The acute-phase mediator serum amyloid A is associated with symptoms of depression and fatigue.

OBJECTIVE: Establish whether inflammatory biomarkers-serum amyloid A (SAA), C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α)-are related to key symptoms of depression, including anxiety and fatigue, in a cross-sectional, out-patient setting to identify biomarkers that reflect psychiatric symptomatology in a naturalistic, real-life population. METHODS: We measured SAA, CRP, IL-6, and TNF-α in plasma samples from 89 adult psychiatric out-patients by multiplex, high-sensitivity electrochemiluminescent assays. Psychiatric symptoms were evaluated using the Hamilton Depression Rating Scale (HAMD-17), the Patient Health Questionnaire (PHQ-9), and the Center for Epidemiological Studies Depression Scale (CES-D). RESULTS: Plasma SAA was most robustly associated with depressive symptoms across diagnostic boundaries in this cohort of out-patients. Elevated SAA was significantly associated with higher total scores on the HAMD-17 scale and correlated with multiple scale items that rated symptoms of fatigue and depressed mood, but not with anxiety-related items. CONCLUSIONS: SAA might constitute a cross-diagnostic marker indicative of depressed mood and fatigue in a naturalistic patient setting. Because SAA activates Toll-like receptors 2 and 4, present on macrophages and glial cells, its association with depression severity could also implicate this inflammatory mediator in the pathogenesis of mood disorders.

Usefulness of enzyme immunoassay (EIA) for screening of anti HIV antibodies in urinary specimens: A comparative analysis.

BACKGROUND: Standard HIV testing is done using serum or plasma. FDA approved ELISA to screen urine for IgG antibodies to HIV-1 in 1996. It is a simple, noninvasive test and is appropriate for developing countries where health care personnel may not be professionally trained or where clean needles for drawing blood may not always be available. METHODS: 436 individuals with high-risk behavior and strong clinical suspicion of HIV infection were screened for IgG antibodies to HIV-1 in urine by ELISA. Urine HIV testing was performed by enzyme immunoassay, at the ongoing Voluntary Confidential Counseling and Testing Center (VCCTC) at a large tertiary care microbiology lab. The individuals enrolled for the study had high-risk exposure to the virus and majorities were from a state with a high incidence of HIV infection. In all individuals, both serum and urine were tested for IgG antibodies to HIV-1. RESULTS: Overall, 135 individuals (30.96%) were HIV-positive, of whom 96 (71%) had never previously tested positive; 87% of those who tested positive received their results, and most were referred for medical care. Sensitivity, specificity and predictive values of HIV-1 urine ELISA test kit were determined. Sensitivity was found to be 89.6%; 95% CI [82.9-94.0], specificity 97.3%; 95% CI [94.6-98.8], positive predictive value 93.8%; 95% CI [87.8-97.1] and negative predictive value 95.4%; 95% CI [92.3-97.4]. CONCLUSION: Efficiency, sensitivity, and specificity of the urine-based screening for HIV-1 test kits were excellent as compared to the reference test.

The representation of authors of color in schizophrenia research articles published in high-impact psychiatric journals.

OBJECTIVE: We evaluate how often scholars of color publish papers on schizophrenia in high-impact psychiatric journals, and whether they are more likely than white authors to prioritize race/ethnicity as a primary variable of interest in analyses. METHODS: Prior work categorized the types of ethnoracial analyses reported in 474 papers about schizophrenia published in high-impact psychiatric journals between 2014 and 2016. In this study, the photographs of the first and last author for each paper were coded as "person of color" (POC) or "white". Additionally, each author was asked to self-report their race and ethnicity. The percentage of papers published by white versus POC authors was calculated. Chi-square analyses tested the hypotheses that (a) white scholars are more likely than POC scholars to conduct any sort of racial analysis; (b) POC scholars are more likely to conduct primary analyses by race/ethnicity; and (c) white scholars are more likely to analyze race/ethnicity as extraneous variables. RESULTS: Eighteen percent of papers were published by POC first authors, and 17% were published by POC last authors. There were minimal differences in the types of analyses conducted by POC and white authors. Self-reported race/ethnicity showed that Asian scholars were the most highly represented within POC authors (9% of respondents), but only 3% of authors identified as Hispanic/Latinx and none identified as Black or Indigenous American. CONCLUSIONS: People of color are underrepresented as authors in US-based schizophrenia research published in high-impact journals. Culturally-informed mentorship as well as prioritization of race/ethnicity in funding structures are important to increase representation of POC authors.

Newer versus Conventional Methods in the Diagnosis of Malaria: A Comparison.

