Abstract: Multi Drug Resistant Tuberculosis (MDR-TB) is an emerging problem of great importance to public health worldwide. Resistance to Rifampicin (RIF) and Isoniazid (INH) are considered as surrogate markers for MDR-TB. Resistance in Mycobacterium tuberculosis to Rifampicin is reported to be conferred by mutation in an 81bp rifampicin resistance determining region (RRDR) of the β subunit of RNA polymerase encoded by rpoB gene corresponding to codons 507-533. Resistance to Isoniazid is conferred by mutation in Catalase-peroxidase gene (katG), alkyl hydroperoxidase gene (aphC) and enoyl acyl reductase gene (inhA). The aim of this study was to identify the mutation conferring resistance to INH and by automated DNA sequencing. Seventy-four isolates of M. tuberculosis were tested phenotypically with four anti tuberculosis drugs namely Rifmapicin (RIF), Isoniazid (INH), Ethambutol (EMB) and Streptomycin(SM) by absolute concentration method. Three isolates from pulmonary tuberculosis (PTB) patients were resistant to RIF with minimum inhibitory concentration (MIC) greater than or equal to 128µg/ml and to INH with MIC greater than are equal to 1.5 µg/ml. The genome of these three MDR-TB isolates were amplified by Polymerase Chain Reaction (PCR) and DNA sequencing was performed. All three isolates showed a point mutation at codon 315 (Ser ® Thr) in the sequenced katG region for INH resistance, but did not show any mutation in the 81bp hotspot sequenced rpoB region for resistance and promoter region of inhA and aphC for INH resistance. Two of three isolates were from patients who had not taken treatment previously which is of great concern with respect to public health.

Abstract: Cryptogenic epilepsy is a group of epilepsy syndromes where aetiology is unknown but an underlying brain disease is suspected. Increased seropositivity for Toxocara and Toxoplasma gondii have been observed in epileptic patients with sparse data about their seropositivity in cryptogenic epileptic patients. Therefore, we investigated the probable relationship between seropositivity against T. gondii and Toxocara with cryptogenic epilepsy. We examined patients who had cryptogenic epilepsy and healthy non epileptic controls for seropositivity for Toxocara and T. gondii antibodies by ELISA. Out of 132 cryptogenic epileptic patients, 80 (60.6 %) and 64 (48.5%) were seropositive for T. gondii and Toxocara immunoglobulin G (IgG) antibodies respectively. The seropositivity in the control group was 26 (43.3%) and 28 (46.7%) for T. gondii and Toxocara IgG respectively. We found a significant association between chronic T. gondii infection and cryptogenic epilepsy while the association between Toxocara infection and cryptogenic epilepsy was insignificant. Our findings indicate that toxoplasmosis may be a cause of cryptogenic epilepsy. We recommended both promoting health education to prevent such infection and screening children for toxoplasmosis which would help early treatment and so decreasing the incidence of epilepsy.

Abstract: After the discovery of human immunodeficiency virus 1 (HIV-1) infection more than three decades ago, there has been a significant development in the laboratory diagnosis, treatment and management of patients on highly active antiretroviral therapy (HAART). Initially HIV-1 infection was implicated to cause various cancerous conditions (Kaposi’s sarcoma), and infectious diseases (tuberculosis, other bacterial, viral, parasitic and fungal infections). Studies have demonstrated that HIV-1 infection and the disease course is complex and that many HIV infected patients do not progress to acquired immune deficiency syndrome (AIDS) even after 10-15 years (late/non progressors). Introduction of HAART has significantly reduced the morbidity and mortality in HIV-1 infected patients resulting in extended life on par with HIV non infected individuals. Late research has revealed that HIV-1-infected individuals are at greater risks of developing non infectious complications (liver disease, cardiovascular disease (CVD)) that may precipitate with the initiation of HAART. With the increased availability and affordability of HAART, the focus now is on developing effective strategies to monitor HIV -1 disease progression and treatment response.

Abstract: Lower respiratory tract infections (LRTI’s) are amongst the most common causes of morbidity and mortality arising from infectious diseases both in the developed and developing nations. Prompt clinical and laboratory diagnosis along with appropriate treatment strategies would be helpful in the management of both community and nosocomially acquired LRTI’s. Our study was aimed at evaluating the aetiology and antimicrobial susceptibility patterns of LRTI’s in a tertiary care teaching hospital in south India. The results of the current study revealed that among the samples tested 56 (52.83%) were positive for various bacteria, 6 (5.6%) were showing the growth of fungi and 44 (41.5%) were revealing no pathogens. Klebsiella pneumoniae (45.1%) was the predominant gram negative bacterial pathogen isolated followed by Citrobacter freundii (12.9%), Pseudomonas aeruginosa (9.6%), and Staphylococcus aureus (9.6%) was the significant gram positive bacterial pathogen followed by Streptococcus pneumoniae (5.6%). The antimicrobial susceptibility pattern of the isolated bacteria indicated the presence of multidrug resistance, the production of Extended spectrum beta lactamases (ESBL) (75%) and metallo-betalactamases/carbapenemases (MBL) (25%) among gram negative bacterial isolates and MRSA (16.6%) and VRSA (16%) among the gram positive bacterial isolates. With varied geographical prevalence, and different antimicrobial susceptibility patterns, it becomes imperative to regularly evaluate the aetiology and antibiotic profiles of LRTI’s and formulate regional guidelines that guide clinical, laboratory diagnosis and management of patients suffering from LRTI’s.

Abstract: A total of 4860 animals were screened 2570(52.88%) were goats and 2290(47.12%) were sheep. The fungi associated with the infections were identified. Of the 2570 and 2290 of goats and sheep, 80(3.11%) and 144(6.29%) had fungal lesions respectively. Fifty soil samples from the environment were collected for fungal analysis and 31 nomads were checked for fungal lesions. Antifungal biogram and animal pathogenicity studies were also done. Prevalence of fungal infections was higher on the animals from farms than those at the markets. Infection was more prevalent in animals between 13-24 months of age. The glaborous skin was mostly affected (37.5%) in the goats, while in the sheep, the face was affected most (62.5%). Fungi recovered from the animals included Trichophyton verrucosum (19.64%), Trichophyton mentagropytes,(20.54%), Microsporum gypsum (5.80%), Sporothrix schenckii (20.98%), Candida albicans (7.59%), Fusarium solanii (5.36%), Geotricum candidum (3.13%) and Aspergillus species (16.96%). Almost the same types of fungi were isolated from the nomads and the soil. These parameters when compared statistically using ANOVA was not significant, P > 0.05. Pathogenecity studies of the isolates on laboratory mice revealed that T.mentagrophytes and T.verrucosum were highly virulent. The antifungal biogram test showed the fungal isolates to be more sensitive to Fluconazole than Ketoconazole, Miconazole and Grisofulvin. Fungal skin infections are communicable diseases and poor sanitary conditions promotes there spread but if proper sanitary measures are taken, the infections may be eradicated.