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Background: Health care workers (HCWs) are at risk of acquiring tuberculosis (TB) infection and disease due to occupational exposure. But there are no national guidelines on routine screening for TB (active case finding (ACF)) among HCWs and understand its implementation and feasibility. Methods: This study was conducted among HCWs in a teaching hospital in India. We used symptom screening to identify those with presumptive TB and were further evaluated for diagnosis of TB. Results: A total of 1,001 HCWs were screened over a period of 18 months. In our study, 51 (5.1%) HCWs were found to have presumptive TB and on further evaluation, 5 (0.5%) of these patients were diagnosed with active TB. The number needed to screen (NNS) for one active TB among the HCWs was 200. Alcohol use was significantly associated with both presumptive TB (P = 0.037) and active TB (P = 0.035) among HCWs, and exposure to active TB patients (P = 0.014) in the family and workplace and increased frequency of exposures (P = <0.001) were associated with presumptive TB. Conclusion: ACF for TB among HCWs had a good yield in our study. ACF utilizing routine national TB program guidelines is feasible to be implemented among HCWs to aid in the early diagnosis and treatment of TB in this high-risk group. [ABSTRACT FROM AUTHOR]

Following the line of approach enumerated in the tsunami toolkit of Chagué-Goff et al. (2011), 'Expanding the proxy toolkit to help identify past events - Lessons from the 2004 Indian Ocean Tsunami and the 2009 South Pacific Tsunami, Earth Sci. Rev. 107 (1–2), 107–122', measurements of elemental and mineral magnetic properties coupled with textural parameters have been used to evaluate the 2004 Indian Ocean Tsunami (IOT) induced sediments on the Muttukadu backwaters, East Coast of India. To investigate the sediment provenance, specific Fe, Mn and Pb elemental concentrations were measured in surface sediments and compared with the previously published pre-tsunami database of backwater/inner continental shelf sediments. We found the enrichment of Fe and Pb, against depletion of Mn concentration in present tsunami sediments as compared with pre-tsunami Muttukadu sediments, reflecting the variation of the sediment source area. However, the present data of Fe and Pb enrichment and Mn depletion correlates well with continental shelf sediments hinting at sedimentary routes, processes of erosion and wave propagation. The studied tsunami deposits are characterized by dominant ∼40–85% coarse sand fractions and higher proportion of detrital low and high coercivity Fe-Ti oxides, such as magnetite, titanomagnetite and hematite, reflected by magnetic concentration (magnetic susceptibility (χ), anhysteretic remanent magnetization (ARM)) and coercivity-dependent parameters (soft isothermal remanent magnetization (Soft IRM), Hard IRM, magnetomineralogical S-Ratio and saturation IRM (SIRM)). So, it can be shown that the random spatial variability and the inverse relationship between magnetic concentration χ, ARM and SIRM parameters and grain-size ARM/χ, SIRM/χ and ARM/SIRM ratios as diagnostic criteria for the tsunami impacted the distribution of magnetic parameters in coastal backwater environments. Contrasting mineral magnetic and geochemical properties together with more sand (mean 65%) when compared with silt (mean 25%) content in tsunami sediments indicates that the area was affected by high-energy tsunami waves. The study validates environmental magnetism as a proxy, which is fast and robust for identifying the tsunami or palaeotsunami deposits. [ABSTRACT FROM AUTHOR]

Heavy rainfall triggered landslides are on the rise along the Western Ghats making it a matter of priority to identify landslide-prone areas well in advance. The present effort is aimed at identifying landslide susceptible villages (LSV) around the Kalsubai region of Deccan volcanic province (DVP), Maharashtra, India from 8 weighted landslide parameters- rainfall, slope, lithology, land use and land cover (LULC), soil properties, relative relief, aspect and lineament. These parameters were combined with advanced remote sensing (RS) data and processed in geographical information system (GIS) as well as in image processing software, which are an integral part of geospatial techniques. Out of the total 59 villages, the study identified 9 villages are situated in very high, 13 in high, 12 in moderate, 11 in low and 14 in very low risk zones. Our data reveals incessant heavy rains and steep slopes are the dominant factors in triggering landslides, exacerbated by anthropogenic activity prevalent in the study area. The spatial and non-spatial database created will help to take effective steps in preventing and/or mitigating landslide disasters in the study area. The methodology can be applied to identify other landslide prone areas in a cost effective way. [ABSTRACT FROM AUTHOR]

Purpose: The use of all- trans -retinoic acid (ATRA) and arsenic trioxide (ATO) in the treatment of low- and intermediate-risk acute promyelocytic leukemia (APL) is the standard of care. We report the combined use of ATRA, ATO, and daunorubicin (DNR) in patients newly diagnosed with high-risk APL. The primary focus was to describe the drug dosage modifications made in the real-world scenario., Methods: In this descriptive study, we included 16 out of 28 patients with high-risk APL from two tertiary care centers in South India (Vijayawada and Trichy) between January 2015 and December 2018. A unique approach of initiating ATRA at a dose of 25 mg/m 2 on day 1 and escalation to 45 mg/m 2 after cytoreduction with DNR and hydroxyurea was followed in all patients to avert differentiation syndrome, in the setting of hyperleukocytosis at presentation., Results: All patients who survived the first 3 days of admission achieved complete remission after a median duration of 29 days. There were no deaths during induction or consolidation, and the regimen was well tolerated; two patients developed grade 3/4 peripheral neuropathy requiring treatment modification. After a median follow-up duration of 1.9 years, there were no hematologic or molecular relapses., Conclusion: The study sheds light on the modifications made to recommended dosages of ATRA, ATO, and DNR to optimize outcomes in high-risk APL and reaffirms the importance of ATO use in the front-line setting to achieve durable responses with minimal toxicity., Competing Interests: Conflicts of Interest Statement:

Introduction: Guillain-Barré syndrome (GBS) is a fulminant polyradiculoneuropathy that is acute, frequently severe and autoimmune in nature. Etiology of GBS is incompletely understood, prognosis is usually good with early detection and prompt treatment. This retrospective study was done to evaluate clinical profile, epidemiological, laboratory, and electrodiagnostic features of patients with GBS and mode of management, complications and prognostic factors., Methods: Data of 1,166 patients admitted with GBS or presented to outpatient department (previous medical records) with GBS between January 2003 and January 2014 were analyzed., Results: No difference in genders noted. Around 35% of patients are above 50 years of age. Poor control of diabetes with mean HbA1c of 8.1 ± 2.11 is found on analysis. Seasonal occurrence in GBS is prominent in winter 484 (41.50%) and mechanically ventilated were 449 (38.50%) patients. 48 (4.11%) deaths were attributed to GBS. Neurological analysis revealed cranial nerve involvement in 407 (34.90%) patients, facial palsy in 401 (34.39%) and ataxia in 88 (7.54%) patients. Most patients in plasma exchange group belonged to the lower socio-economic status. Mean cerebrospinal fluid (CSF) protein levels was (n=962) 113.8 ± 11.8 mg/dl. Conduction block determined indirectly by absent H-reflex was noted in 891 (90.64%) patients. No difference in complications and outcome is found in treatment regimens of intravenous immunoglobulin (IVIG) and plasma exchange., Conclusion: Seasonal occurrence predominantly in winter is noted. Peak flow test may be a predictor of assessing requirement of mechanical ventilation and prognosis. Conduction block is the major abnormality noted in electrophysiological studies and proximal nerve segment assessing with Erb's point stimulation has high predictive value. IVIG treatment is more expensive but is associated with less duration of hospital stay.