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   2015| February  | Volume 141 | Issue 2  
    Online since April 21, 2015

 
 
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REVIEW ARTICLES
Undescended testicle: An update on fertility in cryptorchid men
Prabudh Goel, JD Rawat, A Wakhlu, SN Kureel
February 2015, 141(2):163-171
DOI:10.4103/0971-5916.155544  PMID:25900951
Cryptorchidism or undescended testis is one of the most common anomalies encountered in paediatric urology and is estimated to affect 1 to 4 per cent of full term and upto 30 per cent of preterm male neonates. The associated problems of sub-fertility or infertility and malignant transformation have been recognized for long. Fertility is impaired after both unilateral and bilateral cryptorchidism. The reported paternity rates in adults are about two-third for unilateral undescended testis and less than one-third for bilateral disease. Over the last five decades, the concepts related to cryptorchidism have changed dramatically as knowledge about its effects has accrued from research conducted worldwide. The recommended age of orchidopexy has fallen progressively from adolescence to less than one year. The realization that the infantile testes are not in a state of 'suspended animation' and the recognition of the defect in the androgen dependent transformation of gonocytes into adult dark spermatogonia in cryptorchidism have been recognized as the primary cause of sub-fertility in these patients. This has paved the way for hormone therapy in an attempt to simulate the 'post-natal gonadotropin surge' or 'mini-puberty'. This review summarizes the current knowledge about the various factors affecting the fertility status in cryptorchidism with a particular focus on the derangements in the development and maturation of the germ cells and the role of surgery, hormone therapy and antioxidants in reversing these changes.
  1,587 536 6
VIEWPOINTS
Healthcare agenda for the Indian government
Mahaveer Golechha
February 2015, 141(2):151-153
DOI:10.4103/0971-5916.155541  PMID:25900948
  1,503 366 3
COMMENTARIES
An understanding of spinocerebellar ataxia
NB Ramachandra, L Kusuma
February 2015, 141(2):148-150
DOI:10.4103/0971-5916.155537  PMID:25900947
  1,368 339 3
ORIGINAL ARTICLES
Prevalence of tuberculosis in Faridabad district, Haryana State, India
SK Sharma, Ashish Goel, SK Gupta, Krishna Mohan, V Sreenivas, SK Rai, UB Singh, LS Chauhan
February 2015, 141(2):228-235
DOI:10.4103/0971-5916.155593  PMID:25900959
Background & objectives : Epidemiological information on tuberculosis (TB) has always been vital for planning control strategies. It has now gained further importance for monitoring the impact of interventions to control the disease. The present study was done to estimate the prevalence of bacillary tuberculosis in the district of Faridabad in Haryana State of India among persons aged older than 15 years. Methods: In this cross-sectional study, residents of Faridabad district were assessed for the prevalence of tuberculosis. Twelve rural and 24 urban clusters with estimated populations of 41,106 and 64,827 individuals were selected for the study. Two sputum samples were collected from individuals found eligible for inclusion. The samples were also cultured by modified Petroff's method and were examined for growth of Mycobacterium tuberculosis once a week for eight weeks. A person found positive by smear and/or culture was identified as sputum-positive pulmonary TB positive. Results: A total of 105,202 subjects were enumerated in various clusters of the Faridabad district. There were 50,057 (47.58%) females and 55,145 (52.42%) males. Of these 98,599 (93.7%) were examined by the study group (47,976 females; 50,623 males). The overall prevalence of sputum smear or culture positive pulmonary tuberculosis in our study was found to be 101.4 per 100,000 population. Interpretation & conclusions : The present results showed that the prevalence of sputum positive pulmonary tuberculosis was higher in Faridabad district than the notification rates recorded by the World Health Organization for the contemporary period, a disparity that could be explained by a difference in case detection strategy employed for the study.
  1,206 344 5
VIEWPOINTS
Stem cells, progenitors & regenerative medicine: A retrospection
Deepa Bhartiya
February 2015, 141(2):154-161
DOI:10.4103/0971-5916.155543  PMID:25900949
  1,125 279 11
CORRESPONDENCES
Endometriosis: Ancient or modern disease?
