Study of placental histopathology in COVID-19 mothers at a dedicated COVID-19 hospital in India.

Introduction: Maternal infections can affect the placenta, which acts as a fetomaternal barrier. This study aimed to determine the spectrum of morphologic alterations in the placentas of pregnancies complicated by SARS-CoV-2 infection and the impact on fetal or neonatal outcomes. Materials and Methods: This is a prospective case-control study. One hundred SARS-CoV-2 positive pregnant women and an equal number of SARS CoV-2 negative pregnant women in their third trimester who delivered at our tertiary care center between December 2020 and November 2021 were enrolled in the study. This study was conducted at the end of the first wave and during the second COVID-19 wave. Histopathological examination of the placentas was done using Amsterdam consensus criteria. We observed for evidence of maternal vascular malperfusion [MVM], fetal vascular malperfusion, and inflammation in the placenta. Results: The clinical findings were compared between the cases and controls. Evidence of MVM was seen in comparable numbers between the cases and controls, but as it involved less than 30% of the placental disc, it was considered an insignificant finding. Deciduitis was seen in equal proportions in both groups. The comparison between the asymptomatic and symptomatic groups failed to show any difference in placental pathology between both groups. There was no adverse fetal outcome seen in the pregnancies complicated by SARS-CoV-2 infection. Conclusion: Placental injury at the microscopic level was observed but was neither significant nor specific to the SARS-CoV-2 infection. SARS CoV-2 infection did not influence the placental pathology. Also, no adverse neonatal outcomes were observed.

Molecular detection of respiratory avian mycoplasmosis associated bacterial and viral concurrent infections in the poultry flocks.

Respiratory tract infections are of serious concern to the poultry industry. The present study was aimed to delineate the extent of respiratory avian mycoplasmosis associated bacterial and viral concurrent infections in the poultry flocks. A total of 146 poultry flocks of Haryana and Rajasthan, India, suspected for chronic respiratory disease (CRD) were screened for avian mycoplasmas, Newcastle disease virus (NDV), infectious bronchitis virus (IBV), and avian pathogenic Escherichia coli (APEC) by conventional polymerase chain reaction (PCR) assays. A total of 49.31% (72/146) flocks were found positive for Mycoplasma infection. Of the Mycoplasma-positive flocks, 80.55% (58/72) represented pathogenic avian mycoplasmas (MG and/or MS), while 19.44% (14/72) flocks were positive for commensal avian mycoplasmas (other than MG and MS). A correlation was deduced between avian mycoplasmosis and bacterial and/or viral co-infections. The results revealed that 17.24% (10/58) flocks had only avian mycoplasmosis infection. However, in the remaining flocks, the avian mycoplasmosis was associated either with APEC infection [17.24% (10/58)], IBV infection [43.10% (25/58)], or both APEC and IBV infections [22.41% (13/58)], respectively. Further epidemiological studies on respiratory avian mycoplasmosis associated concurrent infections with other pathogens are recommended to assess circulating strains, risk factors, and economic losses.

Multiple antigenic peptide-based flow through dot-blot assay for simultaneous antibody detection of infectious bronchitis virus and Newcastle disease virus.

The present study describes the development of a novel affordable and rapid visual dot-blot assay using synthetic multiple antigenic peptides (MAP) for simultaneous detection of antibodies to infectious bronchitis virus (IBV) and Newcastle disease virus (NDV). Antibody detection efficiencies of MAP peptides namely, NP1 MAP (Nucleoprotein IBV) and HN MAP (Haemagglutinin-neuraminidase NDV) were studied in solid-phase indirect peptide ELISA. In comparison with the commercial kit, the NP1 MAP showed 89.20% diagnostic sensitivity (DSn) and 85.90% diagnostic specificity (DSp) at 19.45% ROC cut-off. Similarly, HN MAP was evaluated and showed 89.70% DSn and 92.90% DSp at 19.90 % ROC cut-off. The peptides after evaluating their ELISA performance were further used to device a flow-through dot-blot assay (FT-DBA) for simultaneous detection of IBV and NDV antibodies. The kappa value for IBV by FT-DBA in comparison to commercial ELISA was 0.64 whereas for NDV, FT-DBA gave a kappa value of 0.68 in comparison to commercial ELISA indicating substantial agreement between the assays. In essence, the divergent MAP based diagnostic design could provide an alternative for antibody detection of IBV and NDV. Further, the FT-DBA approach could be used for low cost, rapid and pen-side detection of IBV and NDV antibodies simultaneously.

