A R Anand

Publications (9)16.25 Total impact

• Article: Polymerase chain reaction in the diagnosis of Aspergillus endophthalmitis.

  A R Anand, H N Madhavan, N V Sudha, K L Therese
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  ABSTRACT: Aspergillus endophthalmitis is the commonest type of vision threatening fungal endophthalmitis encountered in India. Since conventional methods lack sensitivity, we evaluated polymerase chain reaction (PCR) against the conventional mycological methods in the diagnosis of Aspergillus endophthalmitis. Twenty-seven intraocular specimens from 22 patients with suspected fungal endophthalmitis (proven as non-bacterial origin) and 10 patients with non-infective intraocular disorders (controls) were tested. The intraocular specimens from these patients were subjected to the conventional methods, viz., microscopy and culture for growth of fungi, as well as PCR for the detection and differentiation of species of Aspergillus. None of the controls were positive by microscopy, culture or PCR. Among the 27 test samples, 4 were positive by culture for Aspergillus species, these were also positive by PCR. In addition, PCR detected and identified Aspergillus species in 2 culture negative specimens. The average time required for culture and identification of Aspergillus was 10 days, whereas PCR needed only 24 h. This study indicates that PCR was not only a more sensitive, but also a rapid diagnostic tool compared to the conventional mycological methods in the diagnosis of Aspergillus endophthalmitis.
  The Indian journal of medical research 11/2001; 114:133-40. · 1.84 Impact Factor
• Article: Insect wing case: unusual foreign body.

  R Fogla, S K Rao, A R Anand, H N Madhavan
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  ABSTRACT: To report five cases of insect wing case foreign body. Clinical presentation, investigations, management, and outcome of these cases are discussed. Five patients, four males and one female, in the age group from 4 to 55 years presented with an insect wing case embedded in the cornea or peripheral limbus. All patients were relatively asymptomatic, and the foreign body was associated with vascularization and infiltration. Culture of the foreign body after removal showed Staphylococcus epidermidis in two cases and Corynebacterium species and Mycobacterium fortuitum in one case each. All patients responded to removal of the wing case foreign body and treatment with topical ciprofloxacin (0.3%). Insect wing case is an unusual foreign body and produces minimal symptoms and may be associated with infective agents in some patients.
  Cornea 02/2001; 20(1):119-21. · 1.73 Impact Factor
• Article: Use of polymerase chain reaction (PCR) and DNA probe hybridization to determine the Gram reaction of the infecting bacterium in the intraocular fluids of patients with endophthalmitis.

  A R Anand, H N Madhavan, K L Therese
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  ABSTRACT: To evaluate polymerase chain reaction (PCR) combined with DNA probe hybridization to determine the Gram reaction of the bacterium in intraocular specimens from patients with infectious endophthalmitis. Fifty-seven intraocular specimens - 17 aqueous humor (AH) and 40 vitreous fluid (VF) - from 55 patients with clinically diagnosed infectious endophthalmitis and 25 control intraocular specimens from non-infectious ocular disorders (10 AH and 15 VF) were evaluated by microscopy, culture and PCR-DNA probe hybridization to detect the Gram reaction of the bacterium. PCR-DNA probe hybridization was specific and sensitive to detect 30 fg of both gram-positive and gram-negative bacterial DNA. None of the controls showed bacteria by microscopy, culture or PCR. Of the 57 intraocular specimens, conventional microbiological methods could detect a bacterial aetiology in 32 (56.1%), while PCR-DNA probe hybridization could detect 52 (91.2%) specimens. This difference was statistically significant (P= 0.003). In bacteriologically positive specimens, there was absolute correlation of the Gram reaction between the results of smear and culture methods and PCR-DNA probe hybridization. Of the 25 bacteriologically negative specimens, 20 (80%) were positive by PCR-DNA probe hybridization, of which seven (35%) were gram-positive, 12 (60%) gram-negative and one (5%) positive by both. Results of PCR on AH and VF were not significantly different. PCR and DNA probe hybridization to determine the Gram reaction of the bacterium in intraocular fluids is a specific and sensitive method in the diagnosis of bacterial endophthalmitis. AH is an ideal specimen for PCR, since its collection is a simple and safe office procedure.
  Journal of Infection 12/2000; 41(3):221-6. · 4.13 Impact Factor
• Article: Spectrum of aetiological agents of postoperative endophthalmitis and antibiotic susceptibility of bacterial isolates.

