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Background: Although fast-track treatment pathways are well established in colorectal surgeries, their role in oesophageal resections has not been well studied. This study aims to prospectively evaluate the short-term outcomes of enhanced recovery after surgery (ERAS) protocol in patients undergoing minimally invasive oesophagectomy (MIE) for oesophageal malignancy. Patients and Methods: We studied a prospective cohort of 46 consecutive patients from January 2019 to June 2022 who underwent MIE for oesophageal malignancy. The ERAS protocol mainly consists of pre-operative counselling, pre-operative carbohydrate loading, multimodal analgesia, early mobilisation, enteral nutrition and initiation oral feed. Principal outcome measures were the length of post-operative hospital stay, complication rate, mortality rate and 30-day readmission rate. Results: The median (interquartile range [IQR]) age of patients was 49.5 (42, 62) years, and 52.2% were female. The median (IQR) post-operative day of intercoastal drain removal and initiation of oral feed was 4 (3, 4) and 4 (4, 6) days, respectively. The median (IQR) length of hospital stay was 6 (6.0, 7.25) days, with a 30-day readmission rate of 6.5%. The overall complication rate was 45.6%, with a major complication (Clavien-Dindo ≥3) rate of 10.9%. Compliance with the ERAS protocol was 86.9%, and the incidence of major complications was associated with failure to follow the protocol (P = 0.000). Conclusions: ERAS protocol in minimally invasive oesophagectomy is feasible and safe. This may result in early recovery with shortened length of hospital stay without an increase in complication and readmission rates. [ABSTRACT FROM AUTHOR]

Parasitic diseases, including malaria, leishmaniasis, and trypanosomiasis, continue to plague populations worldwide, particularly in resource-limited settings and disproportionately affecting vulnerable populations. It has limited the use of conventional health-care delivery and disease control approaches and necessitated exploring innovative strategies. In this direction, artificial intelligence (AI) has emerged as a transformative tool with immense promise in parasitic disease control, offering the potential for enhanced diagnostics, precision drug discovery, predictive modeling, and personalized treatment. Predictive AI algorithms have assisted in understanding parasite transmission patterns and outbreaks by analyzing vast amounts of epidemiological data, environmental factors, and population demographics. This has strengthened public health interventions, resource allocation, and outbreak preparedness strategies, enabling proactive measures to mitigate disease spread. In diagnostics, AI-enabled accurate and rapid identification of parasites by analyzing microscopic images. This capability is particularly valuable in remote regions with limited access to diagnostic facilities. AI-driven computational methods have also assisted in drug discovery for parasitic diseases by identifying novel drug targets and predicting the efficacy and safety of potential drug candidates. This approach has streamlined drug development, leading to more effective and targeted therapies. This article reviews these current developments and their transformative impacts on the health-care sector. It also assessed the hurdles that require attention before these transformations can be realized in real-life scenarios. [ABSTRACT FROM AUTHOR]

