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   2014| July  | Volume 140 | Issue 1  
    Online since September 4, 2014

 
 
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REVIEW ARTICLES
Management of newborn infant born to mother suffering from tuberculosis: Current recommendations & gaps in knowledge
Hema Mittal, Saurabhi Das, M.M.A. Faridi
July 2014, 140(1):32-39
PMID:25222775
Tuberculosis (TB) is a global disease with increase in concern with growing morbidity and mortality after drug resistance and co-infection with HIV. Mother to neonatal transmission of disease is well known. Current recommendations regarding management of newborns of mothers with tuberculosis are variable in different countries and have large gaps in the knowledge and practices. We compare and summarize here current recommendations on management of infants born to mothers with tuberculosis. Congenital tuberculosis is diagnosed by Cantwell criteria and treatment includes three or four anti-tubercular drug regimen. Prophylaxis with isoniazid (3-6 months) is recommended in neonates born to mother with TB who are infectious. Breastfeeding should be continued in these neonates and isolation is recommended only till mother is infectious, has multidrug resistant tuberculosis or non adherent to treatment. BCG vaccine is recommended at birth or after completion of prophylaxis (3-6 months) in all neonates.
  2,106 766 -
Epidemiology & social costs of haemophilia in India
Anita Kar, Supriya Phadnis, Sumedha Dharmarajan, Juhi Nakade
July 2014, 140(1):19-31
PMID:25222774
India lacks a national policy on the prevention and control of genetic disorders. Although the haemoglobinopathies have received some attention, there are scarce data on the epidemiology of other genetic disorders in India. Haemophilia, an inherited single gene disorder with an incidence of 1 per 10,000 births, manifests as spontaneous or trauma-induced haemorrhagic episodes in patients, progressing to chronic disability and premature mortality in untreated patients or patients with sub-optimal treatment. Although the genetic basis of this disorder has been well studied in India, data on the number of patients, trends of the disorder in India, social costs of the condition and opportunities and competencies for offering genetic counselling through a public health programme have not been reported. This review article summarizes the available Indian data, which show that the country harbours the second highest number of global patients with haemophilia A. The reported number of patients with haemophilia A is 11,586 while the estimated prevalence could be around 50,000 patients. This review also identifies the need to immediately initiate a national programme for haemophilia, with components of prevention, care for patients, surveillance and education and support for families.
  1,459 379 -
ORIGINAL ARTICLES
Predictors of atypical femoral fractures during long term bisphosphonate therapy: A case series & review of literature
Sanjay Kumar Bhadada, Subbiah Sridhar, Jeyaram Muthukrishnan, Ambrish Mithal, Dinesh C Sharma, Anil Bhansali, Vandana Dhiman
July 2014, 140(1):46-54
PMID:25222777
Background & objectives: Bisphosphonates (BPs) are the most widely prescribed medicines for the treatment of osteoporosis because of their efficacy and favourable safety profile. There have been, several reports on an increased incidence of atypical femoral fractures after long term treatment with BPs. The objective of this study was to evaluate the clinical presentation including prodromal symptoms, skeletal radiograph findings, type and duration of BPs received and treatment outcome of patients who developed atypical femoral fractures during bisphosphonate therapy. Methods: In this retrospective study, eight patients with atypical femoral fractures were analysed based on clinical features, biochemical and radiological investigations. Results: Of the eight patients, who sustained atypical femoral fractures, six were on alendronate and two were on zoledronate therapy before the fractures. In addition to BPs, two patients were on long term corticosteroid therapy for rheumatoid arthritis and Addison's disease. Three patients had bilateral atypical femoral fractures. Except one, all of them had prodromal symptoms prior to fracture. Skeletal radiograph showed cortical thickening, pointed (beaking of) cortical margin and transverse fracture in meta-diaphyseal location. Serum calcium, phosphate, alkaline phosphatase (ALP) and intact parathyroid hormone (iPTH) concentrations were within the reference range in all patients. Interpretation & conclusions: Long term bisphosphonate therapy may increase the risk of atypical femoral fractures. Presence of prodromal pain, thickened cortex with cortical beaking may be an early clue for predicting the atypical fractures. High risk patients need periodical skeletal survey and a close follow up for early detection of cases.
