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Background: Lakadong turmeric (LKD) from Meghalaya, India, boasts high curcumin levels, but lacks scientific study. Moreover, Curcumin's poor solubility hinders its clinical use in inflammation and wound healing. This study isolated curcumin from LKD, forming a PLGA nanosuspension-based nanogel and explored for its potential anti-inflammatory and cutaneous wound healing activity in Wistar rats. Methodology: The LKD rhizome was successively extracted by soxhlet using chloroform, hexane, ethyl acetate and methanol and their total phenolic content and antioxidant property was determined. Chloroform extract was loaded in column chromatography and curcumin was isolated, purified and characterized by FTIR, NMR, DSC, MS and HPTLC and its purity was analyzed by HPLC. The isolated curcumin was loaded into PLGA nanosuspensions by nanoprecipitation method followed by conversion to carbopol based Nanogel. The nanogels were characterized physicochemically and the drug permeation was observed. The optimized nanogel was evaluated for its anti-inflammatory and cutaneous wound healing activity by carrageenan-induced paw edema and excision wound model in albino Wistar rats divided in five groups and treated with plain carbopol gel, marketed turmeric cream and Cur NS nanogel (0.6% w/w equivalent curcumin each). Results: Results depicted that the chloroform extract showed the presence of a considerable amount of phenolics with 50-60% yield of curcumin. HPLC analysis depicted that the LKD curcumin had higher purity when compared to standard curcumin. Homogenous curcumin nanosuspensions were obtained with size 150 ± 50 nm and PDI 0.2 ± 0.1. The Cur-NS-nanogel showed satisfactory physical property, drug loading and stability. Ex vivo permeation studies in rats showed controlled permeation with steady state flux of 21.28 ± 0.23 µg/cm2/hr in 24 h. Topical intervention with Cur-NS-nanogel (0.6%) significantly (p < 0.05) decreased the paw volume by 43.97% in the 3rd hour and 72.19% on the 4th hour. Furthermore, the cutaneous wound healing property of Cur-NS-nanogel when compared to negative control rats showed a substantial (p < 0.05) reduction in the percentage wound contraction from 5 to 20th days. Conclusion: LKD showed high curcumin content with significant antioxidant effects. LKD curcumin loaded into stable nanogel depicted safe and controlled skin permeability with promising cutaneous wound healing and anti-inflammatory activity in experimental rats. [ABSTRACT FROM AUTHOR]

The present study aimed to investigate an outbreak of Theileria annulata (T. annulata) infection in an organized dairy cattle farm in Madhya Pradesh, India, using clinical and molecular techniques. Following the deaths of two crossbred cattle in March 2021, 43 blood samples were collected from infected and apparently healthy animals and examined by blood smear and polymerase chain reaction (PCR) techniques. The blood smear examination showed that 23.25% of samples were positive for Theileria organisms, while conventional PCR targeting the 18S ribosomal RNA (18S rRNA) and T. annulata merozoite surface antigen-1 (TAMS-1) genes revealed that 32.55% of samples were positive for T. annulata. PCR targeting cytochrome b (Cytb) gene showed 46.51% of samples were positive for T. annulata. Haematological analysis confirmed clinical signs of infection in affected animals, which were treated with buparvaquone @ 2.5 mg/kg body weight intramuscularly along with supportive medicine. Two 18S rRNA gene amplicons were sequenced and analysed in a phylogenetic tree and haplotype network with 54 Indian and 38 foreign sequences. The phylogenetic tree revealed two groups with a high posterior probability and bootstrap value, while the haplotype network revealed 35 haplotypes, with haplotype 1 (H1) being the most abundant and several single haplotypes clustering around it, indicating fast and widespread expansion. Genetic diversity indices and neutrality tests confirmed that the population was expanding. These studies highlight the significance of prompt and precise diagnosis and management of T. annulata outbreaks and provide insights into its evolutionary history and population dynamics of T. annulata in India, which could aid improving disease preventive and control strategies. [ABSTRACT FROM AUTHOR]

Bengali or Bangla is an Indo-Aryan language. It is the state language of West Bengal and Tripura and also spoken in some parts of Assam. Bangla is the official language of Bangladesh. With nearly 230 million speakers (Wikipedia 2010), Bangla is one of the most spoken language in the world. Bangla language is the most commonly used language in West Bengal. As there is no formal test in Bangla to test the verbal auditory comprehension of an individual, the present study is an attempt to develop and standardize a test based on the principles of Revised Token Test & concrete object form Token Test. Fifty names of common objects and seven names of common colours were selected and were given to 200 native Bangla speakers for familiarity rating. The five most familiar objects, in two colours & two sizes were selected for the test. The test developed was administered to a sample of 120 participants, comprising normal and clinical population, both male and female in the age range of 4 to 55 years. The results revealed that there is a trend of gradual enhancement of auditory verbal skills in children from Standard (Std) I to Standard (Std) IV. There is a significant difference in the performance between children and adults. The adults & children have performed significantly better than brain damaged population. The performances of receptive persons with aphasia were comparatively lesser compared to expressive persons with aphasia. The brain damaged person with aphasia performed significantly poorer than brain damaged with non aphasics. However, brain damaged non aphasics did not differ significantly from normal. These differences have also been found across most of the subtests & linguistic elements. The test can identify the level of difficulty in comprehension due to brain damage as well as the performance in different age groups. It can also be useful in differentiating receptive person with aphasia from expressive person with aphasia and brain damaged person with aphasia from brain damaged non-aphasics. It can be used as an assessment and intervention tool.