Background: Youth are considered to be most vulnerable to health and lifestyle issues (HLS) in India. The current study aims to investigate the factors that contribute to health and lifestyle issues among youth attending mental health promotion clinics (YMHP) in Karnataka. Method: Three-year first-visit data from beneficiaries (aged 15–35 years) attending YMHP clinics in Karnataka between 2017 and 2020 were analyzed. Multivariable logistic regression analysis included beneficiaries reporting any HLS issue as the outcome and a host of 57 hypothesized variables as exposures. Results: Overall, 2,615 (25%) beneficiaries reported HLS issues. Years of schooling (AOR 5–7 years = 0.89; 95% confidence interval [CI] =0.60–1.31), (AOR 8–10 years = 0.65; 95% CI = 0.46–0.91), (AOR >10 years = 0.67; 95% CI = 0.49–0.93)], unemployed youth (AOR = 0.52; 95% CI = 0.45–0.61) business and salaried workers (AOR = 1.69; 95% CI = 1.33–2.13), and other occupations (AOR = 2.11; 95% CI = 1.73–2.56), junk food consumption (AOR = 0.76;95% CI = 0.68–0.84), having issues related to relationships with parents (AOR = 3.01; 95% CI = 2.47–3.68) and intergenerational issues (AOR = 1.71; 95% CI = 1.19–2.45), self-development issues (AOR low-self-awareness = 1.57; 95% CI = 1.33–1.85), (AOR low-self-esteem = 1.29; 95% CI = 1.062–1.57), (AOR emotional issues = 1.57; 95% CI = 1.31–1.89), education and academics (AOR = 1.23; 95% CI = 1.09–1.39), safety issues (AOR = 4.11; 95% CI = 3.07–5.50), gender sex and sexuality issues (AOR = 2.44; 95% CI = 1.43–4.15), suicidal ideation (AOR = 1.91; 95% CI = 1.44–2.54), substance use (AOR tobacco chewing = 1.45; 95% CI = 1.09–1.93), (AOR tobacco-smoking = 1.66; 95% CI = 1.18–2.32), (AOR smoking = 4.94; 95% CI = 3.52–6.93) and experiencing emotions (AOR feel anxious = 1.63; 95% CI = 1.41–1.88), (AOR forgetfulness = 1.50; 95% CI = 1.41–1.98), (AOR difficulty in concentration = 1.37; 95% CI = 1.035–1.81), (AOR anger = 1.61; 95% CI = 1.25–2.07), (AOR feel worthless = 2.21; 95% CI = 1.71–2.86) were associated with HLS issues among beneficiaries. Conclusion: This analysis addresses an important but neglected component of HLS issues among youth highlighting the importance of early intervention among youth to prevent the development of diseases later in life. The study has important implications for youth health promotion in India and countries such as India. Health and Lifestyle Issues Among Youth: A record analysis of contributing factors among beneficiaries attending Youth Mental Health promotion clinics (Yuva Spandana Kendras) in Karnataka, India. [ABSTRACT FROM AUTHOR]

By converging advanced science, engineering, and design, deep techs are bringing a great wave of future innovations by mastering challenges and problem complexity across sectors and the field of parasitology is no exception. Remarkable research and advancements can be seen in the field of parasite detection and diagnosis through smartphone applications. Supervised and unsupervised data deep learnings are heavily exploited for the development of automated neural network models for the prediction of parasites, eggs, etc., From microscopic smears and/or sample images with more than 99% accuracy. It is expected that several models will emerge in the future wherein greater attention is being paid to improving the model’s accuracy. Invariably, it will increase the chances of adoption across the commercial sectors dealing in health and related applications. However, parasitic life cycle complexity, host range, morphological forms, etc., need to be considered further while developing such models to make the deep tech innovations perfect for bedside and field applications. In this review, the recent development of deep tech innovations focusing on human parasites has been discussed focusing on the present and future dimensions, opportunities, and applications. [ABSTRACT FROM AUTHOR]

Epiphrenic diverticulum is a rare abnormality of the distal oesophagus. Both thoracic and abdominal approaches are suitable for this diverticulum. A 46-year-old male presented with complaints of regurgitation and chest pain for 2 years. Contrast-enhanced computed tomography of the neck, thorax, abdomen and oesophageal endoscopy revealed 12 cm × 10 cm size large intrathoracic oesophageal diverticulum. He underwent an elective laparoscopic transabdominal oesophageal diverticulectomy. Gastrograffin study on the first post-operative day did not reveal any leak. In this case report, we are sharing our experience in the management of large epiphrenic oesophageal diverticulum through a laparoscopic approach. The benefits of the laparoscopic approach include decreased morbidity because we can avoid large thoracotomy or laparotomy incision. [ABSTRACT FROM AUTHOR]

Background: Malocclusion is defined as an occlusion in which there is malrelationship between the arches in any of the three planes or anomalies in tooth position beyond normal limits, the etiology being multifactorial. Malnutrition may also be allied to malocclusion, predominantly crowding, due to insufficient space for the teeth to erupt in the correct place. Objectives: The present study was conducted to investigate the role of diet as an etiological factor in the occurrence of malocclusion. Materials and Methods: Two hundred and twenty malnourished subjects were examined by a single experienced dental professional and the occlusal relationships were evaluated at a centric occlusion position by instructing the subject to swallow and then bite on the teeth together. Results: Ninety-eight subjects (44.54%) had Angle's Class I malocclusion with crowding: 18 (8.1%) presented with spacing. Angle's Class II division 1 malocclusion was evident in 52 subjects (23.63%), while Class II division 2 in 38 subjects (17.27%). Only 14 subjects (6.3%) presented with Angle's class III malocclusion. Conclusion: Dietary factors and dentition measures from a subset 220 malnourished subjects found that malnourished subjects with basal metabolic index <18.5 had statistically significant relationships with the crowding variables. [ABSTRACT FROM AUTHOR]

