Scalp lesion in a lepromatous patient--case report

The occurrence of lesions over the scalp in an Indian lepromatous patient has been reported. The scalp lesion had histological features consistent with lepromatous leprosy.     

Calcification of nerves in leprosy--report of three cases

Three cases of leprosy who showed evidence of calcification of nerve trunks on radiological examination are reported. Two of these had calcified ulnar nerve at elbow and in one lateral popliteal nerve was calcified at the knee level.     

Produced Water Treatment with Conventional Adsorbents and MOF as an Alternative: A Review

A large volume of produced water (PW) has been produced as a result of extensive industrialization and rising energy demands. PW comprises organic and inorganic pollutants, such as oil, heavy metals, aliphatic hydrocarbons, and radioactive materials. The increase in PW volume globally may result in irreversible environmental damage due to the pollutants’ complex nature. Several conventional treatment methods, including physical, chemical, and biological methods, are available for produced water treatment that can reduce the environmental damages. Studies have shown that adsorption is a useful technique for PW treatment and may be more effective than conventional techniques. However, the application of adsorption when treating PW is not well recorded. In the current review, the removal efficiencies of adsorbents in PW treatment are critically analyzed. An overview is provided on the merits and demerits of the adsorption techniques, focusing on overall water composition, regulatory discharge limits, and the hazardous effects of the pollutants. Moreover, this review highlights a potential alternative to conventional technologies, namely, porous adsorbent materials known as metal–organic frameworks (MOFs), demonstrating their significance and efficiency in removing contaminants. This study suggests ways to overcome the existing limitations of conventional adsorbents, which include low surface area and issues with reuse and regeneration. Moreover, it is concluded that there is a need to develop highly porous, efficient, eco-friendly, cost-effective, mechanically stable, and sustainable MOF hybrids for produced water treatment.     

Potential of dynamic bacterial communities in the bio-corrosion process: a proof study with surface morphology of metal coupons

Bio-corrosion is a well-known phenomenon of corrosion caused by bacterial communities. It is considered as a worldwide problem as it causes billion-dollar damages to the pipeline industries (mainly oil and gas) each year. Therefore, this investigation was undertaken to understand the significance of bacterial communities in the bio-corrosion system by studying the physical alteration in the metal surface of coupons through different techniques (EIS, XRD, FT-IR and SEM) and the community identification of consortia responsible for the corrosion. Furthermore, supporting data were obtained from APS reductase assays and DAPI microscopy. The EIS plots suggested that the metal coupons in a biotic system were more prone to corrosion than the coupons in an abiotic system. FT-IR analysis of the biotic system validated the presence of magnetite (Fe₃O₄), goethite (α-FeOOH) and lepidocrocite (γ-FeOOH); the XRD spectrum confirmed the presence of oxide and sulphide of iron (Fe₃O₄ and FeS), which are considered as notable compounds for corroding substances. The community profile indicated the presence of mixed anaerobic consortia containing Firmicutes and Proteobacteria (beta and delta) in the cultured sample. The presence of Desulfovibro sp. and Clostridium sp. in the consortium revealed a synergistic effect, where the by-product of one species acted as a carbon source for the other species, which further established the bio-corrosion process by depositing oxides of iron and sulphur on the metal coupon surface. This study signifies that a mixed culture has a greater impact on the bio-corrosion process than the pure and single culture of Desulfovibro sp. Furthermore, this study also provides a bio-monitoring strategy for the pipeline industries.

Bio-corrosion is a well-known phenomenon of corrosion caused by bacterial communities.     

Cohort study of the seasonal effect on nasal carriage and the presence of Mycobacterium leprae in an endemic area in the general population

Leprosy continues to be a significant health problem in certain pockets in developing countries. Better understanding of the transmission and source of the infection would help to decipher the transmission link, leading to control of the spread of the disease. The nose is considered to be a portal of entry, suggesting an aerial route for transmission through droplet infection. The evidence suggests that many individuals from endemic countries carry Mycobacterium leprae in their nasal cavities without having obvious symptoms of leprosy. The objective of the present study was to assess the presence of M. leprae on the nasal mucosa in the general population from a leprosyendemic pocket. M. leprae detection was carried out using PCR targeting RLEP. Four hundred subjects from an area highly endemic for leprosy were included in the study and followed up during three different seasons—winter, summer, and monsoon—for evidence of nasal exposure to M. leprae. PCR positivity for M. leprae was observed in 29%, 21% and 31% of the samples collected in winter, summer and the monsoon season, respectively. Twenty-six individuals from the cohort showed amplification for M. leprae for all seasons. Our results are consistent with reports in the literature showing widespread exposure to M. leprae in the endemic community. The results also suggest possible association of the environmental conditions (climate) with the transmission pattern and levels of exposure to M. leprae. However, the present study indicated that the population from highly endemic pockets will have exposure to M. leprae irrespective of season.     

