BACKGROUND: Community associated MRSA infection appears to be on the rise and has been described in several well-defined populations. The aim of the present study was to evaluate the epidemiology of CA-MRSA in the healthy community of Kashmir.

METHODS: Nasal swabs, wrist swabs and ocular specimens were collected randomly from the healthy subjects. The samples were processed on selective media and identification of the S.aureus was performed by using biochemical tests and by the amplification of nucA gene. Methicillin-resistance was confirmed by 30µg Cefoxitin disk diffusion method and by amplification of mecA gene. Pulsed field gel electrophoresis was used for the typing of CA-MRSA.

 RESULTS: Of 1000 healthy subjects that were screened in the present study, 100 (males 33, females 67) were positive for S.aureus. The highest prevalence of S.aureus (30%) was observed in the age group 50-59 years while the lowest 1% was reported in the age group 80-89 years. Of the 100 S. aureus colonization, 9 were MRSA and 91 were MSSA as determined by Cefoxitin 30µg disk diffusion test and PCR. DNA was extracted from all 9 CA-MRSA isolates and was used for amplification of mecA and nucA genes. A product size of 533bp was amplified for mecA gene and 275bp for nucA. PCR was performed for the amplification of PVL gene in all 100 isolates and only two were identified as PVL positive. The pulsed field gel electrophoresis results of CA-MRSA isolates were striking and expressed a similar banding pattern among all the isolates from the Kashmiri community.

 CONCLUSION: We found that the prevalence of CA-MRSA in the healthy population of Kashmir valley is quite high.

BACKGROUND: Milk and dairy products are natural sources of B group vitamins in the human diet. This study was carried out to compare the ability of probiotic and conventional microorganisms of yogurt to influence the status of vitamin B2 (riboflavin) and vitamin B3 (niacin) during refrigeration.

METHODS: After preparation of conventional and probiotic yogurt, all samples were stored at 4°C, and the content of B2 and B3 vitamins was assessed on first, third and seventh day of refrigeration. Vitamins B2 and B3 were analyzed in samples using high-performance liquid chromatography followed by fluorescence detection and ultraviolet detection, respectively. Data was analyzed using SPSS version 18 (SPSS Inc., Chicago, USA).

RESULTS: Vitamin B2 content of probiotic yogurt samples was significantly higher than the control samples on all experiment days (P< 0.05). Significant differences between content of vitamin B3 in conventional and probiotic yogurt were found only on the seventh day of refrigeration (P< 0.05).

CONCLUSION: This study showed that using probiotic strains from yogurt manufacturers might provide higher B2 and B3 vitamin content provided yogurt is refrigerated for storage.

BACKGROUND: Allergic rhinitis is an inflammatory disease with worldwide prevalence of 10-40%. Clinically, the condition manifests as nasal itching (pruritus), sneezing, rhinorrhea, congestion and itchy eyes. The second generation antihistamines are commonly used either as nasal sprays (azelastine) or orally (levocetirizine). Studies have demonstrated equal efficacy of azelastine and levocetirizine, but the data on Indian population is lacking. Hence, we designed this study to evaluate the effectiveness and safety of azelastine in comparison to levocetirizine in patients with allergic rhinitis.

METHODS: This prospective, randomized, parallel group study was conducted in the otorhinolaryngology outpatient department. Both male and female patients between the ages of 18 to 55 years were enrolled in the study after informed consent. Patients were randomized into two groups. Subjects in group 1 received azelastine whereas group 2 received levocetirizine. Clinic visits were scheduled at baseline and after every 2 weeks of treatment for 4 weeks. The primary outcome measure was mean change in the total daytime nasal symptom scores (PDTS) and secondary outcomes were mean change in the nighttime nasal symptom scores (PNTS) and composite symptom scores (PCS).

 RESULTS: We enrolled 40 patients, 20 in each group. Both groups were comparable at baseline and tolerated treatment well. There was significant (p<0.05) improvement in mean PDTS, PNTS and PCS scores in both groups from second week onwards. There was significant (p<0.05) improvement in patients in group 1 at 4 weeks in the mean PDTS and PCS score. There was no significant difference in mean PNTS scores in both groups. There were no reported adverse events.

 CONCLUSION: In our study, both azelastine and levocetirizine improved the symptoms of patients with allergic rhinitis but azelastine showed better improvement in symptoms at the end of 4 weeks.

Mesenteric cysts are usually discovered incidentally during routine abdominal examinations and they may present with nonspecific symptoms. There are different types of cysts but tubercular cyst is a rare variety. The management includes complete excision of the cyst to avoid recurrence, followed by anti-tubercular drug therapy. We report a case of tubercular cyst in relation to transverse mesocolon, which was incidentally found in a patient who presented with features of peritonitis due to perforation of tubercular ulcer of terminal ileum. The coexistence of tubercular mesocolic cyst along with perforation of tubercular ulcer in the terminal ileum is a rare form of presentation and both are managed surgically followed by anti-tubercular drug therapy to avoid recurrence.

Duplications of the gastrointestinal tract are rare congenital malformations that usually present in the first two years of life with symptoms of poor weight gain and palpable abdominal mass. We report here a case of a 9-year-old boy who was evaluated for massive upper gastrointestinal bleeding. Upper endoscopy revealed a submucosal large mass in fundus of the stomach with a 3-centimeter diameter ulcer. Our provisional diagnosis was gastrointestinal stromal tumor (GIST) which was later revised to gastric duplication cyst. Gastric duplication cyst is misdiagnosed as leiomyoma or GIST endoscopically and it should be considered in the differential diagnosis of gastrointestinal mass in young children.

Tarlov or perineural cysts are nerve root cysts that are predominantly regarded as asymptomatic incidental feature of CT and MRI. However, as indicated in our case report, it may cause a variety of neurologic and urologic symptoms along with back pain. We report here a case of a 27-year-old female who presented with bilateral radiculopathy for six months. Patient underwent imbrication with laminectomy procedure and had an uneventful recovery, suggesting that such cysts and the presence of associated radicular symptoms strongly correlate with excellent outcome after surgery.