Background: The mini-implants introduced new possibilities of adequate anchorage in orthodontics. Furthermore, due to its small size, it can even be placed at relatively difficult sites with ease. Removal torque should be high to prevent implant unscrewing. Objective: This prospective clinical trial was aimed to evaluate the insertion torque and removal torque of single-threaded and double-threaded cylindrical orthodontic mini-implants. Materials and Methods: A total of 36 cases were randomly divided into two groups, with an equal number of patients in each group (n = 18). In Group 1 single-threaded cylindrical mini-implant was placed, and in the other group, cylindrical implants with double-threaded were placed. Maximum insertion torque (MIT) and maximum removal torques (MRTs) were recorded for both groups. Data collected were subjected to statistical analysis. Results: MIT was found to be significantly higher than MRT for both the groups and between the groups. Intergroup comparison in the present study showed significantly higher values for MIT than MRT. Intergroup comparison of MIT showed more values for Group 2 as compared to Group 1. Similar statistically significant values were seen in terms with MRT, where double-threaded cylindrical mini-implants had more torque value than the other group. Conclusions: Orthodontic mini screws represent effective temporary anchorage devices. Double-threaded cylindrical mini-implants have significantly higher insertion and removal torque than single-threaded mini-implants and hence better stability. [ABSTRACT FROM AUTHOR]

Introduction: [18F]-Fluorodeoxyglucose ([18F]-FDG) is the most widely used positron-emission tomography tracer used for imaging in clinical studies such as early detection of cancer or its malignancies, quantifications, staging, and restaging of several malignancies. For clinical application, routine production of this tracer is mandatory in compliance to regulatory guidelines. Several dedicated commercial synthesizers are currently used for producing [18F]-FDG for clinical usage. Being at hospital radiopharmacy, it is our responsibility and duty to support the clinical service with uninterrupted production and supply of [18F]-FDG. This document describes the production of [18F]-FDG using two different automated synthesizers in terms of its production yield, time of synthesis, and analyze the quality control (QC) of the produced [18F]-FDG. Materials and Methods: The precursor, mannose triflate ultra-pure, authentic nonradioactive standard FDG and [18O]-water were obtained from ABX, Germany. Solvents and reagents were purchased from Sigma Aldrich India Ltd. and Fisher Scientific India Ltd., (Mumbai, Maharashtra, India). Results: The protocol developed for the synthesis with MPS-100 synthesizer yield of [18F]-FDG is approximate about 45% End of Bombardment (EOB) with synthesis time of around 35 min, whereas with F300E synthesizer it is around 60% with synthesis time of 25 min. The quality of the tracer produced by both synthesizers is at par with the QC parameter for clinical applications. Conclusions: Finally, we have developed the production using two automated synthesis modules which have the capability to produce [18F]-FDG, to do the patient studies in good yield and purity. Our protocol is simple, reproducible, and robust. [ABSTRACT FROM AUTHOR]

Background: Lockdown is an emergency measure or condition in which people are temporarily prevented from entering or leaving a restricted area or building during a threat or danger. Since the start of COVID-19 till date, almost one-third of the world's population is under some degree of restriction and lockdown, and the mental health effect of which is something that is being discussed widely. Aim: The study aimed to assess the effect of lockdown on mental health among individuals (patients or accompanying person) seeking services at a tertiary care center. Materials and Methods: Kathmandu Medical College is a tertiary care center and a medical college in Kathmandu, Nepal. In this study, we enrolled every 4th individual coming to the hospital's outpatient department registration counter to seek service and giving consent, for the duration of 1 month during the ongoing lockdown period. A semi-structured questionnaire was developed and approved by the department and was used to collect sociodemographic details and to rate the stress level. The General Health Questionnaire (GHQ-12) Nepali version was used to assess psychological well-being of the participants and a score of ≥3 by binary method was taken as positive case. Results: The total number of cases enrolled in the study was 204, out of them 62.2% were male and 32.8% were female and the mean age was 32.03 years. Twenty-three percent (23.5%) had preexisting health conditions. Out of the 204 participants, 67.6% said they were stressed following the lockdown and the mean rated stress was 2.90 in a scale ranging from 1 to 7. The frequently identified stressors were fear of contamination, restricted movement, and for inadequate supplies. Twenty-seven percent said they had some psychological symptoms and the most common symptoms were palpitation and sleep disturbance. Seventy-three individuals (36.5%) were found to have psychiatric problem according to their scores in GHQ-12. Rated stress and GHQ-12 scores were found to be strongly correlated (P = 0.000). Similarly, those who stated "Yes" in psychological symptoms significantly scored higher on GHQ-12 and stress (both P = 0.000). Conclusion: The lockdown has caused stress in majority of cases, and a significant number of individuals have diagnosable mental health conditions. Mental health impact of the lockdown is something that needs to be addressed seriously. [ABSTRACT FROM AUTHOR]