The present study aims at analyzing speech samples of four Bengali speaking children with repaired cleft palates with a view to differentiate between the misarticulations arising out of a deficit in linguistic skills and structural or motoric limitations. Spontaneous speech samples were collected and subjected to a number of linguistic analyses (analysis of phonetic inventory, analysis of substitutions and analysis of phonological processes). Linguistic skills were evaluated using Receptive-Expressive Emergent Language Test and Linguistic Profile Test (in Bengali). The results revealed that, out of the four subjects, two had delayed linguistic skills with respect to their age. However, the phonetic inventories of all the four participants were similar to each other with no significant delay. The four children differed in the frequency and type of phonological processes used. This may be due to the variations in their linguistic skills. The data therefore suggests that all the articulatory problems might not be solely attributed to their present or past structural deficits; linguistic deficits may play a crucial role. (Contains 3 tables.)

Unplanned urbanization, industrial enhancement, and tremendous increase in motor vehicle traffic lead to exponential rise in pollution. Air pollutants, such as nitrogen oxides (NOx), sulfur dioxide (SO2), carbon monoxide (CO), particulate matter (PM 2.5 and PM 10), volatile organic compounds (VOCs), ozone (O3), and heavy metals are found at a high concentration in the atmosphere. Particulate matter with 10 µm or less in diameter (PM10) is known to have adverse effects on human health and the environment. Particle pollution is known to have many environmental effects from poor visibility to more serious consequences such as acid rain, which pollutes soil and water. Heavy metal determination in ambient air is an important area for environmental researchers because of their toxicity to human beings. Some heavy metals (hexavalent chromium (Cr), arsenic (As), cadmium (Cd) and nickel (Ni)) have been listed as carcinogens. Furthermore, heavy metals in the atmosphere can accumulate in various plants and animals and enter humans through the food chain. Heavy metals have toxic effects when they are involved in biochemical reactions in living organisms. The Government of India has proposed National Clean Air Programme (NCAP)—a powerful step in acknowledging and resolving the problem of deteriorating ambient air quality. This study reports the major sources of particulate matter and heavy metals in the atmosphere, their effects and control for sustainable environment. [ABSTRACT FROM AUTHOR]

Air pollution is a big danger to medium and low‐income countries like India. It is one of the most serious pollution issues and the main source of adverse health consequences in humans. It is discovered that it is responsible for nearly 4.2 million premature deaths each year due to particulate matter (PM) pollution, which causes cardiovascular, infectious, and carcinogenic diseases. According to various epidemiological analyses, NO2, i.e., nitrogen dioxide and RSPM, i.e., respirable suspended particulate matter have a comparatively higher association with respiratory problems and a modest correlation with cough and asthma, indicating that NO2 and RSPM are of significant concern. The key cause of air pollution is an exponential increase of licensed cars, which causes traffic congestion, the proliferation of older vehicles, inadequate inspection and repair, the absence of public transit and carpooling, poor fuel quality, insufficient traffic enforcement, poor road conditions, a lack of public knowledge, and the inefficiency of pollution control boards. In 2020, based on the recommendations of the 15th Finance Commission, the Government of India has set aside about $1.7 billion to fight air pollution over the next 5 years for the 42 Indian cities that have million‐plus populations—provided they reduce their air pollution levels by 15% every year. [ABSTRACT FROM AUTHOR]

In developing countries, anti-D has been used in immune thrombocytopenia (ITP) as a cheaper alternative to human immunoglobulin. We aim to analyze the response and safety profile of anti-D in patients with severe ITP. A retrospective study was conducted at a tertiary care hospital in Northern India. Patients received a single intravenous infusion of 75 μg/kg anti-D. In total, 36 patients (20 females) were included in this study. The median duration from ITP diagnosis to anti-D therapy was 235 days (range 1–1613 days). Four (11.1%) patients received anti-D as an upfront treatment. The patients' platelet counts rose significantly by the end of day three and continued to be significantly high until day 30 of receiving anti-D (p ≤ 0.001). The overall response rate (ORR) by day seven was 88.89%. There was no effect of age, sex, duration of disease, prior therapy, and platelet count on the ORR. Patients were followed up for a median duration of 52 days (longest follow-up: 3080 days). Six (6/36, 16.67%) patients continued to be in remission till the last follow-up. The hemoglobin fall was statistically significant on day three and day seven (p < 0.001 and p = 0.001) and got normalized by day 30. We observed equally good ORR in mixed populations and different phases of ITP along with long-term sustained response. The study demonstrates a quick and high response rate along with good safety profile to anti-D in all forms of ITP. [ABSTRACT FROM AUTHOR]

