First Report on Association of Colletotrichum coccodes with Chili Anthracnose in India.

Chili (Capsicum annuum L.) is an important condiment and cash crop grown throughout India, including Andhra Pradesh, Karnataka, Maharashtra, Punjab, Tamilnadu, and Himachal Pradesh. In Himachal Pradesh (HP), a northwestern Himalayan state of India, chilies including sweet pepper occupy an area of 2,447 ha with total production of approximately 31,810 t and productivity of 13.00 t per hectare. In 2007 and 2008, chili- and sweet pepper-growing areas of HP were surveyed for the prevalence of fruit rot/anthracnose disease caused by a complex of Colletotrichum species. Fields infested with disease were randomly sampled and four samples from each location were collected. Disease incidence ranged from 12.5 to 45.0% based on total plants assessed in the field. Symptoms of disease in the field included light brown, sunken lesions containing salmon-colored masses of conidia and microsclerotia on the fruit. Microscopic examination of the diseased samples revealed a variation in morphology of spores from two isolates (Cc 70 and Cc 74) collected from two locations in HP, the Kotkhai area of district Shimla and Shamsher (Ani) locality of district Kullu. Five fruits and ten leaves from five plants of a susceptible local variety were inoculated with a suspension of 5 × 105 conidia/ml of isolates Cc70 and Cc74 using a pin prick method as described by Montri et al. (2). The inoculated fruits and leaves were kept in humid chambers at 25 ± 1°C with 12 h of light. After 48 h, the fruits and leaves were observed daily for the appearance of disease symptoms. Disease symptoms were similar to those of natural infections but with darker lesions. The fungus was recovered from infected fruit on Mathur's medium (glucose 2.80 g, peptone 2.00 g, magnesium sulfate hydrated 1.72 g, potassium dihydrogen orthophosphate 1.23 g, and agar 1.50 g/liter) and initially produced white-to-gray mycelia that became dark brown with age. Setae were present along with production of microsclerotia by the tenth day of culturing. A daily average growth of 8.1 mm was recorded on potato dextrose agar at 25 ± 1°C. Conidia were hyaline, unicellular, aseptate, and fusiform abruptly tapering to each end, and 15.5 to 19.6 µm long and 4.2 to 5.3 µm wide. The fungus was identified as Colletotrichum coccodes based on morphological and cultural traits as per the descriptions of Junior et al. (1). The identity of the isolates was confirmed by amplifying the internal transcribed spacer (ITS) region using primer pair ITS1 and ITS4 (3). The sequences (550 bp) were subjected to a BLAST search with the isolates showing the highest identity to GenBank Accession Nos. GU935878 and EF017205. The sequences have been submitted to GenBank (Accession Nos. HQ264175 and HQ264176). Very few reports exist about the natural occurrence of C. coccodes on Capsicum spp. around the world. To our knowledge, this current report constitutes the first record of this pathogen on Capsicum spp. from the Indian subcontinent. References: (1). H. J. T. Junior et al. Summa Phytopathol. Botucatu 33:418, 2007. (2). P Montri et al. Plant Dis. 93:17, 2009. (3) T. J. White et al. Page 315 in: PCR Protocols: A Guide to Methods and Applications. Academic Press, San Diego, 1990.

Diagnoses and management of adult cough: An Indian Environmental Medical Association (EMA) position paper.

BACKGROUND: Cough is a common yet distressing symptom that results in significant health care costs from outpatient visits and related consultations. OBJECTIVE: The understanding of the pathobiology of cough in recent times has undergone an evolution with Cough hypersensitivity syndrome (CHS) being suggested in most cases of dry cough. However, in the case of productive cough, ancillary mechanisms including impaired Mucociliary clearance, in addition to hypermucosecretory bronchospastic conditions of Smoker's cough, asthma-COPD overlap, bronchiectasis, and allergic bronchopulmonary aspergillosis, need to be critically addressed while optimizing patient care with symptomatic therapy in outpatient settings of India. METHODS: In this review, evidence-based graded recommendations on use of antitussives - & protussives as a Position Paper were developed based on the Level and Quality of Scientific evidence as per Agency for Health Care and Quality (AHRQ) criteria listing and Expert opinions offered by a multidisciplinary EMA panel in India. RESULTS: Management of acute or chronic cough involves addressing common issues of environmental exposures and patient concerns before instituting supportive therapy with antitussives or bronchodilatory cough formulations containing mucoactives, anti-inflammatory, or short-acting beta-2 agonist agents. CONCLUSION: The analyses provides a real world approach to the management of acute or chronic cough in various clinical conditions with pro- or antitussive agents while avoiding their misuse in empirical settings.

