An in vitro system to study drug sensitivity of Mycobacterium leprae using infected human tissue

A reliable screening technique for assessing the sensitivity of Mycobacterium leprae to drugs has been developed. The method is based on the susceptibility or otherwise of M. leprae- infected tissues from lepromatous leprosy patients to the action of diaminodiphenyl sulphone (dapsone) or rifampicin on the incorporation of [14C]-acetate into lipids. The extent of inhibition or lack of inhibition correlated very well with the drug sensitivity or resistance of the bacteria isolated from the patients to the above drugs. A similar trend was observed when the incorporation into individual fractions of neutral lipids was measured. There was no incorporation by heat-killed tissues. This method correlates well with the 3,4-dihydroxyphenylalanine uptake studies

Early surgical results with intent to treat by radical retropubic prostatectomy for clinically localized prostate cancer

Aims: To evaluate the early cancer control rates, morbidity and mortality in men undergoing radical retropubic prostatectomy (RRP) for clinicallylocalized adenocarcinoma prostate.Methods: Patient\u27s characteristics, operative data, progressive-free survival rates, morbidity and mortality were analyzed for 23 men with clinical T1-2 prostate cancer who underwent surgery with an intent to treat by RRP between December 1997 to July 2001.Results: Patient\u27s mean age was 63 +/- 6.2 years (range 51 to 76 years) with American Society of Anesthesiology (ASA) status I in 4%, II in 65% and III in 31%. Two third of the patients had lower urinary tract obstructive symptoms, followed by hematuria (9%) and back pain (4%). Clinical stages were T1b in 4%, T1c in 9%, T2a in 17%, T2b in 22% and T2c in 48% of the patients. Mean pre-operative serum prostate specific antigen (PSA) was 25 +/- 29 ng/ml (1.1 to 99.3). Bilateral pelvic lymphnode disection(PLND) and RRP was performed in 20 cases (nerve-sparing RRP 5 cases). In 3 cases with gross lymph node metastasis at frozen section, only bilateral orchidectomy was done. The mean operative time was 270 +/- 65 minutes and mean blood loss was 1097 +/- 654 mls. Packed cell transfusions were nil in 26%, 1-2 units in 44%, 3-4 units in 26% and 5 units in 4% of the patients who underwent RRP. The mean length of hospital stay was 10.2 +/- 1 days. Out of 20 patients who underwent RRP, 65% of tumors were confined to the specimen, 20% had seminal vesicle invasion and 15% had nodal metastasis. There was no peri-operative mortality while 2 patients developed epididymo-orchitis and 1 had myocardial ischemia (without infarction). Overall 87% of the patients were fully continent and 13% had mild to moderate stress urinary incontinence. The mean time of return of continence was 11.5 +/- 11.6 weeks. Two of the 3 patients (66%) with follow up information and having undergone nerve-sparing RRP are potent. At a mean follow up of 19.4 +/- 13 months (range 3-45 months), 20 of 23 total patients (87%) and 17 of 20 RRP patients (85%) remained free of disease recurrence with PSA \u3c or = 0.4 ng/ml. Conclusion: Our early results confirm the excellent potential for cancer control and low morbidity of radical prostatectomy for men with localizedprostate cancer. These results are in conformity with the vast Western experience. Long-term results will be provided

The prevalence of silent kidney stones: An ultrasonographic screening study

Objective: Silent and not yet discovered stones of the upper urinary tract are potentially dangerous, since in due course they may cause infection, obstruction and renal damage. The aim of this study was to determine the prevalence of such silent kidney stones in a representative Pakistani population of Karachi. Subjects and Methods: We studied 201 consecutive subjects at our hospital who underwent additional kidney screening whilst undergoing abdominal ultrasound. All these subjects did not have a history or symptoms of urolithiasis. Results: We found silent kidney stones in 3% of subjects. All stone bearers were males. Most stones were in the left kidney. Notably, multiple stones and stones of a considerable size went unnoticed. Conclusion: In addition to the usual figures of incidence and prevalence of stone disease drawn from patient data, there is a prevalence of 3% silent stones that may only be discovered incidentally or by screening. This is true for a “stone country” like Pakistan. Figures for other regions have yet to be determined. Due to socioeconomic reasons, we believe that a general kidney screening for urolithiasis is, however, not indicated, at least in our countr

Molecular characterization of Indian potato (Solanum tuberosum L.) varieties for cold-induced sweetening using SSR markers

Cold-induced sweetening developed during storage of potatoes (Solanum tuberosum L.) at low temperature is a crucial factor influencing the processing quality of potato tubers and remains one of the principal concerns of potato processing industry. Developing CIS-resistant genotypes is the most effective method to cope with this stress. In this study, the genetic diversity of 11 Indian potato varieties with different reactions to CIS was assessed using 10 SSR primers. The primers detected a total of 42 alleles arranged in 44 different configurations, among which 37 alleles (88%) were polymorphic. The polymorphic information content (PIC) value of the SSR locus ranged from 0.473 to 0.787 thus indicating a high utility of these markers for study of genetic diversity in potato. A number of polymorphic fragments appeared to be specific to a given sugar-forming group. Primer Sti007 generated one fragment Sti007131bp present only in all the high sugar-forming varieties. The dendrogram derived from Dice’s similarity coefficients among the 11 varieties could partially but efficiently differentiate close parents and sugar-forming groups among the varieties. These findings demonstrate the effectiveness of SSR markers to assess the genetic variation among potato cultivars in order to develop molecular markers associated with CIS to improve potato breeding programs

Evidence-Based Guideline on Laparoscopy in Pregnancy: Commissioned by the British Society for Gynaecological Endoscopy (BSGE) Endorsed by the Royal College of Obstetricians & Gynaecologists (RCOG).

