Treatment of cutaneous lesion of 20 years' duration caused by leishmanization

The inoculation of live Leishmania (L.) major to produce a single lesion is called leishmanization (LZ). LZ lesion upon cure prevents further natural infection which might be multiple lesions on unwanted sites such as face. Cutaneous leishmaniasis (CL) usually leads to a self healing lesion; though rarely the lesion persists and becomes refractory to all types of remedies. Here, we present a 41-year-old patient with a 20-year history of cutaneous lesion caused by leishmanization. The causative agent is identified as L. major. The patient did not respond to treatment with meglumine antimoniate, 20 mg/kg/day Sb(+5) for three weeks and allopurinol 10 mg/kg for four weeks. After two months, the same treatment was repeated. In addition, a topical liposomal preparation containing 10% paromomycin sulfate was administered twice a day for four weeks. The lesion showed marked improvement during the treatment and was eventually completely healed.     

Anti-inflammatory effects of serum isolated from animals on intermittent feeding in C6 glioma cell line

Multiple sclerosis (MS) is a demyelinating disease of the CNS. Early inflammation leads to later destruction of myelin in MS. Dietary restriction (DR) produces anti-inflammatory and immunomodulatory effects in many species. Based on the reported anti-inflammatory effects of DR, we investigated whether sera collected from rats fed on intermittent feeding (IF, a type of DR) diet could modulate cytokine secretion and matrix metalloproteinase (MMP-2) activity that are involved in MS pathogenesis. Cytokine levels (IL-6 and TGF-β1) were measured in supernatant from C6 glioma cell line cultures treated with IF and AL fed animals' sera by enzyme-linked immunosorbent assay (ELISA) and MMP-2 activity was detected by gelatin zymography. Our results indicated that sera of animals on IF diet significantly reduced IL-6 (p<0.05) and increased TGF-β1 (p<0.05) production by C6 glioma cells. A significant decrease (p<0.05) in MMP-2 activity was also found. These results indicate anti-inflammatory and immunomodulatory activity in the sera of animals on IF regimen on cells involved in multiple sclerosis pathogenesis. Further studies on the detection of factors responsible for such activities and their mechanism of action in MS pathogenesis are recommended.     

Is neonatal group B streptococcal infection preventable?

Early onset group B streptococcal (EOGBS) infection causes significant neonatal morbidity and mortality. We determined the incidence of EOGBS at Galway University Hospital (GUH) and examined any "missed opportunities" for preventing neonatal infection between 2004 and 2009. Our obstetric approach is risk-based. The incidence was 0.45/1,000 live-births; one death and one with neurological sequelae. A single mother received IAP; however we could not determine any potential for reducing cases of EOGBS by improving current IAP usage.     

Myths about diabetes mellitus among non-diabetic individuals attending primary health care centers of karachi subrubs

Objective: To determine the myths and misconception about diabetes mellitus among non-diabetics attending primary health care centers of Gadap town, Karachi. Design: Cross-sectional study. Place and Duration of the Study: Primary Health Care Centers, Gadap Town, Karachi, during the month of July 2005. Patients and Methods: Data was collected from four primary health care centers, located at Gadap Town, Karachi, and about 198 non-diabetic patients, above 18 years of age, and resident of Gadap Town, coming consecutively during the month of July 2005, were interviewed after taking the informed consent by using a semi-structured pre-tested questionnaire regarding prevailing myths about diabetes mellitus. The data collected was entered and analyzed by using a statistical package SPSS 11.0. Myths are defined as stories shared by a group, as part of the cultural identity. Results:There were 198 participants in the study. Mean age of study participants was 40 years with standard deviation of 13, while approximately two thirds, 62.6%, were females. About 39% had history of type II diabetes mellitus in family. Overall myths related to diabetes mellitus were common among the individuals, males reported myths pre-dominantly contagiousness of diabetes (p= < 0.03), diabetics becoming more ill (p=<0.009) and belief in spiritual treatment for permanent cure of diabetes (p=< 0.006). People having 5-16 years of education were less misconceived as compared to illiterates. The variables that showed significant difference were over-eating, causing diabetes (p= < 0.006), diabetics falling ill more than others (p=< 0.04), eating less starch (p= < 0.0006) and alternative treatment like spiritual treatment (p=< 0.00001). Family history of diabetes was also found significantly associated with reporting myths. Conclusion: Frequency of reporting myths was significantly high in this study with preponderance of males, family history of diabetes mellitus and educational status. Education serves as protective factor, hence efforts should be made to promote education and health awareness regarding the disease, with more emphasis on addressing myths regarding diabetes mellitus.     

A survey on 30 months electrical burns in Shiraz University of Medical Sciences Burn Hospital

Electrical burn is less common nowadays but still has complications and requires therapeutic interventions especially in developing countries. It occurs more in males and in industrial sites. The importance of electrical burn led us to study a 30 months history of electrical burn in Shiraz, Southern Iran. In a cross-sectional retrospective study, 1352 patients were surveyed for 30 months in relation to the cause, time, demographic information, therapeutic measures and prognosis of the electrical burn. Among burn patients, 4.73% were due to electrical burns (mean age, 30.5 years) and 95.3% were male. The mean hospitalization period was 11.5 days and the mean burn extent was 27.5%. Half of the victims were employees and 59.3% of the electrical burns occurred at their work site. 67.2% of burns were due to high voltage electrical current (more than 1000 V) and 4.6% of the patients died due to the direct cause of electrical burn. The high prevalence of electrical burn in males and workers emphasizes on the essence of standardization of occupational areas and use of trained workers to prevent electrical burns.     