Epidemiology of bovine brucellosis in Hisar, India: identification of risk factors and assessment of knowledge, attitudes, and practices among livestock owners.

Brucellosis caused by facultative intracellular bacteria, Brucella, remains a global threat to both animal and human health. In this study we aimed to identify potential risk factors of bovine brucellosis and to assess the knowledge, attitudes, and practices (KAPs) of livestock keepers in Hisar, India. A standardized questionnaire was used to collate information regarding potential risk factors of bovine brucellosis and livestock owners' KAPs. A total of 127 livestock keepers were involved. Serum samples from their animals (n = 635) were tested for the presence of antibodies against Brucella by Rose Bengal Plate Test (RBPT) and indirect enzyme-linked immunosorbent assay (iELISA). Out of these, 78 (61.4%) of the herds had at least one seropositive animal, and 302 (47.6%) of the cattle were seropositive. Univariate and multivariate analysis revealed significant associations between intensive farm type (OR = 4.6; 95% CI, 1.6-16.7; P = 0.009), hygienic disposal of aborted fetuses (OR = 0.3; 95% CI, 0.08-0.9; P = 0.04) and herd seropositivity for brucellosis. The majority, 96 (75.6%) of the respondents, were males aged 18-50, and 82 (64.6%) owned a small-backyard farm. Only 51 (40.2%) of the participants knew about brucellosis; out of them, 54.9% (28/51) could not identify clinical signs of brucellosis. Six (11.8%) participants indicated abortion as the most noticeable clinical sign, and 45.1% indicated that consumption of raw milk is associated with high risk of contracting brucellosis. A large proportion of respondents confirmed that milk from their animals was regularly consumed (86.6%) and sold (59.8%) to other people. These results suggest that bovine brucellosis is endemic in Haryana, where Brucella-contaminated milk is likely being regularly sold. Brucellosis control efforts in Haryana should include education programs to raise awareness of the disease and means to control it in cattle and to prevent zoonotic transmission.

Installing oncofertility programs for common cancers in limited resource settings (Repro-Can-OPEN Study): An extrapolation during the global crisis of Coronavirus (COVID-19) pandemic.

PURPOSE: The state of limited resource settings that Coronavirus (COVID-19) pandemic has created globally should be taken seriously into account especially in healthcare sector. In oncofertility, patients should receive their fertility preservation treatments urgently even in limited resource settings before initiation of anticancer therapy. Therefore, it is very crucial to learn more about oncofertility practice in limited resource settings such as in developing countries that suffer often from shortage of healthcare services provided to young patients with cancer. METHODS: As an extrapolation during the global crisis of COVID-19 pandemic, we surveyed oncofertility centers from 14 developing countries (Egypt, Tunisia, Brazil, Peru, Panama, Mexico, Colombia, Guatemala, Argentina, Chile, Nigeria, South Africa, Saudi Arabia, and India). Survey questionnaire included questions on the availability and degree of utilization of fertility preservation options in case of childhood cancer, breast cancer, and blood cancer. RESULTS: All surveyed centers responded to all questions. Responses and their calculated oncofertility scores showed different domestic standards for oncofertility practice in case of childhood cancer, breast cancer, and blood cancer in the developing countries under limited resource settings. CONCLUSIONS: Medical practice in limited resource settings has become a critical topic especially after the global crisis of COVID-19 pandemic. Understanding the resources necessary to provide oncofertility treatments is important until the current COVID-19 pandemic resolves. Lessons learned will be valuable to future potential worldwide disruptions due to infectious diseases or other global crises.