Giuseppe Benagiano, Ivo Brosens, Donatella Lippi
February 2015, 141(2):236-238
DOI:10.4103/0971-5916.155594  PMID:25900960
  1,087 311 -
ORIGINAL ARTICLES
Spinocerebellar ataxia 7 (SCA7) in Indian population: predilection of ATXN7-CAG expansion mutation in an ethnic population
Mohammed Faruq, Achal Kumar Srivastava, Suman Singh, Rohit Gupta, Tanuj Dada, Ajay Garg, Madhuri Behari, Mitali Mukerji
February 2015, 141(2):187-198
DOI:10.4103/0971-5916.155556  PMID:25900954
Background & objectives : Spinocerebellar ataxia 7 (SCA7) is a rare form of neurodegenerative disorder with the clinical manifestation of cerebellar ataxia and retinal degeneration. In this study we describe the clinico-genetic characteristics of nine SCA7 families of Indian origin and cross compare these with other available worldwide studies. Methods: Thirty five individuals from nine SCA7 families were clinico-genetically characterized and CAG repeat distribution analysis was carried out in 382 control DNA samples from healthy controls (derived from 21 diverse Indian populations based on ethnic and linguistic and geographical location). Results: Of the nine families studied, 22 affected individuals and one asymptomatic carrier were identified. The average age at disease onset was 23.4±12.6 yr. The length of expanded CAG ranged from 40-94 with mean value of 53.2±13.9. The main clinical findings in affecteds individuals included cerebellar ataxia, and retinal degeneration along with hyper-reflexia (95%), slow saccades (85%) and spasticity (45%). Analysis of the association of number of CAG repeats with disease onset revealed that <49 repeats were associated with earlier age at onset in South East Asians compared to European populations. Further analysis of CAG repeats from 21 diverse Indian populations showed pre-mutable repeats (28-34) alleles in the IE-N-LP2 population. Six of the nine families identified in this study belonged to the same ethnic population. Interpretations & conclusion : Our results show that presenece of SCA7 is relatively rare and confined to one ethnic group from Haryana region of India. We observed a homogeneous phenotypic expression of SCA7 mutation as described earlier and an earlier age of onset in our patients with CAG <49. The identification of pre-mutable allele in IE-N-LP2 suggests this population to be at the risk of SCA7.
  1,105 273 3
Molecular characterization of hepatitis A virus strains in a tertiary care health set up in north western India
Mini Pritam Singh, Manasi Majumdar, Babu Ram Thapa, Puneet Kumar Gupta, Jasmine Khurana, Bimal Budhathoki, Radha Kanta Ratho
February 2015, 141(2):213-220
DOI:10.4103/0971-5916.155577  PMID:25900957
Background & objectives: Hepatitis A virus usually causes acute viral hepatitis (AVH) in the paediatric age group with a recent shift in age distribution and disease manifestations like acute liver failure (ALF). This has been attributed to mutations in 5'non-translated region (5'NTR) which affects the viral multiplication. The present study was aimed to carry out the molecular detection and phylogenetic analysis of hepatitis A virus strains circulating in north western India. Methods: Serum samples from in patients and those attending out patient department of Pediatric Gastroenterology in a tertiary care hospital in north India during 2007-2011 with clinically suspected AVH were tested for anti-hepatitis A virus (HAV) IgM antibodies. Acute phase serum samples were subjected to nested PCR targeting the 5'NTR region followed by sequencing of the representative strains. Results: A total of 1334 samples were tested, 290 (21.7%) were positive for anti-HAV IgM antibody. Of these, 78 serum samples (< 7 days old) were subjected to PCR and 47.4% (37/78) samples showed the presence of HAV RNA. Children < 15 yr of age accounted for majority (94%) of cases with highest seropositivity during rainy season. Sequencing of 15 representative strains was carried out and the circulating genotype was found to be III A. The nucleotide sequences showed high homology among the strains with a variation ranging from 0.1-1 per cent over the years. An important substitution of G to A at 324 position was shown by both AVH and ALF strains. The cumulative substitution in AVH strains Vs ALF strains as compared to GBM, Indian and prototype strain in the 200-500 region of 5' NTR was comparable. Interpretation & conclusion: Our results showed hepatitis A still a disease of children with III A as a circulating genotype in this region. The mutations at 5'NTR region warrant further analysis as these affect the structure of internal ribosomal entry site which is important for viral replication.
