Besides well-known mycobacterial pathogens such as Mycobacterium tuberculosis and M. leprae, others have been lumped together and given various nomenclatures such as atypical mycobacteria, anonymous ...mycobacteria, mycobacteria other than M. tuberculosis complex (MOTT) and NTM. Several reports on NTM disease were published in the next 20-25 years. Besides 10 species isolated in this study1 published in this issue, other NTM species reported from patients from India include M. chelonae, M. fortuitum, M. mucogenicum, M. avium, M. triviale, M. celatum, M. porcinum, M. massiliense, M. phlei and M. genavense. ...of the nearly 50 NTM species known to be opportunistic pathogens in humans across the world, only half have been reported from India4.
By age of 5 years, almost every child will have been infected by rotavirus. ...in 2005 with the aim of systematically collection of data and to have a sustainable surveillance program, the Indian ...Council for Medical Research (ICMR) in collaboration with Centers for Disease Control and Prevention (CDC) in Atlanta, USA, established a network for hospital based surveillance of rotavirus in different parts of the country.
The membership list of genus mycobacterium is ever expanding and it has grown to 95 in year 2003. While leprosy and tuberculosis are specific diseases caused by mycobacteria, other members are ...usually saprophytes but can be opportunistic and at times deadly pathogens. These other mycobacteria are referred to as atypical mycobacteria, non-tuberculous mycobacteria (NTM) or mycobacteria other than tubercle bacilli (MOTT). These organisms can produce localized disease in the lungs, lymph glands, skin, wounds or bone. Occasionally they may produce disseminated disease. Of the more than 90 known species of NTM, about one third have been associated with disease in humans. The species causing human disease are : Mycobacterium avium, M. intracellulare, M. kansasii, M. paratuberculosis, M. scrofulaceum, M. simiae, M. habana, M. interjectum, M. xenopi, M. heckeshornense, M. szulgai, M. fortuitum, M. immunogenum, M. chelonae, M. marinum, M. genavense, M. haemophilum, M. celatum, M. conspicuum, M. malmoense, M. ulcerans, M. smegmatis, M. wolinskyi, M. goodii, M. thermoresistible, M. neoaurum, M. vaccae, M.palustre, M. elephantis, M. bohemicam and M. septicum. Isolation of these mycobacteria from representative specimens and their rapid identification is very important as the treatment strategy for tuberculosis and other mycobacterioses is different. Several biochemical, chemical (lipid) and molecular techniques have been developed for rapid identification of these species. Along with suggestive clinical features, poor response to antitubercular treatment and repeated isolation of the organisms from the clinical specimens these techniques can help in establishing correct diagnosis. Further, many drugs like rifampicin, rifabutin, ethambutol, clofazimine, amikacin, new generation quinolones and macrolides effective against mycobacterial infections are available that can be used in appropriate combinations and dosage to treat these infections.
In spite of a consistent protection against tuberculosis (TB) in children, Mycobacterium bovis Bacille Calmette-Guerin (BCG) fails to provide adequate protection against the disease in adults as well ...as against reactivation of latent infections or exogenous reinfections. It has been speculated that failure to generate adequate memory T cell response, elicitation of inadequate immune response against latency-associated antigens and inability to impart long-term immunity against M. tuberculosis infections are some of the key factors responsible for the limited efficiency of BCG in controlling TB.
In this study, we evaluated the ability of a DNA vaccine expressing α-crystallin--a key latency antigen of M. tuberculosis to boost the BCG induced immunity. 'BCG prime-DNA boost' regimen (B/D) confers robust protection in guinea pigs along with a reduced pathology in comparison to BCG vaccination (1.37 log(10) and 1.96 log(10) fewer bacilli in lungs and spleen, respectively; p<0.01). In addition, B/D regimen also confers enhanced protection in mice. Further, we show that B/D immunization in mice results in a heightened frequency of PPD and antigen specific multi-functional CD4 T cells (3(+)) simultaneously producing interferon (IFN)γ, tumor necrosis factor (TNF)α and interleukin (IL)2.
These results clearly indicate the superiority of α-crystallin based B/D regimen over BCG. Our study, also demonstrates that protection against TB is predictable by an increased frequency of 3(+) Th1 cells with superior effector functions. We anticipate that this study would significantly contribute towards the development of superior booster vaccines for BCG vaccinated individuals. In addition, this regimen can also be expected to reduce the risk of developing active TB due to reactivation of latent infection.
Injuries are a major public health problem, resulting in high health care demand and economic burden. They result in loss of disability adjusted life years (DALYs) and high out-of-pocket expenditure. ...However, there is little evidence on the economic burden of injuries in India. We undertook this study to report out-of-pocket expenditure and the prevalence of catastrophic health expenditure for injuries related hospitalizations in public sector hospitals in North India. Further, we also evaluate the determinants of catastrophic health expenditure.
