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Background:Vitamin B12 deficiency causes serious neurologic problems among infants. However, its neuroradiologic correlate is still largely obscure. Methodology: This prospective study was conducted on patients aged 6 months to 2 years. All children with proven vitamin B12 deficiency were planned to undergo magnetic resonance imaging (MRI) and magnetic resonance spectroscopy of the brain. Results: A total of 35 patients (63% female) were enrolled. Twenty-six (74%) patients had significant findings on brain MRI scan, commonest of which were thinning of corpus callosum and prominence of extra-axial spaces in 28.6% children, cerebral atrophy in 17%, and diffuse symmetrical hyperintensity of white matter in 5.7% patients. Using logistic regression, it was found that odds of abnormal neuroimaging findings were higher in children below 12 months, in females, and in patients with developmental regression, but none of them were statistically significant. Conclusion: Most of the infants with vitamin B12 deficiency have abnormal neuroimaging findings.

Nocardiosis is an acute, subacute or chronic infectious disease that occurs in cutaneous, pulmonary and disseminated forms. We present a case of Nocardiosis in a post-COVID-19 patient with cutaneous ulceration due to Nocardia otitidiscaviarum, managed with cotrimoxazole and linezolid. Early diagnosis and management proved crucial in preventing dissemination of the organism and improving the patient's outcome.

This article seeks to understand the modern-day value of children to middle class Indian parents. It examines parental strategies aimed at raising successful children by providing them with the best education possible. These strategies, involving ‘concerted cultivation’ and gendered ‘educational labour’, are analysed in relation to schooling and preparation for a highly competitive national entrance exam, for admission to an elite engineering college in the country. Describing and analysing the classed and gendered nature of these strategies, the article explores the shifting nature of returns that middle class parents expect from their grown children. As the article shows, gendered burdens and class location of parents are crucial in shaping the value of children. Mothers across class contribute disproportionately to children’s educational training and highly educated mothers are withdrawn from the labour market to immerse themselves in educational labour. Ironically, educated mothers’ own educational inputs remain invisible even to themselves, resulting from an acceptance of culturally constructed norms around the gendered division of labour. Family strategies are oriented towards aspirations of upward social mobility, a return that parents seek to derive from educationally and professionally successful children.

The idea of caste has always been debatable, contested and controversial. Since the time of its inception, it has been prevalent throughout India. Any Indian cannot define his or her identity without referring to his or her caste. However, it also became and still is a reason behind the marginalization and exploitation of millions of people. Various activists, scholars, thinkers, political leaders and literary writers have tried to fight against the stigmatization of a particular caste. However, the experience of caste discrimination is not the same in all the states of India. Though the basic problems and concerns of Dalits such as untouchability and exploitation are the same, their degree and intensity vary from one state to another. Various cultural, social and economic moorings impact the way caste-based discrimination is practised in a particular society. Various critics from Punjab such as Ronki Ram, Harish Puri and Paramjit Judge argue that the experience of Dalits in Punjab is comparatively different than those in other parts of India because in Punjab casteism was practised not on the basis of purity/pollution syndrome but as a divide between the landless and the land-owning communities, so they have studied the material aspect of caste. It is observed that the literary writings by Dalits from Punjab highlight instances of untouchability and caste-based discrimination in the pre- and post-independence periods. They resisted and protested against the caste system and also claimed to overthrow it. Therefore, the article seeks to evaluate the notion of casteless in Punjab. It takes into account the poetry of Gurdas Ram Alam, Charan Das Nidharak and Pritam Ramdaspuri. Through the qualitative content analysis using theories of Dalit aesthetics, the article explores the major thrust areas of Punjabi Dalit poets and highlights how these poets express their caste identity and try to raise the consciousness of their fellow caste members and protest against the discriminatory practices of the dominant Punjabi society and culture. It also, in a way, makes these poets (and those communities to which they belong) a subcultural phenomenon that runs parallel to the dominant Jatt culture of Punjab.

