Background: Immunological responses may be possibly involved in the pathogenesis of idiopathic nephrotic syndrome (INS). Cytokines act as a potent immunomodulator. Pathogenesis of INS is associated with Th1 and Th2 cytokines imbalance. Aims, Settings and Design: We have investigated the association of IL-4, IL-6, and TNF-α gene polymorphisms and analyzed the data to evaluate the effect of these polymorphisms on the pathogenesis and clinical course of INS. Materials and Methods: One hundred fifty children with INS were selected. Children were analyzed for IL-4, IL-6, and TNF-α gene polymorphisms by using polymerase chain reaction and restriction fragment length polymorphism. Statistical Analysis Used: Chi-square test was used for different comparisons. The synergistic effects of IL-4, IL-6, and TNF-α gene polymorphisms were evaluated by using logistic regression analysis. Results and Conclusions: We compared the steroid-resistant (SR) and steroid-responsive (SS) groups. Our results showed strong association of IL-6 -G174C, and IL-4 -C590T at genotypic level (P = 0.0121, OR = 14.71, 95% CI = 1.59-136.46; and P = 0.0386, OR = 7.29, 95% CI = 1.26-41.69). TNF-α revealed a strong association at genotypic level (P = 0.0121, OR = 14.71, 95% CI = 1.59-136.46), as well as at allelic level (P = 0.0433, OR = 2.251, 95% CI = 1.09-4.66), demonstrating that it may be considered one of the genetic risk factors affecting the steroid response in INS patients. The GG genotype of IL-6 -G174C, TT genotype of IL-4 -C590T, and AA genotype of TNF-α -G308A cytokine gene polymorphisms may be causative factors for nonresponsiveness towards steroid therapy among INS children.

Background: The current resistance pattern of GABHS (group-A beta-hemolytic streptococci) in India has not been discussed. Aim: To fill the above-mentioned void, we planned this study to determine the prevalence and degree of antibacterial resistance in GABHS isolates. Settings and Design: Children with acute pharyngo-tonsillitis who had not received antibiotic in the preceding week, attending the pediatric OPD, were prospectively enrolled over a period of 1 year. Throat swabs were collected from each child and transported to microbiology laboratory, as early as possible. Materials and Methods: A throat swab culture for GABHS was done. All GABHS were subjected to antibiotic susceptibility and minimum inhibitory concentration (MIC) test according to Clinical Laboratory Standard Institute (CLSI) guidelines. Results: In the present study, 12.6% (55/435) of the children with acute pharyngo-tonsillitis had throat swab culture positive for GABHS. The prevalence of macrolide resistance was 10.2%. The MIC50 for macrolide-resistant strain was 0.5 µg/mL (range, 0.125-8 µg/mL), and MIC90 was 8 µg/mL (range, 0.125-8 µg/mL). Tetracycline and co-trimoxazole resistances were 24.5% and 12.2% respectively. The values of MIC50 for tetracycline- and co-trimoxazole-resistant strains were 4 µg/mL (range, 0.125-32 µg/mL) and 2 µg/mL (range, 0.25-8 µg/mL) respectively. All isolates were sensitive to penicillin G and chloramphenicol on disc diffusion test. However, their MIC50 was 0.032 µg/mL (range, 0.012-0.125 µg/mL) and 2 µg/mL (range, 0.25-4 µg/mL) respectively. Conclusion: High prevalence of antimicrobial resistance found among GABHS needs a longitudinal surveillance of isolates from different centers in India.

Background: The enumeration of absolute CD4 counts is of primary importance, since therapeutic protocols for HIV1 patients are based on these. Aims: To establish reference ranges for the CD4 and CD8 T-lymphocytes in the Indian population. Settings and Design: Enumeration of absolute numbers and percentages of lymphocyte subsets was performed in 252 healthy adult Indians. Methods and Materials: The assays for SPT were carried out using the Beckman EPICS XL-MCL flow cytometer and the cytostat tetraCHROME reagent containing CD45/CD8/CD4/CD3 monoclonal antibodies. For comparison with DPT the absolute lymphocyte count was obtained using the Coulter STK-S fully automated hematology analyzer. Statistical Analysis: Regression analysis and Students t test were used for data analysis. Results: Median values were as follows; absolute CD3 counts 1446 cells/mm3 (total), 1361 cells/mm3 (males) and 1511 cells/mm3 (females); absolute CD4 counts are 771 cells/mm3 (total), 705 cells/mm3 (males) and 839 cells/mm3 (females); absolute CD8 counts are 555 cells/mm3 (total), 552 cells/mm3 (males) and 561 cells/mm3 (females). The median CD4/CD8 ratio for the total samples was 1.34, for males 1.22 and for females 1.49. Conclusions: In this study we have established reference ranges for normal Indian adults using the fully automated Single Platform Technology. The lymphocyte subsets values of our population are closer to those of the population from Botswana and China rather than the Western population. The absolute CD3 and CD4 counts and the CD4:CD8 ratio are higher in females than in males. Consistently higher values are obtained by the DPT as compared to the SPT.

Background and Aims: The aim of this study was to determine sex hormone binding globulin (SHBG) concentrations in premenopausal obese women and to evaluate the relationships between sex hormones and features of the metabolic syndrome (MetS). Settings and Design: Retrospective cross-sectional analysis was carried out on 350 obese patients aged 25 to 69 years referred to the Department of Endocrinology, Pamukkale University in 2002-2003. Materials and Methods: 125 premenopausal euthyroid patients were eligible for this study. Subjects were divided into two groups according to the body mass index (BMI): Group I, women with BMI < 30 kg/m ² (n = 17) and Group II,, women with BMI ≥ 30 kg/m ² (n = 108). Median SHBG concentration of Group I was 50.1 nmol/L. Group II was divided into two subgroups according to the median SHBG concentration of Group I: subjects with high SHBG levels (SHBG concentration ≥ median level of the control group, i.e ≥ 50.1 nmol/L) and subjects with low SHBG levels (< 50.1 nmol/L). All statistical analyses were performed using SPSS 9.0 software (SPSS Inc.). Results: No significant difference was found in mean age between the low and high SHBG groups. The low SHBG group was significantly heavier, and with higher waist circumference than the high SHBG group. In the low SHBG group, fasting glucose, postprandial glucose and gamma glutamyl transferase (GGT) and free androgen index (FAI) were significantly higher. Lipid profile, blood pressure, uric acid, insulin and HOMA were found similar between two groups. Linear regression analyses revealed that body mass index and FAI were significant, being independent predictors of SHBG concentrations in premenopausal women. (r = 0.365, r square = 0.134). Conclusions: It is concluded that low SHBG concentrations may indicate visceral obesity and glucose intolerance in premenopausal women.