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Mumbai, India

Kothavade R.J.,Microbiology Laboratory | Kothavade R.J.,Sir Jj Group Of Hospitals | Dhurat R.S.,LTM Medical College | Mishra S.N.,Venereology and Leprology | Kothavade U.R.,University of Alberta
European Journal of Clinical Microbiology and Infectious Diseases | Year: 2013

Rapidly growing mycobacteria (RGM) are known to cause pulmonary, extra-pulmonary, systemic/disseminated, and cutaneous and subcutaneous infections. The erroneous detection of RGM that is based solely on microscopy, solid and liquid cultures, Bactec systems, and species-specific polymerase chain reaction (PCR) may produce misleading results. Thus, inappropriate therapeutic measures may be used in dermatologic settings, leading to increased numbers of skin deformity cases or recurrent infections. Molecular tools such as the sequence analyses of 16S rRNA, rpoB and hsp65 or PCR restriction enzyme analyses, and the alternate gene sequencing of the superoxide dismutase (SOD) gene, dnaJ, the 16S-23S rRNA internal transcribed spacers (ITS), secA, recA1, dnaK, and the 32-kDa protein gene have shown promising results in the detection of RGM species. PCR restriction enzyme analyses (PRA) work better than conventional methods at identifying species that are closely related. Recently introduced molecular tools such as matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), pyrosequencing, DNA chip technology, and Beacon probes-combined PCR probes have shown comparable results in the detection of various species of RGM. Closely related RGM species (e.g., Mycobacterium fortuitum, M. chelonae, and M. abscessus) must be clearly differentiated using accurate molecular techniques because their therapeutic responses are species-specific. Hence, this paper reviews the following aspects of RGM: (i) its sources, predisposing factors, clinical manifestations, and concomitant fungal infections; (ii) the risks of misdiagnoses in the management of RGM infections in dermatological settings; (iii) the diagnoses and outcomes of treatment responses in common and uncommon infections in immunocompromised and immunocompetent patients; (iv) conventional versus current molecular methods for the detection of RGM; (v) the basic principles of a promising MALDI-TOF MS, sampling protocol for cutaneous or subcutaneous lesions and its potential for the precise differentiation of M. fortuitum, M. chelonae, and M. abscessus; and (vi) improvements in RGM infection management as described in the recent 2011 Clinical and Laboratory Standards Institute (CLSI) guidelines, including interpretation criteria of molecular methods and antimicrobial drug panels and their break points [minimum inhibitory concentrations (MICs)], which have been highlighted for the initiation of antimicrobial therapy. © 2012 Springer-Verlag Berlin Heidelberg. Source

Purohit D.P.,Mount Sinai School of Medicine | Batheja N.O.,Mount Sinai School of Medicine | Sano M.,Mount Sinai School of Medicine | Sano M.,Medical Center | And 8 more authors.
Journal of Alzheimer's Disease | Year: 2011

Systematic studies on Alzheimer's disease (AD)-related pathology that complement clinical and epidemiological data on dementia from low and middle income countries are rare. We report the first large study on AD-related pathology in autopsy service-derived brains from an urban center in India, a low/middle income country, and compare findings with a similar sample from New York. Amyloid-β plaques and neurofibrillary tangles were assessed in 91 brain specimens derived from hospital autopsy cases from Mumbai, India (age 60+ years; mean age 71.1 years, ±8.3 SD; range 60-107 years) and compared with identically examined age-matched sample obtained in New York. These cases had no known clinical history of dementia. Our study showed that in comparison with the New York sample, the mean brain weight of the Mumbai sample was lower (p = 0.013) and mean diffuse plaque density was higher (p = 0.019), while differences in mean density and counts of neurofibrillary tangles and neuritic plaques were not statistically significant (p > 0.05). Our findings indicate that the burden of AD-related pathology was approximately equivalent in Mumbai and New York samples, which is at variance with expected lower AD-related lesion burden based on the clinical/epidemiological studies suggesting lower prevalence of AD in India. © 2011 - IOS Press and the authors. All rights reserved. Source

Buchade D.,LTM Medical College | Mohite S.,TN Medical College
Journal of Indian Academy of Forensic Medicine | Year: 2011

