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[Display omitted] There is a significant need for alternative fuels as a result of increased fuel usage and resource depletion. Esters made from vegetable oils, waste cooking oil and bio alcohols are majorly used in IC engines as a substitute. Coconut oil (Co) and sunflower oil (Su), which have sufficient productivity in India, biodiesel synthesized from karanja oil. In this study, fossil diesel (D) was mixed with karanja biodiesel (B), neat coconut oil and sunflower oil along with ethanol (Et), propanol (Pr) and n-butanol (Bu) alcohols was used. Quinary fuel blends of DB, DBCoSuEt, DBCoSuPr and DBCoSuBu were prepared. The physio-chemical properties of blends were tested and performance and emission tests were carried out on a single cylinder four stroke diesel engine. The results indicate that DBCoSuPr fuel combination increases brake thermal efficiency by 9.2% and DBCoSuEt fuel decreases HC and CO emissions by 37.2% and 53.93% respectively. [ABSTRACT FROM AUTHOR]

The long arcuate Singhbhum Shear Zone (SSZ) of around 160 km length having roughly an E-W trend hosts many uranium deposits and working uranium mines viz., Mohuldih, Bandhuhurang, Turamdih, Narwapahar, Bhatin, Jaduguda and Bagjata from west to east in addition to Cu deposits viz., Rakha, Mosabani etc. REE is well known from Kanyaluka area. Recent sub-surface exploration for uranium by AMD unravelled occurrence of thorite (ThSiO4)-bearing bands in a number of locations in western, central and eastern sectors of uranium mineralisation in SSZ, spanning over the entire shear zone. Thorite is observed in various host rocks involving metapelites of Dhanjori and Singhbhum Group and also in the Soda Granite/ feldspathic schist unit emplaced along the shear zone at the contact between the two groups. The individual lithounits that host thorite-bearing bands are restricted along the Singhbhum Shear Zone and include feldspathic schists (possible derivative of Soda Granite), albite veins, quartz-chlorite schists, quartz-biotite schists and sericite/muscovite-quartz schists. The thorite bearing zones transgresses lithology, stratigraphy as well as uraniferous zones along the shear zone evidently placing them as epigenetic hydrothermal mineralisation possibly later to major uranium metallogeny. Thorite occurs as discrete, rounded as well as subhedral to euhedral grains in various metapelites. They also form veins of their own besides occurring as phases within veins of albite and magnetite-apatite along the shear zone. Such multiple modes of occurrence and varied associated mineralogy suggest hitherto unknown thorium related hydrothermal mineralisation in SSZ. Presence of secondary thorium phases such as brockite (Ca-Thphosphate) as well as post tectonic vein-type occurrence, points towards the mobility of thorium under a hydrothermal regime as well. However, present study thus, for the first time, establish the occurrence of thorite along with REE-Th minerals showing definite evidences of thorium mobilisation in several sectors of the well know U-Cu province of Singhbhum Shear Zone. Thorium-REE mobility is a widely understudied domain and the present findings place the SSZ as an ideal ground for exploring the concept with more understanding of this metal. [ABSTRACT FROM AUTHOR]

Background: Bovine tropical theileriosis (BTT) is a haemoprotozoan tick-borne disease that implicates huge losses to livestock in terms of considerable mortality and morbidity in tropical and subtropical regions of the globe. Currently available diagnostic methods have less specificity and sensitivity towards the detection of Theileria species. Therefore, an attempt was made to diagnose Theileria annulata by targeting a multi-copy gene, viz. mitochondrially encoded cytochrome b (MT-CYB) gene via polymerase chain reaction (PCR) in different agro-zones of India. Methods and Results: 129 cattle blood samples were collected from major livestock rearing regions of India and processed for both molecular and microscopic techniques. Screening of Giemsa-stained thin blood smears was able to detect 14 samples (10.85%) as positive for T. annulata. However, the MT-CYB gene-based PCR assay detected 107 samples (82.94%) positive for T. annulata out of 129 samples. Furthermore, the MT-CYB gene-based PCR assay was standardized in terms of its sensitivity and specificity. Specificity of PCR assay was evaluated against other common haemoprotozoan parasites of tropical countries viz. Babesia bigemina, Anaplasma marginale and Trypanosoma evansi. The multi-copy MT-CYB gene-based PCR assay provided an optimum level of sensitivity (up to the level of 10 femtogram) and high specificity. Haematological examination (Hb, PCV and TLC) of 113 samples revealed significantly (p < 0.05) decreased Hb and PCV levels in positive animals in comparison with the control group of healthy animals. However, the control group had significantly higher (p < 0.001) TLC levels than the positive group. Conclusion: The MT-CYB gene-based PCR assay was found to be highly sensitive that can accurately detect the occurrence of T. annulata infection in carrier animals which are potential infection sources to healthier populations in naive demographic locations through infected ticks. [ABSTRACT FROM AUTHOR]