Continuous and indiscriminate use of synthetic acaricides contribute to the development and establishment of acaricide-resistant tick populations. Monitoring of acaricide resistance in field ticks and use of suitable practices are essential for managing tick populations, infesting animals. In the present study, adult immersion test (AIT) was used for evaluation of resistance against commercially available synthetic pyrethroids (deltamethrin and cypermethrin) in Rhipicephalus microplus ticks collected from various villages of Rewa district of Madhya Pradesh, India. All the eight isolates of R. microplus were found resistant with deltamethrin and their resistance factors (RFs) were between 3.91 to 57.92, whereas, seven isolates were found resistant with cypermethrin and their resistance factor ranges from 0.56 to 9.98. Lethal concentrations (LC50 and LC95), confidence intervals (CI) and slope(s) were estimated by probit analysis and the highest and lowest level of resistance appeared in Sagra Bekchera and Silpara isolates of R. microplus for both deltamethrin and cypermethrin. It was observed that of the two compounds used for tick management, the resistance to deltamethrin was comparatively higher than cypermethrin. Data generated on pyrethroid resistance status of ticks in this region will provide new insights in acaricidal resistance scenario particularly from remote areas of this region and will help in formulating suitable tick management strategy. [ABSTRACT FROM AUTHOR]

Final results of Northern Italy Leukemia Group (NILG) Trial 10/07 combining pediatric-type therapy with minimal residual disease study and risk-oriented hematopoietic cell transplantation in adult acute lymphoblastic leukemia (ALL). Keywords: acute lymphoblastic leukaemia; adolescent and young adult; India; outcomes; survival; treatment abandonment EN acute lymphoblastic leukaemia adolescent and young adult India outcomes survival treatment abandonment e1 e4 4 04/01/21 20210401 NES 210401 Adolescent and young adult (AYA) patients with acute lymphoblastic leukaemia (ALL) have inferior survival when compared to children. Nearly a quarter (336/1383, 24%) of the patients either did not start treatment ( I N i = 242) or abandoned therapy after starting ( I N i = 94), which is one of the major challenges when treating AYA patients in resource-challenged situations. A total of 336/1383 (24%) patients either did not start therapy (N = 242), or abandoned therapy after starting induction (N = 94) (A). [Extracted from the article]

The groundwater crisis in northwestern India is the result of over-exploitation of groundwater resources for irrigation. The Government of India has targeted a 20 percent improvement in irrigation groundwater use efficiency. In this perspective, and using a regional-scale calibrated and validated three-dimensional groundwater flow model, this article provides the first forecasts of water levels in the study area up to the year 2028, both with and without this improvement in use efficiency. Future water levels without any mitigation efforts are anticipated to decline by up to 2.8 m/year in some areas. A simulation with a 20 percent reduction in groundwater abstraction shows spatially varied aquifer responses. Tangible results are visible in a decade, and the water-level decline rates decrease by 36–67 percent in over-exploited areas. Although increasing irrigation use efficiency provides tangible benefits, an integrated approach to agricultural water management practice that incorporates use efficiency along with other measures like water-efficient cropping patterns and rainwater harvesting may yield better results in a shorter period. [ABSTRACT FROM AUTHOR]

The Yamuna flood plains spread across the northern part of Indian subcontinent is home to millions of people. The ever-growing population in these plains make it difficult to sustain the demand of freshwater resources. However, the productive aquifers of flood plains could provide solution for these issues. In this context, it is necessary to understand the aquifer characteristics. Thus, the paper attempts to characterize the aquifer in Palla area of the flood plain using integrated approach. Besides, grain size analysis and site-litholog study, the nature of aquifer material was also ascertained from bulk mineralogy of the sediments using X-Ray Diffraction. The aquifer parameters were estimated with help of long duration pumping test data. Moreover, the effect of pumping on salinity variation and hydrochemical facies evolution was also examined. The sand dominant, unconfined aquifer was estimated to have horizontal hydraulic conductivity in the range of 25 m/day and vertical hydraulic conductivity of 6-7 m /day. While the specific yield of the aquifer was estimated in the range of 0.07-0.08. It is observed that under conducive active flood plain environment, the given sand mineralogy at the site does not allow salinity increase in groundwater even after more than a decade of groundwater pumping. In fact, over years, hydrochemical facies have evolved towards Bicarbonate type. These things put together make the active flood plain aquifer a sustainable groundwater resource. [ABSTRACT FROM AUTHOR]