The present study was carried out in the City of Greater Mumbai's all post mortem centres during the calendar year of 2004 to 2006 with aims and objective to determine the pattern of injuries in cases of homicides during this period with special reference to injuries sustained during these homicidal incidences. Total 371 cases of homicidal deaths were collected from post mortem reports, panchnama, police requisition and statements of relatives. The injuries present on the particular body area were noted with due consideration of kind of weapon used, internal organs injured and cause of death. Male victim's preponderance was noted over female victims with male age group of 21-30 years being most commonly affected. The head face and neck region of the body was most often targeted. Internal organs most commonly affected were neck structures followed by brain while least involved organ was heart. Hard and blunt weapons were most commonly used followed by sharp edged and pointed weapons. Infanticide was most common in female infants. The most common cause of death in male victims was shock and haemorrhages and in female victims was mechanical asphyxia. Source

Kumta S.,Bill and Melinda Gates Foundation | Lurie M.,Brown University | Weitzen S.,Brown University | Jerajani H.,LTM Medical College | And 7 more authors.
Journal of Acquired Immune Deficiency Syndromes | Year: 2010

Objectives: To describe sociodemographics, sexual risk behavior, and estimate HIV and sexually transmitted infection (STI) prevalence among men who have sex with men (MSM) in Mumbai, India. Methods: Eight hundred thirty-one MSM attending voluntary counseling and testing (VCT) services at the Humsafar Trust, answered a behavioral questionnaire and consented for Venereal Disease Research Laboratory and HIV testing from January 2003 through December 2004. Multivariate logistic regression was performed for sociodemographics, sexual risk behavior, and STIs with HIV result as an outcome. Results: HIV prevalence among MSM was 12.5%. MSM who were illiterate [adjusted odds ratio (AOR) 2.28; 95% confidence interval (CI): 1.08 to 4.84], married (AOR 2.70; 95% CI: 1,56 to 4.76), preferred male partners (AOR 4.68; 95% CI: 1.90 to 11.51), had partners of both genders (AOR 2.73; 95% CI: 1.03 to 7.23), presented with an STI (AOR 3.31; 95% CI: 1.96 to 5.61); or presented with a reactive venereal disease research laboratory test (AOR 4.92; 95% CI: 2.55 to 9.53) at their VCT visit were more likely to be HIV infected. Conclusions: MSM accessing VCT services in Mumbai have a high risk of STI and HIV acquisition. Culturally appropriate interventions that focus on sexual risk behavior and promote condom use among MSM, particularly the bridge population of bisexual men, are needed to slow the urban Indian AIDS epidemic. © 2010 by Lippincott Williams & Wilkins. Source

Jerajani H.,LTM Medical College | Mizoguchi H.,Procter and Gamble | Li J.,Procter and Gamble | Whittenbarger D.,Procter and Gamble | Marmor M.,Procter and Gamble
Indian Journal of Dermatology, Venereology and Leprology | Year: 2010

Background : The B vitamins niacinamide and panthenol have been shown to reduce many signs of skin aging, including hyperpigmentation and redness. Aims : To measure the facial skin effects in Indian women of the daily use of a lotion containing niacinamide, panthenol, and tocopherol acetate using quantitative image analysis. Methods : Adult women 30-60 years of age with epidermal hyperpigmentation were recruited in Mumbai and randomly assigned to apply a test or control lotion to the face daily for 10 weeks. Effects on skin tone were measured using an image capturing system and associated software. Skin texture was assessed by expert graders. Barrier function was evaluated by transepithelial water loss measurements. Subjects and evaluators were blinded to the product assignment. Results : Of 246 women randomized to treatment, 207 (84%) completed the study. Women who used the test lotion experienced significantly reduced appearance of hyperpigmentation, improved skin tone evenness, appearance of lightening of skin, and positive effects on skin texture. Improvements versus control were seen as early as 6 weeks. The test lotion was well tolerated. The most common adverse event was a transient, mild burning sensation. Conclusions : Daily use of a facial lotion containing niacinamide, panthenol, and tocopheryl acetate improved skin tone and texture and was well tolerated in Indian women with facial signs of aging. Source

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