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This paper assesses the quality of water using different graphical and statistical methods like Durov, Schoeller, Piper - Tri linear diagram, Box and Whisker plot for three seasons in the study area Alathur block, Perambalur District. The graphical representation provides limitations compared with the multivariate method for large data sets. A total of 10 groundwater samples were collected from hand dug wells in this area and they were analyzed for various physical and chemical parameters. The sequence of the dominance of the major ions are in the following order Na+ > Ca2+ > Mg2+ > K+ and Cl- > SO42- > HCO3- > NO3-. The dominating hydrochemicals of facies of groundwater are Ca-Cl and mixed Ca-Mg-Cl and alkaline earth metals (Ca2+, Mg2+) and strong acids (SO42-, Cl-) that dominate over alkalis (Na+, K+) and weak acids like HCO3-, CO3-. Based on the analytical result, groundwater in the study area is generally hard to very hard, slightly alkaline to brackish in nature. This indicates that leaching of salts, rock weathering and evaporation are among the most dominant processes in controlling water quality. For industrial purposes, the quality of water was assessed by using the Langeliner saturation index (LSI) and Ryznar saturation index (RSI). Seasonal variations in different parameters were also determined. [ABSTRACT FROM AUTHOR]

The productivity is the corner stone of banking growth and economic development. In common parlance, productivity indicates efficiency and effectiveness of services. In order to survive in the present competitive environment, the banks should be strengthened adequately and would attain competitiveness through the use of its existing resources and managing business in effective manner. Therefore, it is imperative to assess the productivity performance of Meghalaya Rural Bank. In the present article, an attempt has been made to study the effectiveness of MRB in the productivity performance keeping in view the trends of rural banks in the national context. The productivity measured in terms of labor, branch, return on assets (ROI), return on investment (ROA), profit as percent of business volume, etc., have been calculated to examine the innovativeness of MRB. [ABSTRACT FROM AUTHOR]

Background: & objective: The existence of visually identical cryptic Aspergillus species that can be distinguished only by molecular techniques is becoming more widely acknowledged. For the majority of antifungal drugs, these are known to exhibit a greater minimal inhibitory concentration in vitro. For the purpose of receiving the proper care, it is crucial to identify these species at right time. Our aim in this work is to identify and describe the Aspergillus species that are cryptic from all of the clinical samples., Methods: Routine samples from inpatients and outpatients received in department of Microbiology, All India Institute of Medical Sciences, New Delhi, showing growth of Aspergillus species were included in this study. Phenotypic and Matrix Assisted Laser Desorption Ionisation - Time of Flight identified isolates were analysed for cryptic species, by PCR and ITS/ß - tubulin sequencing. In accordance with CLSI recommendations, antifungal susceptibility testing was conducted using micro broth dilution., Results: Of the 94 isolates, 54 A. fumigatus, 34 A. flavus, 3 A. nidulans, 2 A. terreus, and 1 A. niger were morphologically identified. MALDI-TOF misidentified 2 A. nidulans isolates and 1 A, stellatus isolate. The ß - tubulin sequence analysis revealed that 2 isolates (2.08 %) were cryptic, one was A. stellatus and another one was A. tubingensis., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Indian Association of Medical Microbiologists. Published by Elsevier B.V. All rights reserved.)

Background: This study aims to evaluate the accuracy rate of foramen magnum dimensions in determining sex among the South Indian population using discriminant functional analysis., Methods: An observational study in which CBCT images from 200 full field of view (FOV) scans were analysed. The dimensions of the foramen magnum were measured. Intra- and interobserver reliability were calculated. Independent t -tests were used to compare the various parameters between sexes. Stepwise discriminant function analysis was used to determine sex., Results: A total of 200 CBCT scans were included in the study. The mean age (±SD) was 25.66 (±7.11) years among males and 24.64 (±5.12) years among females. The measurements and the circumference of the foramen magnum were significantly ( p < 0.001) greater in males than in females. The univariate analysis of foramen magnum measurements reached an accuracy rate of 73.5% in sex determination. The discriminant function analysis combining the foramen magnum measurements and circumference yielded an overall predictability rate of 66.5% for determining sex., Conclusion: Taking into account the predictability rate of sex based on foramen measurement in the present population, it can be concluded that its applicability should be limited to cases associated with fragmentary skull bases., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2024 Junaid Ahmed et al.)

