A prospective study comparing insulin and glibenclamide in gestational diabetes mellitus in Asian Indian women.
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Adult↗
Biomedical subjects
V Balaji
Publications and source records attributed to V Balaji.
Maternal glycemia and neonates birth weight in Asian Indian women.
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Adult↗
Gestational diabetes mellitus--guidelines.
The Diabetes In Pregnancy Study group India (DIPSI) is reporting practice guidelines for GDM in the Indian environment. Due to high prevalence, screening is essential for all Indian pregnant women. DIPSI recommends that as a pregnant woman walks into the antenatal clinic in the fasting state, she has to be given a 75g oral glucose load and at 2 hrs a venous blood sample is collected for estimating plasma glucose. This one step procedure of challenging women with 75 gm glucose and diagnosing GDM is simple, economical and feasible. Screening is recommended between 24 and 28 weeks of gestation and the diagnostic criteria of ADA are applicable. A team approach is ideal for managing women with GDM. The team would usually comprise an obstetrician, diabetes physician, a diabetes educator, dietitian, midwife and pediatrician. Intensive monitoring, diet and insulin is the corner stone of GDM management. Oral agents or analogues though used are still controversial. Until there is evidence to absolutely prove that ignoring maternal hyperglycemia when the fetal growth patterns appear normal on the ultrasonogram, it is prudent to achieve and maintain normoglycemia in every pregnancy complicated by gestational diabetes. The maternal health and fetal outcome depends upon the care by the committed team of diabetologists, obstetricians and neonatologists. A short term intensive care gives a long term pay off in the primary prevention of obesity, IGT and diabetes in the offspring, as the preventive medicine starts before birth.
Continuity of Patient Care↗
Rapid identification of Burkholderia pseudomallei in blood culture supernatants by a coagglutination assay.
In total, 309 blood culture supernatants were tested for the presence of Burkholderia pseudomallei antigen using an in-house coagglutination test prepared by sensitising Cowan I staphylococcal cells with B. pseudomallei polyclonal antiserum. The coagglutination test gave a sensitivity, specificity, positive predictive value and negative predictive value of 100% in comparison with blood culture. A subset of 102 supernatants was also tested for B. pseudomallei antigen using a monoclonal antibody-based latex agglutination test. The sensitivity, specificity, positive predictive value and negative predictive values of this test were 100%, 90%, 75% and 100%, respectively.
Agglutination Tests↗
Comparison of two methods to detect carbapenemase & metallo-beta- lactamase production in clinical isolates.
BACKGROUND & OBJECTIVE: Bacterial resistance has greatly hampered effective treatment of patients in clinical settings. Non-fermenting Gram-negative bacilli (NFGNB) are common nosocomial pathogens. In this study we attempted to develop a convenient test for early detection of carbapenemase and metallo-beta-lactamase (MbetaL) production in NFGNB. Lack of sufficient reports from India in this area indicated the need for this study. METHODS: A total of 50 imipenem resistant NFGNB were speciated, and their resistance reconfirmed by disk diffusion and minimum inhibitory concentration (MIC) determination by agar dilution. Two different methods namely modified Hodge and EDTA disk synergy tests were evaluated for carbapenemase and metallo-beta-lactamase (MbetaL) production. RESULTS: Of the 50 imipenem resistant NFGNB, 48 and two respectively fell in the resistant and intermediate range in MIC using agar dilution. Majority of these were Pseudomonas aeruginosa (n=28), followed by Burkholderia cepacia (n=9). The modified Hodge test could detect 28 strains as carbapenemase and MbetaL producers, while the EDTA disk synergy test was able to detect an additional 8 strains producing MbetaL and carbapenemase. INTERPRETATION & CONCLUSION: Pseudomonas aeruginosa was found to be the predominant NFGNB in our hospital setting and EDTA disk synergy could detect more carbapenemase and metallo-beta- lactamase producers compared to modified Hodge test.
Anti-Bacterial Agents↗
Bioremediation of 60Co from simulated spent decontamination solutions.