The clinical challenges in the management of deep lymphangioma of the foot.

A 12-year-old girl presented with swelling on the lateral aspect of the left foot since early childhood, progressively increasing in size and now causing pain on walking. Pain was relieved with medication only. There was also history of a single episode of blood-tinged discharge from the swelling 3 years prior. There was no history of trauma, diabetes, or hypertension.

Long-term application of agronomic management strategies effects on soil organic carbon, energy budgeting, and carbon footprint under rice-wheat cropping system.

In the plains of western North India, traditional rice and wheat cropping systems (RWCS) consume a significant amount of energy and carbon. In order to assess the long-term energy budgets, ecological footprint, and greenhouse gas (GHG) pollutants from RWCS with residual management techniques, field research was conducted which consisted of fourteen treatments that combined various tillage techniques, fertilization methods, and whether or not straw return was present in randomized block design. By altering the formation of aggregates and the distribution of carbon within them, tillage techniques can affect the dynamics of organic carbon in soil and soil microbial activity. The stability of large macro-aggregates (> 2 mm), small macro-aggregates (2.0-2.25 mm), and micro-aggregates in the topsoil were improved by 35.18%, 33.52%, and 25.10%, respectively, over conventional tillage (0-20 cm) using tillage strategies for conservation methods (no-till in conjunction with straw return and organic fertilizers). The subsoil (20-40 cm) displayed the same pattern. In contrast to conventional tilling with no straw returns, macro-aggregates of all sizes and micro-aggregates increased by 24.52%, 28.48%, and 18.12%, respectively, when conservation tillage with organic and chemical fertilizers was used. The straw return (aggregate-associated C) also resulted in a significant increase in aggregate-associated carbon. When zero tillage was paired with straw return, chemical, and organic fertilizers, the topsoil's overall aggregate-associated C across all aggregate proportions increased. Conversely, conventional tillage, in contrast to conservation tillage, included straw return as well as chemical and organic fertilizers and had high aggregate-associated C in the subsurface. This study finds that tillage techniques could change the dynamics of microbial biomass in soils and organic soil carbon by altering the aggregate and distribution of C therein.

Emergence of decreased susceptibility to extended-spectrum cephalosporins in Neisseria gonorrhoeae in India.

BACKGROUND: In the past, Neisseria gonorrhoeae has developed resistance to antimicrobial agents used for its treatment. Consequently, extended-spectrum cephalosporins form the mainstay of treatment for gonorrhoea. METHODS: Samples from 88 patients attending the sexually transmitted diseases clinics from December 2009 to January 2011 in two referral hospitals in New Delhi were studied. Antimicrobial susceptibility testing was done using the disc diffusion method as per the calibrated dichotomous sensitivity technique against the following antibiotics: penicillin (0.5 i.u.), tetracycline (10 µg), nalidixic acid (30 µg), ciprofloxacin (1 µg), spectinomycin (100 µg), ceftriaxone (0.5 µg) and cefpodoxime (10 µg) (Oxoid UK). Azithromycin (15 µg) (Oxoid, UK) was tested as per the guidelines of the Clinical and Laboratory Standards Institute. Minimum inhibitory concentrations were determined using the Etest for penicillin, tetracycline, ciprofloxacin, ceftriaxone, spectinomycin and azithromycin as per the manufacturer's instruction (Biomerieux, France). RESULTS: Eighteen isolates of Neisseria gonorrhoeae were obtained. Three of these had decreased susceptibility to ceftriaxone and cefpodoxime by the disc diffusion method. The minimum inhibitory concentrations of ceftriaxone for two isolates were 0.064 µg/ml and for one isolate it was 0.125 µg/ml. CONCLUSION: Higher minimum inhibitory concentrations to extended-spectrum cephalosporins is of concern as it has been shown to precede treatment failure. This may warrant its use in increased/multiple dosages alone or possibly in combination (dual therapy), thereby complicating effective disease control. Our report is in accordance with earlier reports from different parts of the world. Therefore, a continuous surveillance of antimicrobial resistance is crucial to tailor treatment schedules for Neisseria gonorrhoeae in a particular geographical region.

