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Pseudohypoparathyroidism (PHP) is a rare hereditary disorder having the prevalence of 3.4 per million. It is characterized by symptoms and signs of hypoparathyroidism, typically in association with distinctive skeletal and developmental defects. The features of hypoparathyroidism are due to tissue resistance to the effect of parathyroid hormone (PTH). We will describe a 32-yearold woman who had recurrent convulsion for 16 years, infertility, cataract, psychosis, candidiasis and typical features of Albright's hereditary osteodystrophy (AHO), which include a round face, short neck, short stature and brachydactyly. Laboratory investigations showed hypocalcemia, hyperphosphatemia with high PTH level. Computed tomography scan of head revealed wide spread calcification in basal ganglia and cerebral hemispheres. X ray of left foot showed short left 4th metatarsal bone. The patient was diagnosed as a case of PHP on the basis of somatic features of AHO with typical biochemical abnormalities and uncontrolled convulsion with combined antiepileptic drugs for 16 years. The unusual features in our case are long delay in clinical diagnosis and absence of family history. She was treated with calcium salt and vitamin D. With this treatment patient's condition was improved and she experiences no attack of convulsion and carpal spasm. Anticonvulsants were withdrawn gradually. We recommend that hypocalcaemia should be excluded before commencing anticonvulsant therapy in all epileptic patients and those patients whose seizures are refractory to anticonvulsant drugs. [ABSTRACT FROM AUTHOR]

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Objectives: The goals of this study were to assess the effectiveness of a new triple therapy consisting of amoxicillin and metronidazole with plaunotol in the eradication of Helicobacter pylori infection in humans, and to determine whether this treatment regimen reduces the rate of recurrence of gastric ulcer in patients infected with H. pylori without instituting maintenance therapy with H2-receptor antagonists. Methods: Thirty patients with active gastric ulcer who were infected with H. pylori were first treated with omeprazole until scarring occurred. Patients then received plaunotol for 4 wk, with amoxicillin and metronidazole for 7 days. Results: This triple therapy resulted in the safe eradication of H. pylori in 26 (86.7%) of 30 patients, with no recurrence of ulcer seen during a 12-month follow-up period in patients who tested negative for the presence of H. pylori. In addition, histological inflammatory changes improved in these patients. Of the four patients with persistent H. pylori infection, in three (75%), ulcers recurred. Conclusion: This new triple therapy was very effective in eradicating H. pylori in infected patients and in reducing the rate of recurrence of gastric ulcer in these patients. [ABSTRACT FROM AUTHOR]

We present a case of 30-year-old lady presenting with gradual difficulty in standing up from sitting position for 6 months, pain in arms and thighs, tingling sensation and numbness in palms and soles, increased fluid intake and increased frequency of micturition for the same duration. She was hypertensive for 12 years. On general examination patient seemed depressed and on nervous system examination her power of muscles in both upper and lower limb of both side was 3/5. Plasma sodium at the upper normal range 144mmol/l (normal range 135-146), lower level of serum potassium 1.7mmol/L (normal range 3.5-5.0), high urinary potassium 26.7mmol/l (normal range 1-10), very high serum CPK 4269U/L (for female normal range 10-79), low normal plasma rennin 1.58mg/ml/hr (normal range standing 0.40-8.80, supine 0.30-3.0), high serum aldosterone 1326.39pg/ml (normal range 25-315), high pH 7.45 (normal range 7.36-7.44) and on imaging evidence of an adrenal adenoma on left side was found and the patient was diagnosed as a case of Conn's syndrome.