We recently reported our findings from a longitudinal, prospective study where we identified 10% infants who were low vaccine responders (LVR) at age 9–12 mo following routine primary series vaccine schedule. We found multiple cellular deficiencies in LVR children, including low number of memory B cells, reduced polyclonal stimulation of naïve/memory T cell response and suboptimal APC response. These children outgrew their poor vaccine response by the time they received booster doses of vaccine. Studies in human infant innate immunity are rare because of the unique challenges in specimen collection. As innate immunity instructs adaptive immunity, we hypothesized that the primary immune defect lies with innate immunity and in this study we sought to determine the ontogeny of innate immune response in LVR children between 6 and 36 mo of age. Interestingly, suboptimal APC response observed in LVR children at 6–9 mo of age characterized by significantly ( P

ObjectiveAcute otitis media (AOM) causes an inflammatory response in the middle ear. We assessed differences in innate immune responses involved in bacterial defense at onset of AOM in children who were stringently defined as otitis prone (sOP) and children not otitis prone (NOP).Study DesignInnate immune genes analysis from middle ear fluid (MEF) samples of children.MethodsGenes of toll-like receptors (TLR), nod-like and retinoic acid-inducible gene-I-like receptors, downstream effectors important for inflammation and apoptosis, including cytokines and chemokines, were studied from MEF samples by using a real-time polymerase chain reaction array. Protein levels of differentially regulated genes were measured by Luminex.ResultsGene expression in MEF among children who were sOP was significantly different in upregulation of interleukin 8, secretory leukocyte peptidase inhibitor, and chemokine (C-C motif) ligand 3, and in downregulation of interferon regulatory factor 7 and its related signaling molecules interferon alpha, Toll-like receptor adaptor molecule 2, chemokine (C-C motif) ligand 5, and mitogen-activated protein kinase 8 compared with children who were NOP. Differences in innate gene regulation were similar when AOM was caused by Streptococcus pneumoniae or nontypeable Haemophilus influenzae.ConclusionInnate-immune response genes are differentially regulated in children who were sOP compared with children with NOP.

The impending arrival of the long awaited “good times” emerged as a powerful meme in the 2014 general elections in India. The vague but exhilarating promise of good times was not only translated into catchy campaign slogans but also acquired its own fast-circulating hashtags, domain names, and strong everyday presence on social media. In this article, I open up the notion of good times through an account of #acchedin and locate it within the longer trajectory of neoliberal economic reforms. I ask what good times might even mean in a nation that has transformed itself fully into commodity-form to become an attractive investment destination for global investors. The newly crafted Brand Modi, the natural inheritor and prime agent of 1990s Brand India, now works in tandem in anticipation of the long awaited, and ever elusive, transformative epochal threshold of good times ahead.

Background: Few studies have addressed the issue of adverse drug reactions with non-protease inhibitor (PI)-based antiretroviral therapy (ART) in resource-constrained settings. We studied prospectively the incidence of adverse drug reactions with generic ART among our patients. Methodology: A total of 100 HIV-infected individuals were recruited. Patients received nevirapine (NVP) or efavirenz (EFV) with lamivudine (3TC) and zidovudine (ZDV)/stavudine (d4T). They were followed for 6 months for evidence of adverse drug reactions. Results: The mean CD4 count was 114.09 ± 60.07 cells/mm3 (range, 12-232 cells/mm 3). Transient gastrointestinal symptoms were most frequent. Fourteen individuals (12 receiving ZDV/d4T, 3TC, NVP and 2 receiving ZDV/d4T, 3TC, EFV) developed skin rash. Among patients receiving NVP, 25.7% developed grade 1 hepatotoxicity. Three patients had numbness in both lower limbs. Among those individuals who received EFV, 32.3% individuals had central nervous system (CNS) symptoms in the form of insomnia, vivid dreams, dizziness, and drowsiness. Conclusion: As the developing world increasingly uses generic ART, the clinician must be constantly vigilant for treatment-related adverse events.

