Link between infertility and female genital tuberculosis

By Syed Akbar

Hyderabad, July 5: A team of city doctors has established a link between infertility and female genital tuberculosis, which is fast spreading in South India after lying low for many years.

The team has also found easy diagnostic methods to detect genital tuberculosis in women with 100 per cent accuracy. Currently diagnosing female genital tuberculosis is nothing short of a Herculean task. In many countries diagnosis is mainly limited to clinical suspicion based on symptoms. The problem is further compounded as abdominal and vaginal examinations reveal nothing.

Dr Roya Rozati, Dr Sreenivasagari Roopa and Dr Cheruvu Naga Rajashwari of the department of reproductive medicine at Mahavir Hospital and Research Centre have not only solved the diagnosis problem by identifying mycobacterial DNA tests through polymerase chain reaction but also established a link between the disease and infertility.

Genital tuberculosis is an important cause of infertility, more so in endemic zones such as South India. The proportion of extra-pulmonary TB is increasing down the Vindhyas and currently stands slightly higher than smear-positive pulmonary TB. Effective chemotherapy had reduced all forms of TB including FGTB until the HIV epidemic reversed the trend over the last decade.

However, the true epidemiology of this disease remains unknown due to lack of highly sensitive and specific tests. Genital tuberculosis not only causes tubal obstruction and dysfunction but also impairs implantation due to endometrial involvement and ovulatory failure from ovarian involvement.

The prevalence of FGTB in infertility clinics shows marked variations in different countries ranging between 15 and 25 per cent. In India in 80 to 90 per cent of cases, FGTB affects young women between 18 and 38 years of age, besides being an important cause of infertility.

"A high erythrocyte sedimentation rate and a positive mantoux test are non-specific. AFB staining is not sensitive enough and both culdoscopy and laparascopy carry a significant risk of bowel injury. Surgery is disadvantageous as it is highly invasive and carries a risk of activating silent infection. Only histopathological evidence in biopsy of premenstrual endometrial tissue or demonstration of tubercle bacilli in culture of menstrual blood or endometrial curetting can provide diagnosis with certainty," says Dr Roya Rozati.

The doctors investigated biopsy or curettage samples from 65 women clinically suspected to have genital tuberculosis for mycobacterium.

Genital tuberculosis is often a secondary complication as a result of reactivation of a silent bacillemia, primarily from lungs, affecting most commonly the fallopian tubes, ovaries, cervix, endometrium and vagina and vulva, and in some instances also from kidney and intestines.

"Direct inoculation of tubercle bacilli can also take place over vulva or vagina during sexual intercourse with a partner suffering from tuberculous lesions of genitalia," she said.

Peptide treatment for white patch disease or vitiligo

2007
By Syed Akbar
Hyderabad, June 30: City scientists have developed a group of chemical peptides that will help in treating vitiligo, the "white patch disease", and controlling wrinkles, the symbol of ageing.
The molecules were developed using the DNA recombinant technology. They have the ability to remove the disfiguring white patches from the body even while controlling formation of wrinkles. They also have essential "anti-wrinkle" properties and hides the age of people.
Vitiligo is caused when melanocytes, the cells that give colour or pigmentation to skin, are lost. This leads to white patches on mainly the exposed parts of the body. Vitiligo often causes hypo or hyper thyroidism, diabetes and anaemia, not only disfiguring the body but also affecting its physiological functions.
The pioneering work has been jointly carried out by the Centre for Cellular and Molecular Biology and Celestial Laboratories. A drug is being prepared based on the research work. These peptides are chemically synthesised and tested for their efficacy in cell cultures. Four of these peptides showed profound effect as mitogens of melanocytes. They induced melanosome differentiation and migration.
A group of researchers led by Dr Ch Mohan Rao of the CCMB has synthesised oligonucleotides following the amino acid sequence of the effective mutein peptides. They are later cloned for strong promotion and expression.
"There is evidence that the presence of pro-opomelanocortin peptides are responsible in regulation of skin tan in humans. A few of the melanotropic peptides have been identified from human placental preparations that are known to have melanogenic potential or ability to give skin its colour," says AN Singh of Celestial Labs.
Vitiligo is a major concern in developing countries especially in India where, in the western zone the prevalence is as high as eight per cent.
World surveys show a similar prevalence in Mexico and Japan. The global prevalence is observed to be around three per cent.
Presently vitiligo is treated temporarily with make-ups. Medication has thus far proved futile with no satisfactory results.
Optimisation of protein induction is in procedure. Once the recombinant peptide is expressed in sufficient quantities the peptide will be purified and will be used for further studies.