  A R Anand, K L Therese, H N Madhavan
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  ABSTRACT: To determine the spectrum of infectious agents of postoperative endophthalmitis, the relationship with the time of onset of symptoms after surgery and the antibiotic susceptibilities of the aerobic bacterial isolates. A retrospective review of microbiological records from January 1995 to December 1998 yielded 173 isolates from intraocular specimen of 170 patients with culture-proven postoperative endophthalmitis. Antibiotic susceptibility of these isolates was determined for various ocular antibiotics using the Kirby-Bauer disk-diffusion test. Based on the time of onset of illness, clinical presentation was classified into acute, delayed and chronic. Among 170 cases, 71 (41.7%) were attributable to gram-negative, 64 (37.6%) to gram-positive bacteria, and 37 (21.8%) to fungi. Gram-negative bacteria included P. aeruginosa (29;17.1%), other Pseudomonas spp (15;8.8%), non-fermenters (18;10.6%) and others (10;5.8%). Among these, 40 of 72 (55.5%) were sensitive to gentamicin, 47 of 72 (65.2%) to cefotaxime, 47 of 69 (68.1%) to amikacin, 52 of 71 (73.2%) to ciprofloxacin, and 25 of 40 (62.5%) to ceftazidime. The gram-positive bacteria included S. epidermidis (22;12.9%), S. aureus (13;7.6%), P. acnes (10;5.9%), Enterococcus spp (4;2.3%), Streptococcus spp (7;4.1%) and others (8;4.8%). Among these, 41 of 53 (77.3%) were sensitive to gentamicin, 47 of 53 (88.6%) to cefotaxime, 46 of 52 (88.4%) to ciprofloxacin, 38 of 41 (92.6%) to cefazolin and 27 of 37 (72.9%) to ceftazidime. All gram-positive bacteria were sensitive to vancomycin. In this large series of postoperative endophthalmitis, gram-negative bacilli followed by fungi accounted for the largest number of cases. A high degree of resistance of gram-negative bacilli to gentamicin, cefotaxime, amikacin and ceftazidime was recorded.
  Indian Journal of Ophthalmology 07/2000; 48(2):123-8. · 1.02 Impact Factor
• Article: Detection of herpes simplex virus (HSV) genome using polymerase chain reaction (PCR) in clinical samples comparison of PCR with standard laboratory methods for the detection of HSV.

  H N Madhavan, K Priya, A R Anand, K L Therese
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  ABSTRACT: Diagnosis of Herpes simplex virus (HSV) infections is achieved by detecting the antigen and isolating the virus from the specimen, which requires 7-28 days. With the recently introduced molecular biological technique of polymerase chain reaction (PCR), the diagnosis of HSV infections has been made more rapid and specific. We evaluated PCR in comparison with the standard laboratory methods on different types of clinical specimens referred to in our laboratory. A total of 54 specimens, from 54 patients, were investigated. Antigen detection on direct smears was carried out using fluorescent antibody test (FAT) and virus isolation was performed using conventional tube culture method. PCR was carried out with the DNA extracted from various specimens using primers, which coded for the DNA polymerase gene giving a 179 base pair (bp) product. The primers were specific for HSV-1 and HSV-2, and the sensitivity of the primers was found to be 0.5 and 0.2 fg in the detection of HSV-1 and HSV-2 DNA, respectively. Of the 50 specimens (excluding 4 archival formalin fixed tissue specimens, which were not subjected to virological methods of detection) HSV was detected by virological methods and PCR in nine specimens, and by PCR alone in 15 additional specimens, thus increasing the analytical sensitivity significantly by 30% (McNemar test: P = 0.0001). The positivity of PCR in all nine virologically positive specimens and the 4 archival specimens obtained from proven lesions of HSV infections further confirmed the specificity of the PCR. PCR, in our study, was found to be a rapid, specific and highly sensitive method for the detection of HSV in clinical specimens.
  Journal of Clinical Virology 11/1999; 14(2):145-51. · 3.97 Impact Factor
• Article: Polymerase chain reaction in the diagnosis of bacterial endophthalmitis.

