Dengue continues to surge in the national capital, with 95 more cases being reported on Sunday, taking the total number of people infected with the mosquito-borne disease to 2,916, an official said.

Five people have succumbed to dengue in the capital this year, including one from outside Delhi, a Municipal Corporation of Delhi (MCD) official said.

With 433 cases, south Delhi is the most affected area this season, followed by the MCD's Civil Lines zone (378) and Rohini zone (341).

According to the MCD, the number of dengue cases this year could cross the 2006 figure of 3,366 cases.

Tuberculosis is an impotant disease of coming time although controlled by modern medicines but drug resistant TB as Multidrug resistant Tuberculosis (MDRT) or XDRT (Extreme durg resistant TB) are very dangerous for developing and developed countries both as no drug can take care of it , so once spread in society , it will cause extensive damge both mortality and morbidity will increase .The main reason behind this is a fact to detect TB in early stage once TB bacilli are not secreted or expelled out in Sputum because to detect TB bacilli in pus,blood,serum, csf,semen, vaginal fluid, stool, swaet, urine , peritoneal or pericardial or plueral fluid is almost very difficult and as by simple AFB staining it is not visible then we have to go for culture which takes about 4-6 wks either by inocculation in guinea pig or different recetly developed cultural media and recently developed Bactec Method of incubation also takes 07 days ,and to determine culture and sensitivity is again time lasting costly herculian task, ADA testing of fluid provide indirect evidence, PCR TB is very costly and requires good time and is selectively avaiable in few centre in India so mostly TB is diagnosed either by clinical judgement , starting treatment empirically and continuing if found clinical improvement.Mostly TB is daignosed by ESR, CRP,Total count,chest X-ray, CSF cobweb coagulum,Mantoux test, IGg and IGm for TB bacilli or ADA testing all provide indirect support for positivity of TB , recently for cultures new media and methods have developed but few are in practice only and 7-10 days are minimumly required to get culture of TB Mycobacterium whether typical or atypical type. Mostly if Drugs are not controlling it or if Bacilli continue to grow and if not seen by different tests then it is really a serious situation as we continue costly 3-4 to 4-6 drug regime but patient have got no cure and in many cases we become hopeless , so it was an urgent need that some tests should be developed where TB bacilli is detected exactly and correctly in 2-3 days and its sensitivity to drugs is also determined as then really correct medicines will be prescribed and we shall control MDRT and XDRT which is rapidly growing with growing number of HIV and other Immunocompromised and transplanted , cancer and collagen diseased patients on immunosupression and chemotherapy .

In America, National Institute of Health (NIH) Scientists have developed an automated test that can rapidly and accurately detect tuberculosis and drug - resistant TB bacteria in patients. The finding could pave the way for earlier diagnosis and more targeted treatment of this disease. Current diagnostic tests as mentioned above have many shortcomings.Even most widely used test, called smear microscopy for AFB by Zeil Nelson Staining , misses more than half of TB cases and cannot determine whether the bacteria are drug resistant. A more sensitive test involves growing bacterial cultures. It can spot drug resistance but may take up to 6 weeks to get results. Both tests require assessment by trained staff.

Dr. David Alland of the University of Medicine and Dentistry of New Jersey collaborated with Cepheid, a diagnostics company, has develoed a test called a DNA- based test called Xpert MTB/RIF. The test detects the TB - causing bacterium Mycobacterium tuberculosis and also resistance to rifampin (RIF) is also tested, a drug mostly used in both primary in all category I,II and III as well as in drug resistant cases until patients developed Hepatitis or idiosyncracy to this drug. RIF resistance is a good indicator of multidrug resistance.NIH's National Institute of Allergy and Infectious Diseases (NIAID) has supported the development of the MTB/RIF test for more than 8 years. To use the test, a technician adds a small sample of a patient's sputum to a plastic test cartridge and loads it into the machine. The instrument then automatically performs a series of steps that ultimately leads to an analysis of DNA from bacteria in the sample. A computerized printout reports the presence of TB bacteria and whether or not the bacteria are resistant to RIF

As described in the September 1, 2010, issue of the New England Journal of Medicine, the researchers assessed the performance of the new automated test on 1,730 patients with suspected TB in 4 countries. Each patient provided 3 sputum specimens. The samples were assessed by MTB/RIF and by conventional smear microscopy and bacterial culture tests. The new automated test successfully identified 98% of all confirmed TB cases and 98% of patients with RIF- resistant bacteria in less than 2 hours. In addition, a single MTB/RIF analysis detected TB in over 72% of patients who did not appear to have TB according to smear microscopy but who were later found to have TB in culture tests. When the automated test was repeated, the sensitivity increased by about 13%. When the test was run a third time, it detected about 90% of TB cases that were missed by smear microscopy.The scientists note that the MTB/RIF test makes it possible to detect TB and drug resistance in a single clinic visit and perhaps begin treatment immediately, a significant advantage in developing countries. "The test also indicates rapidly whether difficult- to - treat drug- resistant forms are present," says Alland. "This is a major advance over other rapid TB detection methods, which are complex, labor- intensive, and technically challenging."

Therefore,if later on such tests and machine becomes cost effective and easily procurable in our country or Developing countries or Africa where HIV is widely spread , it will be a test of time and most trusted test and gradually scientist will determine drug resistance to INH,Ethambutol,Pyrizinamide etc.