WHO says AP has both chikungunya and dengue in tandem

2007
Syed Akbar
Hyderabad, June 27: The World Health Organisation has bracketed Andhra Pradesh as one of the very few places where chinkungunya is prevalent with dengue.
Though chinkungunya is prevalent in quite a number of places across the globe, it is not generally associated with other infections. But in Andhra Pradesh and Orissa cases of co-infection of chikungunya-dengue are noticed complicating the matters for medical doctors. The WHO lists AP, Orissa and Malegaon (in Maharashtra) as the only places "with occurrence of dengue and or chikungunya". Treatment for chinkungunya is not disease-based but based on the symptoms the patient suffers from and this often leads to overdose of anti-biotics and other medicines.
However, the WHO in its "Epidemic and Pandemic Alert and Response (EPR)" does not feel the need for any special travel advisory to tourists visiting Hyderabad or other parts of Andhra Pradesh. Moreover, the WHO has also not updated its EPR alert after March 17 for Andhra Pradesh which means that there's no major change in chikungunya infection scenario in the State during the past three months. Also AP had the highest number of suspected chikungunya cases.
Several countries including Mauritius, Seychelles, France, Germany, Italy, Norway and Switzerland have reported cases of chikungunya but only in Andhra Pradesh and Orissa there is a "mixed outbreak of chikungunya, with sporadic cases of dengue".
Stating that several cases of "fever with arthralgia" (neuralgic pain in joints) have been reported from Andhra Pradesh, the WHO relates the cases to "high density of Aedes aegypti mosquitoes". These signs are consistent with an arbovirus (virus transmitted by mosquitoes and ticks) outbreak.
According to the WHO report, chikungunya and dengue viruses are transmitted to humans by the bites of infected mosquitoes. While Aedes albopictus is more active outdoors Aedes aegypti typically feeds and rests more indoors. Andhra Pradesh has reported cases of Aedes aegypti. Chikungunya (which in Swahili language means "that which bends up" referring to the stooped posture developed in patients due to arthritic symptoms) has assumed epidemic and pandemic proportions in the State since December last year.
"Although transmission of chikungunya and dengue is continuing in the affected areas, WHO recommends no special restrictions on travel or trade to or from these areas. However, it is recommended that individuals take precautions to protect themselves from mosquito bites, e.g., by wearing clothes that minimise skin exposure and applying insect repellents to exposed skin or clothing in accordance with label instructions," the WHO report pointed out.
Meanwhile, Hyderabad District Medical and Health Officer Dr Satyavati said of the 5326 cases screened for chikungunya only six patients in fever hospital are suspected to be suffering from the disease.

Allergy and Genes go hand-in-hand, say Hyderabad scientists

June 26, 2007
By Syed Akbar
Hyderabad, June 25: A group of city scientists has identified the genetic link in Indian population to over-allergic reactions (atopy) and asthma.
Researchers at the city-based Centre for Cellular and Molecular Biology, Saboo Hospital and Research Centre, Osmania Medical College and Niloufer Children's Hospital came out with a genetic analysis of bronchial asthma in Indian population elucidating the complex genetic regulation of the disease including atopy. The study will help in better understanding of the root causes of these chronic diseases and effective diagnosis and treatment.
The research work gains significance in the backdrop of increasing instances of asthma and active allergic problems in the country. So far, researchers have been looking at asthma from environmental point of view and for the first time in India, the city researchers have turned their concentration on the genetic aspects of this complex polygenic disease. Asthma is commonly associated with familial atopic syndrome and increased levels of total IgE (immunoglobulins E).
The study carried out by GR Chandak, M Mohammed Idris, Sandeep Saboo, GS Ramalaxmi and others points out asthma and allergy are not inherited as single gene disorders and do not follow a simple Mendelian inheritance. A complex interaction between environmental and genetic factors produces the disease susceptibility and expression.
Identifying specific genetic polymorphisms that influence asthma and atopic phenotypes will also help in better screening of the "at risk" population and pave the way for extension of these markers in different population groups in the country. It may also lead to a novel strategy to modulate the course of this disease or identify better therapeutic modalities.
The city researchers investigated the association of polymorphisms and extended haplotype in genes (IL4 and IL4RA) with atopy and asthma in the Indian population and attempted to study whether genotypic and haplotypic differences can account for the phenotypic variations in atopic and non-atopic asthmatic individuals.
The probands (individual subjects of a genetic study) and control subjects were recruited based on the evaluation of clinical and family history using a standardised questionnaire following the guidelines of American Thoracic Society. They were examined for a self-reported history of breathlessness, wheeze, allergic rhinitis and eczema and confirmed by various pulmonary function tests.