  1,046 284 2
Envelope specific T cell responses & cytokine profiles in chikungunya patients hospitalized with different clinical presentations
Anuradha S Tripathy, Babasaheb V Tandale, Saravana S Balaji, Supriya L Hundekar, Ashwini Y Ramdasi, Vidya A Arankalle
February 2015, 141(2):205-212
DOI:10.4103/0971-5916.155570  PMID:25900956
Background & objectives : Since the 2006 massive outbreaks, chikungunya (CHIK) is a major public health concern in India. The aim of this study was to assess envelope specific immune responses in patients with chikungunya infection. Methods: This study included 46 hospitalized patients with chikungunya virus infection (encephalitis, n=22, other systemic involvement, OSI, n=12, classical, n=12) and six controls from Ahmedabad city, Gujarat, India. T cell responses and the levels of Th1, pro/ anti-inflammatory cytokines against the CHIK virus envelope antigens were assessed by lymphocyte proliferation assay and by cytometric bead array in flow cytometry, respectively. Results: Lymphoproliferative response was uniform among the patients. Comparisons of cytokines revealed significantly higher levels of interleukin (IL)-4 and IL-5 in encephalitis, OSI and classical patients versus controls. The levels of tumour necrosis factor (TNF)-α were higher in classical patients categories compared to the controls. Interferon (IFN)-γ levels were lower in encephalitis patients versus control. Interpretation & conclusions : Our findings showed recognition of T cell epitopes on the envelope region of chikungunya virus by all patient categories. Lower level of IFN-γ may be associated with the severity of disease in these patients.
  889 362 2
REVIEW ARTICLES
Current advances related to Clostridium difficile infection
Yong Gil Kim, Byung Ik Jang
February 2015, 141(2):172-174
DOI:10.4103/0971-5916.155545  PMID:25900952
Clostridium difficile infection (CDI) can trigger various responses, ranging from asymptomatic carriage to fulminant colitis. Hard-to-cure CDI, such as severe CDI, multiple recurrences of CDI, refractory CDI, and hypervirulent strains of C. difficile, require new treatments, although antibiotics such as metronidazole and vancomycin are the treatment of choice for initial and first relapsing CDI. Active immunization with C. difficile toxins and faecal microbiota transplantation deserve special attention. Here we describe these strategies for difficult-to-treat CDI.
  834 399 -
ORIGINAL ARTICLES
Development of low-density oligonucleotide microarrays for detecting mutations causing Wilson's disease
Manjula Mathur, Ekta Singh, TB Poduval, Akkipeddi V.S.S.N. Rao
February 2015, 141(2):175-186
DOI:10.4103/0971-5916.155548  PMID:25900953
Background & objectives : Wilson's disease (WD) is an autosomal recessive disorder caused by mutations in ATP7B, a copper transporter gene, leading to hepatic and neuropsychiatric manifestations due to copper accumulation. If diagnosed early, WD patients can be managed by medicines reducing morbidity and mortality. Diagnosis of this disease requires a combination of tests and at times is inconclusive due to overlap of the symptoms with other disorders. Genetic testing is the preferred alternative in such cases particularly for individuals with a family history. Use of DNA microarray for detecting mutations in ATP7B gene is gaining popularity because of the advantages it offers in terms of throughput and sensitivity. This study attempts to establish the quality analysis procedures for microarray based diagnosis of Wilson's disease. Methods: A home-made microarrayer was used to print oligonucleotide based low-density microarrays for addressing 62 mutations causing Wilson's disease reported from Indian population. Inter- and intra- array comparisons were used to study quality of the arrays. The arrays were validated by using mutant samples generated by site directed mutagenesis. Results: The hybridization reaction were found to be consistent across the surface of a given microarray. Our results have shown that 52 °C post-hybridization wash yields better reproducibility across experiments compared to 42 °C. Our arrays have shown > 80 per cent sensitivity in detecting these 62 mutations. Interpretation & conclusions: The present results demonstrate the design and evaluation of a low-density microarray for the detection of 62 mutations in ATP7B gene, and show that a microarray based approach can be cost-effective for detecting a large number of mutations simultaneously. This study also provides information on some of the important parameters required for microarray based diagnosis of genetic disorders.