The present study investigated the incidence of tropical theileriosis in cattle caused by Theileria annulata in the central and southern parts of Chhattisgarh State, India. One hundred fifty-nine blood samples were collected randomly from apparently healthy indigenous and crossbred cattle and subjected to microscopy and cytochrome b (Cyto b) based PCR analysis. The overall incidence of tropical theileriosis in Chhattisgarh was found to be 37.1% and 56.6% by microscopy and PCR assay, respectively. The prevalence was higher in the Central region (37.61% and 60.55% by microscopy and PCR, respectively), compared to the Southern region of Chhattisgarh (36% and 48%, respectively, by microscopy and PCR). [ABSTRACT FROM AUTHOR]

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The application of hydro geochemical exploration for sub-surface uranium mineralization is becoming significant due to the geochemical properties of uranium. The oxygen in natural water enhances the mobility of uranium by the complexing action of carbonates and bicarbonates with oxidized uranyl ions. The uranium and its decay products (i.e., radium group) can be used as good tracers for pinpointing uranium mineralization. The basement complex in the south of Cuddapah basin comprises granite, gneiss-migmatites and patches of greenstone belts. There are different generation of fractures and mafic dykes trending E–W, N S, NW-SE and NE–SW directions. The NNE–SSW to NE–SW trending fractures are youngest and often show higher uranium values in water along the same trend indicating possible mineralization. The fractures are often intruded by younger basic intrusive rocks and quartz reefs which often show high uranium content. Several NE–SW to NNE–SSW trending fracture zones with uranium mineralization are observed in the areas around Shivaramapuram-Nutankalva, Kamaguttapalle and T. Sundupalle villages. These sympathetic fracture zones are important for further sub-surface exploration. The present focus is given on a NE-SW fracture zone along Sivaramapuram–Nutanakalva tract extends over a strike length of ~15 km with a plan width of ~1 to 1.5 km. The tract is mostly soil covered and rock outcrops are scanty. Radioactive anomalies are located at small outcrops in fractured basic dyke, fractured and altered granite, deformed quartz vein, sludge samples collected from private village drilling sites, Pincha river channel sands and soils (U 3 O 8 values up to 0.19% (β/γ); n = 44;). Hydrogeochemical exploration along this fracture zone has indicated anomalous concentration of uranium in water samples ranging from 100 to 19,434 ppb U (n = 110). Selective borewells have been monitored for 8 months to check the seasonal variation. The data remain persistent and indicated encouraging outcome. This NE–SW fracture zone has affected the Nagari quartzite of Cuddapah Supergroup, thus indicate Post Nallamalai Mesoproterozoic Grenville orogeny, which is metallogenically favourable epoch for fracture controlled uranium mineralization. The surface anomalies vis-a-vis the hydro uranium anomalies and suitable geochemical condition along the NE-SW trending fracture make this zone a potential target for further sub-surface exploration. • The application of hydro geochemical exploration for sub-surface uranium mineralization is the topic of the paper. • the study area is mainly a granitoid province where a soil covered concealed fracture controlled uranium mineralization is being reported. • NE-SW trending fracture zone showed upto 19434 ppb uranium content in water. • Radioactive anomalies are located at small outcrops exposed near Sivarampuram in fractured basic dyke [0.13 and 0.19% U 3 O 8 (β/γ; n =2)] and Katramuduku in fractured granite [0.014 to 0.135% U 3 O 8 (β/γ); n =3]. • These surface anomalies vis-a-vis the hydro uranium anomalies and suitable geochemical condition along the NE-SW trending fracture make this zone a potential target for further sub-surface exploration. [ABSTRACT FROM AUTHOR]

