Tuesday, February 20, 2018
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Research

  • Evaluation and analysis of immune architecture of CNS Tuberculomas
  • Standardization of immunological techniques for diagnosis of neurocysticercosis Development of immunodiagnostic test for neurocysticercosis
  • Standardization of immunediagnosis of tuberculous meningitis using monoclonal antibodies and defined antigens
  • Application of polymerase chain reaction and DNA probes of mycobacterium tuberculosis in the diagnosis of neurotuberculosis.
  • A co-ordinated research program on immune diagnosis of TBM using TIA and ELISA methods.

The department of Neuromicrobiology is mainly a service orientated para clinical department to aid in the diagnosis and prognosis of non viral CNS infectious diseases as seen in the practice of Neurology, Neurosurgery and Psychiatry at this institute and also serves as a referral center for Diagnosis of CNS infections. Diagnostic work comprises 70-80% of the departmental activities.

Need based research to better, the neuro infection - diagnostic services especially molecular diagnosis, understanding the pathogenesis and molecular epidemiology formed the basis of research activities.

  1. Ph.D. Work:
    1. A study on molecular typing and immunological profiles Mycobacterium causing tuberculosis meningitis with special emphasis on neurotropism, was conducted and formed the basis of the doctoral degree in the year 2004 to Mr. M V Manjunath. This study contributed for the first time, the DNA pattern of M tuberculosis infecting the meninges. Several unique DNA patterns were discovered which were not present in the M tb DNA pattern library (of 23,000 strains from across the world). Associations and relationships of M tb DNA patterns with HIV and drug susceptibility were assessed in Tuberculous meningitis .A comparison was also done with DNA patterns of M.tb isolated from pulmonary TB.
    2. A study on Molecular diagnosis of Central nervous system infections with special reference to tuberculous meningitis was conducted and formed the basis of the doctoral degree awarded in 2007 to Mr R Wasiulla. Several types of PCR were used to test on large numbers of CSF samples of acute and chronic meningitis cases, mounting to more than one thousand clinical cases. The 16S rRNA semi nested PCR protocol was associated with a sensitivity of 93.75%, 1005 and 83.33% of confirmed cases of meningitis caused by S pneuminiae, N meningitides and H influenzae. A pneumolysin gene based PCR was 100% sensitive in diagnosis of Pneumococcal meningitis. A comparative assay of IS6110, MPB-64 and 65kDa primers based PCR on TBM CSF samples established the superiority of IS6110 based PCR. Extension of this IS6110 base PCR to 165 culture positive TBM CSF samples anf 677 clinical TBM cases yielded a crystal clear finding of 100% and 70% positivity respectively. Thus a in low cost house PCR assay as compared to expensive commercial PCR kit was established to suit the needs of a developing country.
    3. ICMR JRF topic “Etiopathogenesis biochemical analysis and molecular characterization of M.tuberculosis and C.neoformans in CSF of patients with chorinic meningitis” – Jyothi E.K.
    4. PhD Research Protocol “Etiopathogenesis biochemical analysis and molecular characterization of M.tuberculosis and C.neoformans in CSF of patients with chorinic meningitis” – Jyothi E.K.
      1. Role of Cytokines in Epileptic patients NIMHANS study. One-year study.
      2. Role of cysticercal inflammation in causation of hydrocephalus and chronic meningitis. A longitudinal twenty year study; from the departmental records: on CSF anti cysticercal antibodies to secretory / excretory Cysticercal antigens, with analysis of case files from the medical records of the Institute. A definitive cysticercal etiology was observed in 233 cases admitted to neurosurgical cases for shunt surgery. These cases were notoriously diagnosed as chronic TBM with repeated shunt revisions.
      3. Molecular typing of Cryptococcal species isolated from Cryptococcal: A recently initiated study with inputs from Maria Anna Viviani of dept of Public Health University of Milan Italy.
      4. Isolation of a rare fungal species from stereotactic brain aspirate from a frontal lesion; Scytalidium dimidiatum: The first isolation from CNS tissue in world literature: electronic transfer of fungal morphological images, to Mayo clinic Dr Glenn Roberts and initiation of recently introduced antifungal agent Posaconazole ( Noxafil) Schering Plough, for therapy to the patient: A kind free gift and courtesy from Mayo clinic and the Schering Plough company. The quality controlled diagnostic mycological assay and the timely seeking of global reference lab inputs, aided in the therapeutic advances to treating neurologist, by the departmental efforts, is a first in the thirty years history of the department.
      5. External Students Project:
        1. Cryptococcal species Biotyping
        2. Biotyping and molecular typing of hospital strains MRSA
        3. Neuropsychiatric manifestations of Syphilis at Tertiary Care Hospital in South India – in collaboration with Departments of Psychiatry and Neurology, NIMHANS.
        4. Techniques of antibiotic sensitivity testing
        5. Cultivation of Bacteria
        6. Cultivation of Fungi
        7. Cultivation of Mycobacteria
        8. Meningitis due to bacterial pathogens in a neurological center
        9. Study of increased resistance to antibiotics due to production of extended spectrum ß-lactamases in P.aeruginosa in patients with neuro disorders
        10. Metallo- ß-lactamases in Klebsiella pneumoniae – Increased resistance to carbapenems in patients suffering from neuro disorders and its multifocal outbreaks.
        11. A study of shunt infections in a neurosurgical care center.
        12. In-vitro detection of anti AchR antibodies secreted by lymphocytes in myasthenia gravis – A preliminary study.
        13. Cryptococcal meningitis in a neurological center
        14. Etiological agents of post operative bacterial meningitis
        15. Differentiation of Staphylococcus species by coagulase test and antibiotic sensitivity.
        16. A study of multidrug resistant gram negative bacilli and its antibiogram in a tertiary care hospital
        17. Isolation and identification of mycobacterium tuberculosis from cerebrospinal fluid by conventional and molecular methods-mtb12 gene.
        18. Isolation and identification of mycobacterium tuberculosis from cerebrospinal fluid by conventional and molecular methods-1pqH gene
        19. Isolation and identification of mycobacterium tuberculosis from cerebrospinal fluid by conventional and molecular methods-cpn60.1 gene
        20. Characterisation of cryptococcus isolated from cerebrospinal fluid of cryptococcal meningitis patients
        21. Immunodiagnosis of Neurocysticercosis by enzyme linked immunosorbent assay from cerebrospinal fluid and serum in neuropsychiatric patients.
        22. A study of neurotuberculosis by enzyme linked immunosorbent assay for detection of IgG and IgM from cerebrospinal fluid and serum in a neurological center.
        23. Bacterial infections and its resistance pattern in a neurological tertiary care hospital.