SARS-CoV-2 evolution has continued to generate variants, responsible for new pandemic waves locally and globally. Varying disease presentation and severity has been ascribed to inherent variant characteristics and vaccine immunity. This study analyzed genomic data from 305 whole genome sequences from SARS-CoV-2 patients before and through the third wave in India. Delta variant was reported in patients without comorbidity (97%), while Omicron BA.2 was reported in patients with comorbidity (77%). Tissue adaptation studies brought forth higher propensity of Omicron variants to bronchial tissue than lung, contrary to observation in Delta variants from Delhi. Study of codon usage pattern distinguished the prevalent variants, clustering them separately, Omicron BA.2 isolated in February grouped away from December strains, and all BA.2 after December acquired a new mutation S959P in ORF1b (44.3% of BA.2 in the study) indicating ongoing evolution. Loss of critical spike mutations in Omicron BA.2 and gain of immune evasion mutations including G142D, reported in Delta but absent in BA.1, and S371F instead of S371L in BA.1 could explain very brief period of BA.1 in December 2021, followed by complete replacement by BA.2. Higher propensity of Omicron variants to bronchial tissue, probably ensured increased transmission while Omicron BA.2 became the prevalent variant possibly due to evolutionary trade-off. Virus evolution continues to shape the epidemic and its culmination.Communicated by Ramaswamy H. Sarma.

Yield gaps in milk production are here defined as the differentials between the actual yield obtained by the dairy farmer and the potential farm yield (production achieved by the top 10% of farmers: Gap 2) as well as the differential between this potential farm yield and the yield registered in the research stations (Gap 1). Assessment of yield gaps provides valuable information on potential production enhancement and drivers behind yield gaps. Milk production can be increased by narrowing the predominant large yield gaps in resource-poor smallholder farming system. Hence, this study assessed the milk yield gap and factors affecting the yield gap in Ri-Bhoi district of Meghalaya, a state located in the north-eastern Himalayan region of India. This research paper provides a scope for exploring the possibilities for improving dairy production in the state as well as contributing to literature through incorporating crucial determinants responsible for milk yield gap. A sample of 81 respondents was drawn purposely from two blocks of the district. The results indicated that the average number of cattle per household was 9.38 in standard animal units. The total yield gap was estimated at 6.20 l (91.06%) per day, composed of 0.80 l (11.76%) per day of yield gap I and 5.40 l (79.30%) per day of yield gap II. This demonstrates that the top performing farms were achieving a production level not dissimilar to that obtained on the research stations, but many were doing far less well. The size of cattle shed, dairy farming experience, concentrate price and human labour were the important determinants of the yield gap. Hence, encouraging the right stocking density of cattle, training on the preparations of home-made concentrates, access to cheap and quality concentrates, incorporating training and experience sharing on proper dairy management practices and use of technology could benefit the dairy farmers of the region.

Examination of carcasses of Himalayan goral (Naemorhedus goral) revealed nodular, pox-like eruptions in the skin. Similar disease was also seen in domestic goats (Capra aegagrus hircus) in the same area. Goatpox virus was identified as the etiology of the disease in both cases, with probable transmission between the species., (© Wildlife Disease Association 2021.)

Background: As per national policy, all diagnosed tuberculosis patients in India are to be tested using Xpert® MTB/RIF assay at the district level to diagnose rifampicin resistance. Regardless of the result, samples are transported to the reference laboratories for further testing: first-line Line Probe Assay (FL-LPA) for rifampicin-sensitive samples and second-line LPA(SL-LPA) for rifampicin-resistant samples. Based on the results, samples undergo culture and phenotypic drug susceptibility testing. We assessed among patients diagnosed with tuberculosis at 13 selected Xpert laboratories of Karnataka state, India, i) the proportion whose samples reached the reference laboratories and among them, proportion who completed the diagnostic algorithm ii) factors associated with non-reaching and non-completion and iii) the delays involved., Methods: This was a cohort study involving review of programme records. For each TB patient diagnosed between 1st July and 31st August 2018 at the Xpert laboratory, we tracked the laboratory register at the linked reference laboratory until 30th September (censor date) using Nikshay ID (a unique patient identifier), phone number, name, age and sex., Results: Of 1660 TB patients, 1208(73%) samples reached the reference laboratories and among those reached, 1124(93%) completed the algorithm. Of 1590 rifampicin-sensitive samples, 1170(74%) reached and 1104(94%) completed the algorithm. Of 64 rifampicin-resistant samples, only 35(55%) reached and 17(49%) completed the algorithm. Samples from rifampicin-resistant TB, extra-pulmonary TB and two districts were less likely to reach the reference laboratory. Non-completion was more likely among rifampicin-resistant TB and sputum-negative samples. The median time for conducting and reporting results of Xpert® MTB/RIF was one day, of FL-LPA 5 days and of SL-LPA16 days., Conclusion: These findings are encouraging given the complexity of the algorithm. High non-reaching and non-completion rates in rifampicin-resistant patients is a major concern. Future research should focus on understanding the reasons for the gaps identified using qualitative research methods., Competing Interests: It is declared that none of the authors have any competing interests.