  1,289 532 -
CORRESPONDENCES
Chronic inflammatory arthritis with persisting bony erosions in patients following chikungunya infection
Itta Krishna Chaaithanya, Nagarajan Muruganandam, Uppoor Raghuraj, Attayur Purushottaman Sugunan, Reesu Rajesh, Maile Anwesh, Subhodh Kumar Rai, Paluru Vijayachari
July 2014, 140(1):142-145
PMID:25222790
  1,025 528 -
ORIGINAL ARTICLES
Mosquito larvicidal potential of four common medicinal plants of India
Anjali Rawani, Anupam Ghosh, Goutam Chandra
July 2014, 140(1):102-108
PMID:25222784
Background & objectives: Mosquitoes transmit serious human health diseases, causing millions of deaths every year. Plants may be sources of alternative mosquito control agents. The present study was carried out to assess the role of larvicidal activities of the crude extracts of four plants viz. Alternanthera sessilis L. (Amaranthaceae), Trema orientalis L. (Cannabaceae), Gardenia carinata Smith. (Rubiaceae) and Ruellia tuberosa L. (Acanthaceae) against Culex quinquefasciatus Say in laboratory bioassay. Methods: Selective concentrations (0.5, 1 and 1.5%) of crude extract of all four plant leaves were tested against I st to IV th instar larvae of Cx. quinquefasciatus. Log probit analysis (at 95% confidence level) revealed the LC 50 values. Preliminary qualitative phytochemical analyses of crude extracts were also done. The lethal concentrations (%) of crude extracts at 24 h against III rd instar larvae were also studied on non-target organisms. Result: In a 72 h bioassay experiment with crude extract, the highest mortality was recorded in 1.5 per cent extract. A. sessilis showed the highest mortality (76.7 %) at 1.5 per cent crude extract against II nd instar larvae having LC 50 value of 0.35 per cent, followed by R. tuberosa (LC 50 =1.84%), G. carinata (LC 50 = 2.11) and T. orientalis (LC 50 = 2.95%). The regression equation showed a dose-dependent mortality, as the rate of mortality (Y) was positively correlated with the concentration (X). Phytochemical analysis of the crude extract showed the presence of many bioactive phytochemicals such as steroids, alkaloids, terpenes, saponins, etc. No changes in the swimming behaviour and survivality of non-target organism were noticed at the studied concentrations. Interpretation & conclusions: Crude extract of the four selected plants showed larvicidal activity against Cx. quinquefasciatus. The extracts at the studied concentrations did not produce any harmful effect on non-target organisms.
  997 334 -
Interleukin-6 (IL-6)-597 A/G (rs1800797) & -174 G/C (rs1800795) gene polymorphisms in type 2 diabetes
Madhukar Saxena, CG Agrawal, Neena Srivastava, Monisha Banerjee
July 2014, 140(1):60-68
PMID:25222779
Background & objectives: Diabetes is a metabolic pro-inflammatory disorder characterized by chronic hyperglycaemia and increased levels of circulating cytokines suggesting a causal role for inflammation in its aetiology. In order to decipher the role of interleukin-6 (IL-6) in type 2 diabetes mellitus (T2DM) we analyzed two promoter polymorphisms -597 A/G (rs1800797) and -174 G/C (rs1800795) in T2DM cases from north India, and in healthy controls. Methods: DNA was isolated from venous blood samples of T2DM patients (n=213) and normal healthy controls (n=145). Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was performed after biochemical analysis. The genotypic and allelic frequency distributions were analyzed. Results: The clinical/biochemical parameters of T2DM cases when compared to controls showed a significant difference. No significant association was observed with -597A/G polymorphism while, -174 G/C showed a highly significant association (P<0.001). In haplotypic analysis, combination of -597G*/-174C* showed significant association (P=0.010). Interpretation & conclusions: Our data suggest that IL-6 gene polymorphisms play a prominent role in T2DM disease susceptibility in population from north India.