Hyperacusis has recently attracted professional attention. Previously, this topic was not well researched or documented. In many instances, due to a lack of understanding regarding the diagnosis, the pathophysiology and treatment options, patients' complaints were ignored. Hyperacusis is defined as an abnormally strong reaction to sound occurring within the auditory pathways. In the present study, an attempt has been made to make a telephonic survey regarding awareness of hyperacusis by asking a set of 19 questions from otorhinolaryngologists and audiologists in almost all parts of India. It is found that 56.6% of the participants report that hyperacusis is not diagnosed in their clinics, 73.4% do not know the etiology, 33.3% manage hyperacusis and tinnitus simultaneously while others are not sure which should be managed. Decreased sound tolerance, including hyperacusis, misophonia, and phonophobia, is a challenging topic to study and treat. The etiology is not clear, neural mechanisms are speculative and treatments are not yet proven. The general recognition of decreased sound tolerance, as a problem requiring attention and proper treatment, should be considered a priority in the community of hearing professionals. [ABSTRACT FROM AUTHOR]

Background: Data is scarce on prevalence of extracranial carotid atherosclerosis (ECA) in strokes <50 years and its association with lifestyle factors. Objective: Study role of (a) ECA in non-cardio-embolic anterior circulation young strokes, and (b) smoking and alcohol in ECA. Materials and Methods: Cardiovascular risk factors and evidence of ECA on carotid doppler ultrasound (CDUS) was evaluated in an one-year preliminary cross-sectional study of consecutive strokes between 20 years and 49 years. Females were excluded. Results: There were 46 male strokes (mean age 38.26 yrs), 17.39% had hypertension, 2.23% had coronary artery disease; none was diabetic. Tobacco users and alcohol consumers were 24/46 (52.17%) cases each. ECA was found in 14/46 (30.44%) cases. Seven of these 14 (50%) i.e., 7/46 cases (15.21%) had carotid occlusion, four had <50%, three had >70% stenosis. 'Smoking and smokeless tobacco use' was found in 71.42% (10/14) symptomatic carotid lesions compared to 43.75% (14/32) strokes without carotid lesions. Prevalence odds ratio for tobacco use and ECA was 3.21 (95% CI: 0.83-12.44) while that of alcohol and ECA was 1.33 (95% CI: 0.38-4.72). Conclusion: Prevalence of ECA in strokes <50 years was high due to lifestyle factors which predispose to atherosclerosis at younger age. [ABSTRACT FROM AUTHOR]

Dengue is an important arboviral disease of tropical and subtropical regions, with significant morbidity and mortality. Dengue virus is antigenically classified into four serotypes, which are further classified into 4-5 genotypes based on their genetic diversity. Since genotypes vary in their virulence, their detection and analysis of spatial and temporal transition are essential. We utilized sequence information from the E-NS1 gene region for molecular and phylogenetic characterization of dengue viruses isolated from dengue patients between 2007 and 2009. All four serotypes and multiple genotypes were detected, with predominance and emergence of DENV-1 genotype V. Phylogenetic analysis revealed the emergence of DENV-1 genotype V from India for the first time, which has replaced the earlier circulating genotype III and genotype I. The circulation of multiple genotypes and genotype replacement is critical, since genotypes vary in their virulence, and this should be a point of concern for healthcare agencies. [ABSTRACT FROM AUTHOR]

The present paper aims at evaluating the performance of 26 Public Sector Banks (PSBs) operating in India by using one-stage performance evaluation model on the basis of Human Resource Deployment (HRD). Data Envelopment Analysis (DEA) is employed for computing the efficiency scores for individual PSBs using the cross-sectional data for the financial year 2009-10. The overall performance is derived based on the variable returns to scale technical efficiency scores. The empirical results uphold positive association between HRD and banks' performance. Further, the study reveals that on the efficiency front, Corporation Bank, Indian Bank, State Bank of Bikaner and Jaipur and State Bank of Mysore performed well. Corporation Bank seems to set the benchmark. It is recommended that Indian PSBs should pay more attention to proper deployment of human resources to improve their overall performance. [ABSTRACT FROM AUTHOR]

