A study of paraoxonase1 (PON1) activities,HDL cholesterol and its association with vascular complication in type 2 diabetes mellitus

The aim of this study is to find out the clinical relevance of estimating serum paraoxonase1 (PON1) arylesterase and PON1 lactonase activity in type 2 diabetes mellitus patients in relation to the development of vascular complications. We have investigated the fasting blood glucose level, HDL cholesterol levels, PON1 arylesterase and PON1 lactonase activities in 80 type 2 diabetes mellitus (DM) patients (DM without complication n?=?40, DM with vascular complication n?=?40) and compared with 40 healthy age- and sex-matched controls. PON1 arylesterase (ARE) and lactonase (LACT) activities in DM patients with complications (ARE?=?60.615?±?15.510 KU/L, LACT?=?18.056?±?4.215 U/L) are decreased significantly than in DM without complications (ARE?=?93.507?±?21.813 KU/L, LACT?=?32.387?±?8.918 U/L) which are also decreased significantly as compared to controls (ARE?=?159.94?±?45.87 KU/L, LACT?=?50.625?±?6.973 U/L). Logistic regression analysis is applied for assessing predictive utility for diabetic complications demonstrated a significant contribution of PON1 lactonase (Naglekerke’s R ²?=?0.625, AUC?=?0.907) and arylesterase (Naglekerke’s R ²?=?0.427, AUC?=?0.853) activities. Decreased PON1 lactonase and arylesterase activities may be considered as an additional risk factor for the development of vascular complications in type 2 DM.     

Bilateral adrenal histoplasmosis in immunocompetent patients

Histoplasmosis is a fungal infection caused by Histoplasma capsulatum, which commonly presents as transient pulmonary infection that usually subsides without treatment. Disseminated histoplasmosis may affect almost all systems, including the reticuloendothelial system, lungs, gastrointestinal tract, renal tract, central nervous system, bone marrow, and adrenal glands. Adrenal gland is frequently involved in disseminated histoplamosis but commonly present as unilateral mass; bilateral involvement is rare. It is also rare in immunocompetent hosts and only few cases have been reported in past. We report four cases of adrenal histoplasmosis with bilateral involvement. These cases were initially diagnosed cytopathologically on fine needle aspirations performed on adrenal glands. All these patients were immunocompetent and two of them also had associated adrenal insufficiency. Diagnosis of adrenal histoplasmosis can be easily made on fine needle aspiration cytology. Adrenal histoplasmosis can occur in immunocompetent individuals and should be considered in differential diagnosis of bilateral adrenal masses in immunocompetent individuals. Diagn. Cytopathol. 2011;39:294–296. © 2010 Wiley‐Liss, Inc.     

Small Bowel Adenocarcinoma – Report of Two Cases and Review of Literature

Although accounting for 90 % of the intestinal surface area, small bowel adenocarcinomas are not common. The majority of these lesions are incidentally detected during laparotomy for intestinal obstruction or perforation. The symptoms associated with these lesions are not very specific and preoperative diagnosis is rare. We report two cases of jejunal adenocarcinomas detected in patients undergoing laparotomy for acute abdomen and review the literature for small bowel adenocarcinomas.     

Evaluating the efficacy of stool sample on Xpert MTB/RIF Ultra and its comparison with other sample types by meta-analysis for TB diagnostics

European Journal of Clinical Microbiology & Infectious Diseases - Precise and timely detection of tuberculosis (TB) is crucial to reduce transmission. This study aims to assess the accuracy of...     

Molecular mechanisms associated with Fluconazole resistance in clinical Candida albicans isolates from India

Resistance to azole antifungals is a significant problem in Candida albicans. An understanding of resistance at molecular level is essential for the development of strategies to tackle resistance and rationale design of newer antifungals and target‐based molecular approaches. This study presents the first evaluation of molecular mechanisms associated with fluconazole resistance in clinical C.albicans isolates from India. Target site (ERG11) alterations were determined by DNA sequencing, whereas real‐time PCRs were performed to quantify target and efflux pump genes (CDR1, CDR2, MDR1) in 87 [Fluconazole susceptible (n = 30), susceptible‐dose dependent (n = 30) and resistant (n = 27)] C.albicans isolates. Cross‐resistance to fluconazole, ketoconazole and itraconazole was observed in 74.1% isolates. Six amino acid substitutions were identified, including 4 (E116D, F145L, E226D, I437V) previously reported ones and 2 (P406L, Q474H) new ones. CDR1 over‐expression was seen in 77.7% resistant isolates. CDR2 was exclusively expressed with CDR1 and their concomitant over‐expression was associated with azole cross‐resistance. MDR1 and ERG11 over‐expression did not seem to be associated with resistance. Our results show that drug efflux mediated by Adenosine‐5′‐triphosphate (ATP)‐binding cassette transporters, especially CDR1 is the predominant mechanism of fluconazole resistance and azole cross‐resistance in C. albicans and indicate the need for research directed towards developing strategies to tackle efflux mediated resistance to salvage azoles.