Background: The ability of mothers to correctly detect jaundice in their newborns is largely unknown. The objective was to ascertain the ability of mother to correctly detect the presence of significant jaundice in her newborn. Materials and Methods: This cross-sectional study was conducted in a tertiary care hospital in eastern India from February 2015 to July 2016. All inborn neonates more than 34 weeks' gestation were included. Congenital malformations, perinatal asphyxia, neonatal sepsis, readmission after discharge, and isoimmunization were excluded. A total of 505 inborn newborns were independently assessed by the mother and the treating pediatrician for significant jaundice every day till discharge. Each newborn underwent total serum bilirubin estimation on suspicion of significant jaundice by either of the two or at discharge, whichever was earlier. Results: The sensitivity, specificity, positive predictive value (PPV), and negative predictive value of maternal detection of significant jaundice was 51.47%, 88.33%, 39.29%, and 92.12%, respectively. Conclusion: Mothers have poor sensitivity and PPV to detect significant neonatal jaundice in the Indian population. [ABSTRACT FROM AUTHOR]

The article is an editorial from the journal Tropical Parasitology. The editor expresses gratitude to Dr. Abhijit Chowdhary for his contributions as editor and welcomes new editors and assistant editors to the journal. The editor emphasizes the importance of parasites and their impact on humans, animals, and biodiversity. The journal aims to publish high-quality research in various parasitological sections and bridge traditional and interdisciplinary research fields. The current issue features articles on topics such as artificial intelligence for parasitic disease control, the relationship between Cryptosporidium and irritable bowel disease, and molecular diagnosis of echinococcosis. The journal also includes a new section called "Photo challenge" and an email interview with Dr. PS Banerjee. The articles in this edition are available for open access and are distributed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License. [Extracted from the article]

Cryptosporidium spp. was first described in mice in 1907. The first human case was reported in an acquired immune deficiency syndrome patient after which it gained importance. It is one of the emerging protozoan parasites according to the Centre of Disease Control and Prevention. The special structure which is present in them such as rhoptries and micronemes are responsible for their virulence and pathogenicity. They can be transmitted from animals, human to human, water, food, and tends to cause waterborne outbreaks. The clinical manifestation in immunocompetent patient is self-limiting when compared to immunocompromised individual where it causes chronic diarrhea not responding to treatment. Hence, it is necessary to diagnose them early to prevent any complication in these patients. There are many investigations currently available such as stool microscopy after Sheather's concentration technique, rapid test targeting specific antigen, molecular methods, and imaging techniques. [ABSTRACT FROM AUTHOR]

Background: Human hookworm infection is caused mainly by Necator americanus and Ancylostoma duodenale. Among the zoonotic hookworm species, only Ancylostoma ceylanicum causes potent human infections where dogs and cats act as reservoir of infection. Hence, species differentiation is imperative because the eradication of both anthroponotic and zoonotic hookworm depends on the concurrent human and animal health programs, hygienic practices, and mass drug administration for humans and dogs. Objective: This study was performed to evaluate the utility of polymerase chain reaction (PCR) for detection of hookworm infections. Materials and Methods: A total of 209 stool samples were collected and subjected to stool microscopy, Kato-Katz method to identify the intensity of the infection, coproculture for L3 larval identification and species differentiation and semi-nested PCR with sequencing. Results: The prevalence of hookworm was estimated as 7.6%. Highest hookworm prevalence was seen in 20-30 years of age group. Majority of the infections were mild intensity infections. Sensitivity of stool microscopy was found to be 81.2% and the specificity was 100%. Sensitivity of Kato-Katz method was 87.5% and specificity was 100%. True positivity by agar plate culture was 83.3% and false positivity rate was 16.6%. Conclusion: Stool microscopy is the major mode of detection, but it has a higher false negative rate. Coproculture is time-consuming and needs the expertise to differentiate the species. On the other hand, PCR is known to be a sensitive, specific, and a reliable investigative tool which can help in diagnosis as well as in species differentiation. [ABSTRACT FROM AUTHOR]