Comparison of serology, culture, and PCR for detection of brucellosis in slaughtered camels in Iran

Brucellosis is a zoonotic disease which is characterized by abortion and reduced fertility in many species. Camel brucellosis is caused by Brucella abortus and Brucella melitensis. To investigate sensitive methods in the detection of camel brucellosis, PCR was used to overcome the limitations of serology and culture methods. Three hundred ten camels were examined for brucellosis infection using serological tests (RBPT, mRB, Wright, and 2-ME). In addition, 100 serological tested cases (39 mRB positive and 61 mRB negative) were analyzed with both bacteriological (lymph node culture on Brucella agar supplemented with antibiotics) and PCR (nested-PCR on sera and blood samples) methods. The nested-PCR was genus-specific and amplified the 16S rDNA locus. Six out of 310 (1.94 %) of the examined camels were positive using the serological tests, whereas, no bacteria was isolated from lymph tissues. Nested-PCR was positive in six and nine individuals in sera and blood samples, respectively. The genus-specific nested-PCR assay on blood samples detected a higher number of camel brucellosis compared with serological and classical culture methods. These results have identified a sensitive PCR method which could be used as a complement test for the detection of brucellosis in live camels with the lowest risk of infection to laboratory workers.     

Temperature and the development and survival of infective <Emphasis Type="Italic">Toxocara canis</Emphasis> larvae

The influence of temperature on the development and survival of Toxocara canis larvae was investigated under laboratory conditions, in water at 15, 20, 25, 30 and 35°C and at room temperature 22°C ± 1°C. T. canis eggs were able to develop to the larvated stage at all the tested temperatures. Development rate increased with temperature. Linear regression of development rate against temperature predicted a lower development threshold of 11.8°C. Eggs survived cooling to 1 and −2°C for 6 weeks, and could develop to the infective, larvated stage when transferred to higher temperatures, but their development rates were then retarded compared with non-chilled eggs. Larvated eggs remained viable after 7 weeks of incubation across the tested temperature range, with the highest percentage viability (47%) obtained at 25°C. Development of eggs to the infective larval stage required, on average, 121 degree days between 20°C and 30°C. Results provide a basis for predicting variation in the infectivity of eggs in the environment over time in different climates.     

Screening of a Large Cohort of Leber Congenital Amaurosis and Retinitis Pigmentosa Patients Identifies Novel LCA5 Mutations and New Genotype–Phenotype Correlations

This study was undertaken to investigate the prevalence of sequence variants in LCA5 in patients with Leber congenital amaurosis (LCA), early‐onset retinal dystrophy (EORD), and autosomal recessive retinitis pigmentosa (arRP); to delineate the ocular phenotypes; and to provide an overview of all published LCA5 variants in an online database. Patients underwent standard ophthalmic evaluations after providing informed consent. In selected patients, optical coherence tomography (OCT) and fundus autofluorescence imaging were possible. DNA samples from 797 unrelated patients with LCA and 211 with the various types of retinitis pigmentosa (RP) were screened by Sanger sequence analysis of all LCA5 exons and intron/exon junctions. Some LCA patients were prescreened by APEX technology or selected based on homozygosity mapping. In silico analyses were performed to assess the pathogenicity of the variants. Segregation analysis was performed where possible. Published and novel LCA5 variants were collected, amended for their correct nomenclature, and listed in a Leiden Open Variation Database (LOVD). Sequence analysis identified 18 new probands with 19 different LCA5 variants. Seventeen of the 19 LCA5 variants were novel. Except for two missense variants and one splice site variant, all variants were protein‐truncating mutations. Most patients expressed a severe phenotype, typical of LCA. However, some LCA subjects had better vision and intact inner segment/outer segment (IS/OS) junctions on OCT imaging. In two families with LCA5 variants, the phenotype was more compatible with EORD with affected individuals displaying preserved islands of retinal pigment epithelium. One of the families with a milder phenotype harbored a homozygous splice site mutation; a second family was found to have a combination of a stop mutation and a missense mutation. This is the largest LCA5 study to date. We sequenced 1,008 patients (797 with LCA, 211 with arRP) and identified 18 probands with LCA5 mutations. Mutations in LCA5 are a rare cause of childhood retinal dystrophy accounting for ～2% of disease in this cohort, and the majority of LCA5 mutations are likely null. The LCA5 protein truncating mutations are predominantly associated with LCA. However, in two families with the milder EORD, the LCA5 gene analysis revealed a homozygous splice site mutation in one and a stop mutation in combination with a missense mutation in a second family, suggesting that this milder phenotype is due to residual function of lebercilin and expanding the currently known phenotypic spectrum to include the milder early onset RP. Some patients have remaining foveal cone structures (intact IS/OS junctions on OCT imaging) and remaining visual acuities, which may bode well for upcoming treatment trials.     

Interleukin-32: a cytokine and inducer of TNFalpha

We describe the gene structure, regulation, signal transduction. and functions of a cytokine, interleukin (IL)-32. An IL-18 unresponsive cell was converted to a responsive cell by transfection of the IL-18 receptor beta chain, and IL-18-induced microarray revealed high expression of a cytokine-like gene. Although IL-32 does not share sequence homology with known cytokine families, IL-32 induces various cytokines, human TNFalpha, and IL-8 in THP-1 monocytic cells as well as mouse TNFalpha and MIP-2 in Raw macrophage cells. IL-32 activates typical cytokine signal pathways of nuclear factor-kappa B (NF-kappaB) and p38 mitogen-activated protein kinase. IL-32 mRNA is highly expressed in immune tissue rather than other tissues. Human IL-32 exists as four splice variants, and IL-32 from other species were found as expressed sequence tag clones in the databank. Induced in human peripheral lymphocyte cells after mitogen stimulation, in human epithelial cells by IFNgamma, and in NK cells after exposure to the combination of IL-12 plus IL-18, IL-32 may play a role in inflammatory/autoimmune diseases.