Bioremediation of 60Co from simulated spent decontamination solutions by utilizing different biomass of (Neurospora crassa, Trichoderma viridae, Mucor recemosus, Rhizopus chinensis, Penicillium citrinum, Aspergillus niger and, Aspergillus flavus) fungi is reported. Various fungal species were screened to evaluate their potential for removing cobalt from very low concentrations (0.03-0.16 microM) in presence of a high background of iron (9.33 mM) and nickel (0.93 mM) complexed with EDTA (10.3 mM). The different fungal isolates employed in this study showed a pickup of cobalt in the range 8-500 ng/g of dry biomass. The [Fe]/[Co] and [Ni]/[Co] ratios in the solutions before and after exposure to the fungi were also determined. At micromolar level the cobalt pickup by many fungi especially the mutants of N. crassa is seen to be proportional to the initial cobalt concentration taken in the solution. However, R. chinensis exhibits a low but iron concentration dependent cobalt pickup. Prior saturating the fungi with excess of iron during their growth showed the presence of selective cobalt pickup sites. The existence of cobalt specific sorption sites is shown by a model experiment with R. chinensis wherein at a constant cobalt concentration (0.034 microM) and varying iron concentrations so as to yield [Fe/Co]initial ratios in solution of 10, 100, 1000 and 287000 have all yielded a definite Co pickup capacity in the range 8-47 ng/g. The presence of Cr(III)EDTA (3 mM) in solution along with complexed Fe and Ni has not influenced the cobalt removal. The significant feature of this study is that even when cobalt is present in trace level (sub-micromolar) in a matrix of high concentration (millimolar levels) of iron, nickel and chromium, a situation typically encountered in spent decontamination solutions arising from stainless steel based primary systems of nuclear reactors, a number of fungi studied in this work showed a good sensitivity for cobalt pickup.
Biodegradation, Environmental↗
Analysis of an isolate of Mungbean yellow mosaic virus (MYMV) with a highly variable DNA B component.
One DNA A (KA30) and five different DNA B components (KA21, KA22, KA27, KA28 and KA34) of a geminivirus, Mungbean yellow mosaic virus-Vigna (MYMV-Vig) were cloned from a pooled sample of field-infected Vigna mungo plants from Vamban, South India. MYMV-Vig DNA A (KA30) and one of the DNA B components (KA27) exhibited 97% and 95% sequence identities, respectively, to those of MYMV reported from Thailand. However, the DNA B components KA21, KA22, KA28 and KA34 exhibited only 71 to 72% sequence identity to MYMV DNA B. Co-existence of multiple DNA B components in field-infected V. mungo was proved by Southern and PCR analyses. Each of the five DNA B components was infective together with the DNA A upon agroinoculation. Agroinoculation with mixed cultures of Agrobacterium with partial dimers of DNA A and all five DNA Bs proved that all five DNA B components can co-infect a single V. mungo plant.
Blotting, Southern↗
Infectivity analysis of two variable DNA B components of Mungbean yellow mosaic virus-Vigna in Vigna mungo and Vigna radiata.
Mungbean yellow mosaic virus-Vigna (MYMV-Vig), a Begomovirus that causes yellow mosaic disease, was cloned from field-infected blackgram (Vigna mungo). One DNA A clone (KA30) and five different DNA B clones (KA21, KA22, KA27, KA28 and KA34) were obtained. The sequence identity in the 150-nt common region (CR) between DNA A and DNA B was highest (95%) for KA22 DNA B and lowest (85.6%) for KA27 DNA B. The Rep-binding domain had three complete 11-nt (5'-TGTATCGGTGT-3') iterons in KA22 DNA B (and KA21, KA28 and KA34), while the first iteron in KA27 DNA B (5'-ATCGGTGT-3') had a 3-nt deletion. KA27 DNA B, which exhibited 93.9% CR sequence identity to the mungbean-infecting MYMV, also shared the 3-nt deletion in the first iteron besides having an 18-nt insertion between the third iteron and the conserved nonanucleotide. MYMV was found to be closely related to KA27 DNA B in amino acid sequence identity of BV1 (94.1%) and BC1 (97.6%) proteins and in the organization of nuclear localization signal (NLS), nuclear export signal (NES) and phosphorylation sites. Agroinoculation of blackgram (V. mungo) and mungbean (V. radiata) with partial dimers of KA27 and KA22 DNA Bs along with DNA A caused distinctly different symptoms. KA22 DNA B caused more intense yellow mosaic symptoms with high viral DNA titre in blackgram. In contrast, KA27 DNA B caused more intense yellow mosaic symptoms with high viral DNA titre in mungbean. Thus, DNA B of MYMVVig is an important determinant of host-range between V. mungo and V. radiata.
Amino Acid Motifs↗
Detection of virulence attributes of Burkholderia pseudomallei.