Soil-transmitted helminths (STH) consist of Ascaris lumbricoides, Trichuris trichiura, and hookworm (Necator americanus and Ancylostoma duodenale). It affects nearly 1.7 billion people globally in which Ascaris contributes nearly 1.2 billion cases. The main mode for transmission of Ascaris and Trichuris is through contaminated food and water, whereas hookworm transmitted by skin penetration. STH were mainly seen in areas with poverty, overcrowding, and poor sanitation. The prevalence is more in rural areas compared to urban areas. It affects mainly children and causes lack of school attendance, anemia, and cognitive deficits. This review emphasizes on the epidemiology and clinical features of all STH and emphasizes on the role on preventive measures in containing STH. [ABSTRACT FROM AUTHOR]

Introduction: Amebiasis is known to be caused by the protozoan parasite Entamoeba histolytica. Entamoeba dispar is considered to be a sibling species of E. histolytica, as the two are phylogenetically closest. There are reports that certain strains of E. dispar isolated were capable of causing hepatic lesions in the experimental animal models. The intra-/inter-species genetic variation has been found to have profound implication in the invasiveness of the disease. Thus, studying polymorphism in E. dispar aids to improve our perspective related to the variability in the genome of the parasite. Materials and Methods: The highly polymorphic region of the gene encoding the enzyme chitinase was targeted for the strain variation analysis in E. dispar. Isolates from the stool and liver abscess aspirate were subjected to the polymerase chain reaction (PCR) for the amplification of the targeted polymorphic loci. The PCR products were sequenced, and genetic variability analysis was carried out. Results: A total of 23 samples in the stool and 1 sample from liver abscess pus were positive for E. dispar by nested multiplex PCR which was confirmed by sequencing. Of these positive samples, 13 amplified for chitinase gene by PCR. We observed seven genotypes in our study isolates, of which four were found to be distinct. Conclusion: This study shows that high degree of genetic variation exists among the clinical isolates of E. dispar in our location. The future studies including the analysis of other genetic makers such as serine-rich E. dispar protein or other loci have to be carried out to get an idea about the distribution of the different strains of E. dispar. [ABSTRACT FROM AUTHOR]

Introduction: Cryptosporidium species is the most common opportunistic enteric parasite encountered in the immunocompromised patients. Considering the need to diagnose them early relies mostly on rapid tests such as antigen detection by immunochromatographic test (ICT), ELISA, and microscopy. However, the sensitivity and specificity varies with different methods and different kits used. This study was conducted to determine the intestinal parasitic profile in immunocompromised patients and to assess the diagnostic accuracy of the ICT using ImmunoCard STAT kit in detecting Cryptosporidium spp. Materials and Methods: The patients in this study were divided into two groups: one group was immunocompromised patients (n = 73) and the other was nonimmunocompromised individuals (n = 73). Stool microscopy, ICT, and polymerase chain reaction (PCR) were carried out for all stool samples. Results: Totally, 4 (5.4%) of 73 patients of the study group were positive for Cryptosporidium. The species detected were Cryptosporidium parvum and Cryptosporidium hominis. PCR was taken as gold standard in the current study. PCR detected Cryptosporidium in four samples while ICT in two samples and microscopy in one sample. Conclusion: Cryptosporidium was found to be the most common enteric parasite in the immunocompromised patients studied, followed by Cystoisospora, Entamoeba histolytica, and Strongyloides stercoralis. Although the ICT is a rapid test, it was less sensitive and more expensive in comparison to the PCR; hence, its utility appears to be limited in our setting. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to compare the protein expression patterns of Plasmodium falciparum extracellular and intracellular proteins separated by two-dimensional electrophoresis (2-DE) from the chloroquine-sensitive (CQS) MRC2 strain and chloroquine-resistant (CQR) RKL9 strain. Materials and Methods: Both the extracellular protein (ECP) and intracellular protein (ICP) were extracted and solubilized. The proteins were separated by 2-DE, first based on their charges using isoelectric focusing and then their sizes by electrophoresis. The separated protein spots were detected by silver staining, and further, the protein spot density was analyzed by an image analysis software. Results: 2-DE separated the proteins extracted from the CQS and CQR strains based on their differentially expressed protein patterns. Extracellular Protein Analysis: A total of 109 and 77 protein spots were detected by image analysis of ECP extracted from MRC2 and RKL9 strains, respectively. There was a marked reduction in protein expression pattern in the CQR strain when compared with the CQS strain. Interestingly, 50 and 18 protein spots were uniquely expressed in MRC2 and RKL9 strains, respectively. When MRC2 strain-expressed proteins were taken as the control, 12 upregulated and 14 downregulated protein spots were observed in the RKL9 strain-extracted proteins. Intracellular Protein Analysis: ICP extracted from MRC2 and RKL9 strains showed 187 and 199 protein spots by an image analysis software, and a small enhancement of protein expression was measured when comparing the CQR strain with CQS strain. There were 67 and 79 unique protein spots detected in MRC2 and RKL9 strains, respectively. A total of 120 protein spots were similar when MRC2 proteins were taken as the control; among these protein spots, 40 upregulated and 22 downregulated protein spots were detected in RKL9 strain-expressed protein. Conclusions: Both these unique and matched protein spots might be molecularly potent drug targets for chloroquine resistance in P. falciparum. Further identification of these proteins by mass spectrometry/peptide sequencing is essential to clearly understand the mechanism of resistance. [ABSTRACT FROM AUTHOR]

