Nandini Duggal

Septic arthritis due to Salmonella Typhi in children—A case series

In this work, we isolated and characterized the first factor X activator from Bothropoides jararaca (= Bothrops jararaca ) venom, Bojaractivase X, which is probably involved in the genesis of the envenomation process. Bojaractivase X was purified by a combination of gel filtration and ion exchange chromatographies on Superdex HR 75 10/30 and HiTrap SP FF, respectively. Bojaractivase X consists of a single polypeptide chain with molecular mass of 28 kDa determined by SDS-PAGE. The enzyme shows maximum activity on factor X activation at pH 7.0 and 37°C. The activator converts factor X to its active form, factor X a , in the presence of Ca 2+ ions. Bojaractivase X also degrades the Aα, Bβ and γ -chain of fibrinogen molecule as well as casein. Inhibition of Bojaractivase X amidolytic activity by benzamidine suggests that it is a serine proteinase. Mass spectrometry analysis showed similarity between Bojaractivase X and a venom serine protease homolog from B. jararacussu .C. parapsilosis and C. orthopsilosis emerged as fungal pathogen with significant worldwide prevalence, particularly in causing nosocomial and skin infections. In this study, we aimed to develop molecular assay based on real-time PCR for sensitive and accurate detection of C. parapsilosis and C. orthopsilosis . A pair of primers that specifically target on both of these yeast species was designed and real-time PCR amplification assay was optimized using EvaGreen as the DNA binding dye. The optimized assay could detect and quantify up to 1 pg concentration of C. parapsilosis and C. orthopsilosis DNA with amplification efficiency of 104% and 103%, respectively. Both the designed primers and the quantitative assay will have a great potential as molecular diagnosis tool for early detection of fungal infection caused by either C. parapsilosis or C. orthopsilosis , which merits future clinical study prior to use in diagnosis.Sirenomelia or the “mermaid syndrome” is a rare entity. Malformations of almost every system have been reported in sirenomelia and it is invariably incompatible with survival; most babies are stillborn, or die shortly after birth. Isolated levocardia is an extremely rare condition in which the heart is located in the normal position while abdominal viscera are inverted .We report a case of symelia unipus having situs inversus of abdominal viscera with isolated levocardia, a ventricular septal defect, bilateral genitourinary agenesis and thoracic vertebral defects.[Abstract] Objective To explore the expression of IL-27, Th17 cells and their related cytokines IL- 17 in peripheral blood of patients with allergic rhinitis (allergic rhinitis, AR). Method 18 Cases of allergic rhinitis patients (10 males, 8 females) whose allergen was dust mite were collected from April to June 2012 as the AR group, and 10 cases of healthy volunteers (4 males, 6 females) without allergic diseases were put into the control group. IL-27 and IL-17 levels in serum of peripheral blood of the two groups were detected by ELISA, and the percentage of Th17 cell was detected by flow cytometry. Result IL-27 levels of AR group and control group were (21.69 ± 12.62) pg / ml and (53.10 ± 12.55) pg / ml respectively, and the difference was statistically significant (P <0.01); IL-17 levels of AR group and control group were (672.82±63.45) pg / ml and (576.62±22.81) pg / ml respectively, and the difference was statistically significant (P <0.01); Th17 cell percentage of AR group was 1.76 ± 0.60%, and in the control group it was 0.59 ± 0.17%. The difference between the two groups was statistically significant (P <0. 01). IL-27 was negatively correlated to Th17 cell and IL-17 (r was -0.361 and -0.435 respectively, P <0 05). Conclusion The reduction of IL-27 level in the peripheral blood of patients with allergic rhinitis, the increase of Th17 cells percentage and IL-17 level, as well as the negative correlation of IL-27 with Th17 cell and IL-17 suggest that decline of IL-27 suppression to Th17 cell may play an important role in the pathogenesis of allergic rhinitis.

Bacteriological Profile and Antimicrobial Sensitivity Pattern in Sterile Body Fluids from a Tertiary Care Hospital

Background: Sterile body sites, if infected by micro-organisms than it can lead to severe morbidity and mortality. Therefore early diagnosis and prompt initiation of empiric treatment is necessary. Aim: This study was done to evaluate causative organisms of sterile body site infections and their antimicrobial sensitivity pattern in a tertiary care hospital, New Delhi. Settings and design: Prospective study over a period of one year from January 2015 to December 2015. Material and methods: Sterile body fluid specimens were processed for bacterial culture according to the standard procedures and antimicrobial susceptibility test for isolated organisms was done using agar disk diffusion method. Results: Amongst 405 samples, 122 fluids samples showed growth of organisms with an isolation rate of 30%. Isolates from different fluids were E. coli (28.6%), Acinetobacter spp. (27%), Klebseilla spp. (19.6%), Staphylococcus aureus (10.6%), Enterococcus spp. (7.3%), Pseudomonas spp. (4.9%) and Citrobacter spp. (1.6%). Gram negative isolates were mostly sensitive to carbepenems, colistin and polymyxin B (100%) and gram positive isolates were highly sensitive to vancomycin (100%), linezolid (100%) and ciprofloxacin (70%). Acinetobacter was the most resistant pathogens to many antibiotics. About 38.5% of S. aureus isolates in our study were MRSA. Conclusion: Therefore, knowledge of bacteriological and antimicrobial profile of sterile body fluids is important so that such life threatening infections can be treated effectively on an urgent basis.

Epidemiology of cryptococcal meningitis associated with HIV in an Indian hospital.

Cryptococcus neoformans is an emerging pathogen especially in the setting of HIV infected patients with meningitis. The infection usually manifests in patients with impaired cell mediated immunity. Forty six culture positive cases of cryptococcal meningitis were identified over a period of three years from a tertiary care institute in Delhi. The patients were predominantly males (91%) of reproductive age group, mostly residing in and around Delhi. Most significant co-infections were HIV infection in 93% and tuberculosis in 43.5% cases. All forty six strains belonged to Cryptococcus neoformans var grubii, molecular type VN I, mating type α (MAT α). There was 100% susceptibility to amphotericin B and azoles, one isolate was resistant to 5-fluorocytosine (MIC 64 μg/ml). Cerebrospinal fluid in symptomatic HIV patients should be carefully screened for Cryptococcus spp. which should be identified and also typed for epidemiological purposes.