We used an Ixodes scapularis population model to investigate potential northward spread of the tick associated with climate change. Annual degree-days >0 degrees C limits for I. scapularis establishment, obtained from tick population model simulations, were mapped using temperatures projected for the 2020s, 2050s and 2080s by two Global Climate Models (the Canadian CGCM2 and the UK HadCM3) for two greenhouse gas emission scenario enforcings 'A2'and 'B2' of the Intergovernmental Panel on Climate Change. Under scenario 'A2' using either climate model, the theoretical range for I. scapularis establishment moved northwards by approximately 200 km by the 2020s and 1000 km by the 2080s. Reductions in emissions (scenario 'B2') had little effect on projected range expansion up to the 2050s, but the range expansion projected to occur between the 2050s and 2080s was less than that under scenario 'A2'. When the tick population model was driven by projected annual temperature cycles (obtained using CGCM2 under scenario 'A2'), tick abundance almost doubled by the 2020s at the current northern limit of I. scapularis, suggesting that the threshold numbers of immigrating ticks needed to establish new populations will fall during the coming decades. The projected degrees of theoretical range expansion and increased tick survival by the 2020s, suggest that actual range expansion of I. scapularis may be detectable within the next two decades. Seasonal tick activity under climate change scenarios was consistent with maintenance of endemic cycles of the Lyme disease agent in newly established tick populations. The geographic range of I. scapularis-borne zoonoses may, therefore, expand significantly northwards as a consequence of climate change this century.

A total of 152 ixodid ticks (Acari: Ixodidae) consisting of nine species was collected from 82 passerine birds (33 species) in 14 locations in Canada from 1996 to 2000. The Lyme disease spirochete Borrelia burgdorferi Johnson, Schmidt, Hyde, Steigerwaldt & Brenner was cultured from the nymph of a blacklegged tick, Ixodes scapularis Say, that had been removed from a common yellowthroat, Geothlypis trichas L., from Bon Portage Island, Nova Scotia. As a result of bird movement, a nymphal I. scapularis removed from a Swainson's thrush, Catharus ustulatus incanus (Godfrey), at Slave Lake, Alberta, during spring migration becomes the new, most western and northern record of this tick species in Canada. Amblyomma longirostre Koch, Amblyomma sabanerae Stoll, and Ixodes baergi Cooley & Kohls are reported for the first time in Canada. Similarly, Amblyomma americanum L., Arnblyomma maculatum Koch, and ixodes muris Bishopp & Smith are reported for the first time on birds in Canada. After removal of an I. muris gravid female from a song sparrow, Melospiza melodia Wilson, at St. Andrews, New Brunswick, eggs were laid, which developed into larvae, and this new tick-host record demonstrates that birds have the potential to start a new tick population. We conclude that passerine birds disperse several species of ixodid ticks in Canada, and during spring migration translocate ticks from the United States, and Central and South America, some of which are infected with B. burgdorferi.

Epidemiological reports reveal that H. pylori is distributed among all population in the world. The present cross-sectional study was undertaken to see the H. pylori seroprevalence rates among the asymptomatic adults, as yet reportedly no such data available in Bangladesh. Serum samples were collected from 181 consecutive subjects who attended at the health check-up centre of Bangladesh Institute of Diabeties, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, during the period of August to November 1995 for medical check up. The mean age of these subjects was 30.33 years (range 20-44 yrs). Incidentally all were male and belonged to average socioeconomic class. H. pylori specific IgG antibody level was assayed by an enzyme immunoassay kit ElAgen (Clone system). Among the 181 subjects, 166 (92%) had H. pylori specific antibodies and 15 (8%) were seronegative. No significant difference (p < 0.90) in seroprevalence rates was observed among different age groups. However, the results of higher seroprevalence rates of H. pylori infection in these asymptomatic adult population of Bangladesh are consistent with that of Africa and India.

To analyse the immune response of mice to Borrelia duttonii infection, BALB/c mice were inoculated intraperitoneally with B. duttonii strain 406K, and the titres of B. duttonii-specific immunoglobulins - IgM, IgG1, IgG2a, IgG2b and IgG3 - were determined by ELISA. IgM antibodies appeared first, followed by IgG2a and IgG3, and then IgG1 and IgG2b. The protective activity of individual classes and subclasses of B. duttonii-specific immunoglobulins was then determined by passive immunisation of BALB/c mice with immunoglobulin preparations purified by affinity chromatography. The mice were then challenged by intraperitoneal inoculation of B. duttonii. The study demonstrated that B. duttonii-specific IgM and IgG3 protected against the development of spirochaetaemia and death after borrelial infection, whereas B. duttonii-specific IgG1, IgG2a and IgG2b had low protective activities.