Setting: Community based five pulmonary tuberculosis (PTB) surveys among adults., Objectives: Estimate sensitivity and specificity of screening tools for PTB and sputum microscopy., Methods: For each survey site, we estimated sensitivity and specificity of different screening criteria and microscopy against culture; pooled estimates were obtained using Random Effects Model., Results: Sensitivity of cough alone, screening for any symptom (persistent cough ≥2 weeks, fever or chest pain ≥1 month, hemoptysis), any symptom or history of anti-TB treatment (h/o ATT) were 56.2%, 66% and 71.2% respectively; specificities were 95.3%, 93.8% and 92.7% respectively. X-ray when used alone for primary screening had sensitivity and specificity of 76.6% and 97.3% respectively. When used along with screening for cough, these figures were 94.3% and 93.1%, and 100% and 97.3% when used with any symptom and h/o ATT. When used for secondary screening, sensitivity and specificity of X-ray was 66.8% and 87.8% respectively after primary screening for cough, 65.0% and 89.8% after screening for any symptom, and 67.1% and 86.7% when used after screening for any symptom or h/o ATT. Pooled sensitivity and specificity of smear was 46.2% and 99.3% respectively., Conclusion: Program managers may use these estimates while evaluating algorithms for active case finding., (Copyright © 2018 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.)

Setting: Implementation study in private health facilities in an Indian metropolis., Objectives: Improve Tuberculosis (TB) care by private practitioners (PPs)., Methods: PPs from a defined city area were imparted short training in TB care and linkages made with public facilities; subsequent practices were recorded., Results: Of 364 presumptive TB patient records, 70 (19.3%) did not conform to its definition. Of the conforming, 174 (59.2%) had presumptive pulmonary TB (PTB), 53 (18%) presumptive extra-pulmonary (EPTB) and 67 (24%) had both. Of conforming presumptive PTB, most underwent Chest X-ray and sputum examination in private laboratories. Tissue based diagnostics were not advised for most presumptive EPTB patients. Of 101 cases diagnosed with TB, 82% were new, 23% known diabetic and 4.7% human immune deficiency virus (HIV) reactive out of 64 tested. Most were notified and initiated treatment within 15 days of diagnosis. One-fourth was prescribed standard treatment regimen and treatment was not directly observed for most. One third was initial defaulters or lost during treatment; 62% of PTB and 46% EPTB cases initiated on treatment in private were successfully treated. Of successfully treated PTB cases, 61% had undergone follow-up sputum examination., Conclusion: Much intensified support mechanisms are needed to improve TB care in private sector., (Copyright © 2018. Published by Elsevier B.V.)

One hundred and twenty-nine qualified private practitioners (PPs) were assessed on their knowledge in diagnosis of pulmonary tuberculosis (PTB), treatment of a new drug sensitive PTB case and practices of case notification, using semi-structured questionnaire. About 20% had adequate knowledge of diagnosis, 29% of treatment regimen, 54% the need for Direct Observation Treatment and 57% about role of sputum smear examination in monitoring treatment response. Of 85 (68%) PPs who had diagnosed any TB case during last two years, 54 (64%) had practised notification. These findings suggest the need for upgrading knowledge of PPs in TB diagnosis, treatment and notification., (Copyright © 2018 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.)

Cryptococcus neoformans infection can occur in a wide range of hosts ranging from those who are severely immunosuppressed to those who are apparently immunocompetent. Two apparently immunocompetent HIV-seronegative patients with cryptococcal meningitis and multiple skin lesions, both due to C. neoformans var. grubii, are reported. Pregnancy was found as an associated factor in cryptococcal meningitis in a 20-year-old female patient from Arunachal Pradesh. Multiple skin lesions were the presenting feature of an 18-year-old male patient from Dibrugarh, eastern Assam. The organism was identified both phenotypically and by sequencing of ITS1 and ITS2 regions of rRNA gene. The cases are reported because of rarity of this infection in non-HIV-infected patients.

