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2015| July | Volume 142 | Issue 1
Online since
August 4, 2015
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EDITORIAL
Child sexual abuse: Issues & concerns
Sydney Moirangthem, Naveen C Kumar, Suresh Bada Math
July 2015, 142(1):1-3
DOI
:10.4103/0971-5916.162084
PMID
:26261159
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5,201
1,095
4
ORIGINAL ARTICLES
Drug-induced diseases (DIDs): An experience of a tertiary care teaching hospital from India
Vishal R Tandon, Vijay Khajuria, Vivek Mahajan, Aman Sharma, Zahid Gillani, Annil Mahajan
July 2015, 142(1):33-39
DOI
:10.4103/0971-5916.162093
PMID
:26261164
Background & objectives:
Drug-induced diseases (DIDs) are well known but least studied. Data on DIDs from India are not available. Hence, this retrospective cross-sectional study was undertaken using suspected adverse drug reaction (ADR) data collected form Pharmacovigilance Programme of India (PvPI) to evaluate profile of DIDs over two years, in a tertiary care teaching hospital from north India.
Methods:
The suspected ADRs in the form of DID were evaluated for drug and disease related variables and were classified in terms of causality.
Results:
DID rate was 38.80 per cent. Mean duration of developing DIDs was 26.05 ± 9.6 days; 25.16 per cent had more than one co-morbid condition. Geriatric population (53.99%) accounted for maximum DIDs followed by adult (37.79%) and paediatric (8.21%). Maximum events were probable (93.98%) followed by possible (6.04%). All DIDs required intervention. Gastritis (7.43%), diarrhoea (5.92%), anaemia (4.79%), hypotension (2.77%), hepatic dysfunction (2.69%), hypertension (1.51%), myalgia (1.05%), and renal dysfunction (1.01%) were some of the DIDs. Anti-tubercular treatment (ATT), anti- retroviral treatment (ART), ceftriaxone injection, steroids, non-steroidal anti-inflammatory drugs, antimicrobials and anticancer drugs were found as commonly offending drugs.
Interpretation & conclusions:
Our findings show that DIDs are a significant health problem in our country, which need more attention.
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3
Alterations of mucosal microbiota in the colon of patients with inflammatory bowel disease revealed by real time polymerase chain reaction amplification of 16S ribosomal ribonucleic acid
Jayakanthan Kabeerdoss, Prabavathi Jayakanthan, Srinivasan Pugazhendhi, Balakrishnan S Ramakrishna
July 2015, 142(1):23-32
DOI
:10.4103/0971-5916.162091
PMID
:26261163
Background & objectives:
Alterations in microbial communities closely associated with the intestinal mucosa are likely to be important in the pathogenesis of inflammatory bowel disease (IBD). We examined the abundance of specific microbial populations in colonic mucosa of patients with ulcerative colitis (UC), Crohn's disease (CD) and controls using reverse transcription quantitative polymerase chain reaction (RT-qPCR) amplification of 16S ribosomal ribonucleic acid (16S rRNA).
Methods:
RNA was extracted from colonic mucosal biopsies of patients with UC (32), CD (28) and patients undergoing screening colonoscopy (controls), and subjected to RT-qPCR using primers targeted at 16S rRNA sequences specific to selected microbial populations.
Results:
Bacteroides-Prevotella-Porphyromonas
group and
Enterobacteriaceae
were the most abundant mucosal microbiota.
Bacteroides
and
Lactobacillus
abundance was greater in UC patients compared with controls or CD.
Escherichia coli
abundance was increased in UC compared with controls.
Clostridium coccoides
group and
C. leptum
group abundances were reduced in CD compared with controls. Microbial population did not differ between diseased and adjacent normal mucosa, or between untreated patients and those already on medical treatment. The Firmicutes to Bacteroidetes ratio was significantly decreased in both UC and CD compared with controls, indicative of a dysbiosis in both conditions.
Interpretation & conclusions:
Dysbiosis appears to be a primary feature in both CD and UC. Microbiome-directed interventions are likely to be appropriate in therapy of IBD.
