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Biomedical subjects

R M Joshi

Publications and source records attributed to R M Joshi.

At least 19 recordsLinked to original sources
PubMed2004

High diversity of group A Streptococcal emm types in an Indian community: the need to tailor multivalent vaccines.

BACKGROUND: Concern about the emergence of antibiotic-resistant strains and about morbidity and/or mortality related to rheumatic fever and rheumatic heart disease has been a continuous impetus for the development of a safe, effective vaccine against group A Streptococcus (GAS). To date, >120 GAS M types are known, as identified by serological typing. In general, serum immunoglobulin G directed to the hypervariable NH2 terminal portion of M protein leads to complement fixation and opsonophagocytosis of the homologous streptococcal serotype by polymorphonuclear leukocytes, and the protection is type specific. The sequence variation at the N terminus ultimately affects the binding of opsonic antibodies. Because of hypervariability in these opsonic sequences from different M types, it was relevant to use epitopes derived from these multiple sequences in a "multivalent vaccine" design for evaluation of protection against these M types of GAS. Thus, any attempts to design vaccines for a given community will require information on N terminal-sequence typing and variation. METHODS: In the present study, we performed molecular characterization of isolates recovered from patients in northern India--to our knowledge, for the first time--in an attempt to study the circulating M types and their N terminal sequence variability. RESULTS: We report tremendous diversity in GAS strains recovered from symptomatic patients, with implications on the design of appropriate vaccines. Fifty-nine isolates represented 33 different sequence types. Very few novel types and no predominant clones were found. CONCLUSIONS: The high diversity of emm types encountered in a single year suggests that any M protein-based multivalent vaccine would have to be specifically tailored for this region.

Bacterial Typing Techniques↗
PubMed2004

Aerobic bacterial isolates from burn wound infections and their antibiograms--a five-year study.

A retrospective study of major aerobic bacterial isolates from pus/wound swabs taken from patients admitted to the burn unit at Govt. Medical College Hospital, Chandigarh, India, over a period of 5 years (June 1997-May 2002) was undertaken. The study was carried out to determine the bacterial profile and antimicrobial susceptibility of the isolates and to describe the change in trends over the study period. The pus/wound swabs yielded very high culture positivity (96%) for 665 total isolates. Pseudomonas aeruginosa was found to be most common isolate (59%) followed by Staphylococcus aureus (17.9%), Acinetobacter spp. (7.2%), Klebsiella spp. (3.9%), Enterobacter spp. (3.9%), Proteus spp. (3.3%) and others (4.8%). Although P. aeruginosa continued to remain the predominant isolate over the five years, a constant and significant increase in the incidence of Acinetobacter spp. was found. Amikacin was found to be the most effective drug against gram negative bacteria, however, resistance to it was significantly increased over 5 years. For S. aureus and P. aeruginosa netilmicin and piperacillin were found to be the most effective drugs. Most of the isolates showed high level resistance to antimicrobial agents.

Bacteria, Aerobic↗
PubMed2004

A cognitive tool to diagnose predominantly inattentive ADHD behavior.

Poor performance on tests of reading comprehension could be the result of weak word-recognition skills, inconsistent attention (ADD), or a combination of the two. Identifying the source of the reading disability (RD) reliably has been difficult because inconsistent attention interferes with reading and weak word recognition skill makes attention wander. The situation is further complicated by the fact that there are no objective diagnostic tests for ADD (Breggin, 1998; Diller, 1998). We proposed a new model of differential diagnosis of ADHD-I/RD and field-tested its utility in two studies. The new diagnostic procedure utilizes intra-individual differences seen in the performance of at-risk learners on tasks related to reading that vary in the degree of sustained attention required for successful performance. The hypothesis is that children whose attention is inconsistent would perform more poorly on tests such as listening comprehension, which require sustained attention, than on tests such as reading comprehension, which are more tolerant of inattention. Such differences will not be seen in the test scores of children who have only a reading disability because their performance on reading tests is determined more by the difficulty level of the tests than by the sensitivity of the tests to attention. The validity of this new model was evaluated by determining the relationship between differences seen in the scores of tests that differ in their attention requirement and the degree of inconsistency in sustained attention as measured by Conners' CPT. The results of the two studies indicate this to be a viable approach. The results of the second study are presented in this report.

