Secondary bacteraemia in adult patients with prolonged dengue fever.

INTRODUCTION: Although dengue management guidelines do not advice on use of antibiotics in dengue shock syndrome, unrecognised bactraemia is likely to contribute to morbidity and mortality. OBJECTIVES: To assess the occurance of secondary bacteraemia in adult patients with prolonged dengue fever. METHODS: A prospective study was conducted recruiting patients with confirmed acute dengue infection who had prolonged fever (>5 days). Two sets of blood cultures were taken in such patients prior to institution of antibiotic therapy. Demographic, clinical, haematological and biochemical parameters were recorded. Development of ascites and pleural effusions were detected using ultrasonography. RESULTS: Fourty patients (52.5% males) with a mean age of 29.8 years (SD 13.6) were studied. The average duration of fever was 7.9 days (SD 1.8). Ten patients (25%) had bacterial isolates in their blood cultures; Staphylococcus aureus (n=2), coliforms (n=3), pseudomonas (n=1) and 4 had mixed growths. The culture positive group had severe body aches at admission and higher fever, third space fluid accumulation, a significant drop in platelets and a higher CRP. CONCLUSIONS: A quarter of dengue patients with prolonged fever had a bacterial isolate. Culture positive patients appeared more ill with body aches and had higher degrees of fever during the latter part of the illness. Increased vascular permeability may predispose to bacterial seepage into blood. Although white cell count is not helpful in detecting bacteraemia, low platelet count and elevation of CRP seem to be helpful.

Spices as a source of lead exposure: a market-basket survey in Sri Lanka.

We performed a laboratory analysis of spices sold in Sri Lanka for lead content. Samples of curry powder, chili powder and turmeric powder from seven provinces, collected using the market basket survey method, underwent atomic absorption spectrometry. Blanks and standards were utilised for instrument calibration and measurement accuracy. The results were validated in two different laboratories. All samples were found to have lead levels below the US Food and Drug Administration's action level of 0.5 µg/g. Spices sold in Sri Lanka contain lead concentrations that are low and within the stipulated safety standards.

Surveillance of invasive pneumococcal disease in Colombo, Sri Lanka.

The South Asian Pneumococcal Surveillance network uses standard recruitment and laboratory procedures for surveillance of invasive pneumococcal disease in India, Nepal, and Sri Lanka. Children aged 2 months to 5 years who were admitted to the sentinel surveillance site, Lady Ridgeway Hospital for Children, in Colombo, Sri Lanka, and who presented with signs and symptoms of meningitis, pneumonia, or very severe disease were studied. Blood culture and CSF culture specimens were analyzed at the microbiology laboratory at Lady Ridgeway Hospital for Children. Specimens were processed by routine conventional methods. Antigen testing was performed on CSF specimens with use of commercially available latex agglutination test kits. From January 2005 to March 2007, we observed 23 isolates of Streptococcus pneumoniae, and the most common serotypes were 19F, 14, 23F, and 6B. Of the serotypes found, 60% are covered by the currently available 7-valent conjugate pneumococcal vaccine. More than 90% of the isolates were penicillin resistant, and the rate of resistance to third-generation cephalosporins was also high.

Shedding light on an extremophile lifestyle through transcriptomics.

The tropical intertidal ecosystem is defined by trees - mangroves - which are adapted to an extreme and extremely variable environment. The genetic basis underlying these adaptations is, however, virtually unknown. Based on advances in pyrosequencing, we present here the first transcriptome analysis for plants for which no prior genomic information was available. We selected the mangroves Rhizophora mangle (Rhizophoraceae) and Heritiera littoralis (Malvaceae) as ecologically important extremophiles employing markedly different physiological and life-history strategies for survival and dominance in this extreme environment. For maximal representation of conditional transcripts, mRNA was obtained from a variety of developmental stages, tissues types, and habitats. For each species, a normalized cDNA library of pooled mRNAs was analysed using GSFLX pyrosequencing. A total of 537,635 sequences were assembled de novo and annotated as > 13,000 distinct gene models for each species. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) orthology annotations highlighted remarkable similarities in the mangrove transcriptome profiles, which differed substantially from the model plants Arabidopsis and Populus. Similarities in the two species suggest a unique mangrove lifestyle overarching the effects of transcriptome size, habitat, tissue type, developmental stage, and biogeographic and phylogenetic differences between them.

Inflammatory myofibroblastic tumor of the esophagus presenting with hematemesis and melaena: a case report and review of literature.

Esophageal inflammatory myofibroblastic tumors (IMT) are extremely rare, and the understanding on the clinical presentation is limited. IMT of esophagus should be considered as a differential diagnosis in the context of unexplained upper gastrointestinal bleeding and rapidly progressing dysphagia in young patients.