Incidence and clinical implication of TT virus in patients with hepatitis and its frequency in blood donors in India.

BACKGROUND: Transfusion Transmitted Virus (TTV), also known as Torque Teno Virus is a new novel viral agent which appears to correlate with some acute and chronic hepatitis cases and may produce liver damage under specific circumstances. Aim of this study was to detect TT virus by real-time PCR, study its clinical implications and effects of its co-infection in HBV and HCV chronic liver diseases. METHODS: The study population comprised 50 acute hepatitis, 50 chronic hepatitis patients and 100 voluntary blood donors. All samples were tested for serum bilirubin, AST, ALT and alkaline phosphatase levels and for all available viral markers for hepatitis. The detection of TT viral genome was carried out by real-time PCR using TTV sequences as reported by Takahashi et al with modifications on the basis of database of the DDBJ/EMBL/GenBank (GenBank accession no. AB008394). RESULT: Serum was positive for TTV in 72% of volunteer blood donors, 77.4% (24/31) of hepatitis A cases, 87.6% (36/41) of HBV-positive, 77% (10/13) of HCV-positive, and 92.8% (13/14) of non-B, non-C cases. Co-infection of TTV with other hepatitis viruses was detected in some patients. CONCLUSION: TTV is a frequent virus detected in patients with various types of viral hepatitis, in cases of hepatitis without obvious viral agent, and from the healthy population in India. Rate of TTV was found to be significantly higher (92.8%) for Non A-E hepatitis group.

Aggressive angiomyxoma of the jejunum: a rare cause of obscure gastrointestinal bleeding.

Obscure gastrointestinal bleeding accounts for nearly 5% of all gastrointestinal haemorrhage and is frequently due to a lesion in the small bowel. We report the case of a male patient with obscure overt gastrointestinal bleed in whom repeated upper gastrointestinal endoscopy, colonoscopy, computed tomography scanning and exploratory laparotomy showed no specific pathology. However, on capsule endoscopy done subsequently, a small polyp in the jejunum was located and resected. Histology revealed an aggressive angiomyxoma. This type of small bowel lesion has not been reported in the literature before.

Outbreak of Multi-drug Resistant Salmonella Typhi Enteric Fever in Mumbai Garrison.

BACKGROUND: There was an epidemic of enteric fever in Mumbai garrison during Nov-Dec 2000 with more than 150 cases admitted to a tertiary care service hospital. METHODS: All the cases presented with fever and some had splenomegaly, bradycardia, abdominal pain and diarrhoea. The epidemic was investigated by the station health organization (SHO) and the case and bacteriological study was carried out in pathology laboratory of the service hospital. The serological study was carried out at Armed Forces Medical College (AFMC), Pune and the Phage typing was carried out at Lady Harding Medical College, New Delhi. RESULTS: Blood cultures were positive in 92(63%) for Salmonella typhi and Widal test was positive in 83(55%). All strains were resistant to four primary drugs i.e. ampicillin, chloramphenicol, co-trimoxazole and tetracycline. All but two were treated successfully with ceftriaxone. The Salmonella typhi belonged to phage group E1 and biotype I. CONCLUSION: Extensive epidemiological investigation of cases and water sources of cantonment area pointed to a common source of the epidemic i.e. the well near 'Gurudwara'.