• A generation of uranium mineralisation in Singhbhum Shear Zone, is co-genetic with chlorite. • Uranium mineralization precipitated from Fe, Mg and Ti rich hydrothermal fluid. • The uranium precipitated within a temperature window of 312 °C–355 °C. • The mineral chemistry of syn -uranium chlorites bears a similarity across the world. • Chlorite's texture, mineral chemistry and geothermometry act as a useful reconnoitre tool for uranium exploration. The Singhbhum Shear Zone (SSZ) in eastern India is one of the major uranium repositories of the country. Some of the important uranium deposits viz., Bagjata, Jaduguda, Bhatin, Narwapahar and Banadungri-Singridungri are juxtaposed in the central part of SSZ. The uranium mineralization in central SSZ is mainly hosted by tourmaline-apatite-magnetite bearing sericite quartz chlorite schist with uraninite being the main radioactive mineral phase. A close spatial relationship exists between uraniferous minerals and chlorite occurrences in central SSZ. Three different types of chlorite assemblages were recognized and their relationship with uranium mineralization was studied in detail to unravel the physico-chemical conditions for precipitation of uranium vis-a-vis chlorite geothermometry and constrains on the chlorite chemistry. Detailed petrographic studies and mineral chemical studies of the host rocks indicate three distinct chlorite type viz. (1) metamorphic chlorite, forming a typical metamorphic assemblage with quartz, muscovite, sericite, biotite and K-feldspar, (2) hydrothermal alteration product of biotite and (3) hydrothermal vein chlorite. The three chlorite types were characterized based on: (1) the range of X Fe and AlIV, (2) correlation between Si (apfu) and X Fe and (3) compositional diagram between X Fe vs. AlIV. Based on the mineral chemistry and thermometry of chlorite 3, the co-genetic uranium mineralization has been suggested to be precipitated from a hydrothermal fluid rich in Fe, Mg and Ti in a reducing environment within a temperature window of about 312 °C–355 °C. A fluid mixing model for the remobilization and reconstitution of this hydrothermal uranium mineralization vis-a-vis chlorite occurrence is postulated and its geothermometry suggest an epithermal mineralization in the study area. A comparative study of chlorites from four important uranium provinces of the world i.e. Jabiluka of Australia, Rozna of Czech Republic, Beaverlodge of Canada and central SSZ of India reveals a similarity in the mineral chemistry of the chlorites associated with uranium mineralization. Thus, textural study of chlorites corroborated with their mineral chemistry and geothermometry is a useful reconnoitre tool for uranium exploration. [ABSTRACT FROM AUTHOR]

Aims: Characteristics of diabetes-related foot ulcers (DFU), association with recurrence and amputation are poorly described in the Asian Indian population., Methods: A prospectively maintained database was reviewed to characterize DFU and its association with amputation and recurrence., Results: Of 200 patients, 63.5 % were male, the median age was 62 years (Min-Max:40-86), and median BMI was 27.90 kg/m 2 (Min-Max:18.5-42.7). Median duration of Diabetes mellitus was 15 years (Min-Max:2-43). Complete healing occurred at a median of three months (Min-Max:0.23-37.62). Amputation for the current ulcer was required in 43.4 % of individuals. Ulcer recurrence was documented in 42.4 % instances, 66.1 % evolving on the ipsilateral side. Previous amputation was associated with the risk of subsequent amputation (Adjusted OR-3.08,p-0.047). Median time to ulcer recurrence was 4.23 years among those with amputation, in contrast to 9.61 years in those with healing. Cardiovascular death was the commonest cause of mortality, followed by sepsis. At a median follow up of 6.08 years, mortality at 1,3,5 and 10 years was 2.5 %,2.5 %,8.2 % and 30.9 % respectively among those who underwent amputation versus 0 %,0 %,10.1 % and 24.5 % respectively for those who achieved healing., Conclusions: Patients with DFU in India incur amputations at rates higher than conventionally described. With previous amputation, subsequent amputation risk triples. Ten-year mortality is 25%-30 %. Underestimates of the burden of recurrence and mortality are consequential of limited follow-up., 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 Research Trust of DiabetesIndia (DiabetesIndia) and National Diabetes Obesity and Cholesterol Foundation (N-DOC). Published by Elsevier Ltd. All rights reserved.)

