BackgroundTil date, none of the diagnostic techniques available for the detection of female genital tuberculosis (FGTB) are 100% accurate. We therefore, proposed to use the endometrial tissue biopsies (ETBs), ovarian tissue biopsies (OTBs) and pelvic aspirated fluids (PAFs) for the diagnosis of FGTB among infertile women by conventional versus molecular methods.Methodology/Principal FindingsA total of 302 specimens were collected both from 202 infertile women highly suspected of having FGTB on laparoscopy examination and 100 control women of reproductive age. Out of 302 specimens, 150 (49.67%) were ETBs, 95 (31.46%) were OTBs and 57 (18.87%) were PAFs. All specimens were tested by conventional techniques, later compared with multi-gene PCR for the detection of Mycobacterium tuberculosis (MTB) and correlated with laparoscopic findings. The presence of MTB DNA was observed in 49.5% of ETBs, 33.17% of OTBs and 5.44% of PAF specimens collected from highly suspected FGTB patients. All women of control group were confirmed as negative for tuberculosis. The conventional methods showed 99% to 100% specificity with a low sensitivity, ranging from 21.78% to 42.08% while hematoxylin and eosin staining showed a sensitivity of 51.48%. Multi-gene PCR was found to have much higher sensitivity of 70.29% with MTB64 gene, 86.63% with 19 kDa antigen gene at species and TRC4 element at regional MTB complex and 88.12% with 32 kDa protein gene at genus level. The specificity of multi-gene PCR was 100%. Compared with culturing and Ziehl-Neelsen's staining, multi-gene PCR demonstrated improvement in the detection of FGTB (χ2 = 214.612, 1 df, McNemar's test value <0.0001).Conclusions SignificanceWe suggest site specific sampling, irrespective of sample type and amplification of the 19 kDa antigen gene in combination with TRC4 element as a successful multi-gene PCR for the diagnosis of FGTB and differentiation of mycobacterial infection among endo-ovarian tissue biopsies and PAFs taken from infertile women.

The purpose of this investigation was to estimate the proportion of female genital tuberculosis (FGTB) among infertile women, along with the mean cost of diagnosis by different methods. The study was carried out on 211,335 women, of which 31,755 (15.02 %) were infertile. 202 women were highly suspected of FGTB on laparoscopy, which was later ascertained by multi-gene polymerase chain reaction (PCR), and the cost was estimated. The majority of the patients were infertile (77.23 %), with menstrual disturbances (61.88 %). Many of them were having beaded tubes (68.81 %), tubal block with hydrosalpinx (58.91 %) and tubercular salpingitis (48.01 %). Out of 302 case-controls, 105 infertile women were positive by haematoxylin and eosin staining, 14.57 % were acid-fast bacilli-positive and 86 infertile women were positive on culture. 178 (58.94 %) endo-ovarian tissue biopsies and pelvic aspirated fluid specimens were positive for a 32-kDa protein gene as amplified using multi-gene PCR. The proportion of proven FGTB cases was very high (58.94 %) among infertile women highly suspected of FGTB. The estimated cost in rupees (Rs) of FGTB diagnosis by the conventional method ranges from Rs 3.36 to 38.11, while multi-gene PCR was established as being very expensive (Rs 254.21). The expected time of FGTB diagnosis by the conventional method ranges from 0.5 to 1.83 h, whereas culture took 4-8 weeks. The logical time of FGTB diagnosis by multi-gene PCR was 6.48 h. Compared to Ziehl-Neelsen's staining and culturing, multi-gene PCR improved the detection rate of suspected FGTB. Therefore, FGTB can be diagnosed if multi-gene PCR is considered in the evaluation of infertile patients in areas where tuberculosis is endemic.