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39
Immunological & metabolic responses to a therapeutic course of
Basti
in obesity
Urmila Thatte, Shubhada Chiplunkar, Supriya Bhalerao, Aditi Kulkarni, Raman Ghungralkar, Falguni Panchal, Shamal Vetale, Pradeep Teli, Dipti Kumbhar, Renuka Munshi
July 2015, 142(1):53-62
DOI
:10.4103/0971-5916.162099
PMID
:26261167
Background & objectives:
Basti (medicated enema) is a popular Ayurvedic intervention recommended for obesity. However, there are no data to show whether any physiological or biochemical changes occur following this treatment. This study was conducted to identify the immunological and metabolic changes in obese individuals after a therapeutic course of b0 asti.
Methods:
Thirty two obese individuals (18 and 60 yr) with a body mass index (BMI) ≥30 kg/m
[2]
who received a therapeutic course of 16 enemas ( b0 asti) followed by a specific diet and lifestyle regimen for a period of 32 days as their treatment for obesity, were enrolled in the study. Clinical examination, measurement of immune and metabolic markers were done before (S1), immediately after (S2) and 90 days after the completion of therapy (S3).
Results:
A significant reduction (
P
<0.001) in weight, BMI, upper arm and abdominal circumference was seen at S3, along with a decrease in serum interferon (IFN)-γ (
P
<0.02), interleukin (IL)-6 (
P
<0.02) and ferritin (
P
<0.05) and increase in IgM levels (
P
<0.02). Peripheral blood lymphocytes (PBLs) stimulated with anti-CD3 monoclonal antibodies showed significant increase in reactive oxygen species (ROS) generation and calcium flux after Basti. All organ function tests revealed no changes.
Interpretation & conclusions:
Our study documents that a therapeutic course of Basti modulates immune responses by regulating pro-inflammatory cytokines, immunoglobulins and functional properties of T-cells. These changes are associated with a reduction in the body weight which is maintained even after three months of treatment. The study also documents the safety of Basti procedure.
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3
REVIEW ARTICLE
Leptospirosis among the self-supporting convicts of Andaman Island during the 1920s - the first report on pulmonary haemorrhage in leptospirosis?
P Vijayachari, AP Sugunan, SS Singh, PP Mathur
July 2015, 142(1):11-22
DOI
:10.4103/0971-5916.162087
PMID
:26261162
Several researchers had carried out investigations on the possibility of existence of Weil's disease in Andaman Islands during early 20
th
century. The first report of a series of confirmed cases of leptospirosis that occurred during1929 was published in 1931.There were several reports during 1995 to 2009 that described detailed account of leptospirosis including various clinical syndromes. The possibility of pulmonary involvement in leptospirosis being a manifestation historically overlooked rather than newly emerged during the past two decades is examined in this review in the context of Andaman Islands. Two case series of leptospirosis, one occurred in 1929 and the other in 1996-1997 were reviewed with special emphasis on pulmonary involvement and haemorrhagic manifestations. The similarities and differences in the clinical profile of patients of the two case series were analysed. The review shows that respiratory system involvement and pulmonary haemorrhage as evidenced by presence of haemoptysis as a complication of leptospirosis was occurring during 1920s in Andaman Islands. The incidence of pulmonary involvement, however, rose from 9.4 per cent during 1929 to 52 per cent in 1996-1997. The case fatality ratio in patients with pulmonary involvement, which was 50 per cent during 1929 and 42.9 per cent during 1996-1997, was higher than that in cases without pulmonary involvement.Fever, conjunctival congestion, jaundice, vomiting, diarrhoea, hepatomagaly, haemoptysis, haematemesis and subconjunctival haemorrhage were common in both series. The case series in Andaman Islands in 1929 was probably the first report of pulmonary haemorrhage as a manifestation of leptospirosis. The increase in the incidence of pulmonary involvement in leptospirosis in the recent past is probably due to the increase in the density and diversityof its animal vectors,the broadening of the range of circulating serovars and the interactions between the vector and the agent. An increased virulence of
Leptospira
through gene acquisition and loss on an evolutionary time scale and the resulting change in the gene content, gene order and gene expression cannot be ruled out.