Introduction: Amebiasis is the third leading cause of death after malaria and schistosomiasis. Diagnosis is based on microscopy, culture, isoenzyme analysis, and serology-based techniques. In resource-limited nation such as India where polymerase chain reaction cannot be employed, serology is considered to be the reliable diagnostic tool. To find the seroprevalence of Entamoeba histolytica IgG antibody by enzyme-linked immunosorbent assay (ELISA) among the liver abscess cases and healthy controls. Materials and Methods: Commercially available RIDASCREEN Entamoeba IgG ELISA kit was used to evaluate the samples as per manufacturer's instruction. Results: A total of 322 samples were evaluated by ELISA. 94/157 (59.87%) were positive for amebic liver abscess cases, 2/13 (15.38%) were positive in suspected amebiasis group, 5/15 (33.3%) were positive in nonamoebic hepatic disorder group, 5/39 (12.8%) were positive in other parasitic disorders, and 2/98 (2.04%) were positive in presumed healthy controls. The sensitivity and specificity of the assay were found to be 56% and 92%, respectively. Conclusion: In an endemic nation such as India and other developing countries, ELISA can be used as a routine surveillance test in a clinical setup to detect amoebiasis if the cases are judicially evaluated along with the other routine tests. [ABSTRACT FROM AUTHOR]

Introduction: Emergence of chloroquine (CQ) resistance in Plasmodium falciparum has increased the morbidity and mortality of falciparum malaria worldwide. Artemisinin-based combination therapies are now recommended by the World Health Organization as the first line treatment for falciparum malaria. Numerous molecular markers have been implicated in the CQ and artemisinin resistance. Materials and Methods: A total of 26 confirmed cases of falciparum malaria (by giemsa stained thick and thin smear, quantitative buffy coat, immunochromatographic test, or polymerase chain reaction [PCR]) were included in the study. About 5 ml of ethylenediaminetetraacetic acid blood sample was collected and stored at -20°C till use. Plasmodium DNA was extracted using QIAamp whole blood DNA extraction kit. PCR was done to amplify pfcrt, pfmdr1, pfserca, and pfmrp1 genes and the amplicons obtained were sequenced by Macrogen, Inc., Korea. Single nucleotide polymorphism (SNP) analysis was done using Bio-Edit Sequence Alignment Editor. Results: Out of the four genes targeted, we noted a SNP in the pfcrt gene alone. This SNP (G > T) was noted in the 658th position of the gene, which was seen in 13 patients. The pfmdr1 and pfserca genes were present in 9 and 14 patients respectively. But we could not find any SNPs in these genes. This SNP in pfcrt gene was not significantly associated with any adverse outcome and neither altered disease progression. Conclusion: Presence of a single SNP may not be associated with any adverse clinical outcome. As the sample size was small, we may have not been able to detect any other known or unknown polymorphisms. [ABSTRACT FROM AUTHOR]