Mammal-like reptile fossil found

June 2007
By Syed Akbar
Hyderabad, June 19: A new mammal-like reptile has been discovered for the first time in the country from the upper Triassic formation in the Pranahita-Godavari valley in Adilabad district. The fossilised remains of this animal are 225-million-years-old and will provide vital information to scientists on the evolution of early mammals. It belongs to the order Cynodonts and its remains are recorded for the first time from upper Triassic formations.
The animal has been identified as a new genus/species and named as Deccanadon maleriensis (Deccan because it was found in Deccan plateau and maleriensis after the Maleri sedimentation).
Though Cynodonts were discovered elsewhere in the world, no such animals were ever found in India. The Pranahita-Godavari valley is one of the few places on the earth where Triassic period sedimentation are found. So far only three groups of cynodonts are reported from Europe. Deccanodon malerienseis cannot be compared with Indian specimens, as no cynodont teeth are reported.
The discovery was made by palaeontologists P. Yadagiri and T.T. Nath of the Geological Survey of India.
"The discovery of this animal from older stratigraphic horizon assumes importance as the study will help to evaluate the origin and evolution of early mammals from upper Triassic (Carnian) to early Jurassic period," Mr Yadagiri told this correspondent. The GSI team collected five well preserved specimens of post canine teeth from Lakshmipuram village in Adilabad district. The collection includes five well preserved specimens of post canine teeth. The teeth closely resemble that of Microdon if one goes by the shape of the crown, separation of cusps, absence of a constriction between crown and root, and incipient division of the root. Interestingly, the early mammals were nearly microscopic, of the size of a big ant. "The post canine tooth is well persevered except part of the distal root portion. The enamel is smooth. The specimen measures 20 mm in height and 13 mm in length. The width is narrow. The crown part is larger than the preserved root portion. The crown part is laterally compressed, six cusps are arranged in a longitudinal row. The crown and root are not separated by constriction," Mr Yadagiri said. The find of Maleri cynodont teeth has opened a new vista to search for cynodonts along with early mammals.

Mammal-like reptile found in Pranahiti-Godavari valley

2007
By Syed Akbar
Hyderabad, June 19: A new mammal-like reptile has been discovered for the first time in the country from the upper Triassic formation in the Pranahita-Godavari valley in Adilabad district.
The fossil remains of this animal trace back to 225 million years and will provide vital information to scientists on the evolution of early mammals. This mammal-like reptile belongs to the order cynodonts and its remains are recorded for the first time from upper Triassic formations. The animal has been identified as a new genus/species and named as Deccanadon maleriensis (Deccan because it was found in Deccan plateau and maleriensis after the Maleri sedimentation).
The discovery was made by palaeontologists P Yadagiri and TT Nath of the Geological Survey of India. Though cynodonts were discovered elsewhere in the world, no such animals were ever found in India. The Pranahita-Godavari valley is one of the few places on the earth where Triassic period sedimentation are found. So far only three groups of cynodonts are reported from Europe. Deccanodon malerienseis cannot be compared with Indian specimens, as no cynodont teeth are reported.
"The discovery of this animal from older stratigraphic horizon assumes importance as the study will help to evaluate the origin and evolution of early mammals from upper Triassic (Carnian) to early Jurassic period," Yadagiri told this correspondent.
The GSI team collected five well preserved specimens of post canine teeth from Lakshmipuram village in Adilabad district. The collection includes five well preserved specimens of post canine teeth. The teeth closely resemble that of Microdon if one goes by the shape of the crown, separation of cusps, absence of a constriction between crown and root, and incipient division of the root.
Interestingly, the early mammals were nearly microscopic, of the size of a big ant.
"The post canine tooth is well persevered except part of the distal root portion. The enamel is smooth. The specimen measures 20 mm in height and 13 mm in length. The width is narrow. The crown part is larger than the preserved root portion. The crown part is laterally compressed, six cusps are arranged in a longitudinal row. The crown and root are not separated by constriction," Yadagiri said.
The find of Maleri cynodont teeth has opened a new vista to search for cynodonts along with early mammals in the Pranahita-Godavari valley.