ORIGINAL RESEARCH ARTICLE | March 6, 2021
Cell Wall Proteins of Staphylococcus aureus Are Involved in Cross Reactivity with Murine Cytokine Assays
Mehak Gull, Abida Bano, Numan Javed
Page no 89-94
Staphylococcus aureus is one of the important pathogen often termed as superbug. After S. aureus interacting with host innate immune system, it induces the release of pro- inflammatory cytokines like TNF-α and IL-1β from Immune cells. In the current study, various strains of S. aureus and their cell wall lysates indicated cross reactivity with murine cytokines ELISA antibodies. In cell wall lysates of S. aureus, various proteins are involved in this cross reactivity phenomenon. This cross reactivity was exhibited in the form of unusual exaggerated signals while performing ELISA for quantification of murine cytokines. The proteins of cell wall lysates among various stains of S. aureus were determined using SDS-PAGE. To all of our data, it is revealed that unknown epitopes of S. aureus are involved in producing exaggerated signals of cytokines during their quantification by ELISA. This was generated not only during interaction of various strains of S. aureus with murine bone marrow derived macrophages (BMDM) but also in control settings where cell free system was used in ruling out this cross reactivity phenomenon.
ORIGINAL RESEARCH ARTICLE | March 15, 2021
Screening and Confirmatory Anti-Neutrophil Cytoplasmic Antibodies (ANCA) Testing for Rapidly Progressive Glomerulonephritis (RPGN): A Tertiary Care Experience
Dr. Faisal Ansari, Dr. Ram Mohan, Dr. Vijay Dharma Teja
Page no 95-99
Objective: Simultanaeous testing for serum antineutrophil cytoplasmic antibodies (ANCA) by indirect immunofluorescence (IF) and by anti-proteinase-3 (PR3)/anti-myeloperoxidase (MPO) antibody assays may identify patients with PR3-ANCA or MPO-ANCA despite a negative IF (IF negative MPO/PR3-positive); however, the significance of this result is not clear. We sought to determine whether IF-negative MPO/PR3-positive results identified any cases of clinically meaningful systemic vasculitis at our institution. Methods: We conducted a retrospective analysis of all ANCA positive RPGN patients either by IF or ELISA identified at our institution from August 2017 - July 2018. Results: Out of 265 samples 45 were positive for both IF and ELISA, 220 were IF-negative. Among IF negative, 6 samples (2.7%), tested positive for MPO-ANCA or PR3-ANCA. Two IF-negative ELISA positive patients were subsequently diagnosed with ANCA-associated renal limited vasculitis. Two IF-negative ELISA-positive patients were previously diagnosed and treated for AAV, both with positive IF and antibody tests prior to treatment. 1 patient had SLE and 1 had inflammatory bowel disease. Mean age of patients 58±4, 56% were males and P-ANCA 67% and C-ANCA 33% only 1 pt had both C- ANCA AND P-ANCA patterns positive. Conclusion: In our study both IF and ELISA, ELISA positivity without a positive IF rarely led to a definite diagnosis of systemic vasculitis, and was more likely to occur in the context of a non-vasculitis inflammatory condition. Our results suggest that concurrent IF and MPO/PR3 testing may be important in preventing a missed diagnosis of new onset renal limited AAV.
ORIGINAL RESEARCH ARTICLE | March 18, 2021
A Study on Prevalence, Type and Severity of Anemia in Helicobacter Pylori Infection with Respect to RBC Parameters in a Tertiary Care Hospital
Dr. Nazran Akbar Hussain, Dr. Nisha TG
Page no 100-104
Introduction: Helicobacter pylori (H.pylori) has been reported as an etiological agent in many gastric disorders and contribute to Iron deficiency anemia with an increasing prevalance in developing countries. The effect of H.pylori infection on haematological diseases is not well understood. Objective: To detect the prevalence, type and severity of anemia in H.pylori positive cases and to correlate it with RBC parameters. Methods: A retrospective study was done on biopsy proven cases of H.pylori over a period of one year. RBC parameters including Hemoglobin, RBC count, PCV, MCV, MCH, MCHC and Peripheral Smear report were retrieved from the hospital software system. Patients with Hb <13gm/dl(males) and <12gm/dl(females) were considered as anemic, graded as mild, moderate and severe, based on WHO guidelines. Data was entered into excel sheet and statistical analysis was done. Results: The study included 100 H.Pylori positive cases, of which 71 were male and 29 female. Prevalence of anemia was 74%. 23 cases were microcytic hychochromic (MCHC), 37 normocytic normochromic (NCNC), 9 macrocytic and 5 dimorphic anemia. 10%, 46%, 18% and 26% had mild, moderate, severe anemia and no anemia respectively. A significant association was noted between type and severity of anemia. In MCHC anemia, all the RBC indices had significant correlation (p <0.05); others correlated with PCV and RBC counts. Conclusions: This study indicates that H.pylori infection is related to moderate degree of anemia, predominantly of NCNC type, with significant association of RBC indices to MCHC anemia. All patients diagnosed as having H.pylori infection, would hence benefit from being investigated for underlying anemia.
