Heterogeneous Vancomycin Intermediate Staphylococcus aureus Infections in Diabetic and Non-Diabetic Patients - A Hospital-Based Comparative Study.

Purpose: To study the infections caused by methicillin resistant Staphylococcus aureus (MRSA) with emphasis on heterogeneous vancomycin intermediate S. aureus (hVISA) in diabetic and non-diabetic patients and their comparison. Patients and Methods: S. aureus strains isolated from diabetic and non-diabetic patients admitted in four tertiary care hospitals in Coastal Karnataka, South India, were tested for methicillin resistance and included in the present study. Demographic and clinical data of the patients were collected using structured proforma. Antimicrobial susceptibility testing was done using the Kirby-Bauer disc diffusion method, and MLSB phenotypes were identified using the D-test. The minimum inhibitory concentration (MIC) of vancomycin was determined using agar dilution. MRSA isolates were tested for hVISA using vancomycin screen agar and population analysis profile - area under the curve (PAP-AUC) test. Statistical analysis of the results was done using the chi-square test. SPSS version 29.0 was used for this purpose. Results: Out of 665 strains of S. aureus isolated, 220 (33.1%) were MRSA. Of these 220 MRSA strains, 122 (55.5%) and 98 (44.5%) were isolated from diabetic and non-diabetic patients, respectively. There was no significant difference in the antimicrobial resistance patterns of MRSA strains isolated from diabetic and non-diabetic patients. Foot infections and osteomyelitis caused by MRSA were significantly more among diabetic patients. Out of 220 strains of MRSA, 14 (6.4%) were hVISA. The rates of hVISA among MRSA isolated from diabetic and non-diabetic were 9.0% and 3.1%, respectively. This difference was statistically not significant. Conclusion: The rate of hVISA among all MRSA isolates was 6.4%. The risk of hVISA infection was three times more in diabetic patients. The results emphasize the importance of the detection of hVISA among MRSA isolates especially from diabetic patients.

Beneficial Effects of ragi (Finger Millet) on Hematological Parameters, Body Mass Index, and Scholastic Performance among Anemic Adolescent High-School Girls (AHSG).

Adolescence is a period characterized by rapid physical, emotional, and mental growth and changes potentially resulting in health challenges. Anemia, which is a fairly common complication in this age group, is reported to negatively affect the cognitive ability of adolescents. Traditionally, ragi (Finger millet: Eleusine coracana), a cereal available in India, has been recommended as nutritional supplement to combat anemia because of its high protein and mineral content as well as anti-microbial property. This study sought to establish the effect of ragi in improving hematological parameters, body mass index, and scholastic performance among adolescent school girls. Sixty adolescent girls were randomly selected and divided into intervention (n = 30) and control groups (n = 30). The effect of dietary supplementation of ragi porridge on hematological parameters was evaluated on the intervention group at 45 and 90 days. Both groups were monitored for changes in body mass index and scholastic performance. A statistically significant increase in hemoglobin levels was observed in the intervention group after 90 days (from a mean of 11.3 g% to 12.54 g%; t (29) = 7.514, p < .0001), with no significant changes in the control group. No statistically significant differences between the two groups were observed for mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, mean corpuscular volume, red cell distribution width, body mass index, and scholastic performance. The data show that daily dietary supplementation with ragi porridge has a positive effect on hemoglobin levels in adolescent high schools girls. A well planned nutrition education with dietary supplementation is thus recommended for better outcomes.

Tri-phasic fever in dengue fever.

Dengue fever is an acute febrile illness with a duration of 2-12 days. Our observational study observed the 24-h continuous tympanic temperature pattern of 15 patients with dengue fever and compared this with 26 others with fever due to a non-dengue aetiology. A tri-phasic fever pattern was seen among two-thirds of dengue fever patients, but in only one with an inflammatory disease. One-third of dengue fever patients exhibited a single peak temperature. Continuous temperature monitoring and temperature pattern analysis in clinical settings can aid in the early differentiation of dengue fever from non-dengue aetiology.

Gerbode Ventricular Septal Defect -A Rare Cardiac Anomaly Associated with Genetic Variants in Indian Population- A Case Series.

Gerbode defects are rare Ventricular Septal Defects (VSD) constituting approximately one percent cases of congenital heart diseases. The genetic predispositions towards the Gerbode Defect (GD) have remained an unexplored area of study till date. We investigated the genotype-phenotype correlation in patients with Gerbode VSD. Molecular genetic study on Sanger sequencing and subsequent data analysis showed that the contributing sequence variations in the NKX2-5, GATA4 and TBX5 gene lies in one of the highly conserved regions and this region is responsible for encoding a functional protein. The resulting genotype variation may be responsible for causing the diseased phenotype known as GD.