Evaluation of an opa gene-based nucleic acid amplification test for detection of Neisseria gonorrhoeae in urogenital samples in North India.

Due to the poor positive predictive value of nucleic acid amplification tests (NAATs) for gonorrhoea when applied to a low-prevalence setting, current guidelines recommend the use of supplementary polymerase chain reaction (PCR) targeting a different gene for confirmation of true positives in urogenital specimens. This study sought to standardize and evaluate performance of an in-house opa gene-based PCR assay for gonorrhoea compared to assays targeting the porA pseudogene and 16S rRNA gene. Four hundred samples (300 endocervical, 100 urethral swabs) from patients attending STD clinics in New Delhi, India were used. The sensitivity, specificity, positive predictive value and negative predictive value of the opa-based PCR were 100%, 97·9%, 89·5% and 100%, respectively. In females, the use of NAATs provided enhanced diagnosis of gonorrhoea.

Rapid and specific detection of Mycoplasma gallisepticum and Mycoplasma synoviae infection in poultry using single and duplex PCR assays.

Avian mycoplasmosis, mainly caused by Mycoplasma gallisepticum (MG) and Mycoplasma synoviae (MS), is an economically important disease of poultry industry. The present study was aimed to develop duplex PCR as a rapid, specific and economical method for accurate detection of MG and MS in poultry and its comparison with single (monoplex) MG/MS PCR. During present investigation, a total of 146 poultry flocks having clinical history of respiratory disease were screened. Pooled tissue samples (trachea, lungs and air sacs) from 4-5 birds of each flock were collected during necropsy at disease investigation laboratories, Hisar, Haryana, India. The single and duplex PCR assays were standardized using primers of intergenic spacer region (IGSR; 16S-23S rRNA) for MG and hemagglutinin vlhA gene for MS, with expected amplicon size of 812 bp and 1200 bp products, respectively. In single PCR, 6.85%, 2.74% and 2.74% tissue samples were found positive for MG, MS and both MG and MS, respectively. However, duplex PCR showed, 7.53%, 2.74% and 1.37% positivity for MG, MS and both MG and MS, respectively. Taking the results of monoplex PCR as a gold standard, sensitivity and specificity of the developed duplex PCR was found to be 94.44% and 100%, respectively. Moreover, Cohen's kappa statistic (k = 0.97) measured a 'perfect' agreement between monoplex and duplex PCR assays. The positive and negative predictive values of duplex PCR was found to be 1.0 and 0.9922, respectively at 95% confidence interval (CI), as compared to monoplex PCR. The simultaneous use of two genes in a duplex PCR was more rapid and economical than two separate single PCR reactions.

Studies on intra-ocular vaccination of adult cattle with reduced dose Brucella abortus strain-19 vaccine.

Brucella abortus vaccines play a central role in bovine brucellosis control with tremendous success worldwide for decades. The study was aimed to evaluate the efficacy of reduced dose (5.0 × 10 9 cfu) of S19 vaccine in adult cattle and its shedding in the milk of vaccinated cattle using molecular techniques. The OIE recommended tests (RBPT, SAT, and iELISA) for brucellosis screening in cattle were used. Seronegative cattle (n = 90) of different age groups (young, old heifers & milking cows, n = 30 each) were selected for the vaccine trials. Antibody titers were recorded at 7th, 21st, 30th, 60th, 90th and 120th days post-vaccination (DPV) to monitor the immune responses following vaccination and at 150th, 180th, 210th and 240th DPB following booster-dose to an intraocular group. The humoral immune responses observed by RBPT and ELISA, proved that antibody titers persisted in s/c group compared to the i/o group in all categories. The IFN-γ stimulation (CMI) due to reduced dose vaccination was noticed early as 30th in all groups and declined after 90th DPV, with higher IFN-γ stimulation among the s/c group. The Bcsp31 and IS711 targeted PCR detected the presence of Brucella DNA in milk samples (n = 120) from the vaccinated cows (n = 30) and confirmed by qPCR (TaqMan assay) at 30th, 60th, 90th and 120th DPV. A Significant number, 70% (7/10) was detected in s/c by qPCR. BCSP31 sequence was deposited at NCBI GenBank (accession no. MK881173-6). PCR and qPCR techniques could provide a reliable diagnosis of brucellosis from milk. The intraocular route remains the safer route for vaccinating adult cattle than subcutaneous.