BACKGROUND & OBJECTIVES: Melioidosis caused by Burkholderia pseudomallei is an emerging disease in India. This study examined the toxin activity of bacteria-free culture filtrate in three different cell lines (cytotoxic assay) and its effect on Caenorhabditis elegans (nematode toxicity assay). Endotoxic activity of the viable bacteria was also studied in C. elegans (co-culture killing assay). METHODS: For toxin studies, serial doubling dilutions of unheated, heated crude and ultra filtrate of bacteria-free culture supernatants of B. pseudomallei were tested in 96-well microtitre plate containing confluent mono layers of McCoy, Hep-2 and HeLa cell lines. For the effects on C. elegans, the worms were exposed to heated and unheated bacteria-free culture supernatants in 24-well microtitre plate for 24h and then transferred to OP50 Escherichia coli lawn culture. The endotoxic activity of the live bacterium was studied by feeding the worms in the lawn culture of B. pseudomallei. RESULTS: All the clinical isolates (n=38) produced cytotoxic changes in all the cell lines. No difference was observed in the cytotoxicity of unheated, heated and ultra-filtered culture supernatant. The septicaemic isolates were observed to produce cytotoxic changes in high dilutions (1:160) of culture filtrate. None of the unheated and heated crude filtrate had deleterious effect on C. elegans, while all the live bacteria were found to be lethal to the nematode. INTERPRETATION & CONCLUSION: The culture supernatants, though produced cytopathic effect in various tissue cultures, failed to have any deleterious effect on the worms. However, live bacteria were lethal to the worms B. pseudomallei. Use of C. elegans model to detect virulence attributes of B. pseudomallei is recommended as an alternative to tissue culture methods as this can be carried out in laboratories where a tissue culture set up is not available.
Animals↗
Cytotoxin testing of environmental Aeromonas spp. in Vero cell culture.
BACKGROUND & OBJECTIVES: Aeromonas spp. are known to cause a variety of infections in humans and this organism has been isolated from a variety of sources including environmental sources. The pathogenicity of the environmental isolates in and around Vellore has not been studied. This study was conducted to determine the cytotoxicity of the Aeromonas spp. isolated from water bodies, soil sediments, plankton and sewers in and around Vellore. METHODS: Aeromonas spp. isolated from environmental sources were identified by standard procedures. Representative isolates of Aeromonas spp. were tested for cell free cytotoxic factor in tissue culture system. Undiluted and diluted cell free filtrates of isolates and known toxigenic and non-toxigenic bacteria were added to Vero cell monolayer in microtitre plates. After appropriate incubation in 5 per cent CO2 atmosphere, the microtitre plate was examined for cytopathic effect. Cell detachment and shrinkage of Vero cells were recorded as toxic changes. RESULTS: All 36 environmental isolates demonstrated cytopathic effect of which 41.7, 50 and 8.3 per cent belonged to A. hydrophila, A. veronii biotype sobria and A. caviae respectively. INTERPRETATION & CONCLUSION: The results demonstrated the presence of potentially pathogenic environmental aeromonads in and around Vellore and they produced cytotoxin.
Aeromonas↗
Gestational diabetes mellitus in India.
BACKGROUND: Glucose intolerance during pregnancy predisposes the offspring for increased risk of developing glucose intolerance in the future. This vicious cycle is likely to influence and perpetuate the incidence and prevalence of glucose intolerance in any population. AIM: No data is available about the prevalence of glucose intolerance during pregnancy in our country and hence a study was undertaken on this aspect. METHODS: This study was performed in the antenatal clinic of Government Maternity Hospital, Chennai, India. As a pregnant woman in second or third trimester checks into the antenatal clinic, she was given 50 gm oral glucose load and blood sample was collected after one hour. This test was performed on 1251 pregnant women. They were requested to come after 72 hours for the 75 gm OGTT recommended by WHO. Among the 1251 women, 891 responded. The blood sample was taken in the fasting state and at 2 hours after 75 gm of oral glucose. Diagnosis was based on the WHO criteria for gestational diabetes mellitus (GDM). RESULTS: The mean age of these pregnant women was 23+/-4 years. There was a significant increase in the prevalence of GDM in relation to gravida. The effect of BMI did not quite reach statistical significance (chi2 (df=1) = 3.659, P = 0.055), but a model of linear trend was significant. Of the 1251 women who underwent the 50 gm oral glucose challenge test, 670 (53.55%) had one hour plasma glucose > or = 130 mg/dl. Among the 891 pregnant women who had 75 gms OGTT, 168 (18.9%) were diagnosed as GDM, taking both FPG > or = 126 mg/dl and/or 2 hr PPG > or = 140 mg/dl as cut-off values. Taking only 2 hr plasma glucose for analysis, 144 (16.2%) had a value > or = 140 mg/dl. A similar study was conducted in different parts of the country taking only the 2 hr 75 gm post-glucose value of > or = 140 mg/dl as diagnostic criteria for GDM. Of the total number of pregnant women (n = 3674) screened, 16.55% of them found to have GDM. CONCLUSION: Our study has documented the increased prevalence of GDM in our population necessitating universal screening for glucose intolerance in pregnancy. Using 2 hr plasma glucose > or = 140 mg/dl as a one step procedure is simple and economical, particularly for the countries ethnically more prone to high prevalence of diabetes.