The research was carried out to study the evapotranspiration (ET) losses from wheat and black gram (urd) to select most appropriate mathematical model based on meteorological parameters for Uttarakhand Tarai conditions. This study was conducted during rabi and kharif seasons of 2006-07 and 2007-08 by using weighing lysimeter. Different empirical models based on meteorological parameters namely Blaney-Criddle, Jensen-Haise, Stephens-Stewart, Turc, Thornthwaite and Modified Penman were used to evaluate the evapotranspiration loss from wheat and black gram also the relationship of measured ET by lysimeter were evaluated by simple correlation and linear regression. It was found that the evapotranspiration from wheat and black gram under Tarai conditions is about 326.3 and 414.1 mm respectively. The average total rainfall during wheat and black gram season was 27.4 mm and 1037.2 mm respectively. Among the other mathematical models based on meteorological parameters modified penman method is remarkably suitable method for the estimation of ET in Uttarakhand Tarai condition for wheat and black gram crops. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to figure out the status of tinnitus management program (TMP) being conducted in India, to estimate the use of different tinnitus management program, to study the role of various professionals involved and document the current practices of audiologist in country. Design: A questionnaire on "tinnitus management survey" was developed and distributed to 150 institutions all over India. Results and conclusion: The return rate of the Questionnaire was 32.6%, 7 were received from Medical Colleges (MCs) and 42 from speech and hearing clinics (SHCs). Hence, the rates of TMP have not taken up appropriately in the various hospitals and clinics as yet. 71.4% SHCs have the provision of TMP, 74.28% of the institutes have less than 50% of the patients improving with the TMP, involving Audiologists in 62.85% of the institutes. 54.28% of the institutes opted for Tinnitus Masking out of the various tinnitus management programs. Outside funding for TMP was not received by 91.42% of the institutes. 60% of the institutes were provided TMP with hearing aids. 71.42% of the SHCs feel TMP is partially helpful to tinnitus sufferers thus funding should be undertaken by the Government for ensuring effectual program all over India. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: The present study is aimed at figuring out the status of new-born hearing screening program being conducted in India, estimate the use of different screening instruments used and tests practiced, study the role of various professionals involved and document the current practices of audiologists in the country. Method: A questionnaire on “Newborn Hearing Screening Survey” was sent to 185 institutions (165 medical colleges and 20 Speech and hearing centers) all over India and the information gathered was subjected to appropriate analyses. Results: On a 16.75% return rate of the questionnaire, almost half of the colleges have their annual birthing census more than 2000. The majority of sites (57.13%) report an average length of stay for a vaginal delivery to be more than 24 hours with 78.94% also reporting of a NICU of Level II/III type. Only 38.09% of the medical colleges have a universal Newborn Hearing screening program (NBHS) in comparison to 80% of the Speech and Hearing centers. Again 43.8% of the medical colleges who conduct NBHS program have an audiologist and majority of them work towards screening. Almost 63% of the speech and hearing centers use physiological tests like ABR, OAE or their combination to screen newborns. Both medical and speech and hearing organizations prefer that the audiologist inform and even give a written material regarding the results of the tests to the parents. Only 62.65% of the institutions refer less than 11% of their clients for further testing at the time of discharge. In 50% of the medical colleges the results of a test are reported to the parents and primary care physicians/doctors and in 37.5% of the speech and hearing centers the results are informed to the parents. Conclusions: While keeping in mind the incidence of hearing impairment in the neonatal population of India, the results of this survey warrant the need for an urgent implementation of universal neonatal hearing screening in all the health care facilities in the country, at large. [Copyright &y& Elsevier]

Globally, overall survival (OS) of older patients with AML continues to be suboptimal with very little data from India. In a multicenter registry analysis, we evaluated 712 patients with AML older than 55 years. Only 323 (45.3%) underwent further treatment, of which 239 (74%) received HMAs, and 60 (18%) received intensive chemotherapy (IC). CR was documented in 39% of those receiving IC and 42% after HMAs. Overall, 100 (31%) patients died within 60 days of diagnosis, most commonly due to progressive disease (47%) or infections (30%). After a median follow-up of 176 days, 228 (76%) of patients had discontinued treatment. At one year from diagnosis, 211 (65%) patients had died, and the median OS was 186 days (IQR, 137-234). Only 12 (3.7%) patients underwent stem cell transplantation. Survival was significantly lower for those older than 60 years (p < 0.001). Patients who died had a higher median age (p = .027) and baseline WBC counts (p = .006). Our data highlights suboptimal outcomes in older AML patients, which are evident from 55 years of age onwards, making it necessary to evaluate HMA and targeted agent combinations along with novel consolidation strategies to improve survival in this high-risk population., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Male infertility due to spermatogenesis defects affects millions of men worldwide. However, the genetic etiology of the vast majority remains unclear. The present study was undertaken to assess the association of DNAH6 and ATPase6 genes in asthenozoospermia patients in the northern region of India., Methods: A total of 60 semen samples were collected for the study, of which 30 were from the case group and 30 were from the control group. The semen samples for the case group (asthenozoospermia) and control groups were collected from IVF and Reproductive Biology Centre, Maulana Azad Medical College, New Delhi. Sperm count and motility were classified as per World Health Organization (WHO 2021) protocol. A total genomic DNA was extracted as per the stranded TRIZOL method with little modification., Results: In-vitro molecular characterizations of DNAH6 and ATPase6 genes in both groups were checked by Polymerase Chain Reaction (PCR). The 675 bp and 375 bp amplicons were amplified using PCR for ATPase6 and DNAH6 genes. Our study results showed a significant (P ≤ 0.05) null deletion of DNAH6 and ATPase6 genes in asthenozoospermia patients as compared to the control. We found the significant null deletion of DNAH6 in case 45.0%, and the control group was 11.7%. However, in the case of APTase6, it was 26.7% and 10.0%, respectively., Conclusions: Our study concluded that the presence of DHAH6 and ATPase6 genes had a significant impact on male infertility., (© 2024. The Author(s).)