Theileria orientalis is known to cause a benign infection in cattle and buffalo (Bubalus bubalis). However, the Ikeda and Chitose genotypes of the parasite cause lethal disease in beef and dairy cattle. Recently an outbreak of clinical oriental theileriosis occurred in buffalo calves in a Government Animal Husbandry and Agricultural Farm located in Uttar Pradesh, India. Examination of Giemsa stained thin blood smears revealed typical rod-shaped T. orientalis piroplasms in the erythrocytes. The clinical signs included pyrexia, nasal discharge, lacrimation, lethargy, inappetence and anaemia with varying degrees of paleness of the visible mucous membranes. Vascular congestion in internal organs, pulmonary emphysema and consolidation of lungs, focal areas of necrosis in the heart with mononuclear cell infiltration, focal mononuclear cell aggregation in the cortex and tubular degeneration of the kidney were significant necropsy findings. The T. orientalis major piroplasm surface protein (MPSP) gene was amplified by polymerase chain reaction (PCR) using specific primers. The nucleotide sequence analysis of the PCR product revealed 84.8% identity between the T. orientalis Uttar Pradesh isolate and other reference genotypes available in the public domain. Furthermore, the phylogenetic analysis of the MPSP gene sequence ratified that this is a new genotype of T. orientalis. This is the first report of a clinical outbreak of oriental theileriosis in Indian buffalo calves caused by a novel genotype of T. orientalis., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests., (Copyright © 2022 The Author(s). Published by Elsevier GmbH.. All rights reserved.)

Background & Objectives: The delay in communicating the results to tuberculosis (TB) patients leads to increased rates of initial loss to follow up of treatment. The gap in communication among healthcare providers requires application of new tools that will address the challenges. Mobile phone technologies could be a useful tool in this context for the delivery of information. The objective was thus to evaluate communication by mobile applications such as the WhatsApp Messenger to decrease initial loss to follow up after initial treatment for TB., Methods: Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India undertook a community prevalence survey to find the burden of TB. During this survey, mobile phone-based technology (WhatsApp messenger) was employed as an intervention among the healthcare providers and researchers involved for communicating. This was further evaluated for its usefulness by examining the initial loss to follow up and patients initiated on treatment., Results: The study covered four blocks of Thiruvallur district of Tamil Nadu, South India, namely Kadambathur, Poondi, Thiruvalangadu and Periyapalayam. The survey population was around 20,000 from each block, and the average patients diagnosed by community TB prevalence survey were 30 patients from each block. Among the patients diagnosed through this survey, in the first block, only 55 per cent were initiated on treatment; subsequently, with the intervention, the initial loss to follow up was significantly reduced from 45 to zero per cent., Interpretation & Conclusions: After integrating of WhatsApp messenger application for communication among healthcare providers and researchers, the initial loss to follow up among patients being treated for TB was significantly decreased.

Background: The National Tuberculosis Elimination Programme (NTEP) of India is aiming to eliminate TB by 2025. The programme has increased its services and resources to strengthen the accurate and early detection of TB. It is important to estimate the cost of TB diagnosis in India considering the advancement and implementation of new diagnostic tools under the NTEP. The objective of this study was to estimate the unit costs of providing TB diagnostic services at different levels of public health facilities with different algorithms implemented under the NTEP in Chennai, Tamil Nadu, South India., Methods: This costing study was conducted from the perspective of the health system. This study used only secondary data and information that were available in the public domain. Data were collected with the approval of health authorities. The patient's diagnostic path from the point of registration until the final diagnosis was considered in the costing exercise. The unit costs of different diagnostic tools used in the NTEP implemented by Chennai Corporation were calculated., Results: We estimated the unit cost of the eight laboratory tests (Ziehl-Neelsen [ZN], fluorescence microscopy [FM], x-ray, digital x-ray, gene Xpert MTB/RIF (cartridge-based nucleic acid amplification test [NAAT] that identifies rifampicin resistant Mycobacterium Tuberculosis) Mycobacterium Tuberculosis/Rifampicin [MTB/RIF], mycobacteria growth indicator tube [MGIT], line probe assay [LPA] and Lowenstein Jensen [LJ] culture) for diagnosis of drug-sensitive and drug-resistant TB. The unit costs included fixed and variable costs for smear examination by ZN microscopy (₹ [Indian Rupee] 326 [US${\$}$4.72], FM (₹104 [US${\$}$1.5]), x-ray (₹218 [US${\$}$3.15]), digital X-ray (₹281 [US${\$}$4.07]), gene Xpert MTB/RIF (₹1137 [US${\$}$16.47]), MGIT (₹7038 [US${\$}$102]), LPA (₹6448 [US${\$}$93.44]) and LJ culture (₹4850 [US${\$}$70.28]). Out of 10 diagnostic algorithms used for TB diagnosis, algorithms using only smear microscopy had the lowest cost, followed by smear microscopy with x-ray for drug-sensitive TB (₹104 [US${\$}$1.5] to ₹544 [US${\$}$7.88]). Diagnostic algorithms for drug-resistant TB involving LPA and gene Xpert MTB/RIF were the most expensive., Conclusions: Understanding the various costs contributing to TB diagnosis in India provides crucial evidence for policymakers, programme managers and researchers to optimise programme spending and efficiently use resources., (© The Author(s) 2021. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

