Diagnosis of gastrointestinal tuberculosis: Using cytomorphological,microbiological, immunological and molecular techniques — A study from Central India

The present study included three groups: (A) age and gender matched control (n=24) with no previous signs of M. tuberculosis complex (MTBC) infection, (B) patients (n=28) diagnosed with gastro-intestinal TB (GITB), (C) patients (n=50) with clinical and histo-pathological signs of GITB, but were culture and AFB negative. Real time assay performed using fluorescence resonance energy transfer hybridization probes showed a positivity index of 36 % in group C, i.e. 18 were found reactive from the total 50 cases studied. In addition, immune characterization of these 18 cases showed depleted CD₄⁺ count and increased levels of IFN-γ and TNF-α cytokines. No positive case was found in group A, while in group B, out of total 28 cases studied 27 were found positive. A combinatorial diagnostic approach for rapid detection and characterization of GITB might provide specific therapeutic strategies for prevention and treatment of the infection in future.     

Utility of serum LDH isoforms in the assessment of mycobacterium tuberculosis induced pathology in TB patients of Sahariya tribe

The present study was carried out in the Sahariya tribe of Central India, which reportedly have high prevalence of pulmonary tuberculosis. Total serum LDH and its tissue specific isoforms were estimated in TB patients and matched healthy controls to test the utility of LDH as diagnostic marker for tuberculosis. About 210 sputum positive cases and 328 age and sex matched sputum negative controls were recruited. The spectrophotometeric and densitometric analysis of each LDH isoform was carried out in both cases and controls. The mean values of serum LDH were estimated and compared for each class by t-test. The statistical comparisons were made between sputum negative controls and sputum positive cases by Mann-Whitney’s U test. The spectrophotometric estimation of serum LDH revealed significant (P=0.0016) increase in its level in cases (290 IU/L) as compared to controls (248 IU/L). The densitometric analysis of individual LDH isoforms in cases and controls demonstrated significant elevation in LDH1 (P>0.05), LDH2 (P>0.05) and LDH3 (P<0.005) in sputum positive cases in comparison to sputum negative controls. Our study revealed a positive correlation between serum LDH level and the presence of mycobacteria and their load, suggesting utility of LDH as an important diagnostic marker of tuberculosis induced stress, at least in tribal areas lacking access to modern clinical tests.     

Issues in the management of web technologies: a conceptual framework

The current spate of activities in Electronic Commerce draws upon many web-based technologies. Inspite of the large amount of literature being put out on Electronic Commerce, there is no coherent model or theory bearing on issues of the management of Web technologies. This paper makes a beginning in this direction by outlining a conceptual framework for management of Web technologies. The existing literature in the Mangement of Information Technology reveals four major themes: management of investment; management of change; management of quality; and management of technology organization. This paper elaborates on all the four themes in the light of Web technologies.     

Antitubercular activity of garlic (allium sativum) extract on combination with conventional antitubercular drugs in tubercular lymphadenitis

Based on our demonstration earlier that ethanol extract, water extract and a compound purified from garlic possessedin vitro antitubercular activity against drug resistant and susceptibleMycobacterium tuberculosis, we tried the effect of garlic extract in 30 patients of tubercular lymphadenitis. For ethical considerations, two groups of patients, 30 each, were given antitubercular therapy (ATT) consisting of isoniazid, rifampicin, ethambutol and pyrazinamide for 30 days. For the next 15 days (31 to 45 days) group 1 patients received 3–6 garlic pearls per day in addition to ATT while group 2 patients received ATT only. From 46th day onwards both the groups received ATT only for 6–8 months. Antitubercular activity of the serum samples collected on 45th day was assessed by its effect on the growth ofM. tuberculois. The serum of group 1 patients showed significantly much higher antitubercular activity than that of group 2 patients. Further, there was relief of dyspeptic symptoms caused by ATT therapy in patients of group 1 with garlic plus ATT therapy but no change in group 2 patients with ATT only. Liver function and hematological tests were normal in both the groups after 6 months of therapy. Garlic extracts or compounds have a good potential as antitubercular(s) drug if given as a supplement to ATT.     

Correlation of bone mineral density with biochemical markers in post menopausal women

To evaluate the magnitude of bone loss in postmenopausal women and to study the effect of a selective estrogen Receptor Modulator, raloxifene, on bone loss by quantitative ultrasound of calcaneus and serum bone specific alkaline phosphatase (BAP). Postmenopausal women with ostesopenia/osteoporosis were assigned randomly to receive placebo (n=30) or raloxifene (60mg/d, n=30) with calcium (500mg/day) and vitamin D (250 IU/day). The bone mineral density (BMD) and BAP levels were measured at the beginning of therapy and six months later. They were subjected to statistical analysis (t test, p value) using SPSS statistical package. 70% of postmenopausal women suffered from osteopenia/osteoporosis. After raloxifene therapy, there was improvement in the BMD but this was not statistically significant (p>0.05). There was a fall in the value of serum BAP by 26.6% (p<0.05). Raloxifene has a favourable effect on bone turnover as evident from changes in BMD and a significant fall in serum BAP.     

Detection of Helicobacter pylori using nested polymerase chain reaction in gastric biopsy samples

Helicobacter pylori remains a controversial organism with regards to humans, its epidemiology still unclear nearly two decades after discovery. The present study was undertaken to estimate the prevalence of the organism in the gastrointestinal tract in symptomatic and asymptomatic subjects to understand its precise natural history in India. A total of 154 specimens were a part of the study. These included gastric biopsies from peptic ulcer disease and Non ulcer dyspepsia subjects, as visualized on endoscopy, saliva and stool samples from apparently normal healthy adults. Nested polymerase chain reaction was performed using the primers Hp1, Hp2, Hp3 targeting 16S rRNA gene. A prevalence of 65.1%, 100%, 66.7%, and 73.3% respectively was observed by polymerase chain reaction. No association was observed between the H.pylori status and the disease condition of the patient.     

Critical Race Theory and the Transfer Function: Introducing a Transfer Receptive Culture

In California, the majority of students of color who enter postsecondary education do so in the community colleges. However large numbers of them leave and do not transfer to four-year institutions; in particular to highly selective public four-year colleges and universities. By using the theoretical perspective of critical race theory, transfer can be seen as a dual commitment between both the sending and receiving institution as we put forth the conceptual framework of a “transfer receptive culture.” We define a transfer receptive culture as an institutional commitment by a four-year college or university to provide the support needed for students to transfer successfully—that is, to navigate the community college, take the appropriate coursework, apply, enroll, and successfully earn a baccalaureate degree in a timely manner. We outline five elements, informed by critical race theory, that are necessary to establish a transfer receptive culture and outline specific strategies within each element that practioners can employ on their home campuses.