BACKGROUND: This study attempts to evaluate and compare the efficacy of polymerase chain reaction (PCR) and quantitative buffy coat (QBC) assay with conventional Giemsa stained peripheral blood smear (PBS) examination in the diagnosis of malaria. METHODS: The study was conducted on 50 cases of smear positive malaria (group 1), 50 cases of clinically suspected malaria (group 2) and 15 healthy controls. All were subjected to Giemsa stain slide examination both thick and thin smear, QBC assay and PCR. PBS examination by Giemsa stain was taken as gold standard. RESULT: In this study the overall sensitivity and positive predictive value (PPV) of QBC assay in group 1 was 100% and that of PCR was 60% and 100% respectively. In group 2 the sensitivity, specificity, PPV and NPV of QBC assay was 100% and that of PCR was 71%, 100%, 100% and 73% respectively as compared to the gold standard. All the 15 healthy controls were negative by all the three assays showing 100% specificity. CONCLUSION: QBC assay was an excellent alternative to the conventional method as it is rapid and less time consuming and can directly demonstrate the parasite. Utility of PCR lies in species-specific diagnosis of falciparum malaria especially when there is a high degree of clinical suspicion and the report is negative by the other two methods.

Detection of Bacterial Pathogens in Cerebrospinal Fluid using Restriction Fragment Length Polymorphism.

BACKGROUND: Polymerase chain reaction (PCR) is useful for rapid microbial detection in body fluids with low microbial load. It is easier to use universal or broad range primers for the amplification of conserved stretches of DNA common to all bacteria like 16S rRNA gene, followed by restriction fragment length polymorphism (RFLP) of PCR products. METHODS: Forty samples of cerebrospinal fluid were collected. After DNA extraction, universal or broad range PCR was performed using two universal primers U1-5'-CCAGCAGCCGCGGTAATACG-3', corresponding to nucleotides 518 to 537 of the Escherichia coli 16S rRNA gene, and U2 - 5'-ATCGG(C/T)TACCTTGTTACGACTTC-3', corresponding to nucleotides 1513 to 1491 of the same gene. The PCR product was subjected to digestion by endonucleases- HaeIII, Mn11, BstB1 and Alu1. Restriction pattern obtained was compared with that of standard organisms to identify the pathogen. The results were compared with conventional methods. RESULT: Universal PCR could detect pathogens in 20% samples within 13-18 hours as compared to 16% by conventional methods. The analytical sensitivity was 10 Gram negative and 250 Gram positive organisms per 200 µl sample. Overall sensitivity was 83.3% and specificity was 91.2%. CONCLUSION: Universal PCR followed by RFLP of PCR product is a good alternative to conventional diagnosis of bacterial pathogens.

Serological Evidence of Chronic Chlamydia pneumoniae Infection in Coronary Artery Disease.

BACKGROUND: Recent studies have suggested that Chlamydia pneumoniae infection could be involved in atherosclerosis and related clinical manifestations such as coronary artery disease, carotid artery stenosis and myocardial infarction. METHODS: Serum IgG, IgM and IgA antibodies to chlamydia genus specific antigen were measured by enzyme linked immunosorbent assay (ELISA) in 100 cases of angiographically demonstrated coronary artery disease (CAD) and 100 randomly selected healthy individuals as controls after matching for age and sex. All the samples positive for chlamydia genus specific IgG antibodies were then subjected to Chlamydia pneumoniae species specific IgG antibody ELISA. RESULTS: Seroprevalence of chlamydia genus specific IgG antibodies in control group was 59% with an increase in seropositivity with increasing age. The overall seroprevalence of IgG antibodies was 76% in CAD group and the prevalence was significantly high in all age groups as compared to controls. The odds ratio was 2.20 for seropositivity of chlamydia genus specific IgG antibodies in patients with myocardial infarction (MI) and/or angina than in control group. No significant association was observed for IgA and IgM anti-chlamydial antibodies. The odds ratio for prevalence of Chlamydia pneumoniae species specific IgG antibodies in CAD patients increased to 2.55 in comparison to age and sex matched controls. CONCLUSION: Current study supports the reported association between C pneumoniae infection and CAD in Indian population.

Identification of Human Immunodeficiency Virus Type-1 Subtypes by Heteroduplex Mobility Assay.