Refered by: DR. D. R. Nakipuria

http://indiaheartbeat.com/doctor/profile.php?profile=MzIxODk=

Children conceived by in vitro fertilization (IVF) actually perform better than age-and gender-matched peers on academic tests, a new study found.

The University of Iowa study found that children who were conceived by IVF actually scored better than their peers on the Iowa Test of Basic Skills and the Iowa Test for Educational Development (ITBS/ED).

"Our findings are reassuring for clinicians and patients as they suggest that being conceived through IVF does not have any detrimental effects on a child's intelligence or cognitive development," said study's lead author Bradley Van Voorhis.

For the study, Van Voorhis and colleagues compared the academic performance of 423 Iowa children, ages 8 to 17, who were conceived by IVF at UI Hospitals and Clinics with the performance of 372 age- and gender-matched peers from the same Iowa schools.

The researchers also analyzed whether different characteristics of the children, parents or IVF methods affected children's test scores.

The study found that children born by IVF performed above average on standardized tests compared to their peers.

Importantly, the study also showed that different IVF procedures -- using fresh versus frozen embryos -- and different methods of insemination had no effect on children's test scores.

Although the study was not able to fully explain why children conceived by IVF performed better than their peers, Van Voorhis speculated that parents of children conceive by IVF might be older and have higher levels of education than average.

"By using age- and gender-matched children from the same classrooms as a control group to compare to our study participants, we attempted to control for any socioeconomic or environmental differences between the children born by IVF and their peers," Van Voorhis said.

"But there still may have been some differences between the IVF children and the controls that we could not see from our data," he said.

The study was published in the October issue of the journal Human Reproduction. (ANI)

In what could pave the way for early detection of ovarian cancer, scientists claim to have pinpointed new genetic variants which are associated with the risk of developing the disease in women.

An international team, led by Queensland Institute of Medical Research, has identified the genetic variants after comparing genes of 10,283 women with ovarian cancer to 13,185 women without the disease.

Prof Georgia Chenevix-Trench, who led the team, said:"We now have more powerful genetic techniques that enable us to detect small genetics changes that impact our health.

"The study identified five different stretches of DNA that contained single code variations, known as single nucleotide polymorphisms (SNPs) -- that were associated with ovarian cancer risk.

"This is the equivalent of finding five individual spelling mistakes in over 200,000 pages of text. Four of the five new DNA variations were more common in women who had developed the most common and aggressive form of disease known as serous ovarian cancer."

A miracle baby struck down by meningitis has survived despite suffering seven heart attacks in one night.

Ivan Cawley shouldn't have made it through the night after enduring the staggering number of cardiac arrests - including one where his parents lost him for 12 minutes.

Mother and father Sade Jackson, 20, and Phillip Cawley, 24, were told to say goodbye to their first-born after medics said there was little chance of survival.


Sade told how the ten-month-old was left temporarily paralysed and hooked up to a ventilator within hours of contracting the deadly disease.

But now he has one final check-up and should be given the all-clear next week, just two months after his ordeal throughout the night of July 4 and 5.

Sade, of Sheffield, South Yorkshire, said: 'Everything was going fine. I'd had no complications in pregnancy and he was born a healthy 7lb 1oz. We were settling in to being first-time parents.

'It was a Sunday night and we put him to bed as normal and he was fine. But then when he woke up at around 4.30am he was drenched with sweat and his skin felt like it was on fire but at the same time shivering.

'It was really scary. We waited for the doctors to open and took him down straight away.


I had seen a little dot on his belly when I was changing him earlier that day and the doctors said it could be the start of chicken pox, but told us we should go and get him checked out straight away at the hospital.

'At this point we didn't really know what to think - we didn't know what was happening, just that we had to get him seen as soon as possible.'

Over the next few hours more spots developed over Ivan's little body and he was transferred to intensive care at Sheffield Children's Hospital as his functions shut down.

Medics told Ivan's parents that he was critically ill and they were not sure whether he was going to make it through the night.

He then battled through seven cardiac arrests over the course of around eight hours, but each time came round as medics continued to administer oxygen and CPR.

Sade said: 'It was a really horrible time - the longest few hours. It's hard to sum it up really and put into words how we felt.

'It was awful seeing our little baby lying there with all these tubes coming out of him and looking so ill and weak.

'The doctors told us he probably wouldn't make it but him and the doctors kept battling. We lost him for 12 minutes during one of his attacks but amazingly he even pulled through that.'

Ivan was put on a ventilator to keep him alive and he spent the next seven days in intensive care.

Sade said: 'We were told that the worst could happen and to be honest we just thought he wasn't ever going to come round.

'It was the best feeling in the world when he started to show signs he was able to breathe for himself - the hospital staff were amazed by how well he was doing, they said he was a miracle.

'He was transferred to a normal ward and he was getting back to his normal happy self. We felt so lucky to still have him.'

Since his recovery, I van has made a speedy recovery and is back to his usual self as an active and lively little boy.

Sade said: 'He's all over the place now. He has even started to crawl since we have had him back at home. He just has one more check-up at the hospital to go and then we're totally in the clear. It's amazing.'

To thank the Children's Hospital, Sade and Phillip organised a fundraising day at their local pub.