Medically Important Fungi: A Guide to Identification

Extreme obesity associated with alveolar hypoventilation. A Pickwickian syndrome

Introduction: Cytokines are a diverse group of peptides produced by different cell types including cancer cells and various subpopulations of immune system cells. They exert their effects as cellular secreted mediators after binding to appropriate membrane receptors. Area covered: In this modern era of a multiomic approach to immuno-oncology this paper discusses the multiple roles of cytokines in oncology and our current understanding of the complex interactions between a tumor and host (in the so-called tumor microenvironment). Because of their pivotal role in biomedicine, we focus on critical comments about advantage between many techniques which are helping our understanding of the signal transduction process, gene activation, gene regulation and their clinical significance. Expert opinion: Integrated investigations based on a multiomic approach to the interactions between cells of the immune system and cancer, which focus at different cellular, molecular and nuclear levels, and involving proteomics, genomics, transcriptomics, metabolomics and pharmacogenomics, are expected to lead to improved cancer diagnoses and treatment in the future.

Multiomic analysis of cytokines in immuno-oncology

Background While the high burden of multidrug-resistant tuberculosis (MDR-TB) itself is a matter of great concern, the emergence and rise of advanced forms of drug-resistance such as extensively drug-resistant TB (XDR-TB) and extremely drug-resistant TB (XXDR-TB) is more troubling. The aim of this study was to investigate the trends over time of patterns of drug resistance in a sample of MDR-TB patients in greater metropolitan Mumbai, India.

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Resistance Patterns among Multidrug- Resistant Tuberculosis Patients in Greater Metropolitan Mumbai: Trends over Time

Quantitative estimations of fungal aerosols are important to understand their role in causing respiratory diseases to humans especially in the developing and highly populated countries. In this study we sampled and quantified the three most dominantly found allergenic airborne fungi, Aspergillus fumigatus, Cladosporium cladosporioides, and Alternaria alternata from ambient PM10 samples using the quantitative PCR (qPCR) technique in a southern tropical Indian region, for one full year. Highest concentrations of A. fumigatus and C. cladosporioides were observed during monsoon whereas A. alternata displayed an elevated concentration in winter. The meteorological parameters such as temperature, relative humidity, wind speed, and precipitation exhibited a substantial influence on the atmospheric concentrations of allergenic fungal aerosols. The morphological features of various allergenic fungal spores present in the PM10 were investigated and the spores were found to possess distinct structural features. In a maiden attempt over this region we correlate the ambient fungal concentrations with the epidemiological allergy occurrence to obtain firsthand and preliminary information about the causative fungal allergen to the inhabitants exposed to bioaerosols. Our findings may serve as an important reference to atmospheric scientists, aero-biologists, doctors, and general public.

Seasonal variation of the dominant allergenic fungal aerosols – One year study from southern Indian region

Background: Drug-resistant tuberculosis is one of major current challenges to global public health. The transmission of resistant strains is increasing as a burden of multidrug-resistant tuberculosis (MDR-TB) patients in extra pulmonary tuberculosis (EPTB) cases in India. Aim and Objectives: The aim was to study trends of anti-tuberculosis drug resistance pattern in new cases and previously treated cases of EPTB in referral hospitals in northern India. Study Design and Setting: A prospectively observational study and referral medical institutions in northern India. Materials and Methods: All EPTB specimens were processed for Ziehl Neelsen staining, BACTEC culture and BACTEC NAP test for Mycobacterium tuberculosis complex. All M. tuberculosis complex isolates were performed for radiometric-based drug susceptibility pattern against streptomycin, isoniazid, rifampicin and ethambutol using the 1% proportion method. Results: We found that 165/756 (20.5%) isolates were identified as M. tuberculosis complex by the NAP test. We observed that 39.9% were resistant to first-line antitubercular drugs. The resistance rate was higher in previously treated patients: H (30.3%), R (16.3%), E (15.7%) and S (16.3%). MDR-TB was observed in 13.4%, but, in new cases, this was 11.4% and 19.1% of the previously treated patients (P<0.05). Conclusion: MDR-TB is gradually increased in EPTB cases and predominant resistance to previous treated cases of EPTB. The molecular drug sensitivity test (DST) method can be an early decision for chemotherapy in MDR-TB patients. The International Standards of TB Care need to be used by the RNTCP and professional medical associations as a tool to improve TB care in the country.

Trends of anti-tuberculosis drug resistance pattern in new cases and previously treated cases of extrapulmonary tuberculosis cases in referral hospitals in northern India

Detection of 123 bp fragment of insertion element IS6110 Mycobacterium tuberculosis for diagnosis of extrapulmonary tuberculosis

Background: Lung cancer is characterized by uncontrolled cell growth of the lung tissues. It is the leading cause of cancer-related deaths worldwide. Objectives: The study aimed to determine the circulating CRP, TNF-α, IL-6 and IL-8 levels in lung cancer and healthy control and also established association between these biomarkers with the smoking status as well as the stages of the disease. Methodology: 51 lung cancer patients and 51 healthy controls were enrolled in this case-control study. The serum levels of CRP, TNF-α, IL-6 and IL-8 were measured in lung cancer patients and healthy control groups. Results: The levels of serum CRP, TNF-α, IL-6 and IL-8 were significantly higher in lung cancer patients when compared with controls(P<0.0001). The levels of these biomarkers were also significantly higher in stage iii/iv as compared to stage i/ ii(P<0.001). Significant difference in the levels of these biomarkers were also found in smoker and non-smoker lung cancer patients as compared to controls(P<0.001). Conclusion: CRP, TNF-α, IL-6 and IL-8 are the promising biomarkers in the identification of lung cancer patients. The study also supports the association of inflammatory markers to lung cancer risk. Hence these findings suggest the levels of these biomarkers could be a useful tool for guiding the diagnosis of lung cancer. Keywords: Lung cancer, biomarker, inflammation, stage, smoking.

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Association of inflammatory biomarkers with lung cancer in North Indian population.

Pulmonary tuberculosis presenting as multiple nodular opacity is very infrequent. Hereby we reported such type of case in a 40 year old lady, who presented with us with the complaints of exertional dyspnoea.

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Bilateral Nodular Pulmonary Tuberculosis Simulating Metastatic Lung Cancer

Various health problems including symptoms and diseases are known to be associated with microbially contaminated air and can arise through inhalation of airborne fungal spores. The relationship between the viable air floating fungal contamination and the respirable particulate matter with aerodynamic diameter less than 10 μm (PM10) in the ambient air was studied. Samples were collected at each sampling period (10 sites in total) at residential, commercial cum traffic and Industrial sites in the city of Lucknow (Uttar Pradesh) during April, 2010 to June, 2011. The respirable dust sampler (Environtech Model APM 460 NL) was used for the collection. 6 groups of fungi of environmental origin were detected on PM10.The concentration of airborne fungi was increased with increasing mass concentration of PM10.

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Ras Kushwaha

Papers

Trends of anti-tuberculosis drug resistance pattern in new cases and previously treated cases of extrapulmonary tuberculosis cases in referral hospitals in northern India

Detection of 123 bp fragment of insertion element IS6110 Mycobacterium tuberculosis for diagnosis of extrapulmonary tuberculosis

Association of inflammatory biomarkers with lung cancer in North Indian population.

Bilateral Nodular Pulmonary Tuberculosis Simulating Metastatic Lung Cancer

Assessment of fungal contamination present on RSPM/PM10 and its associationwith human health.