Laparoscopy is widely utilised to diagnose and treat acute and chronic, gynaecological and general surgical conditions. It has only been in recent years that laparoscopy has become an acceptable surgical alternative to open surgery in pregnancy. To date there is little clinical guidance pertaining to laparoscopic surgery in pregnancy. This is why the BSGE commissioned this guideline. MEDLINE, EMBASE, CINAHL and the Cochrane library were searched up to February 2017 and evidence was collated and graded following the NICE-approved process. The conditions included in this guideline are laparoscopic management of acute appendicitis, acute gall bladder disease and symptomatic benign adnexal tumours in pregnancy. The intended audience for this guideline is obstetricians and gynaecologists in secondary and tertiary care, general surgeons and anaesthetists. However, only laparoscopists who have adequate laparoscopic skills and who perform complex laparoscopic surgery regularly should undertake laparoscopy in pregnant women, since much of the evidence stems from specialised centres

Autonomic nervous system dysfunction predicts poor prognosis in patients with mild to moderate tetanus

BACKGROUND: Autonomic nervous system (ANS) dysfunction is present in up to one third of patients with tetanus. The prognostic value of ANS dysfunction is known in severe tetanus but its value is not well established in mild to moderate tetanus. METHODS: Medical records of all patients admitted with tetanus at two academic tertiary care centers in Karachi, Pakistan were reviewed. The demographic, clinical and laboratory data was recorded and analyzed. ANS dysfunction was defined as presence of labile or persistent hypertension or hypotension and sinus tachycardia, tachyarrythmia or bradycardia on EKG. Patients were divided into two groups based on presence of ANS dysfunction (ANS group and non ANS group). Tetanus severity was classified on the basis of Ablett criteria. RESULTS: Ninety six (64 males; 32 females) patients were admitted with the diagnosis over a period of 10 years. ANS group had 31 (32%) patients while non ANS group comprised of 65 (68%) patients. Both groups matched for age, gender, symptom severity, use of tetanus immunoglobulin and antibiotics. Twelve patients in ANS group had mild to moderate tetanus (Ablett I and II) and 19 patients had severe/very severe tetanus (Ablett III and IV). Fifteen (50%) patients in ANS group required ventilation as compared to 28 (45%) in non-ANS group (p = 0.09). Fourteen (47%) patients died in ANS group as compared to 10 (15%) in non ANS group (p= 0.002). Out of those 14 patients died in ANS group, six patients had mild to moderate tetanus and eight patients had severe/ very severe tetanus. Major cause of death was cardiac arrhythmias (13/14; 93%) in ANS group and respiratory arrest (7/10; 70%) in non ANS group. Ten (33%) patients had complete recovery in ANS group while in non ANS group 35(48%) patients had complete recovery (p= 0.05). CONCLUSIONS: ANS dysfunction was present in one third of our tetanus population. 40% patients with ANS dysfunction had only mild to moderate tetanus. ANS dysfunction, irrespective of the need of mechanical ventilation or severity of tetanus, predicted poor outcome

Diagnosis of latent tuberculosis infection among HIV discordant partners using interferon gamma release assays

<p>Abstract</p> <p>Background</p> <p>There is limited data on the effect of HIV status and CD4 counts on performance of Interferon-<b>g </b>Release assays (IGRAs) for diagnosis of latent tuberculosis infection (LTBI).</p> <p>Methods</p> <p>A cross sectional study was conducted to assess the prevalence of and risk factors for a positive diagnostic test for LTBI, using tuberculin skin test (TST) and IGRAs among HIV-discordant couples in Zambia.</p> <p>Results</p> <p>A total of 596 subjects (298 couples) were enrolled. Median CD4 count among HIV positive persons was 388 cells/μl, (range 51-1330). HIV negative persons were more likely than their HIV positive partner, to have a positive diagnostic test for LTBI with TST (203 vs 128), QFT (171 vs 109) and TSPOT (156 vs. 109). On multivariate analysis, HIV negative status was an independent predictor for a positive QFT (OR = 2.22, 95% CI 1.42- 3.46) and TSPOT (OR = 1.79, 95% CI 1.16-2.77). Among HIV positive subjects a CD4 count ≥ 388 cells/μl was associated with a positive TST (OR = 1.76 95% CI 1.10-2.82) and QFT (OR = 1.71 95% CI 1.06-2.77) but not TSPOT (OR = 1.20 95% CI 0.74-1.94).</p> <p>Conclusions</p> <p>Persons with HIV had significantly fewer positive diagnostic tests for LTBI with TST, QFT and TSPOT. Persons with a CD4 count < 388 cells/μl were less likely to have a positive TST or QFT, but not less likely to have a positive TSPOT. TSPOT may perform better than TST or QFT in HIV positive individuals.</p

Electrical Network-Based Time-Dependent Model of Electrical Breakdown in Water

A time-dependent, two-dimensional, percolative approach to model dielectric breakdown based on a network of parallel resistor–capacitor elements having random values, has been developed. The breakdown criteria rely on a threshold electric field and on energy dissipation exceeding the heat of vaporization. By carrying out this time-dependent analysis, the development and propagation of streamers and prebreakdown dynamical evolution have been obtained directly. These model simulations also provide the streamer shape, characteristics such as streamer velocity, the prebreakdown delay time, time-dependent current, and relationship between breakdown times, and applied electric fields for a given geometry. The results agree well with experimental data and reports in literature. The time to breakdown (tbr) for a 100 μm water gap has been shown to be strong function of the applied bias, with a 15–185 ns range. It is also shown that the current is fashioned not only by dynamic changes in local resistance, but that capacitive modifications arising from vaporization and streamer development also affect the transient behavior