Increased yield of smear positive pulmonary TB cases by screening patients with >2 weeks cough, compared to >3 weeks and adequacy of 2 sputum smear examinations for diagnosis

Background RNTCP recommends examining three sputum smears for AFB from Chest Symptomatics (CSs) with cough of >3 weeks for diagnosis of Pulmonary TB (PTB). A previous multi-centric study from Tuberculosis Research centre (TRC) has shown that the yield of sputum positive cases can be increased if duration of cough for screening was reduced to >2 weeks. Other studies have shown that two smear examinations are adequate for diagnosis of smear positive PTB . To validate the above findings, a cross sectional multi-centric study was repeated in different settings in five geographical areas in India. Methods Three primary and secondary level health facilities with high out-patient attendance were selected from two Tuberculosis Units (TU) in each of the 15 selected districts to screen about 10,000 new adult outpatients from each state. For patients who did not volunteer history of cough, symptoms were elicited using a structured simple questionnaire. All the CSs were referred for sputum examination. Results A total of 96,787 out-patients were registered. Among them 69,209 (72%) were new adult out-patients. Using >2 weeks of cough instead of > 3 weeks as the criterion for screening, there was an overall increase of 58% in CS and 23% increase in the detection of smear-positive cases. Among 211 patients, 210 were positive at least by one smear from the initial two specimens. Increase in the work-load if 2 smears were done for patients with cough of >2 weeks cough were 2 specimens (i.e.13 to 15) per day for an adult OPD of 150. Conclusion The yield of sputum positive PTB cases can be improved by screening patients with >2 weeks cough and two specimens are adequate for diagnosis

Serum E-selectin levels in Indian children and adolescents: relation to clinical and biochemical parameters.

Background: An adverse pattern of blood lipids and atherosclerosis begin in childhood. Unfortunately, data for children and adolescents, particularly those in the Indian population, are scarce. The present study aims to evaluate the levels of serum E-selectin in Indian children and adolescents and its correlation with anthropometric and biochemical parameters. Methods: The study groups included 338 school children and adolescents. There were 96 obese children, 97 overweight children and 42 children with congenital heart disease who were compared with 103 normal controls, aged 10–17 years. Serum E-selectin and serum leptin were analyzed with enzyme–linked immunosorbent assay kits. Lipid profile and fasting glucose were analyzed using an autoanalyzer. Results: Serum E-selectin levels were significantly increased in obese (65.3 ± 8.39 ng/mL) and overweight (56.01 ± 6.96 ng/mL) subjects (P < 0.001). However, these levels were lower in children with congenital heart disease (40.99 ± 6.54 ng/mL) than in controls (43.79 ± 6.71 ng/mL). Conclusion: Serum E-selectin levels showed good positive association with body mass index, waist-to-hip ratio, systolic and diastolic blood pressure, leptin, total cholesterol, triglycerides and low-density lipoprotein cholesterol and showed negative correlation with fasting glucose and no significant association with high-density lipoprotein cholesterol. These findings indicate that higher E-selectin levels can induce endothelial activation and play an essential role in the earliest stage of the atherosclerotic process in obese and overweight children. Regular camps at schools to counsel the identified overweight and obese children and to encourage physical exercise would help to reduce the risk of these children being prone to major cardiovascular anomalies in adulthood

Comparison between serum insulin levels and its resistance with biochemical, clinical and anthropometric parameters in South Indian children and adolescents

There is a rising trend in the prevalence of insulin resistance among obese, overweight children and adolescents. The serum insulin and its correlation with biochemical, clinical and anthropometric parameters were evaluated in 185 children and adolescents (59 control, 52 obese, 49 overweight, 25 congenital heart disease) of age group 10–17 years. The levels of serum insulin were measured by ELISA. Serum insulin levels were found to be significantly increased in children who were obese, overweight and had congenital heart disease, than controls. Serum insulin levels positively correlated with BMI, WHR, and serum C-peptide, serum leptin, total cholesterol, triglycerides, LDL-cholesterol, systolic and diastolic blood pressure. Fasting glucose levels were found to be negatively correlated with serum insulin levels. HDL-cholesterol levels were non-significant among the study groups. We identified nine obese children (five girls and four boys) with the features of metabolic syndrome and 69% of obese and overweight children were identified with insulin resistance. Insulin resistance was strongly associated with metabolic syndrome and its components, especially with central obesity and hypertriglyceridemia

Production, partial optimization and characterization of keratinase enzyme by Arthrobacter sp. NFH5 isolated from soil samples

Abstract The study was conducted to select the best promising keratinolytic bacterial strain. A good keratinase positive bacterium isolated from the soil samples of Hazaribagh tannery industrial zone, Dhaka was identified as Arthrobacter genus depending on the conventional techniques and confirmed as Arthrobacter sp. by sequencing 16S rRNA gene. The medium components and culture conditions were optimized to enhance keratinase production through shake flask culture. Keratin and feather powder (10 g/l or 1%) were good substrates for the highest keratinase production along with yeast extract (0.2 g/l or 0.02%) as an organic nitrogen source and potassium nitrate (1 g or 0.1%) as an inorganic nitrogen source. Maximum yield of keratinase was found after 24 h of incubation at 37 °C with an initial pH of 7.0 and inoculums volume 5% under 150 rpm when keratin, yeast extract and potassium nitrate were used as nutrient sources. Keratinase production was more than 5.0-fold increased when all optimized parameters were applied simultaneously. The optimum reaction temperature and pH were determined to be 40 °C and 8.0 respectively for crude keratinase activity. Therefore, Arthrobacter sp. NFH5 might be used for large scale production of keratinase for industrial purposes in less time

Comparison Between Serum Insulin Levels and Its Resistance With Biochemical, Clinical and Anthropometric Parameters in South Indian Children and Adolescents

There is a rising trend in the prevalence of insulin resistance among obese, overweight children and adolescents. The serum insulin and its correlation with biochemical, clinical and anthropometric parameters were evaluated in 185 children and adolescents (59 control, 52 obese, 49 overweight, 25 congenital heart disease) of age group 10–17 years. The levels of serum insulin were measured by ELISA. Serum insulin levels were found to be significantly increased in children who were obese, overweight and had congenital heart disease, than controls. Serum insulin levels positively correlated with BMI, WHR, and serum C-peptide, serum leptin, total cholesterol, triglycerides, LDL-cholesterol, systolic and diastolic blood pressure. Fasting glucose levels were found to be negatively correlated with serum insulin levels. HDL-cholesterol levels were non-significant among the study groups. We identified nine obese children (five girls and four boys) with the features of metabolic syndrome and 69% of obese and overweight children were identified with insulin resistance. Insulin resistance was strongly associated with metabolic syndrome and its components, especially with central obesity and hypertriglyceridemia