Congenital Zika syndrome (CZS) is a major concern in India and highlights the multifaceted challenges posed by the Zika virus (ZIKV). The alarming increase in CZS cases in India, a condition that has serious effects on both public health and newborns, has raised concerns. This review highlights the importance of raising concern and awareness and taking preventive measures by studying the epidemiology, clinical symptoms, and potential long-term consequences of CZS. The review also contributes to worldwide research and information sharing to improve the understanding and prevention of CZS. As India deals with the changing nature of CZS, this thorough review is an important tool for policymakers, health workers, and researchers to understand what is happening now, plan for what to do in the future, and work together as a team, using medical knowledge, community involvement, and study projects to protect newborns' health and reduce the public health impact of these syndromes., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Maneesh Kumar et al.)

The isolates of Rhipicephalus microplus collected from Madhya Pradesh (MP), Punjab (PJB) and Uttar Pradesh (UP) states of India were characterized using laboratory standardized adult immersion test (AIT) against macrocyclic lactone (ivermectin), synthetic pyrethroids (cypermethrin and deltamethrin), organophosphates (coumaphos and diazinon) and phenylpyrazole compounds (fipronil). Out of the six isolates tested, five isolates except MTH were resistant to deltamethrin and cypermethrin at level II with RF ranging from 16.4 to 24.02 and 7.05 to 13.2, respectively. In case of organophosphates, coumaphos was less effective showing resistance level II (RF 8.52-11.2) in all the six populations compared with diazinon to which three isolates (MHW, RWA and AGS) were resistant at level II. Except MTH, other five isolates were categorized at level I with RF ranging from 1.53 to 3.02 against ivermectin. The phenylpyrazole compound however was found effective, and none of the isolates could survive at a discriminating concentration. The possible strategy for the management of multi-acaricide-resistant ticks in the surveyed districts was discussed in the present study.

Background: The prevalence and clinical significance of hyponatremia in cirrhotics have been well studied; however, there are limited data on hyperkalemia in cirrhotics., Aim: We evaluated the prevalence and prognostic significance of hyperkalemia in hospitalized patients with cirrhosis and developed a prognostic model incorporating potassium for prediction of liver-related death in these patients., Methods: The training derivative cohort of patients was used for development of prognostic scores (Group A, n = 1160), which were validated in a large prospective cohort of cirrhotic patients. (Group B, n = 2681) of cirrhosis., Results: Hyperkalemia was seen in 189 (14.1%) and 336 (12%) in Group A and Group B, respectively. Potassium showed a significant association that was direct with creatinine (P < 0.001) and urea (P < 0.001) and inverse with sodium (P < 0.001). Mortality was also significantly higher in patients with hyperkalemia (P = 0.0015, Hazard Ratio (HR) 1.3, 95% confidence interval 1.11-1.57). Combination of all these parameters into a single value predictor, that is, renal dysfunction index predicted mortality better than the individual components. Combining renal dysfunction index with other known prognostic markers (i.e. serum bilirubin, INR, albumin, hepatic encephalopathy, and ascites) in the "K" model predicted both short-term and long-term mortality with an excellent accuracy (Concordance-index 0.78 and 0.80 in training and validation cohorts, respectively). This was also superior to Model for End-stage Liver Disease, Model for End-stage liver disease sodium (MELDNa), and Child-Turcott-Pugh scores., Conclusions: Cirrhotics frequently have impaired potassium homeostasis, which has a prognostic significance. Serum potassium correlates directly with serum creatinine and urea and inversely with serum sodium. The model incorporating serum potassium developed from this study ("K"model) can predict death in advanced cirrhotics with an excellent accuracy., (© 2015 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)

