB is endemic.MethodsOne hundred and ninety primary isolates on Lowenstein-Jensen medium were tested. Middlebrook 7H9 complete medium with and without rifampicin at 2 μg/mL was inoculated with standard inoculum from suspensions of the clinical isolate. After incubation for 72 h, LRP was added. Following 4 h of further incubation, light output from both control and test was measured as relative light units. Strains exhibiting a reduction of less than 50% relative light units in the drug containing vial compared to control were classified as resistant. Results were compared with the conventional minimum inhibitory concentration method (MIC) of drug susceptibility testing.ResultsThe two methods showed high level of agreement of 97% (CI 0.94, 0.99) and P value was 0.000 1. The sensitivity and specificity of LRP assay for detection of rifampicin resistance were 91% (CI 0.75, 0.98) and 99% (CI 0.95, 1.00) respectively. Time to detection of resistance by LRP assay was 3 d in comparison with 28 d by the minimum inhibitory concentration method.ConclusionsLRP assay with phAE85 is 99% specific, 91% sensitive and is highly reproducible. Thus the assay offers a simple procedure for drug sensitivity testing, within the scope of semi-automation

Phage lysin to control the overgrowth of normal flora in processed sputum samples for the rapid and sensitive detection of Mycobacterium tuberculosis by luciferase reporter phage assay

BACKGROUND: Phage lysin, extracted from three bacteriophages was used in place of antibiotics to control the overgrowth of normal flora in processed sputum samples leading to the sensitive detection of Mycobacterium tuberculosis using diagnostic luciferase reporter phage assay (DLRPA). METHODS: A total of 129 sputum samples were processed by modified Petroff’s method. Two Lowenstein Jensen slopes were inoculated from the processed sputum deposit thus obtained. The remaining deposits were transferred to 7 ml of Middlebrook 7H9 complete medium supplemented with phage lysin and incubated at 37°C. DLRPA was done using phAE129 at days 7, 9, 14 and 21. At the end of day 21, the samples were centrifuged and the pellets were inoculated on to 2 more LJ slopes to validate DLRPA results. RESULTS: The sensitivity and specificity of DLRPA in detecting M. tuberculosis from sputum specimens was 90% and 81% respectively compared to conventional LJ culture. The agreement between the methods was 87%. The rate of contamination for DLRPA using phage lysin was 9.3%. CONCLUSION: Phage lysin can be used to decontaminate sputum samples for the detection of M. tuberculosis by DLRPA directly from processed sputum specimens

Lytic Efficiency of Mycobacteriophages

Abstract: Mycobacteriophages D29 and TM4 are the two virulent phages widely used for the study of mycobacterial genetics. Both the phages are capable of killing Mycobacterium tuberculosis but the efficiency of these phages in killing has not been evaluated and compared. There are reports based on codon usage analysis where TM4 is predicted to be a better killing phage over D29 which corroborated with the whole genome in silico analysis. In addition a kill assay using 5 wild type virulent mycobacteriophages viz. D29, TM4, I3, Che7 and Che11 was performed to study the killing efficiency of these phages using LRP assay. Based on the results, D29 was found to infect all the 10 clinical strains of M. tuberculosis and significantly reduced RLU at 3 hours and this effect continued up to 24 hours. Thus, D29 is found to have better killing efficiency than TM4 contradicting the earlier predictions. In silico analysis of holin and lysin genes of TM4 and D29 substantiated our findings

An alternative sputum processing method using chitin for the isolation of Mycobacterium tuberculosis

An alternative bio-friendly sputum processing method is the need of the hour to augment the rate of detection of TB cases and to improve the sensitivity of rapid growth based diagnostic methods. Chitin, mucolytic in nature and present ubiquitously in animal kingdom, was found to have decontaminating activity when used for processing sputum specimens. The aim of the present study is to develop an alternative bio friendly sputum processing method using chitin. Smear microscopy was done on direct sputum samples and on the deposits obtained after processing with modified Petroff’s method as well as Chitin method. Two direct smears were made from each of the sputum samples and stained by Ziehl Neelsen and Auramine phenol (AP) method. The samples were divided in to two aliquots and processed by chitin and modified Petroff’s method. Smears were made from each of the deposits and stained by both methods. The deposits were inoculated on to two Lowenstein Jensen slopes. AP method showed a sensitivity of 95% in direct smear. Samples processed by chitin and the deposit smears stained by AP method showed a sensitivity of 80% and a specificity of 89% compared to that of modified Petroff’s method. The sensitivity of chitin culture is 87% and the specificity is 85%. Chitin–H2So4 solution took less time compared to 4% NaOH to homogenize the mucopurulent sputum specimens. Chitin–H2So4 can be used as an alternative method of sputum processing for the detection of M. tuberculosis

Isolation and comparative genomics of Mycobacterium tuberculosis isolates from cattle and their attendants in South India

Funder: UK Medical Research Council, grant Reference number (MR/N501864/1)Abstract: The major human pathogen Mycobacterium tuberculosis is rarely reported to cause disease in other animals. Cases in livestock are thought to occur through contact with infected handlers, but previous studies evaluating putative livestock-human transmission used typing techniques with limited resolution. Here, we undertook cross-sectional surveillance for tuberculosis in 271 livestock handlers and 167 cattle on three farms in Chennai, India and defined the relatedness of cultured isolates using whole genome sequencing. Humans and livestock were screened for active mycobacterial infection, and opportunistic post-mortem examination was performed on comparative intradermal test-positive cattle that died. Four cattle and 6 handlers on two farms were culture-positive for M. tuberculosis; M. bovis was not isolated. All 10 isolates (one from each case) belonged to Lineage 1. Pairwise genome comparisons of single nucleotide polymorphism (SNP) differences ranged from 1 to 600 SNPs, but 3 isolate pairs were less than 5 SNPs different. Two pairs were from handlers and the third pair were from two cattle on the same farm. The minimum pairwise SNP difference between a cattle and human isolate was >250 SNPs. Our study confirms the presence of M. tuberculosis infection in cattle in India, sequencing of which characterised relatedness between human and cattle-derived isolates