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.     

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.     

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.