  933 293 2
BOOK REVIEWS
Saliva: Secretion and functions
Mahesh Verma
February 2015, 141(2):253-254
  907 304 -
ORIGINAL ARTICLES
Antimalarial properties of SAABMAL ® : an ethnomedicinal polyherbal formulation for the treatment of uncomplicated malaria infection in the tropics
IC Obidike, B Amodu, MO Emeje
February 2015, 141(2):221-227
DOI:10.4103/0971-5916.155585  PMID:25900958
Background & objectives: Malaria is a serious problem in the countries of the developing world. As the malaria parasite has become resistant to most of the antimalaria drugs available currently, there is a need to search for newer drugs. This study reports the pharmaceutical quality and in vivo antimalarial activities of a polyherbal formulation (SAABMAL ® ) used as malarial remedy in Nigeria. Methods: The antiplasmodial activity of SAABMAL ® was determined by using the 4-day suppressive test in Plasmodium berghei-infected mice. The formulation was tried on three different experimental animal models for in vivo antimalarial activities, which are prophylactic, suppressive and curative in mice. Chloroquine and pyrimethamine were used as standard drugs for comparison. Results: The suppressive study showed that, SAABMAL ® (200 and 400 mg/kg/bw) significantly ( p <0.01) produced a suppression (29.39 - 100%) of parasitaemia in a dose-dependent manner, while the curative study showed that SAABMAL ® at 400 mg significantly ( p <0.01) reduced (95.80%) parasitaemia compared with controls. The mean survival time of SAABMAL ®-treated groups (100 and 200 mg/kg) was higher than that of the chloroquine-treated group. Histopathologically, no changes were found in the spleen of both untreated and treated groups. SAABMAL ® capsules were of good mechanical properties with low weight variation and high degree of content mass uniformity. Interpretation & conclusions: The results obtained in this study showed the efficacy of SAABMAL ® , a herbal antimalarial formulation against chloroquine sensitive malaria and its potential use in the treatment of uncomplicated malaria infection. Further studies need to be done in humans to test its efficacy and safety for its potential use as an antimalarial drug.
  878 236 -
Mannose binding lectin (MBL) 2 gene polymorphism & its association with clinical manifestations in systemic lupus erythematosus (SLE) patients from western India
Vandana Pradhan, Prathamesh Surve, Anjali Rajadhyaksha, Vinod Rajendran, Manisha Patwardhan, Vinod Umare, Kanjaksha Ghosh, Anita Nadkarni
February 2015, 141(2):199-204
DOI:10.4103/0971-5916.155558  PMID:25900955
Background & objectives : Systemic lupus erythematosus (SLE) is a prototypical autoimmune disease characterized by production of autoantibodies. Mannose binding lectin (MBL) is an important element of the innate defense system. t0 he present study was undertaken to determine whether variant alleles in MBL2 gene were associated with disease severity in SLE patients. Methods: The MBL alleles [-550, -221, +4, Codon 52, Codon 54 and Codon 57] were studied by PCR- RFLP (restriction fragment length polymorphism) method in 100 SLE patients fulfilling ACR (American College of Rheumatology) criteria along with 100 healthy controls. SLE disease activity was evaluated using SLE Disease Activity Index (SLEDAI) score. Results: Homozygosity for MBL variant allele (O/O) was observed in 24 per cent of the SLE patients compared to 16 per cent of the normal controls, while no difference was found for heterozygosity (A/O) (37 vs 35%). A significant difference was reported in incidence of double heterozygosity for mutant allele B and D (B/D) among SLE patients as against control group ( p = 0.015). MBL genotypes did not show any association with renal involvement. Interpretation & conclusions : In this study from western India, MBL gene polymorphism showed an influence as a possible risk factor for susceptibility to SLE, but had no direct effect on disease characteristics. Further studies need to be done on a larger number of SLE patients in different regions of the country.