Attention Deficit Disorder with Hyperactivity↗
PubMed2003

Hepatolithiasis with biliary ascariasis--a case report.

BACKGROUND: Biliary ascariasis is regarded as possible etiological factor for hepatolithiasis. Here we report one case of a patient with hepatolithiasis with biliary ascariasis who developed a liver abscess, which was treated with partial hepatectomy. CASE PRESENTATION: A young adult female presented with epigastric pain and vomiting with repeated attacks of cholangitis. ERCP showed evidence of multiple intrahepatic calculi with the development of abscess in the left lobe of liver. The patient underwent partial hepatectomy and was found to have biliary ascariasis on histology. She was treated with antihelmenthic therapy and has had an uneventful postoperative period of 2 years. CONCLUSION: Biliary ascariasis with hepatolithiasis, although rare, should be considered in endemic countries.

Adult↗
PubMed2003

Listeriosis in second trimester of pregnancy: case report from India.

Although Listeria monocytogenes infection occurs in sporadic and epidemic forms throughout the world, there are certain countries (especially Asian countries) that have reported only a few cases or failed to report even a single case. During her third visit at 17(+5) weeks of gestation, a 22-year-old primigravida presented with the complaint of an acute painful abdomen, leaking per vaginum and low-grade fever for the 2 preceding days. On ultrasonography, a single live fetus with no amniotic fluid was seen and the pregnancy was therefore terminated. L. monocytogenes was isolated from a high vaginal swab.

Adult↗
PubMed1998

Crystal structure of Boc-LAla-deltaPhe-deltaPhe-deltaPhe-deltaPhe-NHMe: a left-handed helical peptide.

Alpha,beta-dehydrophenylalanine residues constrain the peptide backbone to beta-bend conformation. A pentapeptide containing four consecutive (deltaPhe) residues has been synthesised and crystallised. The peptide Boc-LAla-deltaPhe-deltaPhe-deltaPhe-deltaPhe+ ++-NHMe (C45H46N6O7, MW = 782.86) was crystallised from an acetonitrile/methanol mixture. The crystal belongs to the orthorhombic space group P2(1)2(1)2(1) with a = 19.455(6), b = 20.912(9), c = 11.455(4) A and Z = 4. The X-ray (MoKalpha, lambda = 0.7107 A) intensity data were collected using the Rigaku-AFC7 diffractrometer. The crystal structure was determined by direct methods and refined using the least-squares technique, R = 8.41% for 1827 reflections with absolute value of Fo > 4sigma(absolute value of Fo). The molecule contains the largest stretch of consecutive dehydrophenylalanine residues whose crystal structure has been determined so far. The peptide adopts left-handed 3(10)-helical conformation despite the presence of LAla at the N-terminus. The mean phi, psi values, averaged across the last four residues are 56.8 degrees and 17.5 degrees, respectively. There are four 4-->1 intramolecular hydrogen bonds, characteristic of the 310-helix. In the crystal each molecule interacts with four crystallographically symmetric molecules with one hydrogen bond each.

Circular Dichroism↗
PubMed1997

Palliative surgery in malignant obstructive jaundice: prognostic indicators of early mortality.

