A Comparison of the Results of Bacteriological Examination of a Sputum Collection and a Pair of Laryngeal Swab Specimens in Patients Receiving Chemotherapy for Pulmonary Tuberculosis

pulmonary tuberculosis is of prime importance. The most valuable assessment of a treatment is its effect on the bacterial population of the sputum. A reduction in the number of organisms being excreted, or their complete elimination, is the best evidence that the patient is responding to treatment, and bacteriological negativity is the crucial desideratum of the quiescence of the disease (American Trudeau Society, 1959; Devadatta et al., 1961). In a previous report from this Centre (Andrews and Radhakrishna, 1959) a comparison was made of the results of smear and culture examinations of specimens of sputum obtained in 2 different ways from patients receiving chemotherapy. It was found that “spot” specimens, that is, specimens produced in the Centre within the course of a few minutes were less frequently positive than “collection” specimens, that is, specimens produced overnight in the home. During treatment and usually within a few months of the start of effective chemotherapy, the majority of patients find it difficult to expectorate and it, therefore, becomes of interest to study the relative usefulness of collection specimens of sputum and laryngeal swabs in detecting the presence of tubercle bacilli. This report presents the results of a comparison of an overnight collection specimen of sputum (referred to as sputum specimen in the rest of the report) with a pair of laryngeal swabs (considered as a single specimen in the laboratory) taken from patients during the third to twelfth month of anti-tuberculosis chemotherapy

The Susceptibility to Hydrogen Peroxide of Indian and British Isoniazid-Sensitive and Isoniazid- Resistant Tubercle Bacilli

The present work describes an attempt to modify the method of Kreis and Le Joubioux (1957a) so that it would accurately estimate the relative proportions of catalase-positive and catalase-negative organisms in strains containing mixtures of the two types. A bactericidal test was chosen in preference to a bacteriostatic test, since it is difficult to obtain quantitative measurement with the latter technique. In performing a bactericidal test residual peroxide must be inactivated or removed by dilution so that it does not inhibit the growth of surviving organisms. Knox, Meadow and Worssam (1956) removed peroxide by centrifugation and washing, but this method was considered impracticable if this test were to be used on a large scale, and likely to produce inaccurate counts on the surviving organisms. In the present work the method of removal of peroxide was studied as well as the determination of the optimal peroxide concentration and period of exposure which would kill all catalase-negative organisms, but would leave catalase-positive organisms unaffected. In addition, the method of Kreis & Le Joubioux (1957a) was modified by reducing the inoculum of organisms exposed to peroxide so that catalase-positive bacilli would not be able to destroy peroxide during the test itself. The standardised bactericidal test was then employed in comparing the susceptibility to peroxide of isoniazid-sensitive strains from British and Indian patients, and in investigating the relationship between the peroxide susceptibility and the catalase activity of their isoniazid-resistant mutant strains

A simple paper test for isoniazid in urine

Tests for the presence of chemotherapeutic drugs or their metabolites in urine play an important part in the management of the treatment of tuberculosis (Dixon et al., 1957; Fox, 1958). A previous report from this Centre (Gangadharam et al., 1958) presented a comparison of a number of methods for detecting isoniazid in urine including the direct naphthoquinone-mercuric chloride (N-M) test (Short and Case, 1957), and also a modification of this test which employed alkaline hydrolysis to liberate isoniazid from its conjugated forms. The direct-and hydrolysis N-M tests have been employed in this Centre for the past four years to control the self-administration of isoniazid used in the domiciliary treatment of pulmonary tuberculosis. The effect of irregularity in taking isoniazid as detected by these tests on the response to treatment has been reported elsewhere (Tuberculosis Chemotherapy Centre, 1960). Since this method has the disadvantage that it requires a certain amount of equipment and trained personnel, it is not suitable for routine use in all chest clinics or under field conditions. An attempt was therefore made in this Centre to simplify the direct N-M test by incorporating the reagents in absorbent papers; Though impregnation of the paper with the pHl0 buffer and naphthoquinone reagent was successful, impregnation with the aqueous solution of the mercuric chloride was unsatisfactory. In 1960, Cattaneo, Fantoli and Belasio published details of a paper test modification of the N-M test in which this difficulty was overcome by impregnating absorbent papers with a solution of mercuric chloride in ether. Since then this modification has been adopted for the preparation of the test-paper developed in this Centre. Since a lower concentration of the naphthoquinone reagent and a shorter period of exposure was used in the preparation of the testpaper developed in this Centre than described by Cattaneo et al. (1960), both the paper tests have been compared with the direct and combined N-M tests described previously (Gangadharam et al., 1958). This paper presents the results of the comparison and of an of the specificity of the paper test

Identification of Tubercle Bacilli from Indian Patients with Pulmonary Tuberculosis

Pretreatment cultures of bacilli from Indian patients with active pulmonary tuberculosis admitted to a controlled domiciliary chemotherapy study by the Tuberculosis Chemotherapy Centre, Madras, were subjected to a series of in vitro tests designed to identify the bacilli as human or bovine tubercle bacilli, or as anonymous mycobacteria. For the purposes of comparison, pretreatment cultures from British patients with pulmonary tuberculosis were examined by the same series of identification tests. Cultures identifiable as mammalian tubercle bacilli were obtained from all the 341 Indian patients admitted to the chemotherapy study. Tests for niacin production were carried out on the cultures from 277 of these patients ; all gave positive results, indicating that the bacilli in question were Mycobacterium tuberculosis var. hominis. The culture from the Indian patients yielded results similar to those of the cultures from the British patients in all the in vitro tests except the thiacetazone-sensitivity test. In this test the Indian cultures differed from the British cultures, being on the average less sensitive and showing greater variation in sensitivity among themselves

