Adil Raza

Changing trends in prevalence of different Plasmodium species with dominance of Plasmodium falciparum malaria infection in Aligarh (India)

OBJECTIVE To determine the prevalence of malaria in Aligarh and analyze species dominance in different years over a decade. METHODS Diagnosis of malaria was done using microscopy as gold standard, rapid antigen detection assays and quantitative buffy coat (QBC) assays. Giemsa stained blood smear examination was done, thick and thin films were examined for presence of different Plasmodium spp. Rapid antigen detection assays employing detection of HRP-2 and parasite lactate dehydrogenase antigen (pLDH) by immunochromatography was done in patients whose blood smear found to be negative by conventional Giemsa slide examination. QBC was done in cases where there is strong clinical suspicion of malaria with blood smear negative, in patients with chronic malaria, splenomegaly, or in those patients who had inadequate treatment and for post-treatment follow up. RESULTS Plasmodium vivax and Plasmodium falciparum were only species detected in our hospital. Overall prevalence of malaria in Aligarh was found to be 8.8%. The maximum prevalence of 20.1% was observed in year 2008 and lowest 2.3% in 2002. CONCLUSIONS High prevalence of malaria is observed in this part of country with dominance of both species particularly Plasmodium falciparum should be monitored and factors accounting for occurrence should be studied to employ effective control measures.

Genetic Profiling of the Plasmodium falciparum Population Using Antigenic Molecular Markers

About 50% of malaria infections in India are attributed to Plasmodium falciparum but relatively little is known about the genetic structure of the parasite populations. The molecular genotyping of the parasite populations by merozoite surface protein (msp1 and msp2) and glutamate-rich protein (glurp) genes identifies the existing parasite population in the regions which help in understanding the molecular mechanisms involved in the parasites drive for survival. This study reveals the genetic profile of the parasite population in selected regions across the country with varying degree of endemicity among them. We also report the prevalence of Pfcrt mutations in this parasite population to evaluate the pattern of drug resistance development in them.

Dose-dependent effect of histamine on liver function markers in immunized rabbits

OBJECTIVE The present study was designed to delineate the hepatotoxicological roles of histamine dose-dependently in immunized rabbits. METHODS The cohort comprised of three groups (II, III and IV), containing 18 rabbits each, and received subcutaneous histamine 50 μg/kg, 100 μg/kg and 200 μg/kg, respectively for 10 days (b.i.d., starting from 3 days prior to immunization until 7 days after immunization). Group I (control, n=18) received subcutaneous sterile distilled water for 10 days. They were subsequently immunized at day 3 with intravenous injection of SRBC (1×10(9) cells/ml). Blood samples were collected on pre-immunization (pre-I) day 0, as well as on days 7-, 14-, 21-, 28- and 58-post-immunization (post-I). Biochemical parameters aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and bilirubin [total bilirubin (TB), direct bilirubin (DB) and indirect bilirubin (IB)] were determined. RESULTS Groups II and IV revealed a significant decrease (on day 0-pre-I) and a significant increase (on days 7-, 14-, 21-, 28- and 58-post-I) in ALT and AST levels, when compared with the corresponding values of groups I and III while group II showed a significant increase in ALT and AST levels as compared to group IV. ALP levels in groups II, III and IV showed a significant enhancement when compared with group I. Moreover, results of TB, DB and IB demonstrated increased levels in group III when compared with groups I, II and IV. The results were found statistically significant (p<0.05). CONCLUSION Short-term treatment of histamine produces dose-dependent differential patterns of hepatic dysfunctions suggestive mild liver degeneration warranting further long-term studies.

Superoxide dismutase activity in patients of cerebral malaria

Abstract Objective To estimate superoxide dismutase (SOD) activity in erythrocytes infected with Plasmodium falciparum in the cases of cerebral malaria. Methods The diagnosis of cerebral malaria was made clinically and by Giemsa stained peripheral blood smear examination, quantitative buffy coat (QBC) examination and rapid antigen detection test (RDT). Parasitemia per micro litre of blood was evaluated by counting 200 white blood corpuscles and used to calculate parasite density considering 8000 white blood corpuscles per micro litre. SOD activity was estimated by the method given by Joe M. McCord and Irwin Fridovich spectrophotometrically. Statistical analysis was performed by using SPSS software version 17. Results The SOD activity in the cases was found to be (1.06 ± 0.50) nmol/mL and that in the controls was (3.55 ± 0.07) nmol/mL. The SOD activity in the cases was significantly decreased (P Conclusions There is severe oxidative stress in falciparum malaria due to reactive oxygen species and supplementation of antioxidants may modify the course and outcome of the disease.

Emergence of coryneforms in osteomyelitis and orthopaedic surgical site infections.