  883 378 -
EDITORIAL
Viral hepatitis eradication in India by 2080 - gaps, challenges & targets
Manoj Kumar, Shiv K Sarin
July 2014, 140(1):1-4
PMID:25222771
  731 358 -
ORIGINAL ARTICLES
Level of suboptimal adherence to first line antiretroviral treatment & its determinants among HIV positive people in India
Beena Joshi, Sanjay Chauhan, Achhelal Pasi, Ragini Kulkarni, Nithya Sunil, Damodar Bachani, Ranjit Mankeshwar, ART adherence study group
July 2014, 140(1):84-95
PMID:25222782
Background & objectives: National Anti-retroviral treatment (ART) programme in India was launched in 2004. Since then, there has been no published country representative estimate of suboptimal adherence among people living with HIV (PLHIV) on first line ART in public settings. Hence a multicentric study was undertaken in 15 States of India to assess the level of suboptimal adherence and its determinants among PLHIV. Methods: Using a prospective observational study design, 3285 PLHIV were enrolled and followed up to six months across 30 ART centres in India. Adherence was assessed using pill count and self-reported recall method and determinants of suboptimal adherence were explored based on the responses to various issues as perceived by them. Results: Suboptimal adherence was found in 24.5 per cent PLHIV. Determinants of suboptimal adherence were illiteracy (OR-1.341, CI-1.080-1.665) , on ART for less than 6 months (OR-1.540, CI- 1.280-1.853), male gender (OR for females -0.807, CI- 0.662-0.982), tribals (OR-2.246, CI-1.134-4.447), on efavirenz (EFA) regimen (OR- 1.479, CI - 1.190 - 1.837), presence of anxiety (OR- 1.375, CI - 1.117 - 1.692), non-disclosure of HIV status to family (OR- 1.549, CI - 1.176 - 2.039), not motivated for treatment (OR- 1.389, CI - 1.093 - 1.756), neglect from friends (OR-1.368, CI-1.069-1.751), frequent change of residence (OR- 3.373, CI - 2.659 - 4.278), travel expenses (OR- 1.364, CI - 1.138-1.649), not meeting the PLHIV volunteer/community care coordinator at the ART center (OR-1.639, CI-1.330-2.019). Interpretation & conclusions: To enhance identification of PLHIV vulnerable to suboptimal adherence, the existing checklist to identify the barriers to adherence in the National ART Guidelines needs to be updated based on the study findings. Quality of comprehensive adherence support services needs to be improved coupled with vigilant monitoring of adherence measurement.
  806 278 -
COMMENTARIES
Long term bisphosphonate therapy & atypical femoral fractures: A word of caution
Sagili Vijaya Bhaskar Reddy
July 2014, 140(1):8-10
PMID:25228085
  776 255 -
ORIGINAL ARTICLES
Prevalence of systemic co-morbidities in patients with various grades of diabetic retinopathy
Pradeep Venkatesh, Sapna Tibrewal, Dipankar Bhowmik, Manjari Tripathi, Sivasubramanian Ramakrishnan, Naginder Vashist, Rajpal Vohra, Satpal Garg
July 2014, 140(1):77-83
PMID:25222781
Background & objectives : Though diabetes affects multiple organs, most studies highlight the occurence of only one complication in isolation. We conducted a hospital-based study to estimate the co-existence of significant systemic co-morbid conditions in patients with varying grades of diabetic retinopathy. Methods : A total of 170 consecutive patients with diabetic retinopathy were prospectively recruited for the study between June 2009 to June 2010 at a tertiary care eye centre in north India. Retinopathy was graded by fundus biomicroscopy and fundus photography and classified into three categories (mild-moderate nonproliferative retinopathy, proliferative retinopathy requiring only laser and proliferative retinopathy requiring surgery). Nephropathy was classified by calculating the six variable estimated glomerular filtration rate (eGFR) for all patients. Nerve conduction studies and clinical assessment were used to determine presence of neuropathy. Co-existence of macrovascular disease and peripheral vascular disease was also ascertained. Results : The percentages of patients with overt nephropathy in the three groups were 19.2, 38.0 and 41.2, respectively. Significant linear trends were observed for serum creatinine (P=0.004), albumin (P=0.017) and eGFR (P=0.030). A higher per cent had abnormal nerve conduction on electrophysiology than that diagnosed clinically (65.4 vs. 44.2, 76.0 vs. 40.0 and 64.8 