  K L Therese, A R Anand, H N Madhavan
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  ABSTRACT: Microbiological investigations of vitreous fluid (VF) and aqueous humour (AH) specimens have often failed to detect the infecting agent in infectious endophthalmitis, resulting in a clinical dilemma regarding therapy. In this study, the polymerase chain reaction (PCR) was evaluated in the diagnosis of bacterial and Propionibacterium acnes endophthalmitis. 58 intraocular specimens (30 VF and 28 AH) from 55 cases of endophthalmitis and 20 specimens (14 VF and 6 AH) as controls from non-infective disorders were processed for microbiological investigations. Nested PCR directed at the 16S rDNA using universal primers for eubacterial genome was done. PCR for P acnes was performed on specimens microbiologically negative by conventional techniques but eubacterial genome positive. Of the 20 controls from non-infective cases, one (5%) was positive using eubacterial primers and none with P acnes primers. PCR for eubacterial genome showed 100% correlation with 20 (34.5%) bacteriologically positive specimens. Eubacterial genome, was detected in 17 (44.7%) of 38 bacteriologically negative specimens and nine (52.9%) out of the 17 were positive for P acnes genome. Among the 21 eubacterial PCR negative specimens, seven were fungus positive. By inclusion of PCR, microbiologically positive specimens increased from 46.5% to 75.8%. PCR on AH was as sensitive as that on VF for the detection of both eubacterial and the P acnes genome. PCR performed on AH and VF is a reliable tool for the diagnosis of bacterial and P acnes endophthalmitis particularly in smear and culture negative specimens.
  British Journal of Ophthalmology 10/1998; 82(9):1078-82. · 2.90 Impact Factor
• Article: Significance of mycobacterial immune complexes (IgG) in the diagnosis of tuberculous meningitis.

  S A Patil, M Gourie-Devi, A R Anand, A N Vijaya, N Pratima, K Neelam, A Chandramuki
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  ABSTRACT: Tuberculous meningitis (TBM) has high mortality, especially in children. Early accurate diagnosis and adequate treatment would reduce this mortality. Diagnosis of TBM remains an enigma because of low cerebrospinal fluid (CSF) culture positivity for Mycobacterium tuberculosis and weak clinical correlation with conventional immunoassays. To evaluate significance of mycobacterial immune complexes (IgG) and anti-mycobacterial antibodies in the diagnosis of TBM. CSF from TBM patients and various types of other neurological (both infectious and non-infectious) and non-neurological cases was studied for the presence of IgG and anti-mycobacterial antibodies using antigen capture (by anti-BCG) and multilayered ELISA (using M. tuberculosis soluble extract), respectively. IgG in CSF could be detected in 33 of 55 (60%) and anti-mycobacterial antibodies in 30 of 55 (55%) TBM cases. Presence of IgG, anti-mycobacterial antibodies or both could be detected in 45 of 55 (82%) of the TBM cases. Excepting three of the pyogenic meningitis CSF, none of the infectious (49), non-infectious neurological cases (30) and non-neurological controls (32) showed the presence of IgG or anti-mycobacterial antibodies. Detection of IgG along with anti-mycobacterial antibodies aids in diagnosis of a large proportion of TBM cases.
  Tubercle and Lung Disease 05/1996; 77(2):164-7.
• Article: Intravenous catheter-related Candida rugosa fungaemia.

  S Shenoy, M Samuga, S Urs, K M Anuradha, M M Kurian, A Augustine, A R Anand, A Prasad
  Tropical Doctor 02/1996; 26(1):31. · 0.66 Impact Factor
• Article: Significance of mycobacterial immune complexes (IgG) in the diagnosis of tuberculous meningitis