Adult↗
Autoantibodies to GAD65 and IA-2 antibodies are increased, but not tissue transglutaminase (TTG-Ab) in type 2 diabetes mellitus (T2DM) patients from South India.
The frequency of autoantibody-positve T2DM patients identified as LADA was shown to be high in T2DM patients from Eastern India. In this study, we measured autoantibodies to GAD65, IA-2, and TTG in T2DM patients from Southern India. Our results show that either GAD65 or IA-2 was present in 30% of T2DM patients (n = 155) and in 3% of controls for GAD65 and 1% of controls for IA-2 (n = 105). TTG-Ab was not increased in T2DM patients compared to controls. Our results suggest that LADA is more frequent in Southern Indians than in European Caucasians, but not as high as in Eastern Indians.
Autoantibodies↗
Diagnosis and management of diabetes in pregnancy.
Diabetes and pregnancy encompass not only pregestational diabetes mellitus but also any form of abnormal glucose tolerance during gestation. While screening for glucose intolerance is mandatory for high-risk patients in pregnancy, it is not required in others. There are various methods for screening of gestational diabetes mellitus eg, urine glucose detection, O'Sullivan screening test, WHO criteria, etc. Proper management of diabetes in pregnancy can arrest foetal mortality and morbidity. Practical self management skills are essential for attaining good glycaemic control. Management of gestational diabetes mellitus rests on the idea of medical nutrition therapy and insulin therapy.
Counseling↗
Genetic abnormalities detected in ependymomas by comparative genomic hybridisation.
Using comparative genomic hybridisation, we have analysed genetic imbalance in a series of 86 ependymomas from children and adults. Tumours were derived from intracranial and spinal sites, and classified histologically as classic, anaplastic or myxopapillary. Ependymomas showing a balanced profile were significantly (P<0.0005) more frequent in children than adults. Profiles suggesting intermediate ploidy were common (44% of all tumours), and found more often (P<0.0005) in tumours from adults and the spinal region. Loss of 22q was the most common specific abnormality, occurring in 50% of spinal (medullary) ependymomas and 26% of tumours overall. Genetic profiles combining loss of 22q with other specific abnormalities--gain of 1q, loss of 6q, loss of 10q/10, loss of 13, loss of 14q/14--varied according to site and histology. In particular, we showed that classic ependymomas from within the cranium and spine have distinct genetic profiles. Classic and anaplastic ependymomas with gain of 1q tended to occur in the posterior fossa of children and to behave aggressively. Our extensive data on ependymomas demonstrate significant associations between genetic aberrations and clinicopathological variables, and represent a starting point for further biological and clinical studies.
Adolescent↗
Women diagnosed with gestational diabetes mellitus do not carry antibodies against minor islet cell antigens.
Women with gestational diabetes mellitus (GDM) have considerable risk for developing both type 1 and type 2 diabetes in life. Autoantibodies against glutamic acid decarboxylase (GAD65) and tyrosine phosphatase (IA-2) are strongly associated with autoimmune diabetes and can be useful in early identification of the development of type 1 diabetes in women with GDM. On the other hand antibodies against minor islet antigens in adults can be predictors for autoimmune polyendocrine syndrome. The aim of our study was to estimate the prevalence of autoantibodies against minor antigens-tissue transglutaminase (TTG), ICA12, and 21-hydroxylase (21-0H)-in GDM patients from southern India. Eighty-six serum samples from GDM subjects and 114 samples from healthy controls were tested for the presence of GAD65 and IA-2Ab as well as for the presence of 21-OH, TTG, and ICA12Ab by radiobinding assay with in vitro translated recombinant human 35S-GAD65, IA-2, TTG, ICA12, and 21-OH antigens. We observed the presence of GAD65 or IA-2 autoantibodies in 41% (35/86) of GDM patients, while none of the patients tested positive for any of the minor autoantibodies. Our results demonstrate that there is a high prevalence of autoantibodies in GDM subjects that are at higher risk of developing autoimmune diabetes later, but none of the patients carries antibodies against minor antigens, which could predict autoimmune polyendocrine syndrome in adults.
Autoantibodies↗
Quinolone susceptibility of Vibrio cholerae O1 & O139 isolates from Vellore.