vs. 48.6, respectively). The odds ratio (95% CI) for co-existence of nephropathy, neuropathy, CVA (cerebrovascular accidents) and PVD (peripheral vascular disease) was 2.9, 0.9, 4.8 and 3.5, respectively. Independent of retinopathy severity, patients with clinically significant macular oedema (CSME) had a higher percentage of nephropathy ( p0 < 0.005). Interpretation & conclusions : The co-existence of overt nephropathy, nerve conduction based neuropathy and macrovascular co-morbidity in patients with early grades of diabetic retinopathy was significant. Screening for overt nephropathy by eGFR should be considered in all patients with clinically significant macular oedema.
  699 330 -
Grass pea consumption & present scenario of neurolathyrism in Maharashtra State of India
Arjun L Khandare, JJ Babu, M Ankulu, N Aparna, Amol Shirfule, G Shankar Rao
July 2014, 140(1):96-101
PMID:25222783
Background & objectives: Neurolathyrism is a non progressive motor neuron disorder engendered by the prolonged over-consumption of Lathyrus sativus (grass pea) seeds which contain a neurotoxic amino acid, β-N oxalyl- L-α, β-diaminopropionic acid (β-ODAP). It is characterized by spastic paraparesis in the hind limbs. The present study was conducted in 105 households (HHs) of Gondia district in Maharashtra, India, where grass pea is cultivated and consumed to assess the health implication of its consumption. Methods: Across-sectional survey was carried out in 105 HHS in five villages and grass pea samples were collected for β-ODAP estimation. Amino acid analysis was also done, neurolathyrism cases were identified by snowball sampling method and neurological examination was carried out. Results: The study revealed that 61 per cent of population was consuming this pulse as a part of diet. β-ODAP concentration in grass pea was high in Bora village (1254.5 ± 528.21 mg %) and less in Malgaon village (413.6±415.79 mg %). The nutritional status of the people was within the normal range (BMI 18± 3.40 kg/m [2] in the surveyed households. Consumption of grass pea was observed to be less than 25g. Conclusions: The cases of neurolathyrism declined in all the studied villages due to reduced β-ODAP exposure through Lathyrus sativus consumption, however, the grass pea was cultivated and consumed in Gondia district of Maharashtra State.
  784 242 -
Drug resistance of Mycobacterium tuberculosis isolates from tuberculosis lymphadenitis patients in Ethiopia
Fantahun Biadglegne, Belay Tessema, Ulrich Sack, Arne C Rodloff
July 2014, 140(1):116-122
PMID:25222786
Background & objectives: The emergence of drug resistance tuberculosis (TB) is a significant challenge for TB control and prevention programmes, and the major problem is multidrug resistant tuberculosis (MDR-TB). The present study was carried out to determine the frequency of drug resistant Mycobacterium tuberculosis isolates among newly and retreated TB lymphadenitis patients and risk factors for acquiring this infection. Methods: Two hundred twenty five M. tuberculosis isolates from TB lymphadenitis patients who were diagnosed as new and retreated tuberculosis cases between April 2012 and May 2012 were included in this study. Isolates were tested for susceptibility to isoniazed (INH), rifampicin (RMP), streptomycin (SM), ethambutol (EMB) and pyrazinamide (PZA) using the BacT/AlerT 3D system protocol. Results: Among 225 isolates, 15 (6.7%) were resistant to at least one first line anti-TB drug. Three (1.3%) were MDR-TB. Resistance to INH, RMP, SM, and EMB was found in 8 (3.6%), 4 (1.8%), 10 (4.4%), and 4 (1.8%) isolates, respectively. Of the 212 new TB lymphadenitis cases three (1.4%) were MDR-TB. A rifampicin resistant M. tuberculosis isolate was diagnosed from smear and culture negative newly treated cases. All isolates were susceptible to PZA. Matted cervical lymph nodes were the prominent sites involved. Newly treated TB lymphadenitis patients had a greater risk for presenting resistance to anti-TB drugs ( p =0.046). Interpretation & conclusions: Our study showed that TB lymphadenitis patients harboured drug resistant TB and MDR-TB, although at a low rate. Resistance was not associated with age, sex, patients' education and contact history. Further research is required to determine transmission dynamics of drug resistant strains.