  S.A. Patil, M. Gourie-Devi, A.R. Anand, A.N. Vijaya, N. Pratima, K. Neelam, A. Chandramuki
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  ABSTRACT: Setting: Tuberculous meningitis (TBM) has high mortality, especially in children. Early accurate diagnosis and adequate treatment would reduce this mortality. Diagnosis of TBM remains an enigma because of low cerebrospinal fluid (CSF) culture positivity for Mycobacterium tuberculosis and weak clinical correlation with conventional immunoassays.Objective: To evaluate significance of mycobacterial immune complexes (IgG) and anti-mycobacterial antibodies in the diagnosis of TBM.Method: CSF from TBM patients and various types of other neurological (both infectious and non-infectious) and non-neurological cases was studied for the presence of IgG and anti-mycobacterial antibodies using antigen capture (by anti-BCG) and multilayered ELISA (using M. tuberculosis soluble extract), respectivelyResults: IgG in CSF could be detected in 33 of 55 (60%) and anti-mycobacterial antibodies in 30 of 55 (55%) TBM cases. Presence of IgG, anti-mycobacterial antibodies or both could be detected in 45 of 55 (82%) of the TBM cases. Excepting three of the pyogenic meningitis CSF, none of the infectious (49), non-infectious neurological cases (30) and non-neurological controls (32) showed the presence of IgG or anti-mycobacterial antibodies.Conclusion: Detection of IgG along with anti-mycobacterial antibodies aids in diagnosis of a large proportion of TBM cases.RésuméCadre: La méningite tuberculeuse (TBM) a une mortalitéélevée, surtout chez les enfants. Un diagnostic précoce et précis et un traitement adéquat serviraient à réduire ce taux. Le diagnostic de TBM est difficile en raison de la faible positivité de la culture du liquide céphalo-rachidien (LCR) pour Mycobacterium tuberculosis et la faible corrélation clinique avec les déterminations conventionnelles.Objet: Evaluer la signification de complexes immuns mycobactériens (IgG) et d'anticorps antimycobactériens pour le diagnostic de la TBM.Schéma: Le LCR provenant de malades atteints d'une TBM et de diverses conditions neurologiques (infectieuses et non-infectieuses) et non-neurologiques a été étudié afin de déceler la présence des IgG et d'anticorps antimycobactériens en utilisant respectivement la saisie des antigènes (par anti-BCG) et un ELISA pluristratifié (utilisant un extrait soluble de M. tuberculosis).Résultats: Sur 55 cas de TBM, les IgG ont pu être décelés dans le LCR chez 33 (60%) et des anticorps antimycobactériens chez 30 (55%). La présence des IgG, d'anticorps antimycobactériens ou des deux a été décelée chez 45 (82%) des cas. Mis à part trois LCR de méningite pyogène, aucun des cas infectieux (49), des cas neurologiques non-infectieux (30) ou des témoins non-neurologiques (32) n'a montré la présence des IgG ou d'anticorps antimycobactériens.Conclusion: La détection des IgG et des anticorps antimycobactériens aide dans le diagnostic d'une grande proportion des cas de TBM.ResumenMarco de referencia: La meningitis tuberculosa (TBM) tiene una mortalidad elevada, especialmente en los niños. Un diagnóstico precoz y preciso y un tratamiento adecuado servirían para reducir la mortalidad. El diagnóstico de la TBM es dificil debido a la baja positividad del cultivo del líquido encéfaloraquideo (LCR) para el Mycobacterium tuberculosis y la baja correlación clínica con los inmuno ensayos convencionales.Objetivo: Evaluar la importancia de los complejos inmunes micobacterianos (IgG) y de los anticuerpos antimicobacterianos para el diagnóstico de la TBM.Metodo: Se estudió el LCR proveniente de enfermos de TBM y de diversas otras afecciones neurológicas (infecciosas y no infecciosas) y no neurológicas para detectar la presencia de IgG y de anticuerpos antimicobacterianos utilizando la captura de los antígenos (por anti BCG) y un ELISA pluriestratificado (utilizando un extracto soluble de M. tuberculosis), respectivamente.Resultados: De 55 casos de TBM, en 33 (60%) se pudo detectar IgG en el LCR y en 30 (55%) se pudo detectar anticuerpos antimicobacterianos. En 45 casos (82%) se pudo detectar la presencia de IgG, de anticuerpos antimicobacterianos o de ambos. Exceptuando tres muestras de LCR de meningitis piógena, ningún de los casos infecciosos (49), o de los casos neurológicos no infecciosos (30) o de los controles no neurológicos (32) mostró la presencia de IgG o de anticuerpos antimicobacterianos.Conclusión: La detección de IgG y de anticuerpos antimicobacterianos constituye una ayuda para el diagnóstico de una gran proporción de casos de TBM.
  Tubercle and Lung Disease.