A historical sketch; life and time of Jonathan Hutchinson (1828-1913), the first sarcoidologist.

In the years preceding and following the turn of the 19th century several publications appeared independently that drew attention to what is now regarded as sarcoidosis. The first recorded and illustrated example is attributed to Jonathan Hutchinson of London. It appeared in Illustrations of Clinical Surgery (1877).

Sarcoidosis: a rare cause of Kleine-Levine-Critchley syndrome.

Hypothalamic sarcoidosis is a rare entity that can alter the hypothalamic-pituitary axis and induce various combinations of endocrine changes. We present a case of neurosarcoidosis with uncommon features of hypersomnolense and hyperphagia. Current strategies to increase awareness and prevention of the harmful effects of obesity require clinicians to be cognizant of potential disorders that produce these features The mechanism, differential diagnosis and therapeutic options of this organic etiology are reviewed.

Metagenomics in animal gastrointestinal ecosystem: a microbiological and biotechnological perspective.

Metagenomics- the application of the genomics technologies to nonculturable microbial communities, is coming of age. These approaches can be used for the screening and selection of nonculturable rumen microbiota for assessing their role in gastrointestinal (GI) nutrition, plant material fermentation and the health of the host. The technologies designed to access this wealth of genetic information through environmental nucleic acid extraction have provided a means of overcoming the limitations of culture-dependent microbial genetic exploitation. The molecular procedures and techniques will result in reliable insights into the GI microbial structure and activity of the livestock gut microbes in relation to functional interactions, temporal and spatial relationships among different microbial consortia and dietary ingredients. Future developments and applications of these methods promise to provide the first opportunity to link distribution and identity of rumen microbes in their natural habitats with their genetic potential and in situ activities.

Metabolism of 25-hydroxyvitamin D3 by cultured pulmonary alveolar macrophages in sarcoidosis.

Metabolism of [3H]25-hydroxyvitamin D3(25-OH-D3) was studied in primary cultures of pulmonary alveolar macrophages (PAM) from seven patients with sarcoidosis and two patients with idiopathic pulmonary fibrosis. Production of a [3H]1,25-dihydroxyvitamin D3 (1,25-[OH]2-D3)-like metabolite of [3H]25-OH-D3 was detected in lipid extracts of cells from five patients with sarcoidosis. Synthesis of this compound in vitro was limited to viable PAM and was greatest in cells derived from a patient with hypercalcemia and an elevated serum concentration of 1,25-dihydroxyvitamin D. The tritiated PAM metabolite coeluted with authentic 1,25-(OH)2-D3 in three different solvent systems on straight-phase high performance liquid chromatography (HPLC) and demonstrated binding to extracted receptor for 1,25-(OH)2-D3, which was identical to that of commercially available [3H]1,25-(OH)2-D3 of comparable specific activity. Incubation of PAM with high concentrations of 25-OH-D3 resulted in production of an unlabeled metabolite that co-chromatographed with the 3H-PAM metabolite on HPLC and that was bound with high affinity by both the specific receptor for 1,25-(OH)2-D3 and antiserum to 1,25-(OH)2-D3.

Shushaku Endo (1923-1996): his tuberculosis and his writings.

Shushaku Endo, one of the finest 20th century Japanese novelists, is not as well known in the West as some of his contemporary Japanese writers including, Yukio Mishima, Yasunari Kawabata, Kobo Abe, and Kenzaburo Oe. Mishima deals with turmoil of adolescence laced with surrealistic historical romance; Abe conjures strange, evocative images in the Kafkaesque tradition; Kawabata writes about loneliness and desolation; and Oe creates imaginary themes of life and myth that entwine and portray human predicaments. Kawabata and Oe both received Nobel Prizes in Literature. Endo's writing is different. He confronts problems pertaining to faith, morality, and individual responsibility. In his early years Endo struggled as a loner, an outsider, and a misfit. This pattern continued to a large extent into his adult life, most of which was consumed with fighting his life threatening tuberculosis. The agonies of his illness intensified his talent for exploring the complexity of human relationships.

Clinical spectrum of chronic renal failure in the elderly: a hospital based study from eastern India.