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5
ORIGINAL ARTICLES
Association of serotonin transporter (SLC6A4) & receptor (5HTR1A, 5HTR2A) polymorphisms with response to treatment with escitalopram in patients with major depressive disorder : A preliminary study
Aniruddha Basu, RK Chadda, Mamta Sood, Harpreet Kaur, Ritushree Kukreti
July 2015, 142(1):40-45
DOI
:10.4103/0971-5916.162094
PMID
:26261165
Background & objectives:
Genetic factors have potential of predicting response to antidepressants in patients with major depressive disorder (MDD). In this study, an attempt was made to find an association between response to escitalopram in patients with MDD, and serotonin transporter (SLC6A4) and receptor (5HTR1A, 5HTR2A) polymorphisms.
Methods:
Fifty five patients diagnosed as suffering from MDD, were selected for the study. The patients were treated with escitalopram over a period of 6-8 wk. Severity of depression, response to treatment and side effects were assessed using standardised instruments. Genetic variations from HTR1A (rs6295), HTR2A (rs6311 and rs6313) and SLC6A4 (44 base-pair insertion/deletion at 5-HTTLPR) were genotyped. The genetic data of the responders and non-responders were compared to assess the role of genetic variants in therapeutic outcome.
Results:
Thirty six (65.5%) patients responded to treatment, and 19 (34.5%) had complete remission. No association was observed for genotype and allelic frequencies of single nucleotide polymorphisms (SNPs) among remitter/non-remitter and responder/non-responder groups, and six most common side-effects, except memory loss which was significantly associated with rs6311 ( p0 =0.03).
Interpretation & conclusions:
No significant association was found between the SNPs analysed and response to escitalopram in patients with MDD though a significant association was seen between the side effect of memory loss and rs6311. Studies with larger sample are required to find out genetic basis of antidepressant response in Indian patients.
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562
11
Effect of mesenchymal stem cells transplantation on glycaemic profile & their localization in streptozotocin induced diabetic Wistar rats
Shobhit Bhansali, Vinod Kumar, Uma Nahar Saikia, Bikash Medhi, Vivekanand Jha, Anil Bhansali, Pinaki Dutta
July 2015, 142(1):63-71
DOI
:10.4103/0971-5916.162116
PMID
:26261168
Background & objectives:
Bone marrow is a rich source of adult stem cells that can differentiate into various cell types. Administration of mesenchymal stem cells (MSCs) in irradiated diabetic rat model has transiently shown to decrease blood glucose level. This study examines the effect of high dose and multiple injections of MSCs on glycemic profile, their localization and regeneration of islet in diabetic Wistar rat.
Methods:
The study was carried out in male Wistar rats categorized into three groups (n=6, in each group): Group 1 as control, group 2 streptozotocin (STZ) (50 mg/kg) induced diabetic group and group 3 experimental group; 5-bromo-2-deoxyuridine (BrdU) labelled allogenic MSCs were injected in the non-irradiated diabetic rat of the experimental group through tail vein. The blood glucose profile was subsequently monitored at regular intervals. Rats were sacrificed on day 45 and pancreas was examined for localization of BrdU labelled stem cells by immunofluorescence and islet-neogenesis by immunohistochemistry .
Results:
There was a significant reduction in blood glucose level after administration of MSCs in the experimental group (
P
<0.001). The presence of BrdU labelled MSCs in islet suggested their localization in the pancreas. Co-expression of anti-BrdU and anti-insulin antibody indicated trans-differentiation / fusion into insulin producing cells evidenced by significant increase in total number of islet (
P
=0.004) and insulin positive cells (
P
<0.0001) in experimental group.
Interpretation & conclusions:
Our results showed that the MSCs administration in non-irradiated diabetic Wistar rat reduced hyperglycaemia and was accompanied by increased islet-neogengesis, possibly through trans- differentiation/fusion.