BACKGROUND: Human immunodeficiency virus type-1 (HIV-1) has developed marked genomic sequence differences over the course of an epidemic because of an error prone reverse transcriptase (RT), which rapidly incorporates mutations resulting in genomic diversity, altered cell tropism, immune escape and variable resistance to antiretroviral drugs. The best preventive strategy for HIV control is development of an efficacious prophylactic vaccine using the most appropriate (antigenically related) subtypes. On the basis of phylogenetic analysis, HIV strains can be separated into major group "M" consisting of genetic subtypes A-K, "N", the new group and "O", the outlier group. METHODS: Heteroduplex mobility assay (HMA) is a rapid, economical and reliable technique of subtyping HIV-1. It is based on the principle of determining the genomic relatedness and divergence of the unknown sample with the known reference plasmid HIV-1 subtypes by studying the mobility patterns of the resulting heteroduplexes formed on the polyacrylamide gel. RESULT: A total of 70 HIV-1 seropositive samples obtained from service personnel, their families and civilians from service hospitals were analyzed and their subtype distribution studied. 66 (94.28%) were HIV-1 subtype C and two (2.85%) subtype B. In two (2.85%) samples, the subtype distribution was homotypic recombinant, one each of subtype C1 & C2 and C2 & C4 respectively. CONCLUSION: Service personnel and their families represent a divergent population from different regions of India. An analysis of subtypes in these HIV-1 seropositive individuals will help in understanding the geographical distribution and evolution of the virus. Determination of HIV-1 subtypes has significant implications for development of candidate vaccine for India.

Epidemiological Investigation of an Outbreak of Enteric Fever.

BACKGROUND: Ninety five cases of enteric fever among military recruits from a regimental training centre at Maharastra were admitted to the local military hospital in a few weeks time. METHODS: A descriptive epidemiological study and detailed site survey was undertaken. Blood culture, antibiotic sensitivity test (ABST) with serotyping and phage typing of the isolates were done. RESULT: A total of 95 cases occurred from 31 March 2003 to 17 May 2003. Blood culture for Salmonella enterica serovar Typhi was positive in 60 (63.16%) cases. All the isolates showed same serotype - 9, 12: d: Vi and all belonged to phage type E1 biotype 1 indicating single source outbreak. There was one fatality. There was clustering in time and place indicating a common source outbreak. Exploration of water pipeline supply revealed sewage contamination due to pipeline passing close to a overflowing manhole. ABST revealed multi-drug resistance. CONCLUSION: The outbreak of enteric fever occurred due to sewage contamination of drinking water pipeline.

Hepatitis G Virus Infection in Healthy Individuals, Acute Viral Hepatitis and Persons at Risk for Parenteral Transmission.

BACKGROUND: Hepatitis G virus (HGV), transmitted mostly by parenteral route, has been under investigation for its role as an agent for viral hepatitis. This study was carried out to find out the prevalence of HGV in healthy individuals, multi-transfused patients with acute viral hepatitis and those under going dialysis. METHOD: The study included 200 healthy individuals and 180 patients, comprising acute viral hepatitis (100 cases), multi-transfused patients (50 cases) and patients undergoing dialysis (30 cases). HGV RNA and Hepatitis C virus (HCV) RNA was detected by reverse transcription and polymerase chain reaction (RT-PCR) in all. Viral marker studies for hepatitis A, B and E were carried out by ELISA in acute viral hepatitis cases. In healthy individuals, in patients with multiple transfusions or those undergoing dialysis, marker studies for HBV and HCV were carried out. RESULT: The prevalence of HGV in healthy individuals was 2.5% (5/200), in non A-E hepatitis 3% (3/100), in multi-transfused patients 4% (2/50) and in patients undergoing dialysis 6.67% (2/30). There was no significant difference in the prevalence rate of HGV infection in healthy individuals and in patients with non A-E hepatitis. CONCLUSION: Depending on prevalence rate, HGV could not be implicated as cause of acute viral hepatitis. Persons with parenteral risk factor (multiple blood transfusions and those undergoing dialysis) had higher prevalence rate as compared to healthy individuals.

Outbreak of Viral Hepatitis E in a Regimental Training Centre.

BACKGROUND: An outbreak of viral hepatitis occurred in a regimental centre with 265 cases occurring during a 3 months period. METHODS: 190 serum samples were tested for IgM antibodies against viral hepatitis E by Enzyme Immuno Assay (EIA) and for antibodies against Hepatitis A and Hepatitis B viruses. Epidemiological investigation comprised review of surveillance data, filling up epidemiological case sheet, sanitary survey, inspection of water supplies and bacteriological examination of water for coliforms. RESULT: 97.4% of the serum samples were positive for IgM antibodies against Hepatitis E virus. Two leaks were detected in water pipelines, which were passing through contaminated areas around improperly functioning septic tanks and soak pits. The attack rate among recruits being supplied water through leaking pipelines was 11.1% whereas it was 2.89% in those not directly exposed. This difference was statistically significant (p<0.001). Bacteriological examination of water showed a high coliform count. CONCLUSION: The outbreak of viral hepatitis E occurred due to sewage contamination of water pipelines.