The aim of this study was to describe the clinical spectrum of chronic renal failure (CRF) in the elderly. The diagnosis of CRF was made using standard clinical criteria. The elderly was defined as person with over 60 years of age. In total, 200 elderly patients with CRF were evaluated between July 2002 and February 2004. Their age (male: 146; female: 54) ranged between 60 and 90 (mean 64.31+/-4.18) years. Diabetic nephropathy was the most common (46%) cause of CRF. Hypertensive nephrosclerosis, chronic interstitial nephritis and obstructive uropathy were responsible for CRF in 18%, 14% and 13% of patients, respectively. We observed chronic glomerulonephritis in 7% of elderly CRF. Urinary tract infection (55.5%), hypovolemia (22.2%), accelerated hypertension (11.1%) and sepsis (11.1%) were responsible for acute exacerbation of renal failure in 36 (18%) patients. Associated co-morbid conditions were noted in 93 (46.5%) patients. They included; coronary artery disease 46 (49.46%), cerebrovascular disease 20 (21.50%), osteoarthritis 13 (13.97%), chronic obstructive pulmonary disease 6 (6.45%), dilated cardiomyopathy 5 (5.37%), and malignancy in 3 (3.22%) patients. Acute dialytic support was required in 164 (82%) cases and remaining 36 (18%) patients received conservative management. Mortality was noted in 25 (12.5%) cases. The coronary artery disease (48%), acute pulmonary edema (20%) and hyperkalemia (12%) were the main causes of death. Subsequent evaluation revealed that 102 (51%) patients had ESRD of which only 3 (2.94%) patients could afford CAPD. A total of 11 (10.7%) patients underwent chronic maintenance hemodialysis for 3-4 months and then discontinue dialysis mainly because of financial constraints. Remaining 88 (86.27 %) patients with ESRD were discharged from hospital after symptomatic improvement with acute dialysis. Thus, diabetic nephropathy related to type-2 diabetes was the commonest cause of CRF in our elderly patients. Chronic renal failure in elderly was associated with a number of co-morbid conditions, which contributed significantly to morbidity and mortality. Acute on chronic renal failure with severe uremic complications were an important cause of hospitalization. The financial constraint was the major limiting factor for the management of elderly ESRD patients.

Correlation between cytotoxic and suppressor activities of human pulmonary alveolar macrophages.

We have reported previously that pulmonary alveolar macrophages (PAMs) from individuals with lung cancer and active chronic pulmonary diseases were cytotoxic to tumor cells in vitro, whereas PAMs from normal individuals or patients with acute pulmonary disorders were noncytotoxic. In the present study, we evaluated 20 PAM preparations for both suppressor and cytotoxic functions to determine if PAMs could function as suppressor cells and, if so, whether a correlation between the two functions exists. Cytotoxicity was assessed in a 60-hr cytotoxicity assay against [3H]proline-prelabeled human melanoma target cells. More than 20% cytotoxicity was considered to be significant. Suppressor activity was measured by determining whether admixing PAMs at various ratios with autologous or allogeneic mononuclear cells could suppress concanavalin A-induced blastogenesis by T-lymphocytes. At least 50% suppression was considered to be significant. Of the 20 specimens evaluated, 13 were cytotoxic and 5 of these exhibited suppressor activity. None of the 7 noncytotoxic PAM preparations had suppressor activity. Suppression was nonspecific and not HLA restricted, since autologous and allogeneic mononuclear cells were inhibited to a similar extent. Suppression was probably not due to prostaglandin production by the PAMs since assays were performed under optimal conditions and required extremely high concentrations of prostaglandins. A significant correlation between suppressor and cytotoxic activity was found. Suppression was observed only with PAM specimens that were also highly cytotoxic to tumors, but not all cytotoxic PAM specimens were suppressive. Whether these actions reflect different levels of activation of PAMs or are the properties of different macrophage subsets remains to be clarified.

Prevalence & pattern of respiratory diseases including Tuberculosis in elderly in Ghaziabad - Delhi - NCR.

Elderly population is continuously increasing all over the world including India. Old age is associated with significant prevalence of chronic illnesses. Population based study to find prevalence & pattern of respiratory diseases in elderly in India is difficult to find. Present study was done in an urban locality of Ghaziabad inhabited mainly by low socio - economic status population. Two part questionnaire was used as main tool. Through part one 1522 elderly were screened for respiratory disease. Respiratory disease was confirmed & diagnosed by part two of questionnaire, physical examination & necessary investigations. Prevalence of respiratory diseases was 18.8% in this study. Prevalence of respiratory diseases was almost double in elderly males as compared to females. COPD was most prevalent respiratory disease followed by Bronchial asthma.