Transcriptional expression and gelatinolytic activity of matrix metalloproteinases in Henoch-Schonlein purpura.

AIM: Accelerated extracellular matrix breakdown caused by the increased activity of matrix metalloproteinases (MMPs) has been implicated in several rheumatological disorders and systemic vasculitides, especially Takayasu's arteritis and Kawasaki disease. Therefore, the aim of the present study was to investigate the potential role of MMPs in Henoch-Schonlein purpura (HSP), an acute type of systemic vasculitis in children. METHODS: We studied the activity of MMP-2 and MMP-9 in the sera using gelatin zymography and the transcriptional expression in peripheral blood mononuclear cells using semi-quantitative RT-PCR in 20 patients with HSP in acute and convalescent phase and in 20 healthy children, who were siblings of the subjects with same age group. RESULTS: All 20 children with HSP showed increased levels of serum activity of MMP-2 and MMP-9 in acute phase as compared with their convalescent phase [MMP-2 (p > 0.05); MMP-9 (p > 0.05)] and their control counterparts [MMP-2 (p < 0.001); MMP-9 (p < 0.001)]. Similarly, transcriptional expression of MMPs was found to be higher in the acute phase of HSP than in convalescent phase [MMP-2 (p < 0.05); MMP-9 (p < 0.001)] and in their healthy controls [MMP-2 (p < 0.001); MMP-9 (p < 0.01)]. CONCLUSION: The presence of excessive transcriptional expression and gelatinolytic activity of MMPs may be downstream to the actual aetiopathogenetic factors.

Pelvic hydatidosis mimicking a malignant multicystic ovarian tumor.

Echinococcosis is a multisystem disease and has propensity to involve any organ, an unusual anatomical site, and can mimic any disease process. Primary peritoneal echinococcosis is known to occur secondary to hepatic involvement but occasional cases of primary peritoneal hydatid disease including pelvic involvement have also been reported. We report here 1 such case of primary pelvic hydatidosis mimicking a malignant multicystic ovarian tumor where there was no evidence of involvement of the liver or spleen. Our patient, a 27-year-old female, was detected to have a large right cystic adnexal mass on per vaginal examination which was confirmed by ultrasonography. Her biochemical parameters were normal and CA-125 levels, though mildly raised, were below the cut off point. She underwent surgery and on exploratory laparotomy, another cystic mass was found attached to the mesentery of the small gut. The resected cysts were processed histopathologically. On cut sections both large cysts revealed numerous daughter cysts. Microscopic examination of fluid from the cysts revealed free scolices with hooklets and the cyst wall had a typical laminated membrane with inner germinal layer containing degenerated protoplasmic mass. The diagnosis of pelvic hydatid disease was confirmed and patient was managed accordingly. Hydatid disease must be considered while making the differential diagnosis of pelvic cystic masses, especially in endemic areas.

Cervical cancer in Indian rural women: trends over two decades.