  667 339 -
Mortality profile of patients with traumatic spinal injuries at a level I trauma care centre in India
S Lalwani, V Singh, V Trikha, V Sharma, S Kumar, R Bagla, D Aggarwal, MC Misra
July 2014, 140(1):40-45
PMID:25222776
Background & objectives: There is no national spinal trauma registry available in India at present and the research on epidemiology of these injuries is also very limited. The purpose of this study was to describe the mortality profile of patients with spinal injuries brought to a level I trauma centre in India, and to understand the predictive factors which identify patients at an increased risk of spinal trauma mortality. Methods: Retrospective data were collected from computerized patients records and autopsy reports maintained in the department of Forensic Medicine. All the cases with spinal injuries whether in isolation or as a part of polytrauma were reviewed. A total of 341 such cases were identified between January 2008 to December 2011. The demographic data, type of trauma, duration of survival, body areas involved, level of spinal injury and associated injuries if any, were recorded. Results: There were 288 (84.45%) males and 53 (15.55%) females. Most victims (73%) were between 25 and 64 yr of age, followed by young adults between 16 and 24 yr (19.35%). Male: female ratio was 5.4:1. Fifty five per cent cases had spinal injuries in isolation. Injury to the cervical spine occurred in 259 (75.95%) patients, thoracic spine in 56 (16.42%) and thoraco-lumbar spine in 26 (7.62%) patients. The commonest cause of injury was high energy falls (44.28%), followed by road traffic accidents (41.93%). The majority of deaths (51.6%) occurred in the phase IV (secondary to tertiary complications of trauma, i.e. >1 wk). Forty patients died in phase I (brought dead or surviving <3 h), 55 in phase II (>3 to 24 h) and 70 in phase III (> 24 h to 7 days). Interpretation & conclusions: Our data suggest that there is an urgent need to take steps to prevent major injuries, strengthen the pre-hospital care, transportation network, treatment in specialized trauma care units and to improve injury surveillance and the quality of data collected which can guide prevention efforts to avoid loss of young active lives.
  631 307 -
PERSPECTIVE
Diabetic oncopathy - One more yet another deadly diabetic complication!
M Balasubramanyam
July 2014, 140(1):15-18
PMID:25222773
  664 263 -
ORIGINAL ARTICLES
Expression of galectin-3 in gastric adenocarcinoma
Thiago Simão Gomes, Celina Tizuko Fujiyama Oshima, Nora Manoukian Forones, Flávio De Oliveira Lima, Daniel Araki Ribeiro
July 2014, 140(1):69-76
PMID:25222780
Background & objectives: Galectin-3 a member of the galectin family is an endogenous β-galactoside binding lectin. It has been found to be associated with cell adhesion, recognition, proliferation, differentiation, immunomodulation, angiogenesis, apoptosis and can be a reliable marker for cancer aggressiveness. The aim of this study was to verify protein expression in gastric adenocarcinoma tissues and correlate the results with the clinical aspects in the study population. Methods: Galectin-3 expression was examined by immunohistochemistry in 57 samples of gastric adenocarcinomas tissues. Galectin-3 protein expression was observed in the cytoplasm and the nucleus of examined tissues. Results: Thirty one (54.4%) samples had strong or moderate staining and 26 (45.6%) tumours had negative or weak staining. The galectin-3 did not show association with the sex ( p =0.347), age ( p =0.999), Lauren's classification ( p =0.731) and TNM stage ( p =0.222). Regarding the TNM stage, 66.7 per cent of stage I tumours had strong or moderate staining; with tumours stage IV this percentage was 33.3 per cent. Interpretation & conclusion: Our results suggest that gal-3 is not a reliable biomarker for prognosis of the gastric adenocarcinoma by immunohistochemistry. Further studies need to be done on a large sample of tumour tissues in different clinical staging.