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1,859
438
11
Evaluation of profertility effect of probiotic
Lactobacillus plantarum
2621 in a murine model
Praveen Bhandari, Vijay Prabha
July 2015, 142(1):79-84
DOI
:10.4103/0971-5916.162127
PMID
:26261170
Background & objectives:
Urogenital infections of bacterial origin have a high incidence among the female population at reproductive age, affecting the fertility. Strains of Escherichia coli can colonize the vagina and replace natural microflora. Lactobacillus the predominant vaginal microorganism in healthy women, maintains the acidic vaginal pH which inhibits pathogenic microorganisms. Studies on Lactobacillus have shown that these can inhibit E. coli growth and vaginal colonization. An alternative therapeutic approach to antimicrobial therapy is to re-establish Lactobacillus in this microbiome through probiotic administration to resurge fertility. Therefore, the aim of the present study was to determine the capability of L. plantarum 2621 strain with probiotic properties, to prevent the vaginal colonization of E. coli causing agglutination of sperms and to evaluate its profertility effect in a murine model.
m0 ethods:
Screened mice were divided into five groups i.e. control group, E. coli group, Lactobacillus group, prophylactic and therapeutic groups. The control group was infused with 20 µl PBS, E.coli group was administered with 10
[6]
cfu/20 µl E. coli, and probiotic group was administered with Lactobacillus (10
[8]
cfu/20 µl) for 10 consecutive days. In prophylactic group, the vagina was colonized with 10 consecutive doses of Lactobacillus (10
[8]
cfu/20 µl). After 24 h, it was followed by 10 day intravaginal infection with E. coli (10
[6]
cfu/20 µl) whereas for the therapeutic group vagina was colonized with (10
[6]
cfu/20 µl) E. coli for 10 consecutive days, followed by 10 day intravaginal administration with Lactobacillus after 24 h.
Results:
Upon mating and completion of gestation period, control, probiotic and the therapeutic groups had litters in contrast to the prophylactic group and the group administered with E. coli.
Interpretation & conclusions:
Results indicated that Lactobacillus intermitted colonization of pathogenic strains that resulted in reinforcement of natural microflora and resurge fertility.
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1,704
492
6
COMMENTARIES
Drug induced diseases (DID): Need for more awareness & research
C Adithan, S Sandhiya
July 2015, 142(1):7-10
DOI
:10.4103/0971-5916.162086
PMID
:26261161
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1,527
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ORIGINAL ARTICLES
A preliminary study of inherited thrombophilic risk factors in different clinical manifestations of venous thromboembolism in central Iran
Ali Karimi, Marziyeh Abolhasani, Morteza Hashemzadeh-Chaleshtori, Batoul Pourgheysari
July 2015, 142(1):46-52
DOI
:10.4103/0971-5916.162096
PMID
:26261166
Background & objectives:
Inherited thrombophilia is known to be an important risk factor for developing venous thromboembolism. Whether such abnormalities may impact the development of deep vein thrombosis (DVT) and pulmonary embolism (PE) differently is not well defined. This preliminary study was undertaken to compare thrombophilic polymorphism in patients with DVT and PE.
Methods:
A total of 35 DVT, 23 DVT/PE, and 37 PE patients admitted to the Hajar Hospital, Shahrekord, Iran, between October 2009 and February 2011 were included in the study and 306 healthy volunteers matched by age and sex from the same geographical area with no history of venous or arterial diseases were included as control group. Factor V Leiden (FV 1691G/A, rs6025), prothrombin (FII 20210G/A), methylene tetrahydrofulate reductase (MTHFR 677C/T, rs1801133), and PLA2 polymorphisms of platelet glycoprotein IIb/IIIa (GpIIIa 1565T/C, rs5918) were investigated by polymerase chain reaction-restriction fragment length polymorphism.
Results:
The number of patients with the investigated polymorphisms and homozygous carriers was significantly different among the groups (P<0.05). No significant difference was observed in the presence of FV 1691G/A and FII 20210G/A between any of the patients groups and the control group. GpIIIa 1565T/C and homozygous MTHFR 677C/T polymorphisms were higher in DVT patients compared with the control group (OR=6.65, 95% CI=3.09-14.30 and OR=4.08, 95% CI=1.35-12.38, respectively).
Interpretation & conclusions:
As none of the investigated polymorphisms were associated with PE, other thrombophilia polymorphisms may have a role in the pathogenesis of PE in these patients and should be investigated. Because of different prognostic risk factors among different types of patients, the treatment approach could be different.