Worldwide, cervical cancer is considered to be the second commonest cancer as far as mortality and incidence is concerned and India contributes to about 20­30% of the global burden. This paper is based on analysis of records of persons suffering from various cancers over 25 years. Cervical cancer constituted 14.4% of all cancers of men and women put together, 28.8% of the cancers in women and 73.3% of all gynaecological cancer. The cases studied were divided into five Blocks: Block A 1983­1987; Block B 1988­1992; Block C 1993­1997; Block D 1998­2002 and Block E 2003­2007. A 2.34 times increase in cancer cases from Block A to Block E was seen; in women, overall cancer increased by 3.21 times; gynaecological cancer by 3.08 times; cervical cancer 2.91 and ovarian cancer 7.1 times. Cervical cancer in outpatients increased from 0.55% among all gynaecological cases in 1983, to 3.5% in 2007. Cervical cancer comprised of 1.05% of the newly registered outpatients and 70.09% of gynaecological cancer cases. Inpatient gynaecological cancer increased from 2.81% in 1983 to 9.81% in 2007. Out of all cervical cancer in women, cervical cancer was 34.7% in Block A (1983­1987) and 28.6 % in Block E (2003­2007). Of the cervical cancer cases, 43.8% belonged to the age group 30­49 years and 37.6% at 50­64 years. Cervical cancer in women with less than three births increased from 13.1% in Block A to 33.1% in Block E. The proportion of illiterate women or those with primary education was seven times more compared with those with secondary education. Our study revealed that cervical cancer still continues to rank first. Also the overall number of cancer cases has been increasing.

A bio-safe multiple antigenic peptide (MAP) enzyme-linked immunoassay for the detection of antibodies to infectious bronchitis virus in chickens.

The objective of the study was to develop a bio-safe synthetic peptide ELISA for the detection of antibodies against the infectious bronchitis virus (IBV) using a novel multiple antigenic peptide approach (MAP). After initial ELISA optimization, diagnostic sensitivity (DSn) and specificity (DSp) for the linear peptides were determined using receiver operator curve (ROC) analysis. The peptide IBVP1 showed 90.44% DSn and 88.64% DSp at ROC cut off 22.8% while IBVP2 showed 88.24% DSn and 85.23% DSp at ROC cut off 23.05%. The multimerization of linear peptides to MAP design resulted in the improvement of the diagnostic efficiency up to 94.85% DSn and 92.05% DSp for IBVM1 with 19.95% cut off. A similar improvement in the performance was also observed with 92.65% DSn and 90.91% DSp for IBVM2 at 20.72% cut off. All the peptides were tested for diagnostic specificity and did not show the cross-reactivity with Newcastle disease virus and infectious bursal disease virus positive serum samples. In addition, repeatability testing for all linear and multimeric peptide showed that the coefficient of variation for intra-assay was within the expected limits, ranging from 2.4 to 10.4% and inter-assay coefficient of variation was ranging from 5.56 to 14.3%. In a nutshell, the present study used predicted B cell epitope, the synthetic peptide in linear and multimeric design for IBV antibody detection. The study also highlights peptide antigen with modified scaffold design could be a safe alternative to whole virion-based ELISA for IBV antibody detection.

Adjustment to infertility: the role of intrapersonal and interpersonal resources/vulnerabilities.

BACKGROUND: Great variability exists in the degree of adjustment to infertility, which in turn is known to influence wellbeing. The main objective of this study is to identify intrapersonal [neuroticism, adult attachment style (AAS), perceived internal control, meaning of parenthood and intrinsic religiosity] and interpersonal (social support and marital adjustment) associates of adjustment to infertility. METHOD: A cross-sectional analysis of 85 consecutive heterosexual women, attending three infertility clinics in northern India during July 2005-March 2006, participated in the study. A range of scales were used to measure the intrapersonal and interpersonal attributes. The degree of adjustment to infertility was assessed using the Fertility Adjustment Scale. The data were analysed using multiple regression. RESULTS: The intrapersonal model (49.3%) explained a larger proportion of variance than did the interpersonal model (28.4%). Perception of children as necessary for marital completion, and the avoidance type of AAS was associated with poorer adjustment and constituted intrapersonal vulnerabilities. In contrast, intrinsic religiosity, sexual satisfaction and familial support were associated with better adjustment and were identified as helpful intrapersonal and interpersonal coping resources. CONCLUSIONS: The findings of the study highlight the merit of understanding intra- and interpersonal attributes for achieving better wellbeing outcomes. These findings would also prove valuable for researchers and practioners involved in designing and implementing psychosocial interventions.