Psychomotor functions at various weeks of chronic renal failure in rats.

In chronic renal failure there is a gradual retention of substances in the tissues and body fluids, called as uremic retention toxins, which can bring about a number of biochemical activities in the body. Chronic renal insufficiency also leads to progressive behavioural conflict. Uremic toxins can affect both the central and the peripheral nervous system. Uremic encephalopathy is also associated with problems in cognition and memory. To study the psychomotor functional disorders in rats with progressive chronic renal failure surgical nephrectomy was done by resection method. The animals were grouped into two control groups, Sham control (SC) and normal control (NC) and two uremic groups, moderate uremia (GM) and severe uremia (GS). Psychomotor analysis was done by passive avoidance and open field in these animals at 4, 8, 12, and 16 weeks. After the incubation period, the nephrectomised groups (GM and GS) showed significant changes in exploratory, locomotor and emotional behaviour when compared to the controls (NC and SC). Psychomotor changes involve poor cognition, reduced memory, reduced locomotor activity and decreased exploratory drive and emotional disturbance like increased fear during the initial stages. During the later stages a restless behaviour was noticed, associated with diminished fear.

Lipoprotein (a) and other Lipid Profile in Patients with Thrombotic Stroke: Is it a Reliable Marker?

BACKGROUND: Cerebrovascular disease (CVD) and coronary heart disease (CHD) cause 40%-50% of deaths in developed countries with CVD causing 10%-12% of deaths. Though increased Lipoprotein (a) is a risk factor in developing CHD, its role is poorly defined in etiopathogenesis of CVD. AIMS: To find the association of lipoprotein (a) and lipid profile in thrombotic stroke patients after acute phase. SETTINGS AND DESIGN: The study was conducted at Kasturba Medical College, Manipal. Twenty one cases of thrombotic stroke and 18 cases of age and sex matched controls were taken for the study. Informed consent was taken from both case and control. MATERIALS AND METHODS: Overnight fasting sample was collected from both case and control. Serum was separated and parameters such as total cholesterol, triglycerides, high density lipoproteins-C, low density lipoprotein-C, lipoprotein (a), fasting blood sugars were estimated. STATISTICAL ANALYSIS: Data were analyzed by SPSS software, Student's t-test, standard deviation (SD), and standard error of mean (SEM), P-value <0.05 is considered to be significant. RESULTS: In this study, we found no statistical significant differences in serum lipid and lipoprotein (a) profile between controls and thrombotic stroke patients. CONCLUSIONS: Highest frequency (38%) of stroke was found in the age group of 7080 years. There were other associated risk factors such as diabetes in five cases (24%), hypertension in nine cases (43%), and family history of stroke in four cases. However, further studies are required to evaluate the importance of serum Lp(a) estimation in the assessment as a risk factor for thrombotic stroke.

Modified uremic rat model - A tool for uremic studies in rats.

Experimental model of chronic renal failure in rats have been described by many authors and has also been widely used in various studies. Many of these methods used highly sophisticated instruments which was difficult in our settings. The resection model was ideal in our experimental set-up, but this model had the risk of excessive bleeding and hypovolemia. In our study we used a combination of partial resection and ligation of the renal artery to create two models of stable uremia A and Moderate uremia B. Severe uremia. Both these models were compared with a sham operated group which served as controls. Following surgical procedure, the development of uremia was monitored by serial estimation of blood urea and serum creatinine levels that were measured at regular intervals (bi-weekly). From two weeks onwards the animals in the experimental group showed a significant elevation in the serum urea levels and a consistent elevation in the serum creatinine levels upto eight weeks when compared to the animals in the sham operated group. We established a modified method of producing renal failure which can be maintained for a period of six weeks. This model is simple, reproducible and less complicated that can be used for several studies relating to renal failure in the field of research.

Serum total glutathione-s-transferase levels in oral cancer.

We conducted a study wherein serum total glutathione-s-transferase levels were measured in patients (n = 27) with various stages of biopsy proven oral cancer (squamous cell carcinoma) and age and sex matched healthy human volunteers (n=10). In all patients with oral cancer, serum total glutathione-s-transferase was measured before the onset of treatment. There was a significant increase in serum total glutathione-s-transferase levels in patients with stage IV oral cancer as compared to stage II (P = 0.001) and stage III (P = 0.002) oral cancer. This shows that alterations in serum total Glutathione-s-transferase levels may have a role in cancer progression.