Background: To measure and compare economic burden at the household level for tuberculosis (TB) patients who were detected through active case finding (ACF) and passive case finding (PCF) in rural areas., Methods: This study was conducted in the Thiruvallur district from October 2016 to March 2018. TB patients diagnosed through ACF were included in this study. For the comparison, patients diagnosed through ACF were recruited in the ratio of 1:2 from the same study area during the same period. Costs between the groups were compared and a multiple regression model was used to identify factors associated with catastrophic costs due to TB., Results: Of the 336 individuals, 110 were diagnosed through ACF and 226 through PCF. A total of 29% of patients diagnosed through PCF and 9% of patients diagnosed through ACF experienced catastrophic costs due to TB. The multiple logistic model shows that catastrophic costs due to TB had a significant association with higher income status (adjusted odds ratio [aOR] 4.91 [confidence interval {CI} 2.39 to 10.08]; p<0.001), alcohol use (aOR 2.78 [CI 1.33 to 5.81]; p=0.007), private as a first point of care (aOR 3.91 [CI 2.01 to 7.60]; p<0.001) and PCF (aOR 3.68 [CI 1.62 to 8.33]; p=0.002)., Conclusions: Findings highlight that ACF significantly averted catastrophic costs due to TB among patients. ACF as a strategy could ensure financial protection of TB patients and limit their risk of poverty., (© The Author(s) 2019. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Importance: The high household costs associated with tuberculosis (TB) diagnosis and treatment can create barriers to access and adherence, highlighting the urgency of achieving the World Health Organization's End TB Strategy target that no TB-affected households should face catastrophic costs by 2020., Objective: To estimate the occurrence of catastrophic costs associated with TB diagnosis and treatment and to identify socioeconomic indicators associated with catastrophic costs in a setting where TB control strategies have been implemented effectively., Design, Setting, and Participants: In this cross-sectional study, 455 patients with TB in the Chennai metropolitan area of South India who were treated under the TB control program between February 2017 and March 2018 were interviewed. Patients were interviewed by trained field investigators at 3 time points: at the initiation of treatment, at the end of the intensive phase of treatment, and at the end of the continuation phase of treatment. A precoded interview schedule was used to collect information on demographic, socioeconomic, and clinical characteristics and direct medical, direct nonmedical, and indirect costs. Data analysis was performed from August 2018 to November 2019., Main Outcomes and Measures: Direct, indirect, and total costs to patients with TB. Catastrophic costs associated with TB were defined as costs exceeding 20% of the household's annual income. A binary response model was used to determine the factors that were significantly associated with catastrophic costs., Results: Of 455 patients with TB interviewed, 205 (53%) were aged 19 to 45 years (mean [SD] age, 38.4 [16.0] years), 128 (33%) were female, 72 (19%) were illiterate, 126 (33%) were employed, and 186 (48%) had a single earning member in the family (percentages are based on the 384 patients who were interviewed through the end of the continuation phase of treatment). Sixty-one percent of patients (234 patients) had pulmonary smear positive TB. The proportion of patients with catastrophic costs was 31%. Indirect costs contributed more toward catastrophic cost than did direct costs. Multivariate logistic regression analysis found that unemployment (adjusted odds ratio, 0.2; 95% CI, 0.1-0.5; P < .001) and higher annual household income (Rs 1-200 000, adjusted odds ratio, 0.4; 95% CI, 0.2-0.7; P = .004; Rs >200 000, adjusted odds ratio, 0.2; 95% CI, 0.1-0.5; P < .001) were associated with a decreased likelihood of experiencing catastrophic costs., Conclusions and Relevance: Despite the implementation of free diagnostic and treatment services under a national TB control program, TB-affected households had a high risk of catastrophic costs and further impoverishment. There is an urgent demand to provide additional financial protection for patients with TB.