  799 277 7
CORRESPONDENCES
Spotted fever rickettsiosis in Uttar Pradesh
Mastan Singh, Jyotsna Agarwal, Chandra Dev Pati Tripathi, Chandra Kanta
February 2015, 141(2):242-244
DOI:10.4103/0971-5916.155596  PMID:25900962
  771 258 -
Salmonella enterica serovar Weltevreden ST1500 associated foodborne outbreak in Pune, India
Priyanka Jain, Suman Nandy, Renu Bharadwaj, Swapan Kumar Niyogi, Shanta Dutta
February 2015, 141(2):239-241
DOI:10.4103/0971-5916.155595  PMID:25900961
  742 242 4
EDITORIALS
Mesenchymal stromal cells as regulators of anti-tumour immune response
Alessandro Poggi, MR Zocchi
February 2015, 141(2):139-142
DOI:10.4103/0971-5916.155530  PMID:25900944
  722 255 -
COMMENTARIES
Low-density oligonucleotide microarrays - A major step in Wilson's disease diagnosis
Arnab Gupta
February 2015, 141(2):145-147
DOI:10.4103/0971-5916.155534  PMID:25900946
  702 247 4
CLINICAL IMAGES
Herpes zoster complicating bortezomib therapy
Kamal Kant Sahu, Subhash Chander Varma
February 2015, 141(2):247-248
DOI:10.4103/0971-5916.155599  PMID:25900964
  592 265 7
EDITORIALS
International Epilepsy Day - A day notified for global public education & awareness
Man Mohan Mehndiratta, Swati Anil Wadhai
February 2015, 141(2):143-144
DOI:10.4103/0971-5916.155531  PMID:25900945
  596 197 2
CLINICAL IMAGES
Hughes syndrome with cerebral, skeletal infarction & retinal vein thrombosis
P Shanmuga Sundaram, S Padma
February 2015, 141(2):249-250
DOI:10.4103/0971-5916.155600  PMID:25900965
  603 165 -
CORRESPONDENCES
Matching for risk factors in case control studies
Kanica Kaushal
February 2015, 141(2):245-245
DOI:10.4103/0971-5916.155597  PMID:25900963
  519 197 -
Authors' response
NH Ramzi, JK Chahil, SH Lye, K Metnam, KI Sahadevappa, S Velapasamy, N. A. N. Hashim, SK Cheah, G. C. C. Lim, H Hussein, MR Haron, L Alex, LW Ler
February 2015, 141(2):246-246
DOI:10.4103/0971-5916.155598  
  579 112 -
COMMENT
VSELs, stem cells or progenitors - A debate
VM Katoch
February 2015, 141(2):154-154
DOI:10.4103/0971-5916.155608  PMID:25900950
  486 184 -
CLINICAL IMAGES
Mass like lesions disappearing with treatment in a young patient
Kranti Garg, Varinder Saini
February 2015, 141(2):251-252
DOI:10.4103/0971-5916.155601  PMID:25900966
  476 158 -
BOOK REVIEWS
TIA as acute cerebrovascular syndrome
MV Padma Srivastava
February 2015, 141(2):255-256
  394 140 -
Dermatologic principles and practice in oncology: Conditions of the skin, hair and nails in cancer patients
Uday Khopkar
February 2015, 141(2):254-255
  348 149 -
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