Helicobacter pylori, a gram-negative, microaerophilic bacterium, has been established to have a causal association with chronic gastritis, peptic ulcer, gastric adenocarcinoma, and low-grade lymphoma. The present study was undertaken to evaluate the efficacy of culture, histological examination, the rapid urease test, and serology for the diagnosis of H. pylori infection. A total of 45 consecutive subjects with various upper gastrointestinal symptoms were included in this study. The rates of diagnosis of H. pylori infection were 51.1%, 55.6%, 82.2%, and 93.3%, by culture, rapid urease test (RUT), histological examination, and serology, respectively. The sensitivity, specificity, and positive and negative predictive values were 95.5%, 82.6%, 84.0%, and 95.0%, respectively for RUT; 95.5%, 30.4%, 56.8%, and 87.5% for histological examination; 100%, 13.6%, 54.8% and 100% for serology.

Escherichia coli was isolated from 65 urine samples out of 300 specimens collected from diabetic and non-diabetic patients with urinary tract infections. All isolates were screened for susceptibility to commonly used antibiotics. No remarkable difference in sensitivity pattern was observed between the E. coli isolates from diabetic and non-diabetic out-patients. However, the isolates from hospitalized diabetic patients showed a clear difference in sensitivity; E. coli from this group was more resistant to commonly used antibiotics compared with those from non-hospitalized diabetic and non-diabetic patients.

Objective: To investigate the involvement of urease in Helicobacter pylori colonization in the nude mouse stomach by using a genetically defined urease-negative mutant., Methods and Results: Through electroporation-mediated gene replacement, one of the urease genes of an H. pylori strain, CYP3401, was disrupted by insertion of a kanamycin-resistance determinant to construct a stable urease-negative mutant, HPT73. Southern analysis confirmed that gene replacement was achieved. The two isogenic strains were introduced into the stomachs of nude mice, and the number of H. pylori and the histological changes in the stomachs were investigated 1 or 4 weeks after the challenge. Gastritis was present in the CPY3401-challenged stomach, from which bacteria indistinguishable from CPY3401 were successfully recovered. In contrast, no gastritis was found in the HPT73-challenged stomach, and H. pylori was not recovered from these stomachs., Conclusion: H. pylori urease is essential for colonization of the nude mouse stomach.

The growth of Helicobacter pylori, a Gram-negative microaerophilic bacterium, is often difficult and requires complex media with the supplementation of 5% to 10% blood or blood derivatives. We have found that Brucella broth supplemented with 1% heated horse serum and 0.1% beta-cyclodextrin supports the good growth of H. pylori. The degree of growth and production of urease and vacuolating cytotoxin in this medium were equal to those in the medium supplemented with 5% horse serum. This medium was found to be suitable for both the routine laboratory culture and primary isolation of H. pylori from biopsy samples.

Borrelia duttonii strain 406K, a causative agent of relapsing fever, could not be cultivated in vitro in currently available media for borreliae. We have developed an in vitro cultivation system by using SflEp cell cultures. The average increases of the number of borreliae, when inoculated with 1.0 x 10(5) organisms per ml from infected mice, were 23-fold and 150-fold in the primary culture and the 3rd subculture, respectively. Even a single borrelia could propagate in this cultivation system. This system will be useful for immunological and physiological studies on uncultivable Borrelia strains.

In an epidemic of shigellosis in southern Bangladesh the causal organism, Shigella dysenteriae type 1, was resistant to nalidixic acid as well as to co-trimoxazole (trimethoprimsulphamethoxazole) and ampicillin. The genes coding for resistance to nalidixic acid, but not those coding for resistance to co-trimoxazole or ampicillin, are located on a conjugative 20 megadalton plasmid. This epidemic is of particular importance because of the resistance to nalidixic acid, an antibiotic to which shigellae are seldom resistant, and because plasmids were previously thought not to mediate resistance to nalidixic acid.