Diagnosis of sarcoidosis.

During the last decade, many biochemical and immunologic advances have been made in the treatment and understanding of sarcoidosis. These studies have helped us to understand the basic mechanisms involved in granuloma formation, and many clinicians have used the information to diagnose and assess the activity of sarcoidosis. Further studies are needed to clearly establish the role of these advances in the everyday management of patients with sarcoidosis.

Sarcoidosis of the nervous system. A clinical approach.

Sarcoidosis is a multisystem disorder of unknown cause. The disease is characterized by the presence of noncaseating granulomas in the affected tissue system. Clinically recognizable nervous system involvement occurs in about 10% of patients with sarcoidosis, although the incidence of subclinical neurosarcoidosis is much higher. The disease appears in the differential diagnosis of many infectious and noninfectious neurological syndromes. We have reviewed all aspects of neurosarcoidosis from the point of view of practicing internists, including the clinical manifestations, cerebrospinal fluid and radiographic changes, differential diagnosis, and treatment.

Anticardiolipin antibodies in acquired immunodeficiency syndrome.

We undertook a prospective study of IgG and IgM anticardiolipin antibodies (ACAs) to determine their clinical significance in patients with acquired immunodeficiency syndrome (AIDS). IgG ACAs were found in 24 (92.3%) of 26 patients with AIDS who were hospitalized for pulmonary complaints (group 1) and in 13 (93%) of 14 patients with AIDS-related complex (group 2). In addition, 17 (94%) of 18 patients with AIDS (group 3) who had coagulation tests and were studied retrospectively had IgG ACAs. The prevalence of IgG ACAs in these three groups was significantly higher than in healthy controls, but was comparable to that in 31 consecutive patients with systemic lupus erythematosus (67.7%). The mean titer of IgG ACAs in group 1 was higher than in groups 2 and 3 but was not different from that in the patients with systemic lupus erythematosus. The frequency and titer of IgM ACAs in group 1 (7.6%) or group 2 (14.3%) were not significantly different from those in normal controls (4.7%). In contrast, half of the patients in group 3 had low-titer IgM ACAs. The serum titer of IgG ACAs in patients with AIDS with thrombocytopenia was significantly higher than it was in those with normal platelet counts. There was no association between ACAs and Pneumocystis carinii pneumonia or other infections, cancer, thrombosis, positive VDRL test, or presence of the lupus anticoagulant. The prevalence and titer of IgG or IgM ACAs were not associated with abnormal results of any coagulation test. Although we found IgG ACAs to be associated with thrombocytopenia in AIDS, their presence does not carry exactly the same clinical significance as it does in systemic lupus erythematosus. The high prevalence of ACAs in AIDS, in AIDS-related complex, and in otherwise healthy contacts with antibodies to human immunodeficiency virus suggests that their occurrence may be related to the underlying human immunodeficiency virus infection.

Hypothyroidism and ventilator dependency.

Four patients with long-term ventilator dependency and severe hypothyroidism discovered in a single year are described. Correction of hypothyroidism was helpful in weaning three patients from the ventilator. The fourth patient died of other medical problems. None of these patients had goiter or clinical evidence of hypothyroidism. Hypothyroidism was discovered during workup for neurologic or cardiologic problems. Although hypothyroidism is not a common cause of ventilator dependency, it might be more common than we think.

Luteinizing hormone (LH) stimulates both intracellular calcium ion ([Ca2+]i) mobilization and transmembrane cation influx in single ovarian (granulosa) cells: recruitment as a cellular mechanism of LH-[Ca2+]i dose response.