A prospective analysis of 50 patients undergoing palliative bypass surgery for incurable malignant obstructive jaundice was carried out in an attempt to identify factors predicting post-operative mortality. Five clinical and nine laboratory parameters were studied. Fourteen patients died within 30 days of surgery. It was seen that levels of haemoglobin, hematocrit and serum albumin levels were significantly lower while serum bilirubin was significantly higher in patients who died compared with the survivors. Patients having Hb < 10 Gm/dL, serum bilirubin > 350 micromol/dL, serum albumin < 2.5 g/dL and prothrombin index < 60% exhibited a higher percentage of mortality. On multivariate analysis, levels of haemoglobin, serum albumin and serum bilirubin could be used to independently predict the outcome with an accuracy of 86%. This was validated by prospectively applying the regression equation derived from the first 30 patients to the next 20 patients. It was seen that the predicted outcome correlated with the actual outcome with a correlation coefficient of 0.5098 (P = 0.01). It is concluded that in patients with high bilirubin, low haemoglobin and low albumin levels palliative surgical procedures carry a high risk of post-operative mortality and non-surgical methods may be more suitable.

Adult↗
PubMed1990

Antimicrobial susceptibility of non-penicillinase and penicillinase-producing Neisseria gonorrhoeae strains isolated in Tripoli, Libya.

Neisseria gonorrhoeae culture gave a positive result in 42 of 64 male adults with purulent urethral discharge. The majority of the infections were acquired outside Libya. Twenty-seven strains (64.3%) were non-penicillinase producing (NPPNG) and 15 (35.7%) were penicillinase producing (PPNG) by starch paper technique. Antimicrobial susceptibility of the strains to 5 antibiotics was carried out by agar-plate dilution technique. Twenty-three NPPNG strains (54.8%) were susceptible to penicillin with a minimum inhibitory concentration (MIC) of less than or equal to 0.5 micrograms/ml. In 4 strains (9.5%), a high resistance to penicillin (MIC greater than or equal to 16 micrograms/ml) appeared to be chromosomally-mediated (CMRNG). All PPNG strains were resistant to penicillin (MIC greater than or equal to 1 microgram/ml). While resistance to erythromycin (MIC greater than or equal to 1 microgram/ml) and tetracycline (MIC greater than or equal to 1 microgram/ml) was observed in 5 strains, resistance to kanamycin (MIC 32 micrograms/ml) and spectinomycin (MIC 64 micrograms/ml) was present in only one strain. Whereas no significant differences were recorded in MICs of erythromycin, tetracycline, kanamycin and spectinomycin between NPPNG and PPNG strains, one PPNG strain was found to be resistant in vitro to all 5 antibiotics.

Drug Resistance, Microbial↗
PubMed1989

Primary and acquired drug resistance in Mycobacterium tuberculosis strains in western region of Libyan Arab Jamahiriya.

Drug resistance in Mycobacterium tuberculosis strains prevalent in the Western Region of Libyan Arab Jamahiriya was studied for the years 1984, 1985 and 1986 at the regional tuberculosis control centre at Gurgi, Tripoli. Records of resistance to streptomycin, isoniazid, ethambutol and rifampicin were analysed. Whereas primary drug resistance was observed in 5.1%, 19.5% and 3.8%, acquired drug resistance was found in 12.2%, 34.0% and 15.3% of the strains in 1984, 1985 and 1986 respectively. Only 3 out of 598 strains (1.2%) were found to show acquired resistance to rifampicin. No primary resistance to rifampicin was observed. The situation of drug resistance in pulmonary tuberculosis in the Jamahiriya is discussed.

Drug Resistance, Microbial↗
PubMed1987

Shigellosis in Zaria, northern Nigeria.

368 strains of Shigella were recovered from stool specimens in the Department of Medical Microbiology, Ahmadu Bello University Teaching Hospital, Zaria, during the period January 1980 to December 1984. S. flexneri was found to be the most common (60%) followed by S. boydii (20.7%), S. dysenteriae (14.1%) and S. sonnei (5.2%). Males were more frequently infected (61.4%) than females (38.6%). Maximum cases were seen in the 21-to 40-year age group (48.9%). Almost two-thirds of the cases of shigellosis (64.4%) were recorded during the rainy season. Antimicrobial resistance to four or more drugs was recorded in (38%) of the isolates.

Adolescent↗