Breast cancer (BC) is the second most common cancer in women. In the North Eastern Region (NER) of India, BC is emerging as an important concern as evidenced by the data available from population and hospital-based cancer registries. Studies on genetic susceptibility to BC are important to understand the increase in the incidence of BC in NER. The present case control study was conducted to investigate the association between tumour suppressor gene TP53 codon 72 polymorphism and innate immune pathway gene TLR2∆22 (-196-174) polymorphism with BC in females of NER of India for the identification of novel biomarker of BC. Four hundred sixty-two histopathologically confirmed BC cases from four states of NER of India, and 770 healthy controls were included by organizing community surveys from the neighbourhood of cases. In our study, no significant association between TP53 codon 72 polymorphisms and the risk of BC was found. However, our study has shown that TP53 codon 72 polymorphism is an important effect modifier. In the present study it was found that females carrying 22 base-pair deletion in the promoter region of their TLR2 gene had two times (AOR= 2.18, 95 % CI 1.13-4.21, p=0.019 in dominant model; AOR= 2.17, 95 % CI 1.09-4.34, p=0.027 in co-dominant model) increased risk of BC whwn they also carry proline allele at codon 72 of their TP53 gene.

Setting: Four districts of Karnataka State, India, that have implemented the National Tuberculosis Control Programme (RNTCP)., Objective: To assess the proportion of patients diagnosed according to the nationally recommended algorithm among new smear-negative (NSN) PTB cases registered under the RNTCP., Methods: Information on 201 registered NSN-PTB patients as regards date of initial sputum examination, repeat sputum examination and chest X-ray (CXR) if undertaken, treatment initiation and number of days of antibiotic treatment after initial sputum examination, were collected through record review and patient interviews. In patients with negative or unknown human immunodeficiency virus (HIV) status, the algorithm was considered completed if the patient underwent initial sputum examination, antibiotic trial for ⩾10 days, repeat sputum examination ⩾10 days after initial sputum examination, CXR after repeat sputum examination and anti-tuberculosis treatment ⩾10 days after initial sputum examination. In HIV-positive patients, the algorithm was considered completed if CXR was performed after or at the same time as initial sputum examination., Results: Complete information was available for 170 patients. Of these, the algorithm was completed in 14 (8.2%, 95%CI 0.9-15.5): 1/140 patients with negative or unknown HIV status and 13/30 HIV-positive patients., Conclusion: The algorithm was not completed in most patients registered for treatment. Measures are needed to improve the diagnostic process for smear-negative PTB.

Setting: A South Indian district providing anti-tuberculosis services through the Revised National TB Control Programme (RNTCP) and private health care facilities., Objective: To ascertain the profile of tuberculosis (TB) patients diagnosed and/or treated in private health care facilities., Methods: Data on TB cases diagnosed and/or treated in all clinical departments of the medical college, 83 nursing homes and RNTCP health care facilities were collected prospectively., Results: About 83% of new TB cases recorded in the private medical college, 47% in nursing homes and 24.5% in RNTCP TB registers were extra-pulmonary. The proportion of retreatment cases was respectively 5.5%, 9.6% and 19.8%. The proportion of males and those in the economically productive age group were similar in the three data sources. About 94% of cases diagnosed in the medical college and 55% in nursing homes were registered for treatment under the RNTCP. About 11% of the smear-positive patients diagnosed in RNTCP were initial defaulters., Conclusion: The proportion of extra-pulmonary cases was higher in the medical college and nursing homes and that of retreatment cases was lower than in the RNTCP.

Hyper IgM syndrome is a primary immunodeficiency disorder characterized by normal or raised levels of immunoglobulin (Ig) M with low or absent IgG, IgA, and IgE. Five genetic causes of Hyper IgM have been identified. CD40L is deficient on T cells in Type І Hyper IgM, leading to defective interaction between T and B lymphocytes and consequently an inability to switch from production of IgM to other classes of antibodies. This manuscript reports a patient with X linked Hyper IgM (XHIGM) syndrome caused by a novel mutation in the CD40 Ligand (CD40L) gene and a favorable outcome after bone marrow transplantation.