  629 282 -
VIEW POINT
Holobionts: emerging strategy for interventions against infectious diseases, metabolic disorders & cancer
Yadvir Singh, Seyed E Hasnain
July 2014, 140(1):11-14
PMID:25222772
  601 291 -
ORIGINAL ARTICLES
Antibacterial activity of three newly-synthesized chalcones & synergism with antibiotics against clinical isolates of methicillin-resistant Staphylococcus aureus
Dragana D Bozic, Marina Milenkovic, Branka Ivkovic, Ivana Cirkovic
July 2014, 140(1):130-137
PMID:25222788
Background & objectives: Multidrug-resistance of methicillin-resistant Staphylococcus aureus (MRSA) is a serious therapeutical problem. Chalcones belong to a group of naturally occurring flavonoids, usually found in various plant species, and have potent antibacterial, antiviral and antifungal activities. The goal of this study was to evaluate the antibacterial effect of three newly-synthesized chalcones against clinical isolates of MRSA, and their synergism with β-lactam and non- β-lactam antibiotics. Methods: Antimicrobial activity of the three newly-synthesized chalcones was tested against 19 clinical isolates of MRSA and a laboratory control strain of MRSA (ATCC 43300). The synergism with β-lactams: cefotaxime (CFX), ceftriaxone (CTX), and non-β-lactam antibiotics: ciprofloxacin (CIP), gentamicin (GEN) and trimethoprim/sulphamethoxazole (TMP-SMX) was investigated by checkerboard method. Results: All evaluated compounds showed significant anti-MRSA activity with MIC values from 25-200 μg/ml. Observed synergism with antibiotics demonstrated that chalcones significantly enhanced the efficacy of CIP, GEN and TMP-SMX. Interpretation & conclusions: o0 ur study demonstrated that three newly-synthesized chalcones exhibited significant anti-MRSA effect and synergism with non-β-lactam antibiotics. The most effective compound was 1,3-Bis-(2-hydroxy-phenyl)-propenone. Our results provide useful information for future research of possible application of chalcones in combination with conventional anti-MRSA therapy as promising new antimicrobial agents.
  579 297 -
Role of 13 C methacetin breath test for non invasive staging of liver fibrosis in patients with chronic hepatitis C
Carmen Fierbinteanu-Braticevici, Raluca Papacocea, Laura Tribus, Baicus Cristian
July 2014, 140(1):123-129
PMID:25222787
Background & objectives: The development and evaluation of non invasive tests to assess liver fibrosis have been an active field of research. The present study was carried out to evaluate the role of 13 C-methacetin breath test 13 C- MBT) as a non invasive tool for liver fibrosis staging in patients with chronic hepatitis C (CHC). Methods: 13 C-Methacetin breath test was performed in 115 patients with CHC histologically proven and in 55 healthy controls. All patients and controls underwent routine liver function tests. The CHC patients underwent histological assesment of liver by percutaneous liver biopsy. The correlation between the 13 C-methacetin breath test and liver biopsy was tested using Kendall's rank correlation coefficients. The overall validity was expressed as area under receiver operating characteristic curve (AUROC) with 95%CI. Results: Delta over baseline values (DOB) of CHC patients at 20 min were significantly reduced compared with control (16. 2 vs. 21. 06%, p <0.001). There were also significant differences between CHC patients and controls as regard the metabolization speed (dose /h at 20 min (17.80 vs 28.6, p <0.001) and metabolization capacity (cumulative recovery after 60 min (13.8 vs 20.4 p <0.001). The best 13 C-MBT parameter correlated with fibrosis was DOB at 20 min (r= - 0.596). The optimal cut-off for the diagnosis of advanced fibrosis (F ≥ 3) was 15.2 per cent, with AUROC= 0.902, 95%CI: (0.851-0.938), a sensitivity of 82 per cent and a specificity of 80 per cent. DOB at 20 min predicted even better cirrhosis: AUROC = 0.932 95 per cent CI = 0.901-0.953, a sensitivity of 96 per cent and a specificity of 92 per cent. Interpretation & conclusions: Based on our findings the 13 C - methacetin breath test appears to be a promising tool to identify CHC patients with advanced fibrosis and to replace liver biopsy. Further studies need to be done to assess its potential to be used in regular clinical practice.