Internal podalic version for neglected shoulder presentation with fetal demise.

In modern obstetrics, the role of internal podalic version (IPV) is limited to delivery of the second twin. A retrospective study was conducted to assess the efficacy of IPV in singleton neglected shoulder presentation with fetal demise. Women with live fetuses, previous CS or contracted pelvis were excluded. The procedure involved repositioning the prolapsed hand under anaesthetic followed by breech extraction. 12 women were identified over a 19 month period and all underwent successful IPV. One woman had a postpartum haemorrhage. We conclude that, in singleton pregnancies with a transverse lie, IPV has a role to play in the delivery of dead fetuses.

Functional outcome of De Quervain's tenosynovitis with longitudinal incision in surgically treated patients.

INTRODUCTION: De Quervain described tenosynovitis of first dorsal compartment more than 120 years ago. Women, particularly of 4th-5th decades, are at more risk of developing disease. Steroid injection has been described as first line of management over many decades, but it is associated with some significant complications like depigmentation of skin, atrophy of subcutaneous tissue, suppurative tenosynovitis and even tendon rupture. Animal studies have also reported increased risk of peritendinous adhesions with steroid injection. MATERIALS AND METHODS: We prospectively managed 46 cases of De Quervain's tenosynovitis with longitudinal incision at tertiary care hospital from 2014 to 2016. There were totally 40 patients with 9 males and 31 females between age group of 28 and 62 years. All patients were evaluated using DASH and VAS scores preoperatively and post-operatively. RESULTS: The mean preoperative DASH score was 42.26 which reduced to 5.37 post-operatively. The mean preoperative VAS score was 7.30 which reduced to 2.33 post-operatively. Intraoperatively, we found peritendinous adhesions in 8 patients and ganglion arising from first dorsal compartment in one patient. Post-operatively, we found hypertrophic scar in 3 patients and persistent numbness to first dorsal web space due to injury to superficial radial nerve in 2 patients. Six patients had recurrent symptoms and required revision surgery. CONCLUSION: Surgical release of De Quervain's tenosynovitis remains the gold standard treatment, and longitudinal incision offers advantage of easy identification of compartment, more complete releases of tendon sheath and peritendinous adhesions and less risk of palmar subluxation of tendons.

Carriage of Class 1 integrons and molecular characterization of intI1 gene in multidrug-resistant Salmonella spp. isolates from broilers.

AIM: The present study was conducted with the following aims: (i) To screen the Salmonella spp. isolates recovered from suspected cases of fowl typhoid for carriage of Class 1 integrons and analyze their association with antimicrobial resistance and (ii) to carry out molecular characterization and phylogenetic analysis of Class 1 integron-integrase (intI1) gene. MATERIALS AND METHODS: A total of 43 Salmonella isolates were subjected to polymerase chain reaction (PCR) assay to determine the presence of Class1 intI1. Differences between different serotypes in relation to their carriage of integrons and the differences between strains containing or not containing an integron and being resistant to different antimicrobials were analyzed by Fisher exact test using STATA™ (StataCorp, College Station, TX). Phylogenetic analysis was carried out using MEGA6 software. RESULTS: Out of 43 isolates, 40 (93.02%) were found positive for Class 1 integrons. 35/40 (87.5%) intI1-positive isolates were multidrug resistance (MDR) (resistant to ≥4 antibiotics), which support the hypothesis of an association between the presence of Class 1 integrons and emerging MDR in Salmonella. There was no significant difference among isolates resistant to different antimicrobials in Class 1 integron carrying isolates and the Class 1 integron negative isolates (p<0.05). Further, there was no significant difference among different serotypes in respect of their carriage of Class 1 integrons. CONCLUSION: It can be concluded that the high prevalence of Class 1 integrons indicates a high potential of Salmonella isolates for horizontal transmission of antimicrobial genes, especially among Gram-negative organisms.