BACKGROUND & OBJECTIVES: Vellore is an endemic area for cholera. The relative prevalence of clinical cases of Vibrio cholerae O1 and O139 has been fluctuating. Few studies have examined the susceptibility of local isolates to quinolones. The objective of the present study was to look at quinolone susceptibility and determine MIC of ciprofloxacin to representative clinical isolates of V. cholerae O1 and O139 in Vellore, obtained between 1997 and 1999. METHODS: Antimicrobial susceptibility testing of V. cholerae strains was performed by disc diffusion technique and MIC determination by E test. RESULTS: Five of 30 O1 and all the O139 serogroup isolates were susceptible to nalidixic acid. All isolates of both serogroups were sensitive to norfloxacin. All isolates of both serogroups gave MIC results in the susceptible range to ciprofloxacin; the MICs being lower for V. cholerae O139 (MIC50 = 0.004 microgram/ml and MIC90 = 0.047 microgram/ml) than for O1 serogroup (MIC50 = 0.38 microgram/ml and MIC90 = 0.5 microgram/ml). INTERPRETATION & CONCLUSION: V. cholerae O1 and O139 show differences in quinolone susceptibility, the reason for this is not clear. This could be because of longer exposure of the O1 serogroup to quinolone antimicrobials as compared to the O139 serogroup.
Anti-Infective Agents↗
Clinical and molecular stratification of disease risk in medulloblastoma.
The accurate assessment of disease risk among children with medulloblastoma remains a major challenge to the field of paediatric neuro-oncology. In the current study we investigated the capacity of molecular abnormalities to increase the accuracy of disease risk stratification above that afforded by clinical staging alone. 41 primary medulloblastoma tumour samples were analysed for ErbB2 receptor expression using immunohistochemistry, and for aberrations of chromosome 17 and amplification of the MYC oncogene using fluorescence in situ hybridisation. The ErbB2 receptor and deletion of 17p were detected in 80% and 49% of tumours, respectively. 17p loss occurred either in isolation (20%), or in association with gain of 17q (29%), compatible with an isochromosome of 17q. Amplification of MYC was detected in only 2 tumours. Significant prognostic factors included, 'metastatic disease' (P = 0.0006), 'sub-total tumour resection' (P = 0.007), 'high ErbB2 receptor expression' (P = 0.003) and 'isolated 17p loss' (P = 0.003). Combined analysis of clinical and molecular factors enabled greater resolution of disease risk than clinical factors alone, identifying a sub-population of patients with particularly favourable disease outcome. These data support the hypothesis that a combination of clinical and molecular factors may afford a more reliable means of assigning disease risk in patients with medulloblastoma, thereby providing a more accurate basis for targeting therapy in children with this disease.
Adolescent↗
Efficient vir gene induction in Agrobacterium tumefaciens requires virA, virG, and vir box from the same Ti plasmid.
The vir genes of octopine, nopaline, and L,L-succinamopine Ti plasmids exhibit structural and functional similarities. However, we observed differences in the interactions between octopine and nopaline vir components. The induction of an octopine virE(A6)::lacZ fusion (pSM358cd) was 2.3-fold higher in an octopine strain (A348) than in a nopaline strain (C58). Supplementation of the octopine virG(A6) in a nopaline strain with pSM358 did not completely restore virE(A6) induction. However, addition of the octopine virA(A6) to the above strain increased virE(A6) induction to a level almost comparable to that in octopine strains. In a reciprocal analysis, the induction of a nopaline virE(C58)::cat fusion (pUCD1553) was two- to threefold higher in nopaline (C58 and T37) strains than in octopine (A348 and Ach5) and L,L-succinamopine (A281) strains. Supplementation of nopaline virA(C58) and virG(C58) in an octopine strain (A348) harboring pUCD1553 increased induction levels of virE(C58)::cat fusion to a level comparable to that in a nopaline strain (C58). Our results suggest that octopine and L,L-succinamopine VirG proteins induce the octopine virE(A6) more efficiently than they do the nopaline virE(C58). Conversely, the nopaline VirG protein induces the nopaline virE(C58) more efficiently than it does the octopine virE(A6). The ability of Bo542 virG to bring about supervirulence in tobacco is observed for an octopine vir helper (LBA4404) but not for a nopaline vir helper (PMP90). Our analyses reveal that quantitative differences exist in the interactions between VirG and vir boxes of different Ti plasmids. Efficient vir gene induction in octopine and nopaline strains requires virA, virG, and vir boxes from the respective Ti plasmids.
Agrobacterium tumefaciens↗