  582 220 -
Molecular evaluation of a novel missense mutation & an insertional truncating mutation in SUMF1 gene
Udhaya H Kotecha, Sireesha Movva, Deepak Sharma, Jyotsna Verma, Ratna Dua Puri, Ishwar Chander Verma
July 2014, 140(1):55-59
PMID:25222778
Background & objectives: Multiple suphphatase deficiency (MSD) is an autosomal recessive disorder affecting the post translational activation of all enzymes of the sulphatase family. To date, approximately 30 different mutations have been identified in the causative gene, sulfatase modifying factor 1 (SUMF1). We describe here the mutation analysis of a case of MSD. Methods: The proband was a four year old boy with developmental delay followed by neuroregression. He had coarse facies, appendicular hypertonia, truncal ataxia and ichthyosis limited to both lower limbs. Radiographs showed dysostosis multiplex. Clinical suspicion of MSD was confirmed by enzyme analysis of four enzymes of the sulphatase group. Results: The patient was compound heterozygote for a c.451A>G (p.K151E) substitution in exon 3 and a single base insertion mutation (c.690_691 InsT) in exon 5 in the SUMF1 gene. The bioinformatic analysis of the missense mutation revealed no apparent effect on the overall structure. However, the mutated 151-amino acid residue was found to be adjacent to the substrate binding and the active site residues, thereby affecting the substrate binding and/or catalytic activity, resulting in almost complete loss of enzyme function. Conclusions: The two mutations identified in the present case were novel. This is perhaps the first report of an insertion mutation in SUMF1 causing premature truncation of the protein.
  567 235 -
COMMENTARIES
How to prevent early mortality due to spinal cord injuries? New evidence & update
Ellen Merete Hagen
July 2014, 140(1):5-7
PMID:25228084
  566 212 -
CORRESPONDENCES
Risk factors of pulmonary tuberculosis in tea garden communities of Assam, India
PK Chelleng, K Rekha Devi, Debasish Borbora, M Chetia, Avinash Saikia, Jagadish Mahanta, Kanwar Narain
July 2014, 140(1):138-141
PMID:25222789
  554 220 -
ORIGINAL ARTICLES
Dipyrone & 2,5-dimethylcelecoxib suppress Th2-related chemokine production in monocyte
Jeng-Chuan Shiang, Ren-Long Jan, Ming-Kai Tsai, Chong-Chao Hsieh, Hsuan-Fu Kuo, Chang-Hung Kuo, San-Nan Yang, Ming-Yii Huang, Li-Chen Chen, Chih-Hsing Hung
July 2014, 140(1):109-115
PMID:25222785
Background & objectives: Selective cyclooxygenase-2 (COX-2) inhibitor is a form of thnon steroidal anti-inflammatory drug (NSAID) and is commonly used in autoimmune and rheumatic diseases to control inflammation and alleviate pain. Tumour necrosis factor-alpha (TNF-α) production and an imbalance of T helper 1 (Th1)/Th2 contribute to the pathogenesis of autoimmune and also anti-tumour activity. Dipyrone is a NSAID used to treat pain worldwide. The celecoxib analogue, 2,5-dimethylcelecoxib (DMC), lacks COX-2 inhibitory activity but exhibits anti-tumour properties. However, the effects and the mechanisms of dipyrone and 