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2
COMMENTARIES
Inventory of a reservoir : friends & foes
Vineet Ahuja
July 2015, 142(1):4-6
DOI
:10.4103/0971-5916.162085
PMID
:26261160
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1,347
379
4
ORIGINAL ARTICLES
Complete genome sequence of two genotype III Japanese encephalitis virus isolates from West Bengal, India
Debjani Taraphdar, Shyamalendu Chatterjee
July 2015, 142(1):72-78
DOI
:10.4103/0971-5916.162122
PMID
:26261169
Background & objectives:
Japanese encephalitis (JE), caused by a mosquito-borne virus JE virus (JEV), is a serious health problem in West Bengal, India. In this study, we report the complete genome sequence of two JEV isolates from West Bengal. The amino acid and nucleotide sequence homology was compared with other Indian strains.
Methods:
Two JEV isolates (IND-WB-JE1 and IND-WB-JE2) obtained in 2008 and 2010, respectively, from two districts of the State of West Bengal, respectively were analyzed for genetic variations by sequencing the 10934 bp whole genome of the virus. Of these two districts, one was covered under JE vaccination programme in 2007.
Results:
Phylogenetic analysis showed that both the isolates belonged to the genotype III. A total of 16 mutations were identified in the two isolates studied with respect to Vellore P20778 strain. One unique mutation A3215S was only found in IND-WB-JE2 isolate, but not in the isolate IND-WB-JE1. These two isolates showed maximum homology with P20778 strain of India.
Interpretation & conclusions:
This study reports on complete gene based phylogenetic analysis of JEV isolates from the State of West Bengal. It was evident from the results that JEV was still under circulation in both vaccine covered and not covered districts of West Bengal.
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1
CORRESPONDENCES
Real time PCR reconfirmed three novel clinical associations of parvovirus B19: Non-occlusive bowel gangrene, amegakaryocytic thrombocytopenia & myositis
Janak Kishore
July 2015, 142(1):88-89
DOI
:10.4103/0971-5916.162132
PMID
:26261172
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1,236
291
2
High heterozygosity frequency of three exonic SNPs of factor V gene (
F5
): implications for genetic diagnosis
Anshul Jadli, Bipin Kulkarni, Kanjaksha Ghosh, Shrimati Shetty
July 2015, 142(1):85-87
DOI
:10.4103/0971-5916.162130
PMID
:26261171
[FULL TEXT]
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903
242
-
Confounding in case control studies
Sunil Kumar Raina
July 2015, 142(1):93-93
DOI
:10.4103/0971-5916.162144
PMID
:26261175
[FULL TEXT]
[PDF]
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[EPub]
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887
253
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Selective digestive decontamination saves lives whilst preventing resistance
Luciano Silvestri, Miguel A de la Cal, Hendrick K. F. van Saene
July 2015, 142(1):90-91
DOI
:10.4103/0971-5916.162135
PMID
:26261173
[FULL TEXT]
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875
242
-
CLINICAL IMAGES
An unusual foreign body
Makhan Lal Saha, Suvendu Maji
July 2015, 142(1):95-96
DOI
:10.4103/0971-5916.162151
PMID
:26261177
[FULL TEXT]
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794
287
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Multiple jejunal diverticula causing intestinal obstruction
Zhi-Bin Zhang, Chuan Gu
July 2015, 142(1):97-97
DOI
:10.4103/0971-5916.162154
PMID
:26261178
[FULL TEXT]
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[EPub]
[PubMed]
828
225
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CORRESPONDENCES
Authors' response
H Keyt, P Faverio, MI Restrepo
July 2015, 142(1):91-92
PMID
:26261174
[FULL TEXT]
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520
177
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BOOK REVIEWS
Concise pediatric and adolescent hepatology
Radha K Dhiman
July 2015, 142(1):98-99
[FULL TEXT]
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[EPub]
498
166
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Inflammatory bowel diseases: Microbiota versus the barrier
Devendra Desai
July 2015, 142(1):99-99
[FULL TEXT]
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475
173
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Atopic dermatitis in childhood and adolescence
Vinod Kumar Sharma
July 2015, 142(1):100-100
[FULL TEXT]
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420
170
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CORRESPONDENCES
Authors' response
Santosh R Taur, Sunil Karande, Akriti A Saxena, Nithya J Gogtay, Urmila M Thatte
July 2015, 142(1):93-94
PMID
:26261176
[FULL TEXT]
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413
155
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Online since 25 February, 2011