BackgroundToll-like receptor 2 (TLR2) and interferon-gamma (IFN-γ) coordinate with a diverse array of cellular programs through the transcriptional regulation of immunologically relevant genes and play an important role in immune system, reproductive physiology and basic pathology. Alterations in the functions of TLR2 2258G (guanine)/ A, IFN-γ (+874T/A) and signalling molecules that result from polymorphisms are often associated with susceptibility or resistance, which may, in turn, establish the innate host response to various infectious diseases. Presently, we proposed to investigate the risk of common single nucleotide polymorphism (SNP) of TLR2 and IFN-γ genes, for their effect on infertility in women with female genital tuberculosis (FGTB) and healthy women as controls.Methodology/Principal FindingsGenotyping of TLR2 and IFN-γ gene polymorphisms was performed by amplification refractory mutation system multi-gene/multi-primer polymerase chain reaction followed by restriction fragment length polymorphism in 175 FGTB patients and 100 healthy control women (HCW). The TLR2 polymorphism [adenine (A) allele] was observed in 57.7 and 58.0% of FGTB patients and HCW, respectively. The IFN-γ (+874T/A) polymorphism (A allele) was significant in 74.3 and 71.0% of FGTB patients and HCW, respectively, while the odds ratios for the AA and TA genotypes for predisposition of FGTB were found to be 0.304 and 1.650 in HCW, respectively. The SNP of TLR2 was not associated with FGTB but the SNP of IFN-γ was found to be associated with mycobacteria infections and to induce infertility.Conclusions/SignificanceAt present, we hypothesize that infertile women with FGTB and HCW without tuberculosis (TB) have identical frequency of TLR variants, which may be adequate in the production of IFN-γ in response to Mycobacterium tuberculosis infections. Thus, the study appears to be the first of its kind reporting a mutation in the IFN-γ gene [+874 T (thymine) to A] responsible for susceptibility to TB infections and further inducing infertility.

Background Endometriosis is a female physical disorder that happens when cells from the lining of the womb (uterus) grow in other areas of the body i.e., outside of uterine cavity and leads to infertility. It represents a major personal and public health concern. The aim of the study was to investigate the prevalence and interferon-gamma gene CA-repeats polymorphism in patients with different stages of endometriosis. Methodology/Principal Findings It is a case control prevalence study carried out in gynecology research centre. The mutational analysis of Interferonγ gene CA repeats were tested for association in 356 affected women with different stages of disease and 372 women with no evidence of disease. The prevalence of endometriosis was accounted in 44.95% of infertile women. All the women were of South Indian origin and ascertained from the same infertility clinic. The broad IFN-gamma genotype and allele frequencies in all patients with different stages of endometriosis varied significantly from that in the control women (χ 2 = 8.2690, 4 df, P =0.0822). The disparity in distribution was due to an increase in the a13 (114 bp) allele in the patients with endometriosis (χ 2 =13.2394, p= 0.00027, OR=1.6656, 95.0% CI=1.263-2.1953). Conclusions/Significance Significant difference was experiential in universal allele frequencies between the control women and specifically, women with endometriosis staging were tilted in the direction of minimal (39.04%) and mild disease (33.98%). Therefore, we conclude that interferon-gamma CA-repeat polymorphism may influence the likelihood of a woman developing different stages of endometriosis irrespective of its incidence.

Acute Lung Inflammation & Injury (ALI) is a patho-physiological response to interaction of various factors at biomolecular and cellular level and the physiological condition leading to enhancement of the same in contamined environmental conditions. This review aims to discuss the current status of research done in the area of ALI and unique in that it projects a combination of new simulations, experiments and schemes which were not proposed earlier in targeting the ALI at many areas. Utilization of biomarkers in medicine enhances the capacity to detect and support diagnosis of disease for early prediction and for planning therapeutic alternatives. Novel investigation and innovative understanding at molecular level revealed an abundance of exciting arena of new biomarkers which suggests their use for clinical observations. For the last four decades, the search has continued for useful diagnostic and prognostic biomarkers that can enable and guide critical care physicians to precisely distinguish ALI/ARDS from other disorders and to portend disease progression. Quite a few new molecules as biological markers in acute lung inflammation and injury have had clinical applications. The scope of this exhaustive review is to summarize the current status of some biochemical, cellular, physiological markers and role of environmental factors in acute lung inflammation and injury.