Monitoring acaricide resistance in field ticks and use of suitable managemental practices are essential for controlling tick populations infesting animals. In the present study, the acaricide resistance status in Rhipicephalus (Boophilus) microplus ticks infesting cattle and buffaloes of five districts located in the eastern Indian state, Bihar were characterized using three data sets (AIT, Biochemical assays and gene sequences). Adult immersion test (AIT) was adopted using seven field isolates and their resistance factor (RF) was determined. Six isolates (DNP, MUZ, BEG, VSH, DRB and SUL) were found resistant to both deltamethrin and diazinon and except VSH all were resistant to cypermethrin. One isolate (PTN) was susceptible with a RF below 1.5. To understand the possible mode of resistance development, targeted enzymes and gene sequences of the para sodium channel and achetylcholinesterase 2 (AChE2) were analyzed. The esterase, monooxygenase and glutathione-S-transferase (GST) activity of reference susceptible IVRI-I line was determined as 2.47 ± 0.007 nmol/min/mg protein, 0.089 ± 0.0016 nmol/mg of protein and 0.0439 ± 0.0003 nmol/mg/min respectively, which increased significantly in the resistant field isolates. However, except esterases, the fold increase of monooxygenase (1.14-2.27 times) and GST (0.82-1.53 times) activities were not very high. A cytosine (C) to adenine (A) nucleotide substitution (CTC to ATC) at position 190 in domain II S4-5 linker region was detected only in one isolate (SUL) having RF of 34.9 and in the reference deltamethrin resistant line (IVRI-IV). However, the T2134A mutation was not detected in domain IIIS6 transmembrane segment of resistant isolates and also in reference IVRI-IV line despite of varying degree of resistance. The flumethrin specific G215T and the recently identified T170C mutations were also absent in domain II sequences under study. Four novel amino acid substitutions in AChE2 gene of field isolates and in organophosphate (OP) resistant reference IVRI-III line were identified which can possibly have a role in resistance development., (Copyright © 2015 Elsevier GmbH. All rights reserved.)

Background & Aims: Serum ferritin is a known marker of hepatic necro-inflammation and has been studied to predict 1 year mortality and post-transplant survival in decompensated cirrhotics. However, there are no studies evaluating ferritin as a predictor of early mortality. We investigated whether serum ferritin levels could predict 15 day and 30 day mortality in patients with decompensated cirrhosis., Methods: 318 patients with decompensated cirrhosis were included., Results: Patients of decompensated cirrhosis [257 males, mean age of 51 [±13]years, were followed for a median of 31 days. Serum ferritin levels were significantly different between survivors and non-survivors [p<0.001] and showed significant correlation with MELD score [p<0.001], CTP score [p<0.001], leucocyte counts [TLC] [p<0.001], serum sodium [p<0.001], ACLF grades [p=0.005], spontaneous bacterial peritonitis [SBP] [p=0.02], hepatic encephalopathy [HE] [p<0.001] and hepatorenal syndrome [HRS] [p=0.012]. Serum ferritin, etiology, MELD, HE, CTP score, sodium, TLC, and ACLF grades were significant predictors of mortality on univariate analysis. Ferritin [p=0.04, HR 1.66 95% CI (1.02-2.73)] was a significant predictor of early mortality on multivariate analysis along with HE [p=0.006, HR 3.47 95% CI (2.13-8.41)] (Model 1), TLC [p=0.02, HR 1.81 95% CI (1.06-3.07)] (Model 2), ACLF grades [p=0.018, HR 2.013,95% CI (1.126-3.60)], and CTP score [p<0.0001, HR 1.36 95% CI (1.17-1.59)] (Model 3)., Conclusion: Serum ferritin levels correlate with severity of hepatic decompensation and are associated with early liver related death independent of the MELD score in hospitalized patients with decompensated cirrhosis. This could also have a potential therapeutic implication., (Copyright © 2014 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.)

von Willebrand factor (vWF) gene promoter polymorphism at nucleotide positions -2659 and -2525 influences corticosteroid-mediated increase in vWF level and possibly hypercoagulability of the blood. This study was undertaken to correlate plasma vWF levels with plasma cortisol and single nucleotide polymorphisms (SNPs) at positions -2659 and -2525 in Cushing syndrome patients in India. Samples from 22 endogenous and 28 exogenous Cushing syndrome patients and 50 normal volunteers were analyzed to determine vWF level and SNPs. vWF level was raised in 40.91% of endogenous and 14.29% of exogenous Cushing syndrome patients. A positive correlation was seen between plasma cortisol and vWF level (P = 0.01) with 1 μg/ml rise of plasma cortisol causing a 2.52 IU/dl increase in vWF level. Allele frequency of SNPs -2659A, -2659G, -2525A and -2525G was 0.78, 0.22, 0.84 and 0.16, respectively, making cosegregation of -2659A and -2525A the most frequent in our population. Haplotype 1 (-2659A, -2525G) was most frequently associated with higher level of vWF. Patients with haplotype 2 (-2659G, -2525A) had normal vWF. vWF promoter polymorphisms influence corticosteroid-mediated increase in vWF especially in patients with haplotype 1.