Aims: Stage 0 Acute Charcot's Neuroarthropathy (ACN)in Type 2 Diabetes patients is a challenging diagnosis with subtle clinical features and normal appearing plain radiographs of the affected foot. Delay in diagnosis can lead to progression of disease and irreversible deformities. There is a paucity of data on Stage 0 ACN from India. The aim of this study was to assess clinical and radiological characteristics and treatment outcomes in Indian Type 2 Diabetes patients with Stage 0 ACN., Materials and Methods: A comparative, case-control study was carried out amongst patients attending the Integrated Diabetes Foot Clinic at a tertiary care South Indian hospital. During the 3-year study period, a total of 1811 patients with Type 2 Diabetes Mellitus were screened. Of these, n = 10 patients with stage 0 ACN Charcot's arthropathy were identified based on clinical features and MRI imaging of the foot for confirmation of diagnosis. These were compared with an age and duration of diabetes-matched group of n = 50 patients without ACN as controls., Results: Our study identified 10 patients (0.5%) with Stage 0 Acute charcot neuroarthropathy (ACN) in the study population. Those with ACN had higher BMI, poorer glycaemic control and greater degree of peripheral neuropathy (p < 0.05). Clinically relative lack of pain and infrared thermometric temperature difference >2 °C in the affected foot were the most significant findings, while MRI foot was useful in early detection of active and severe stage 0 disease. Total contact cast was the preferred initial offloading modality, with delay in initiating complete immobilization leading to worse outcomes., Conclusions: This is the first study to highlight the characteristic features of Stage 0 ACN in Indian Type 2 Diabetes patients. Thorough clinical evaluation, infrared thermometry and radiological findigs on MRI foot leads to early disease detection. Complete offloading, preferably with total contact casts can prevent disease progression and chronic deformities., (Copyright © 2019 Diabetes India. Published by Elsevier Ltd. All rights reserved.)

Toxoplasmosis, caused by Toxoplasma gondii, is an important food borne zoonosis worldwide. Although goat meat constitutes an important dietary protein source, improperly cooked meat is a potential source of infection to humans. Data on prevalence of toxoplasma in goat is scanty from India. Serological detection is the practical option for prevalence studies on T. gondii, as no biological stage of the parasite is present in the clinical materials from the intermediate hosts. The present study was undertaken in the Jharkhand state of India which is largely inhabited by economically weaker aborigine population, who depend largely on animal husbandry for livelihood. A total of 445 serum samples were collected for testing, which represented goats under intensive and free range system of rearing. T. gondii specific IgG antibodies were detected in 42.47% (n = 189) samples by rSAG1 based indirect ELISA. The seroprevalence data were analyzed in respect of age, sex, breed of the goats and altitude of the study area as well as rearing conditions of the animals to establish correlation, if any. Though age and sex of the animals had a direct correlation with infection, the same could not be established with the other factors. The sensitivity and specificity of the diagnostic ELISA were compared with IFAT, as well as with a commercially available ELISA kit. The rSAG1-ELISA had 92.66% sensitivity and 90.67% specificity with a positive predictive value of 86.77% and negative predictive value 94.92% when compared with IFAT, whereas when compared with the commercial ELISA kit, 87.50% sensitivity and 90.91% specificity with a positive predictive value of 91.30% and negative predictive value 86.96% were observed. Inter rater agreement (kappa) was calculated. rSAG1-ELISA showed good agreement with IFAT (kappa = 0.824) and commercially available ELISA Kit (kappa = 0.783). Receiver Operating Characteristics (ROC) curve analysis, revealed a larger area under curve (AUC) of 0.99 (95%CI, 0.97-1.0) when compared with IFAT as gold standard and a highest relative sensitivity 91.30 (95% CI 72-98.3) and specificity 1.0 (95% CI 85.2-100) for the cut off value of 0.6005. The present study revealed high seroprevalence of T. gondii in goats from Jharkhand, which has public health significance., (Copyright © 2018 Elsevier B.V. All rights reserved.)

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: Transcultural studies have found lack of insight to be an almost invariable feature of acute and chronic schizophrenia, but its influence on prognosis is unclear., Aims: To investigate the relationship between insight, psychopathology and outcome of first-episode schizophrenia in Vellore, India., Method: Patients with a DSM-IV diagnosis of schizophrenia (n = 131) were assessed prospectively at baseline and at 6-month and 12-month follow-up. Demographic and clinical measures included insight, psychopathology, duration of untreated psychosis (DUP) and social functioning. Linear and logistic regression was used to measure predictors of outcome., Results: Follow-up data were available for 115 patients at 1 year. All achieved remission, half of them with and half without residual symptoms. Changes in psychopathology and insight during the first 6 months and DUP strongly predicted outcome (relapse or functional impairment), controlling for baseline measures., Conclusions: Outcome of schizophrenia in this setting is driven by early symptomatic improvement and is relatively favourable, in line with other studies from low- and middle-income countries. Early improvement in insight might be a useful clinical guide to future outcome. Reduction of DUP should be a target for intervention.