The core of symbolic communities, like the community of Partition migrants, is formed through the discursive ownership of historical experiences—for instance, the loss of human lives, personal property and dismemberment of national territory; followed by the restoration of that loss through examples of successful refugee resettlement and national self-assertion. Within the master narrative of Partition migration history, however, the experiences of forced movement and resettlement suffered by the ‘Untouchables’ are obscured. Popular accounts of violence, forced movement and suffering are largely built around the narratives produced by upper caste and upper middle-class migrants and exclude the experiences of Untouchable migrants. This narrative absence becomes a gauge of both the discursive and physical exclusion of ‘Untouchable'refugees from the legitimate community of Partition migrants. Such a meta-version of Partition history constitutes the realm of the normal, outside which ‘Untouchable’ narratives exist as an aberration in the theme of modern citizen-making in post-colonial India. In this article, I examine these ‘aberrations’ to provide an alternate reading that helps us challenge the master narrative of Partition migration history.

This article examines the socio-economic reasons for the steep decline in child sex ratios, as revealed by the 2001 census. It questions existing arguments in the light of new fieldwork in several states in North India. It argues that we have to unpack ‘son preference’ in the modern context to understand why parents continue to prefer boys over girls in many parts of North and North-West India, and especially so in urban areas. Although there is some narrowing of the gender gap (as seen in education, health and work force participation indicators), girls remain undervalued when it comes to intergenerational transfers. The article argues that the changing interrelationships between education, work, marriage and family status in some senses reinforce the perceived need for sons as the source of a family's future stability and parental support. Given these expectations, insecurities around the material and social success of sons, and largely unchanging or even enhanced marriage and dowry expenditure for girls, drive parents to invest more in sons and propel family- building strategies with few or no girls.

An accurate delineation of the surgical anatomy of perianal inflammatory disease is vital before surgery to prevent postoperative recurrence and incontinence. The purpose of this study was to evaluate the use of transperineal sonography for evaluating perianal inflammatory disease. Thirty patients (23 males and 7 females) with clinically suspected perianal inflammatory disease were imaged with transperineal sonography in males and transperineal and transvaginal sonography in females. All fluid collections, sinus tracts, and fistulae were evaluated in relation to the sphincters and perineum. Twenty-seven of the 30 patients had fistulae: 7 intersphincteric, 17 transphincteric, and 1 extrasphincteric fistula. Three patients had perianal fluid collections with sinus tracts. Preoperative sonographic findings were confirmed in 23 patients. Thirty-one internal openings seen on sonography were confirmed on surgery. The authors conclude that transperineal and transvaginal sonography are accurate and painless methods for documenting perianal inflammatory disease.

A 35-year-old female living with AIDS presented with oral thrush 3 months after the initiation of antiretroviral therapy (ART). On investigation, it was found to be due to Candida albicans. She was started on fluconazole. After 4 months on ART, she presented with fever. Blood culture was performed. After 4 days, she expired due to septic shock. Two days after her death, C albicans strain was isolated from the blood culture which was similar to the C albicans strain (by DNA fingerprinting) isolated from oral thrush. Both strains of C albicans were found to be resistant to fluconazole by broth microdilution method. A high index of suspicion in high-risk patients along with early and aggressive management of the patient with antigen detection would go a long way in the management of these patients. Guidelines for treatment of candidiasis need to be re-evaluated, keeping in mind the increasing emergence of resistance to azoles and its effect on morbidity outcome.

L'A., a la suite d'une enquete menee en 1981-82 dans un village du Punjab (Inde), a remarque que les Jat Sikhs, a l'inverse des autres castes ne respectaient pas le code de conduite commun a tous les Sikhs. D'apres l'A., cette attitude s'explique par le fait que dans un contexte villageois et rural l'identite sikh n'est pas menacee si bien que les gens ne se sentent pas astreints a respecter tous les preceptes religieux tandis que dans un milieu urbain, ils doivent se differencier et renforcer leur identite