A prospective observational study was conducted. Participants were recruited from three hospitals for all injury cases. Data were collected via face-to-face baseline interviews and follow-up interviews over the phone at 1, 2, 4 and 12 months post-injury. Prevalence of catastrophic health expenditure (more than 30% of consumption expenditure) and impoverishment (International dollar 1.90) were estimated.
Road traffic injuries (57%) were the leading cause of injury. Direct out-of-pocket expenditure for hospitalizations was INR 16,768 (USD 263) while indirect productivity loss was INR 8,164 (USD 128). The prevalence of catastrophic expenditure was 22.2% with 12.2% slipping below poverty line. Prevalence of catastrophic health expenditure and impoverishment was higher and significantly associated with poorest quintile, tertiary care hospital and increased duration of hospitalization (p< 0.001).
The economic impact of injuries is notably high both in terms of out-of-pocket expenditure and productivity loss. A high proportion of households experienced catastrophic expenditure and impoverishment following an injury, highlighting need for programs to prevent injuries.
Highlights ► Assessment of protective efficacy of rBCG over-expressing SOD-A against TB. ► Over-expression of SOD in BCG completely abrogates protection of BCG vaccine. ► rBCG infected macrophages ...show reduction in apoptosis and microbicidal potential. ► Vaccination with rBCG skews the immune responses towards Th2 type. ► rBCG vaccination fails to generate effective multi-functional CD4 T cell response.
Large area X-ray propositional counter (LAXPC) instrument on
AstroSat
is aimed at providing high time resolution X-ray observations in 3–80 keV energy band with moderate energy resolution. To achieve ...large collecting area, a cluster of three co-aligned identical LAXPC detectors, is used to realize an effective area in access of
∼
6000
cm
2
at 15 keV. The large detection volume of the LAXPC detectors, filled with xenon gas at
∼
2 atmosphere pressure, results in detection efficiency greater than 50%, above 30 keV. In this article, we present salient features of the LAXPC detectors, their testing and characterization in the laboratory prior to launch and calibration in the orbit. Some preliminary results on timing and spectral characteristics of a few X-ray binaries and other type of sources, are briefly discussed to demonstrate that the LAXPC instrument is performing as planned in the orbit.
We present the calibration and background model for the Large Area X-ray Proportional Counter (LAXPC) detectors on board AstroSat. The LAXPC instrument has three nominally identical detectors to ...achieve a large collecting area. These detectors are independent of each other, and in the event analysis mode they record the arrival time and energy of each photon that is detected. The detectors have a time resolution of 10 s and a dead-time of about 42 s. This makes LAXPC ideal for timing studies. The energy resolution and peak channel-to-energy mapping were obtained from calibration on the ground using radioactive sources coupled with GEANT4 simulations of the detectors. The response matrix was further refined from observations of the Crab after launch. At around 20 keV the energy resolution of the detectors is 10%-15%, while the combined effective area of the three detectors is about 6000 cm2.
Background & objectives: Mycobacterium tuberculosis (M. tuberculosis) has four homologous mammalian cell entry (mce) operons (mce1-4) that encode exported proteins and have a possible role in the ...virulence mechanism of this pathogen. The expression of mce operon is considered to be complex and not completely understood. Although expression of mce operon at different in vitro growth phases has been studied earlier, its expression in different M. tuberculosis isolates under different growth phases is not yet studied. The present preliminary study was conducted on a limited number of isolates to know the trend of expression pattern of mce operon genes in different M. tuberculosis isolates under different growth stages.
Methods: In this study, we monitored the transcriptional profile of selected mce operon genes (mce1A, mce1D, mce2A, mce2D, mce3A, mce3C) in different M.tuberculosis isolates (MDR1, MDR2, and sensitive isolate) at early exponential and stationary phases using real-time quantitative PCR.
Results: The expression ratio of all selected mce operon genes in all M. tuberculosis isolates was reduced at the initial phase and increased substantially at a later phase of growth. Higher expression of mce1 operon genes was found in all M. tuberculosis isolates as compared to other mce operon genes (mce2 and mce3 operons) at stationary growth phase.
Interpretation & conclusions: the higher expression of mce operon genes at stationary phase (as compared to early exponential phase) suggested growth phase dependent expression of mce operon genes. This indicated that the mce operon genes might have a role in M. tuberculosis survival and adaptation on the onset of adverse condition like stationary phase. Identification of differentially expressed genes will add to our understanding of the bacilli involved in adaptation to different growth conditions.
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