Each culture influences the perceptions of illness and pathways to health care that its members follow. Non-biomedical beliefs about psychosis and treatment are reported from the developing world. This study explored people's perceptions on psychosis to understand local perceptions of the condition. Focus group discussions were conducted with people who have relatives with psychosis (in five focus groups), with members of the general public (in four focus groups), and with patients who had recovered from psychosis (one group) in Vellore, South India. These discussions were recorded, transcribed and analyzed. Participants recognized psychosis as an illness category, and viewed indigenous healing methods as complementary to allopathic treatments. Multiple and apparently contradictory beliefs on different aspects of psychosis were often simultaneously held by participants. People in the community were more likely to express negative views about mental illness. Relatives of patients with psychosis wanted more support from mental health professionals and community in combating stigma against mental illness. Results of this study reveal the complex nature of illness perspectives among patients with psychosis, their relatives and community. Bio-medical and indigenous beliefs are simultaneously held by a significant number of people who often seek help from both modern and traditional health systems at the same time. The results indicate the need for better understanding of local perceptions of psychosis.

Electroconvulsive therapy (ECT) is controversial but widely practised in India. We elicited perspectives, using qualitative interviews, from patients who received ECT and their relatives. Ethical issues related to personal autonomy, right to information, competence, informed consent and consent by proxy are discussed. We suggest strategies to ensure a basic minimum standard for obtaining informed consent for ECT in India.

Background: Studies from India have reported high rates of suicide. We aimed to understand the social and cultural factors that modulate the risks related to suicide., Methods: Focus group discussions were conducted with community health workers (1 group) and members of the public (6 groups). In-depth interviews were also conducted with 5 people who had attempted suicide and survived. The interviews were tape-recorded and transcribed verbatim. The results were summarized and analysed using standard procedures., Results: The most common causes for suicide were interpersonal and family problems, and financial difficulties. Mental illness was also reported as causal. All 5 subjects who had attempted suicide mentioned marital and family discord as the cause. The majority of the general population and all the subjects who had attempted suicide were not aware of any community and support services for the prevention of suicide., Conclusion: Our study reveals that people perceived suicide as an option to overcome interpersonal, family and financial stress among normal individuals as well as those with mental illness. Healthcare providers should place greater emphasis on educating the general public regarding the policies and services available for suicide prevention.

Background: Lack of insight has been observed in people with schizophrenia across cultures but assessment of insight must take into account prevailing illness models., Aims: To determine whether culturally specific and Western biomedical interpretations of insight and psychosis can be reconciled., Method: Patients with schizophrenia (n=131) were assessed during their first contact with psychiatric services in Vellore, South India. Patients' explanatory models, psychopathology and insight were investigated using a standard schedule translated into Tamil., Results: Supernatural explanations of symptoms were frequent. Some insight dimensions were weakly associated (inversely) with severity of symptoms whereas preserved insight was associated with anxiety, help-seeking and perception of change. Willingness to attribute symptoms to disease, in others and in one's self, but not to supernatural forces was strongly associated with insight., Conclusions: The relationship between insight, awareness of illness and other clinical variables is similar in South India to elsewhere. However, the assessment of insight might have failed to capture locally accepted explanatory frameworks. An inclusive conceptual model which emphasises help-seeking is recommended.

Background: There has been little systematic study from developing countries on the perspectives of patients and their relatives about electroconvulsive therapy (ECT). This study attempted to ascertain the views of patients and their relatives on the possible benefits and adverse effects of ECT., Method: Qualitative methodology using semistructured interviews, with the Short Explanatory Model Interview as the basis, was used to interview 52 patients who received ECT and their relatives before and after a course of the treatment. The most eloquent 10 among them were chosen for further in-depth interviews. Professional perception of efficacy and cognitive adverse effects were obtained from the patients' medical records., Results: More than half of the recipients were not aware of the details of ECT even at the end of the course but were not unhappy about receiving ECT. Most relatives believed in the disease model, considered the illness serious, felt that enough information about the treatment was provided, knew about its benefits and memory problems, and felt that they were offered an alternative choice of treatment, but also admitted to perceiving coercion. All relatives had signed the consent for treatment, and most were not unhappy with ECT. There were significant differences in perception between patients and relatives and between the perceptions of patients admitted to the hospital involuntarily and of those who agreed for admission. The difference between the clinicians' and the relatives' perceptions of benefits and cognitive adverse effects was not statistically significant., Conclusions: The results of the study highlight the complex issues and contradictions in the process of providing information and obtaining consent for ECT.