BACKGROUND Coryneform species other than Corynebacterium diphtheriae are coming up as important pathogens with the potential to cause serious and life-threatening infections not only in immunocompromised but in immunocompetent individuals as well. The exact infectious potential of these bacteria and their rational antimicrobial treatment is a challenging but essential task. METHOD The study was conducted in the Department of Microbiology and the Department of Orthopaedics, JNMCH, AMU, Aligarh between August 2007 and May 2009. Pus samples were collected from patients of osteomyelitis and other bone infections including orthopaedic surgical site infections. The Corynebacterium species isolated in the study was identified using standard microbiological techniques and antimicrobial sensitivity testing was done by Kirby bauer disc diffusion method. RESULTS A total of 312 Corynebacterium species were isolated. The majority of the coryneforms were isolated from the immunocompetent patients 270 (86.54%). C. jeikium was the most common coryneform isolated. Nearly half of the patients 153 (49.04%) had acute infection caused by Corynebacterium species after orthopaedic surgery, a quarter 66 (21.15%) had chronic infection and 72 (23.08%) patients had device-related infection. Coryneforms exhibited maximum resistance to aminoglycosides (58.65%) and P-lactams (penicillin group- 57.55%. C.jeikium was found to be the most resistant amongst all the Corynebacterium species. CONCLUSION The study highlights the fact that the coryneforms are no longer just opportunistic pathogens but they are also becoming important pathogens among immunocompetent individuals as well. The emergence of drug resistance amongst these isolates is of most concern. More studies should be done on identification and on antimicrobial susceptibility of these organisms for the proper treatment of patients with such infections.

In vitro drug susceptibility pattern of Mycobacterium tuberculosis in CAT I and CAT II pulmonary tuberculosis patients in Aligarh, Uttar Pradesh, India

Abstract Objective To evaluate in vitro resistance pattern of the first line anti-tubercular drugs in new and previously treated cases of pulmonary tuberculosis patients in Aligarh region. Methods This study was carried out involving 975 suspected tuberculosis patients. All the specimens of patients were subjected to Ziehl-Neelsen staining, cultured on Lowenstein-Jensen medium and resistance pattern was evaluated by standard proportion method. All patients diagnosed with pulmonary tuberculosis were placed in CAT I and II under Revised National Tuberculosis Control Programme guidelines. Result Out of 220 patients, 129 (58.7%) were from CAT I and 91 (41.3%) were from CAT II. Totally 44.5% were resistant to one or more than two drugs and 18.6% patients showed resistance to both isoniazid and rifampicin. The individual resistance pattern of these first line drugs were as follows: 37.7% patients were resistant to isoniazid, 22.2% to rifampicin, 8.6% to streptomycin and 10% were resistant to ethambutol. Conclusions Our findings concluded a high prevalence of in vitro drug resistance of Mycobacterium tuberculosis isolates, especially multidrug resistant tuberculosis, in both the categories. So there is an urgent need to further study the risk factors for transmission and multidrug resistant tuberculosis in these settings.

Histamine Role in Malaria

Histamine, a biogenic amine derived from the decarboxylation of amino acid histidine by an enzyme histidine decarboxylase. It involves the local immune responses as well as regulating physiological functions. As part of an immune response to foreign pathogen (including malarial parasite infection), histamine is produced by basophils and by mast cells found in nearby connective tissue. Elevation in immune mediators such as IL-1, IL-6, IL-8, TNF-α, NO and histamine have been associated with disease severity in malarial infection. Histamine releasing factor (HRF) is a peptide described in mice and humans, causes the release of histamine from basophils. HRF belongs to a class of protein called translationally controlled tumour protein (TCTP) homologs. Recently a Plasmodium falciparum TCTP is identified. This protein has a high homology to human HRF. The central nervous system signs and symptoms such as drowsiness, coma, multiple seizures, destruction of blood brain barrier etc are supposed to be due to histamine secretion in CNS during Plasmodium falciparum infection. In this chapter we will discuss the pathophysiological effects of histamine in severe malaria infection.

Histamine-Cytokine and Histamine-Antibody Network in Immune Regulation

Histamine has tremendous influence over a variety of pathophysiological processes through the activation of four receptors: H1, H2, H3 and H4 and is known to participate in allergic, inflammation, gastric acid secretion, immunomodulation and neurotransmission. In recent years, accumulating evidences have witnessed the importance of histamine-cytokine and histamine-antibody network in immunoregulation. Moreover, histamine immunobiology pertaining to histamine-receptors is elementary in the existing literature in contrast to increasing frequency of allergic diseases. In this chapter, we tried to elaborate the newer discoveries in the current field and also discussed our recent studies on the immunobiology of histamine receptors. We hope that this article would stimulate discussions and active research on this important aspect.