The gonadotropic hormones, LH and FSH, activate adenylyl cyclase in their respective target cells and thereby initiate many biochemical responses. In addition to stimulating cAMP production, both LH and FSH promote agonist-specific increases in the cytoplasmic concentration of free calcium ions ([Ca2+]i) in gonadal cells. Here, we have applied single cell fluorescence video microscopy with the Ca2+-sensitive dye fura-2 to investigate the mechanism(s) by which LH induces a rise in the [Ca2+]i in individual (swine) granulosa cells collected from single Graafian follicles. Stimulation with LH induced a rapid onset, biphasic, spike- and plateau-like [Ca2+]i signal in responsive granulosa cells. The cellular mechanisms mediating this biphasic LH-stimulated increase in [Ca2+]i were examined by external Ca2+ removal and via the manganese (Mn2+) quench technique, which showed that LH triggers initial intracellular Ca2+ mobilization followed by delayed transmembrane Ca2+ influx. Single cell Ca2+ assessment of the LH dose-response mechanism(s) revealed that higher concentrations of LH progressively recruit a larger number of responding individual granulosa cells. Further analyses disclosed a marked [Ca2+]i response heterogeneity among individual granulosa cells harvested from the same Graafian follicle. In addition, the percentage of cells responding to LH [but not to an alternative putative agonist of the phospholipase C (PLC) pathway, viz. endothelin-1] with a biphasic [Ca2+]i rise increased with maturational development of the follicle. Pretreatment of granulosa cells with a specific PLC inhibitor, U-73122 (but not with its inactive congener U-73343), significantly reduced the percentage of cells responding to a LH challenge from 78% to 25% (P < 0.0001) and prolonged the time required to achieve a half-maximal value of the [Ca2+]i transient, viz. from 22 +/- 1.5 sec (n = 27 cells) to 39 +/- 7.2 sec (n = 12 cells; P = 0.002). In cell population studies, LH stimulated in a concentration- and time-dependent manner the accumulation of inositol phosphate in porcine granulosa cells. In summary, the present single cell investigations in mature granulosa cells demonstrate that LH drives initial intracellular Ca2+ mobilization followed by transmembrane divalent cation influx. The PLC inhibitor U-73122 antagonizes this action of LH. By analyzing [Ca2+]i responses in individual living granulosa cells, we further show that, despite within-follicle diversity, the LH dose biphasic [Ca2+]i response arises via the recruitment of a larger number of responding gonadal cells rather than by increased [Ca2+]i signal amplitude. Finally, the percentage of individual LH (but not endothelin-1)-responding granulosa cells increases with follicular maturation. Collectively, these data highlight the potential importance of the LH-stimulatable, PLC-transduced [Ca2+]i signaling mechanism in the later stages of granulosa cell differentiation.

Mechanisms by which endothelin-1 stimulates increased cytosolic free calcium ion concentrations in single rat Sertoli cells.

The regulation by endothelin-1 (ET-1) of cytosolic free calcium ion concentrations ([Ca2+]i) was investigated in single immature rat (testicular) Sertoli cells. [Ca2+]i was estimated in individual gonadal cells by digital imaging videomicroscopy using the calcium indicator dye fura-2/AM. Two concentration-dependent types of ET-1-induced [Ca2+]i signals were observed. Responses to high ET-1 concentrations (1.0-1000 nM) were characterized by a biphasic, rapid, and transient [Ca2+]i rise (spike) within 10 sec, followed by an exponential decrease toward a new steady state level (plateau phase) in 98% of responsive cells. At low concentrations of ET-1 (0.001 or 0.1 nM), the [Ca2+]i increase was slower, reaching peak values 40-100 sec after stimulation and remaining elevated for 2-3 min of observation. There was cell-cell heterogeneity in the amplitude and kinetics of the [Ca2+]i response to the same concentration of ET-1. However, there was a significant ET-1 concentration-dependent increase in the total percentage of cells responding to ET-1. Removal of extracellular Ca2+ or use of Ca2+ channel blockers (verapamil or cobalt) did not affect the ET-1-induced [Ca2+]i spike phase, but abolished the plateau phase, suggesting that ET-1 induces the mobilization of Ca2+ from internal stores, followed by calcium influx from extracellular sources. In cell population experiments, ET-1 attenuated FSH-stimulated cAMP and estradiol accumulation by Sertoli cells. These inhibitory effects were mimicked by phorbol 12-myristate 13-acetate, an activator of protein kinase-C, suggesting that ET-1 action on Sertoli cells might be linked to the protein kinase-C pathway. In conclusion, the present investigations demonstrate that ET-1 activates an intracellular signaling pathway involving [Ca2+]i in single rat Sertoli cells. The sources of the biphasic [Ca2+]i response include mobilization of Ca2+ from internal stores, followed by Ca2+ influx via verapamil- and cobalt-sensitive Ca2+ channels. Increasing ET-1 concentrations recruit an increasing number of individual Sertoli cells responding with a spike-plateau [Ca2+]i signal, thus offering a mechanism at the single cell level for the ET dose-response curve.