Objective: To identify the perception of the train passengers about the cause and the management of hearing loss., Methodology: A total of 115 passengers, 90 males and 25 females, in the age range of 13-80 years (mean: 39.19, standard deviation: 15.4) years., Results: From the survey, it is found that most of the participants (82.6%) had seen a person with hearing loss. Among them, 10 reported to have relatives who have hearing loss but did not know where they should be taken for remedy. Seventeen individuals (all geriatric) were suspected to be having reduced hearing acuity during the survey. However, none of them admitted to be having a significant disability due to hearing loss. Also 48% of the participants correctly attribute hearing loss to biological and environmental causes (genetic, congenital and noise induced causes) and three percent of them attributed it to myth revealing that most of the participants had awareness about what could cause hearing impairment. Regarding management, most of the participants (25.2%) agreed to medical treatment as the best, followed by hearing aids (23.5%). There were no myths related to management. Five of the participants interviewed, were already undergoing medical treatments from various medical institutions for their hearing impairment, but reported to have no benefit from the treatment. Among the participants who answered yes to question 4, most of them recognized Speech Language Pathologists as professionals who could manage speech difficulties but mostly attributed management of hearing impairment to an Ear Nose and Throat (ENT) specialist., Conclusions: An awareness pamphlet targeting the myths can be distributed on train, role of an audiologist as a hearing professional can also be targeted in the pamphlets, language used in the advertisements and pamphlets should be culture and region specific, pictorial representation could be a better idea, the need for a healthy and comfortable communication has to be explained especially to the adults and geriatric population and the elderly persons must have both, the skills and the motivation to communicate in the external environment which must be conducive for communication., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

Acinetobacter infections are fast emerging as a major nosocomial threat across the globe. With a predilection for blood stream infections in critically ill, immunocompromised patients, their presence is now being felt in febrile neutropenics with underlying malignancies and marrow failure. We aimed through this study to ascertain the current circulating pathogens and levels of antimicrobial resistance in blood stream infections in febrile neutropenia patients, with specific emphasis on elucidating acinetobacter and pseudomonas infections. Clinical and laboratory records of all consecutive neutropenic patients with underlying haematological malignancies and marrow failure, admitted to our AIIMS, New Delhi from April 2009 to March 2010 were analysed for blood stream infections, pathogen profiles and antimicrobial resistance. All clinical and microbiological variables were statistically analysed to elucidate potential risk factors, infection patterns and drug resistance trends. Of the 1,165 blood cultures investigated, 105 episodes of blood stream infections were microbiologically confirmed in febrile neutropenia patients. Gram-negative infections (n = 78, 72.9%) dominated with acinetobacter spp (n = 20, 18.7%) emerging as the most common pathogen. Acinetobacter and pseudomonas together were responsible for 42.9% of all blood stream infections. Both acinetobacter and pseudomonas displayed very high resistance to all five major classes of antibiotics, including multidrug resistance (90.0% and 76.9%) and ESBL production (90.0% and 84.6%), respectively. Comparison of infection patterns and resistance levels with reports over the past decade from this centre and other centres across the globe, revealed a striking increase in multidrug resistant acinetobacter blood stream infections in these patients. Multidrug resistant acinetobacter Infections are a fast emerging threat in febrile neutropenia patients and at this centre in general. Similar early trends from some Indian centres and neighbouring developing countries suggest grave concern. These emerging circulating pathogens and drug resistance patterns demand to systematically evaluate antibiotic and hospital infection policies and to sensitise all clinicians to curb this pathogen capable of rapid nosocomial spread.

Objective: To assess the treatment and outcome of children with acute myeloid leukemia. The Primary objectives were to assess remission rates, treatment related toxicity and disease free survival. Secondary objective was to assess prognostic factors associated with poor outcome., Methods: A retrospective analysis of all treated patients with acute myeloid leukemia, less than 18 year of age from Sept 2005 to Aug 2009 was done. Clinical laboratory, treatment and follow up records retrieved to calculate remission rate, treatment related toxicity, disease free survival and poor prognostic factors., Results: This analysis included thirty five patients (male : female; 23:12), twenty seven (77.1%) achieved remission after one 3 + 7 induction and seven required two inductions. High dose cytosine arabinoside consolidation was given in thirty one patients while one underwent allogenic stem cell transplantation. Two patients died during chemotherapy (TRM- 5.7%), two did not complete the therapy, seventeen relapsed (48.5%) with 80% of relapses occurring within first year of remission and no relapse occurred after 2 years. Fourteen patients are in remission (40%, follow up 5-54 months) and cumulative median disease free survival is of 13 months., Conclusions: The present data suggests that 3 + 7 induction, followed by high dose cytarabine consolidation has low treatment related toxicity and resource utilization; however, relapse free survival is inferior to more intensive regimens, highlighting the need to intensify chemotherapy regimen once the treatment related mortality has been minimized.