Objective: To delineate concepts, categories, causes of common mental disorders (CMD) and their treatment as understood by traditional healers practicing in rural South India., Methods: Key informant interviews, focus group discussions and in-depth interviews with traditional and faith healers were conducted to identify concepts, causes, presentations and treatments for CMD. Patients attending clinics conducted by these healers were interviewed using the Tamil versions of the Revised Clinical Interview Schedule (CIS-R) and the Short Explanatory Model Interview (SEMI) in order to identify CMD and understand their explanatory models of illness respectively., Results: Different terms, concepts and treatments were used by traditional and faith healers. A total of 72 patients were interviewed using the CIS-R and the SEMI. Thirty (42.3%) satisfied the International Classification of Diseases-10 Primary Care Version criteria for CMD. Mixed anxiety depression was the most common diagnosis (40%)., Conclusions: An understanding of local patient perspectives of common mental disorders will allow modern medicine to provide culturally sensitive and locally acceptable health care.

We examined the effect of a structured educational programme on explanatory models of illness among the relatives of people with schizophrenia, in a randomised controlled trial. Participants were assessed at baseline (n=100) and after 2 weeks (n=75) using a vignette from the Short Explanatory Model Interview. There was a reduction in non-biomedical causal explanatory models at follow-up among those who had completed the structured educational programme compared with the control group. There was no significant difference in non-biomedical treatment explanatory models between the two groups.

Aims: To determine whether current and postpartum maternal depression and low maternal intelligence are risk factors for malnutrition in children., Methods: In rural South India 72 children with malnutrition were identified from a central register; 72 controls were matched for age, gender, and residence., Results: Major depression in the postpartum period (OR 5.0, 95% CI 1.0 to 24.0), current major depression (OR 3.2, 95% CI 1.1 to 9.5), and low maternal intelligence (OR 3.8, 95% CI 1.3 to 11.1) were associated with malnutrition in the child. Low birth weight (OR 2.9, 95% CI 1.2 to 6.8) was also significantly associated with infant malnutrition. Conditional logistic regression adjusting for all other determinants yielded the following results: major depression during the postpartum period (OR 7.8; 95% CI 1.6 to 38.51), current major depression (OR 3.1; 95% CI 0.9 to 9.7), low maternal intelligence (OR 4.6; 95% CI 1.5 to 14.1), and low birth weight (OR 2.7; 95% CI 2.5 to 6.8). The interactions between current maternal depression and low birth weight and between postpartum depression and low maternal intelligence were statistically significant. The level of maternal intelligence was associated with nutritional status. The severity of malnutrition was also significantly associated with major depression during the postpartum period and low maternal intelligence., Conclusion: There is evidence for an association between postpartum maternal depression, low maternal intelligence, and low birth weight with malnutrition in children aged 6-12 months.

Objectives: To examine the impact of SCI from a non-Western cultural perspective., Setting: India., Methods: A philosophical approach., Conclusion: Management of the individual with spinal cord injury needs to take in to account the individual's beliefs and cultural context.

Study Design: A cross-sectional study that assessed people with spinal cord injury (SCI) and their carers who attended the 3-day health care program., Objectives: The study examined the nature and prevalence of the factors associated with psychological morbidity among carers of people with SCI., Setting: A community reintegrated population of persons with SCI and their carers attended the 3-day program in the Department of Physical Medicine and Rehabilitation, Christian Medical College Hospitals, Vellore, South India., Methods: Thirty-eight people with SCI and their carers participated in this cross-sectional study., Results: Thirty (78.9%) carers of people with SCI were psychologically distressed. While carers were distressed, they were not significantly depressed. Educational level of carers and suicidal behavior of people with SCI were significantly associated with psychological distress., Conclusion: The findings of this study suggest that health care workers should have a high index of suspicion of psychological morbidity, in carers of people with SCI. Identification of risk factors may lead to useful target interventions.