Detection of Mycobacterium leprae DNA from soil samples by PCR targeting RLEP sequences

Despite near elimination of leprosy as a public health problem, several problems in leprosy still remain. These include early detection, determining efficacy of the treatment and differentiating relapses from re-infection. These aspects have important impact on the patients undergoing treatment and also have a bearing on understanding transmission dynamics in the community. While early diagnosis and management do not need major technological inputs, various reports have suggested that M. leprae is found in the environment and may have a role in continued transmission of disease. In earlier studies from other parts of world the presence of M. leprae DNA in the environment has been investigated both by microbiological and molecular studies. In the present study, an attempt was made to extract M. leprae DNA from soil samples, which were collected from eighteen different locations including 3 from our Institute area and 15 from different villages of Ghatampur area. We optimized a protocol for the extraction of DNA and amplified a fragment of M. leprae using specific primers targeting RLEP sequences. It was found that 33.3% of these soil samples collected from areas inhabited by leprosy cases gave positive result for M. leprae specific DNA. The utility of this method needs to be explored on a larger scale to establish the presence of M.leprae in the environment, and its role in the spread of the disease.     

Increased Serum Circulatory Levels of Interleukin 17F in Type 1 Reactions of Leprosy

Purpose

Leprosy is a chronic infectious disease caused by Mycobacterium leprae affecting mainly skin and peripheral nerves. Acute inflammatory episodes in the borderline immunological spectrum of the disease cause severe nerve and tissue damage leading to deformities. Finding of any serological marker for leprosy reactions will help in prediction of reactions and in early treatment intervention. The objective of this study was to measure the serum circulatory levels of Interleukin 17F (IL 17F) and to correlate the levels with type 1 and type 2 reactional states and with clinico-histopathological spectrum of leprosy. We studied IL 17F to delineate its role and its clinical implications in leprosy reactions.

Methods

Patients were classified based on the Ridley DS and Jopling WH Classification and blood samples (5 ml each) were collected from 80 active untreated leprosy cases in Type 1 reaction (T1R), 21 cases in Type 2 (Erythema Nodosum Leprosum ENL) reaction (T2R), 80 cases without reaction (NR), and 94 non-leprosy cases (NL). Serum was separated and measured for IL 17F levels using ELISA (Commercial Kits, R&D Systems Inc., USA).

Results

IL 17F levels were significantly higher in the T1R group when compared to the NR group (p?<?0.001). The borderline lepromatous group showed the highest levels of IL 17F among the other groups in the disease spectrum. Bacteriological index (BI) showed negative correlation with the IL 17F levels.

Conclusion

The results specify that serum circulatory levels of IL 17F are elevated during T1Rs in the borderline spectrum of the disease and thus may play a role in the regulation of inflammatory responses associated with reactions in leprosy.     

Safety and efficacy of ultrasonography as an adjunct to fluoroscopy for renal access in percutaneous nephrolithotomy (PCNL)

Study Type – Therapy (case series) Level of Evidence 4

OBJECTIVE

? To evaluate the safety and efficacy of ultrasonography (US)‐guided renal access in percutaneous nephrolithotomy (PCNL), as compared with conventional fluoroscopy‐guided renal access in a prospective randomized trial.

PATIENTS AND METHODS

? From January 2008 to October 2009, 224 patients with renal calculi undergoing PCNL were randomized into two groups. ? Group 1 (112 patients) underwent PCNL using only fluoroscopy‐guided renal access; while in group 2 (112 patients), US guidance for puncture was used in addition to fluoroscopy. ? The inclusion criteria were: normal renal functions, American Society of Anesthesiology scores 1 or 2, absence of congenital abnormalities, aged 15–70 years, and anticipated single‐tract procedure. The patients in both groups were matched for age, sex, and stone characteristics. ? The Student t‐test was used for statistical analysis with an allowable error of 5%.

RESULTS

? The mean time to successful puncture was 3.2 min and 1.8 min in group 1 and group 2, respectively (P < 0.01). ? The mean duration of radiation exposure to successful puncture was 28.6 s in group 1 and 14.4 s in group 2 (P < 0.01). ? The mean numbers of attempts for successful puncture in the desired calyx was 3.3 in group 1 as compared with 1.5 in group 2 (P < 0.01). ? The meantime taken for tract formation in group 1 was 7.4 min with radiation exposure of 82 s, while in group 2 it took 4.8 min with radiation exposure of 58 s (P < 0.01). ? Successful access was achieved in all patients. All patients were stone‐free at the end of the operation. The hospital stay (2–3 days) was same in both groups. There was no incidence of significant bleeding requiring transfusion during or after surgery. All the patients were followed‐up for a ≥6 months.

CONCLUSION

? US‐guided puncture in PCNL helps in increasing accuracy of puncture and decreasing radiation exposure for the surgical team and the patients.