Design of e-shoe for Visually Impaired by Using RFID Technology

It is a known fact that blind people find it extremely difficult to detect their way through obstacles and stairs. Using a white stick to detect the obstacles had been an age old method, which cannot provide complete solution. In order to overcome this problem, an obstacle detecting shoe is developed. It senses the obstacle through ultrasonic sensors and alerts the user through the message. The ultrasonic waves transmitted are reflected by the obstacles and echo is received by the ultrasonic receiver, where the distance is calculated by using a microprocessor. The RFID system is used to assist the blind people. When the reader located on the shoe moves on to a specific tag, unique tag ID is sent to the reader. While in the case of walking in traffic, RF Link Transmitter/receiver is used for traffic signal detection and for passing instructions to the user through voice messages. A timer is used to detect the wet areas and helps the blind to avoid slippery.       

The Virulence in the Guinea-pig of Tubercle Bacilli Isolated before Treatment from South Indian Patients with Pulmonary Tuberculosis: 1. Homogeneity of the Investigation and a Critique of the Virulence Test

A series of studies on the virulence in the guinea-pig of tubercle bacilli isolated before treatment from Indian tuberculous patients admitted to a controlled comparison of different regimens of domiciliary chemotherapy has recently been undertaken by the Tuberculosis Chemotherapy Centre, Madras. The main object of these studies was to determine whether the differences in virulence of the tubercle bacilli obtained from Indian patients before the start of chemotherapy were related to the severtiy or type of the patients’ disease at that time and to the subsequent response to treatment. Before these relationships could be‘ investigated, however, it was necessary to find out whether the results of the virulence tests, which were carried out over a period of two-and-a-half years at the Centre and at the Microbiological Research Establishment, Porton, England, could be considered as a unified whole-that, is, as if they had all been done on the same day in the same laboratory. A proportion of the cultures was stored at – 20°C for 44-78 weeks, but this did not affect their virulence. Inter-experimental variation was found to be small in the Porton series of tests and undetectable in the Madras series, and the results in the latter series could be successfully adjusted to those in the former by allowing for differences in the means and standard deviations of the distributions for the two series. The measure of virulence used was found to be reasonably acceptable for the analysis of variance technique. Suggestions are made as to ways of improving the efficiency of the experimental design in future studies

The Virulence in the Guinea-pig of Tubercle Bacilli Isolated before Treatment from South Indian Patients with Pulmonary Tuberculosis 3. Virulence related to Pretreatment Status of Disease and to Response to Chemotherapy

This is the last of a series of three reports from the Tuberculosis Chemotherapy Centre Madras, on a study undertaken with the object of finding out whether differences in the virulence in the guinea-pig of tubercle bacilli isolated from South Indian tuberculous patients before the start of chemotherapy are related to the severity of the patients’ disease on admission to treatment and to the subsequent response to chemotherapy. The 281 patients in this study were drawn from the patients admitted to a l-year comparison of four domiciliary chemotherapeutic regimens : (a) 3.9-5.5 mg/kg isoniazid plus 0.2-0.3 g/kg sodium PAS daily, divided into two doses (PH series) ; (b) 7.8-9.6 mg/kg isoniazid alone daily in one dose (HI-I series) ; (c) 7.8-9.6 mg/kg isoniazid alone daily, divided into two doses (HI-2 series) ; (d) 3.9-5.5 mg/kg isoniazid alone daily, divided into two doses (H series). No evidence was found of an association between the virulence of the organisms and any pretreatment condition of known prognostic importance. There was no association between pretreatment virulence and progress during treatment in the PH series (the most effective regimen). In the other series, however, the progress was more satisfactory in patients infected with organisms of low virulence than in those infected with organisms of high virulence, the association between virulence and progress attaining statistical significance in the combined HI-2 and H series (the least effective regimens) and only just failing to do so in the smaller HI-1 series. Possible explanations are put forward both for the absence of an association between virulence and severity of disease on admission and for the presence of an association between virulence and response in the patients treated with isoniazid alone

The cell polarity regulator hScrib controls ERK activation through a KIM site-dependent interaction

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Metabolic Impact of Adult-Onset, Isolated, Growth Hormone Deficiency (AOiGHD) Due to Destruction of Pituitary Somatotropes

Growth hormone (GH) inhibits fat accumulation and promotes protein accretion, therefore the fall in GH observed with weight gain and normal aging may contribute to metabolic dysfunction. To directly test this hypothesis a novel mouse model of adult onset-isolated GH deficiency (AOiGHD) was generated by cross breeding rat GH promoter-driven Cre recombinase mice (Cre) with inducible diphtheria toxin receptor mice (iDTR) and treating adult Cre+/−,iDTR+/− offspring with DT to selectively destroy the somatotrope population of the anterior pituitary gland, leading to a reduction in circulating GH and IGF-I levels. DT-treated Cre−/−,iDTR+/− mice were used as GH-intact controls. AOiGHD improved whole body insulin sensitivity in both low-fat and high-fat fed mice. Consistent with improved insulin sensitivity, indirect calorimetry revealed AOiGHD mice preferentially utilized carbohydrates for energy metabolism, as compared to GH-intact controls. In high-fat, but not low-fat fed AOiGHD mice, fat mass increased, hepatic lipids decreased and glucose clearance and insulin output were impaired. These results suggest the age-related decline in GH helps to preserve systemic insulin sensitivity, and in the context of moderate caloric intake, prevents the deterioration in metabolic function. However, in the context of excess caloric intake, low GH leads to impaired insulin output, and thereby could contribute to the development of diabetes