ORIGINAL RESEARCH ARTICLE | March 21, 2021
Evaluation of the Impact of Smoking on Spondyloarthritis: Data from the Moroccan Biotherapy Register (RBSMR)
Bouayad S, Rostom S, Hmamouchi I, El Binoune I, Amine B, Abouqal R, Achemlal L, Allali F, El Bouchti I, El Maghraoui A, Ghozlani I, Hassikou H, Harzy T, Ichchou L, Mkinsi O, Niamane R, Bahiri R
Page no 105-109
Objective: The aim of our study was to determine the prevalence of smoking and its impact on the various parameters of spondyloarthritis based on collected data from the Moroccan biotherapy register. Materials and methods: This is a multicenter study based on data from the Moroccan biotherapy register related to patients suffering from spondyloarthritis. An analysis of the socio-demographic parameters as well as an evaluation of the variables associated with the disease were performed. Univariate and multivariate logistic regressions were conducted to assess what the impact of smoking is on the various spondyloarthritis parameters. p<0.05 was set to be the significant threshold. Results: The study is based on data collected from 194 patients (21 smokers and 173 non-smokers) suffering from AS included in the Moroccan biotherapy register. The prevalence of smoking was 10.8%. Male gender was associated with smoking (63% of men in non-smoking group versus 90% of men in the smoking group) (p = 0.006). In addition, a higher CRP: 8 [2-17] was observed in the smoking group compared to 5.5 [2-28] in the non-smoking group (p = 0.048). No significant difference between the 2 groups was statistically noted in terms of the disease activity evaluated by the BASDAI and ASDAS CRP score which were respectively 2.77 +/- 1.82 and 2.25 ± 1.66 in the smoking group and 3.24 +/- 2.15 and 2.09 ± 1.7 in the non-smoking one. Furthermore, our results did not reveal a significant correlation between smoking and the functional impact of spondyloarthritis. No correlation was established between smoking and the structural progression of the disease. Conclusion: Our study suggests that male gender and a higher CRP are statistically associated with tobacco consumption. Larger scale studies are needed to support these results.
ORIGINAL RESEARCH ARTICLE | March 21, 2021
Histomorphological Spectrum of Orbito-Ocular Lesions at Tertiary Care Center
Dr. Anu Sahjlan, Dr. Anita Harsh, Dr. Sapna Gandhi, Dr. Kusum Mathur, Dr. Ranjana Solanki
Page no 110-115
Eye is a special sensory organ which exhibits diverse histological structures. It shows wide spectrum of pathologies ranging from trauma, degenerative, inflammatory, and neoplastic conditions. So this study was done to determine the pattern and proportion of different ophthalmic lesions in hospital. Total 95 biopsies and specimens of orbito-ocular lesions were received and were examined after H & E staining and immunohistochemistry was applied whenever required. This study was carried out in the Department of Pathology, SMS Medical College, Jaipur, for the duration of 1 year. It was found that females 50 (52.63%) were more commonly affected than male 45 (47.36%) with male to female ratio of 0.9: 1. The orbito-ocular lesions were highest 20 (21.05%) in age group of 0-10 years. The lesions were categorised as Non-neoplastic 7 (7.36%), Benign 40 (42.10%) and Malignant 48 (50.52%). Eyelid 48 (50.52%) was the most commonly involved site followed by conjunctiva, and was the significant finding. Most common benign lesion was epidermoid cyst 10 (25%). Among malignant lesions squamous cell carcinoma 12 (25%) was most common. Retinoblastoma was the commonest intraocular malignancy in paediatric age group. All surgically resected ophthalmic lesions should always be subjected to histopathological examination to establish the accurate diagnosis for further management.
CASE REPORT | March 26, 2021
Ileal Duplication Cyst: A Case Report
Dr. Sreelekshmi S. N, Dr. Lillykutty Pothen, Dr. Sankar S
Page no 116-118
Gastrointestinal duplications are rare congenital malformations that may vary greatly in presentation, size, location and symptoms. They can present as solid/cystic tumors, intussusception, perforation or bleeding. A high index of suspicion is needed in all such cases. Radiologic studies may not be enough for a diagnosis. We present a case of ileal duplication cyst in a 2 month old baby who presented with features of abdominal obstruction. Suspecting it to be an infected mesenteric cyst from radiological studies, surgical excision with anastomosis of the ileal segment was done. The histopathological examination of the resected specimen diagnosed it as an enteric duplication cyst.
ORIGINAL RESEARCH ARTICLE | March 28, 2021
A Study of Prevalence and Most Common Genotypes of HPV (Human Papilloma Virus) by Molecular Methods and its Comparison to Pap smear, VIA and VILI Methods
Page no 119-124
Background: Infection with high-risk genotypes of Human papillomaviruses (HPV) is the major factor in the pathogenesis of cervical cancer. HPV genotypes 16,18,31,45 causes 90 % of cervical cancer and these high-risk HPV genotypes cause nearly 100% of invasive cervical cancer. Cervical cancer can be prevented by vaccination against HPV high-risk genotypes. Effective cancer treatment programmes can improve survival rates for cervical cancer. Materials and Method: This study was aimed to evaluate the prevalence of HPV high-risk genotypes, so that high-risk individuals could be targeted, and specific genotypes associated with cervical cancer to be included in the vaccine preparations. Symptomatic patients visiting Gynaecology OPD of tertiary care hospital in India were recruited and Conventional PCR assay was done for detection of High-Risk genotypes of HPV causing cervical cancer. Statistical Analysis was done with PASW 18.0 (Predictive Analysis Software) by statistician. P value obtained by Chi Square test and p<0.05 was considered significant. Results: Out of the 72 symptomatic cases PCR was positive in 17 patients (23.6 %). In asymptomatic cases PCR positivity was 10.7%. Out of the100 patient’s PCR was positive in 20% of the cases. Among the symptomatic PCR was positive in 17 cases. HPV -16 (9.7 %) was the most common genotype among them. Infection with multiple genotypes 16 and 18 was positive in 6 cases (8.3 %), HPV -31 &45 was positive in 2 cases (2.8 %.) HPV -18 was positive in 2 cases (2.8 %) Among the asymptomatic HPV 16 in one case (3.5%), HPV-31 in one case (3.5 %), HPV -31&45 in one case (3.5 %). Conclusion: Our study results suggested inclusion of HPV 31 and 45 genotypes in HPV vaccine available and marketed in India.