2,5-dimethylcelecoxib on tumour necrosis factor (TNF)-α and Th1- and Th2-related chemokines in monocytes remain poorly defined. This study was carried out to investigate the effects of dipyrone and 2,5-dimethylcelecoxib on the expression of Th1 (IP-10) and Th2 (I-309 and MDC) and TNF-α in human monocytes and the associated intracellular mechanism. Methods: THP-1 cells and peripheral blood mononuclear cells (PBMCs) were pre-treated with dipyrone (10 -9 - 10 -4 M) and 2,5-dimethylcelecoxib (10 -9 - 10 -5 M) 2 h before lipopolysaccharide (LPS) stimulation. Cell supernatant was collected 24 h after LPS stimulation. TNF-α, I-309, MDC and IP-10 concentrations of cell supernatants were determined using ELISA. Intracellular signaling was evaluated by w0 estern blot. Results: Dipyrone and 2,5-dimethylcelecoxib downregulated LPS-induced Th2-related chemokine I-309 and macrophage derived chemokine (MDC) production. Only high dose of 2,5-dimethylcelecoxib (10 -5 M), but not dipyrone downregulated LPS-induced IP-10. Only very high dose of 2,5-dimethylcelecoxib had effect on LPS-induced TNF-α expression in PBMCs. Dipyrone and 2,5-dimethylcelecoxib suppressed LPS-induced p65 and JNK MAPK (C-Jun N-terminal kinase mitogen activated protein kinase). expression. Interpretation & conclusions: Dipyrone and 2,5-dimethylcelecoxib downregulated LPS-induced Th2-related chemokine I-309 and MDC in THP-1 cells. The suppressive effect on Th2-related chemokine I-309 and MDC may involve the downregulation of LPS-induced JNK and p65 expression.
  555 209 -
CLINICAL IMAGES
Obturator hernia: a rare cause of acute small bowel obstruction
Shiue-Wei Lai, Tzu-Chuan Huang
July 2014, 140(1):151-151
PMID:25222793
  430 225 -
CORRESPONDENCES
HIV prevention programmes & new interventions for truckers in India
Divya Nair, Anindo Majumdar, Sitanshu Sekhar Kar, S Ganesh Kumar
July 2014, 140(1):146-147
PMID:25222791
  401 184 -
CLINICAL IMAGES
Vascular ring with a Kommerell's diverticulum: Neonatal presentation with oesophageal symptoms
Venkatraman S Bhat, Vimal Raj
July 2014, 140(1):152-153
PMID:25222794
  347 190 -
BOOK REVIEWS
Probiotic bacteria and their effect on human health and well-being
BS Ramakrishna
July 2014, 140(1):155-155
  303 211 -
SOME FORTHCOMING SCIENTIFIC EVENTS
Some Forthcoming Scientific Events

July 2014, 140(1):156-156
  208 202 -
CORRESPONDENCES
Self weighing & non-probability samples
Sunil Kumar Raina
July 2014, 140(1):149-149
PMID:25222792
  213 157 -
Authors' response
Rama Walia, Anil Bhansali, Muthuswamy Ravikiran, Padala Ravikumar, Sanjay K Bhadada, G Shanmugasundar, Pinaki Dutta, Naresh Sachdeva
July 2014, 140(1):150-150
PMID:25354415
  222 141 -
Authors' response
SG Prem Kumar, G Anil Kumar, Ramesh Poluru, John A Schneider, Lalit Dandona, Lakshmi Vemu, T Sudha, Kenneth H Mayer, Rakhi Dandona
July 2014, 140(1):147-148
PMID:25354414
  217 140 -
BOOK REVIEWS
Hepatitis C in renal disease, hemodialysis and transplantation
SK Agarwal
July 2014, 140(1):154-155
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