The authors report a series of seven cases of X-linked Agammaglobulinemia, diagnosed and receiving treatment at a tertiary care centre in Mumbai. The ages of the patients ranged from 15 mo to 15 y. After diagnosis at a mean age of 3 ½ y, all were advised intravenous immunoglobulin (IvIg) infusion therapy in doses of 400-600 mg/kg every 3-4 wk. They were followed up for an average duration of 9 y, throughout which the complications and overall response to immunoglobulin therapy have been observed. The clinical profiles of each of these cases were retrospectively analysed with respect to age at diagnosis, frequency and severity of infections before and after initiation of treatment, co-morbidities and response to therapy. The results demonstrate the importance of early diagnosis and its correlation with decreased complications.

Changes related to chronological age are seen in both hard and soft tissue. A number of methods for age estimation have been proposed which can be classified in four categories, namely, clinical, radiological, histological and chemical analysis. In forensic odontology, age estimation based on tooth development is universally accepted method. The panoramic radiographs of 500 healthy Goan, Indian children (250 boys and 250 girls) aged between 4 and 22.1 years were selected. Modified Demirjian's method (1973/2004), Acharya AB formula (2011), Dr Ajit D. Dinkar (1984) regression equation, Foti and coworkers (2003) formula (clinical and radiological) were applied for estimation of age. The result of our study has shown that Dr Ajit D. Dinkar method is more accurate followed by Acharya Indian-specific formula. Furthermore, in this study by applying all these methods to one regional population, we have attempted to present dental age estimation methodology best suited for the Goan Indian population., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Background: Initiation, perpetuation and cessation of smoking are all multifactorial. It is essential to explore interactions among various parameters influencing smoking and its cessation for effective smoking cessation interventions., Objectives: To obtain insights into smoking and its cessation among current smokers in India., Materials and Methods: The present study was conducted among current smokers visiting the Department of Oral Medicine and Radiology, Manipal College of Dental Sciences (MCODS), Manipal University, Mangalore. Knowledge, attitudes, behavior, worksite practices towards smoking and its cessation, barriers to smoking cessation and socio-demographic variables were explored using a structured, pretested, self-administered questionnaire., Results: A total of 175 current smokers participated in the study. Mean knowledge, attitude, worksite practice and barrier scores were 15.2±5.67 (66.1%), 57.5±7.67(82.1%), 4.18±2.02 (41.8%) and 57.4±12.37 (63.7%) respectively. Correlation analysis revealed: association of knowledge with education, occupation and religion; attitude with education and occupation; worksite practices with occupation; knowledge with attitude; and barriers negatively with worksite practices. The majority (85.7%) of respondents intended to quit smoking and this was associated with higher attitude scores, whereas actual quit attempts were associated with high knowledge, attitudes, worksite practices and low barrier scores., Conclusions: Various socio-demographic factors associated with smoking and its cessation were identified. The present study highlights the importance of identifying and targeting these interactions while framing guidelines and interventions for effective tobacco cessation in a developing country like India.

Background: There is paucity of information on epidemiological situation of Tuberculosis (TB) in Andhra Pradesh. The DOTS strategy under the Revised National Tuberculosis Control Programme (RNTCP) was introduced in the year 2000 to cover the entire State by 2005., Objectives: To estimate the prevalence of tuberculous infection among children 5-9 years of age and to compute the average Annual Risk of Tuberculosis Infection (ARTI) from the estimated prevalence., Methods: A cluster-sample house-based tuberculin survey was carried out in a representative sample of children between 5-9 years of age. The clusters were selected by a two-stage sampling procedure. At first stage, five districts were selected by probability proportional to population size (PPS) method. Depending upon child population ratio, 32 clusters allocated to each district were further sub-divided into rural and urban clusters selected by simple random sampling. A total of 3636 children, irrespective of their BCG scar status, were tuberculin tested using one TU PPD RT23 with Tween 80 and the maximum transverse diameter of induration was measured about 72 hours later., Results: The prevalence of infection estimated by mirror-image technique using observed mode of reactions attributable to infection with tubercle bacilli at 20mm was 9.6% (95% CI: 8.0-11.2). The ARTI was computed at 1.4% (95% CI: 1.1-1.6)., Conclusion: Survey findings indicate a fairly high rate of transmission of tubercle bacilli.