Targeted (PCR-based) screening of antibiotic resistance genes' prevalence in the gut microbiota of tribal people of Nabarangpur, Odisha, India.

Antibiotic resistance is a major public health concern worldwide. The gut microbiota harbours multiple antibiotic resistant genes (ARGs) that contribute to the existing and future microbial population in a community or ecosystem. This study aimed to investigate the prevalence of 35 antibiotic resistance genes (ARGs) in the gut microbiota of the tribal people of Nabarangpur, Odisha, India. A total of 83 faecal samples were collected from three different tribes (Bhatra, Gond, and Paraja). Total faecal DNA was extracted, and the simplex polymerase chain reaction was performed to detect selected ARGs. Further analysis was done to estimate the incidence of these ARGs across these tribes based on alcohol consumption habits. We identified a higher prevalence of tetracycline resistance genes (tetW, tetQ and tetM) in the gut microbiota among three populations. Furthermore, a significant (P = 0·024) difference in ARG prevalence against vancomycin in individuals with and without alcohol consumption habits was noticed. The overall distribution of ARGs among the three major tribes of this location was found to be very similar. Together, irrespective of the tribes, the people of this location have gut microbiota harbouring different kinds of ARGs and tetracycline-resistant genes are the most commonly found ARGs.

Total skin electron irradiation treatment for mycosis fungoides with a new alternate daily treatment schedule to minimize radiation-associated toxicity: a preliminary experience.

Conventional total skin electron irradiation (TSEI) for mycosis fungoides (MF) causes radiation toxicity, requiring treatment interruptions that prolong the treatment period, making patient compliance poor. We evaluated an alternate daily treatment schedule of TSEI, using a high dose rate (HDR) to minimize radiation toxicity and shorten the treatment duration. Four patients (aged 45-73 years with MF duration of 7-22 months) were treated by TSEI using HDR. The treatment was given on 5 days/week for 2 weeks followed by treatment on alternate days to deliver a total dose of 36 Gy. All the patients completed treatment in 10 weeks and had complete remission. Radiation toxicity was much less common with this schedule, requiring no treatment interruption. All the patients were until in remission after 60-84 months of follow-up. This schedule of TSEI treatment caused minimal radiation toxicity and allowed completion of treatment over a shorter period, giving good clinical remission and prolonged disease-free survival.

A novel tandem repeat cloning technique for creation of multiple short peptide repeats to differentiate closely related antigens.

Antibody cross-reactivity is a problem often associated with closely related antigens. This study was aimed to develop a method enabling differentiation of closely related toxins based on antigen designing strategy. The method involves identification of disparate amino acids (AA) confined to target antigen in comparison with two or more closely related antigens, their assembly into a DNA oligomer and further cloning as six tandem repeats (TR) using restriction and ligation strategy into a desired vector and finally generation of antigen specific antibodies. The practical utility of this method was demonstrated by generating and testing the specificity of polyclonal antibodies against staphylococcal enterotoxin C (SEC). Cross-reactivity is a problem often associated with SEC in immunoassays due to its amino acid sequence identity with staphylococcal enterotoxin B (SEB) (40-60%). To circumvent the same, the above-mentioned strategy was applied. Unique AA of SEC (36 AA) in comparison to SEB were selected, reassembled and with deduced corresponding nucleotides, an oligomer of 117 bases was designed. Using primers with restriction overhangs, three constructs were created each with two repeats using a common restriction site. The resulting three constructs were sequentially cloned into alternating restriction sites of pRSET A vector in directional orientation, expressed in E. coli for rTR/SEC protein which was used to generate specific polyclonal antibodies against SEC. Specificity was compared with antibody raised against whole SEC recombinant protein using Western blot and dot blot assays. High specificity was achieved through the developed strategy signifying its possible application to address cross-reactivity problem associated with closely related antigens.

Medical disorders associated with endometrial carcinoma.

UNLABELLED: From January, 1990 to December, 1995, 113 cases of endometrial carcinoma were registered. Of them, 24 patients (20%) had associated medical disorders. A total of 37 medical disorders were found in these 24 patients. The distribution was as follows: diabetes mellitus in 15 patients, hypertension in 13 patients, coronary artery disease in two, asthma in one, RBBB in one and hypothyroidism in five patients. Age of the patients ranged from 48-76 years (Median 62 years). Fifteen patients underwent surgery and rest nine were inoperable due to medical illnesses. Eleven patients received radiotherapy and four received chemotherapy. Of the two failures, one developed metastasis to lung and another to bone. No local recurrence was observed. Median survival was 20 months. Late radiation morbidity was noticed in four patients (36%), all of them were diabetic. CONCLUSION: Hypothyroidism which was unexpectedly found in five patients may also be a risk factor associated with endometrial carcinoma. This finding has never been reported in the literature and it needs to be curiously studied in future series. The risk of late radiation complications is higher in diabetic patients. Overall prognosis of endometrial carcinoma associated with medical illnesses is not very good.

Cutaneous T-cell lymphoma treated with electron beam irradiation in Indian patients.

BACKGROUND: Cutaneous T-cell lymphoma (CTCL) is a rare occurrence in India. Total skin electron irradiation (TSEI) is a well-accepted therapeutic modality for the treatment of CTCL throughout the world. The aim of this study was to retrospectively analyze the treatment outcome of TSEI in Indian patients with CTCL and to determine the different parameters affecting the disease-free survival in these patients. METHODS: Fourteen male patients between 27 and 82 years of age with CTCL (duration of disease, 4 months to 2 years) were treated with TSEI between 1985 and 1998. Seven patients had early stage disease, while the other seven had advanced disease. Two patients had lymph node involvement at the time of presentation. The TSEI was performed according to the Stanford technique delivering a total dose in the range 8-36 Gy. RESULTS: Of the 14 patients, 10 showed complete remission following TSEI. The total follow-up period was 4-110 months (median, 52 months). Five patients were disease free at the end of 5 years. Two patients died due to rapid progression of the disease, while the cutaneous lesions relapsed in three patients after 2-27 months and one patient developed visceral metastasis. CONCLUSIONS: TSEI was an effective therapeutic modality for the treatment of CTCL in this group of patients, both as a curative and palliative measure, although the long-term prognosis is poor.