Malaria is a major public health burden throughout the world. Resistance to the antimalarial drugs has increased the mortality and morbidity rate that is achieved so far through the malaria control program. Monitoring the drug resistance to the available antimalarial drugs helps to implement effective drug policy, through the in vivo efficacy studies, in vitro drug susceptibility tests and detection of molecular markers. It is important to understand the mechanism of the antimalarial drugs, as it is one of the key factors in the emergence and spread of drug resistance. This review summarizes the commonly used antimalarial drugs, their mechanism of action and the genetic markers validated so far for the detection of drug-resistant parasites. [ABSTRACT FROM AUTHOR]

Achalasia cardia is an oesophageal motility disorder characterised by aperistalsis and failure of relaxation of the lower oesophageal sphincter. The management is predominantly palliative with focus on addressing the sphincter that involves either pneumatic dilatation or Heller myotomy which relieves dysphagia in the majority of the cases. End-stage achalasia (ESA) is characterised by failed myotomy, massively dilated and tortuous oesophagus with nutritional deterioration due to progressive dysphagia and vomiting. In these subgroups of patients, oesophagectomy may be the last resort. While oesophagectomy has been described for ESA before, thoracoscopic oesophagectomy has not been reported previously. Hereby, we report our experience of performing minimally invasive oesophagectomy (thoracoscopic) with the gastric pull-up. [ABSTRACT FROM AUTHOR]

Babesiosis is a protozoan parasitic infection affecting humans and animals. These infections are commonly transmitted by various species of Ixodes ticks depending upon the geographical location. They can also be transmitted by packed cell transfusion and transplacental route from mother to child. Various species have been reported to cause human infections, of which Babesia microti is the most common species reported globally. Usually, Babesia infections are asymptomatic or mild, but can be severe/life-threatening in immunosuppressed or splenectomized individuals. A high index of clinical suspicion in residents of endemic areas or individuals who had a recent travel history to such areas, with laboratory confirmation can guide an early institution of appropriate antimicrobial therapy, thereby preventing complications and death. [ABSTRACT FROM AUTHOR]

Granulomatous amebic encephalitis is a life-threatening central nervous system (CNS) infection caused by the free-living amoebae Acanthamoeba spp., Balamuthia mandrillaris and Sappinia pedata. The disease has a subacute to chronic onset affecting commonly the immunocompromised population with high mortality rate. The diagnosis of this disease entity requires high suspicion with appropriate sample collection and testing by the laboratory experts. Radiological investigations are nonspecific and commonly confused with CNS tuberculosis, neurocysticercosis, disseminated encephalomyelitis, viral encephalitis etc., delaying the accurate diagnosis of these cases. Early diagnosis plays a crucial role in the survival of these cases since appropriate management can be initiated. No single drug is effective; hence multiple antibiotics targeting various proteins or receptors are required for successful treatment. A combination of surgical and medical interventions involving multiple specialty experts is required to prevent death and morbidity in survivors. [ABSTRACT FROM AUTHOR]

Incontinentia pigmenti (IP) is a rare genodermatoses with multisystem involvement. Monochorionic diamniotic twins are presented with characteristic skin manifestation and ocular and neurological involvement. Identification of characteristic cutaneous manifestation can lead to rapid diagnosis of IP even in the absence of family history, resulting in prompt management of systemic manifestations. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC), more of lifestyle-related disorder, is one of the deadliest types of cancer across the globe. Nevertheless, infectious agents could be responsible for 20% of cancer. Recent findings have indicated the association of Blastocystis in CRC and recommend routine screening for Blastocystis. Herein, we describe a case of CRC with severe Blastocystis infection. [ABSTRACT FROM AUTHOR]

Translational research is the science of application of basic research knowledge to develop novel methods of improving public health outcome. This review briefly discusses the various phases involved and the hurdles faced in the translational pathway, how translational science originated, and the infrastructures consigned for translational research. Translational research also faces numerous diverse ethical issues similar to those observed in biomedical research. The various types of ethical issues faced whereas conducting translational research are discussed briefly in this review to help researchers identify and prevent unethical practices while conducting or regulating translational research. [ABSTRACT FROM AUTHOR]

Medical and life sciences research is a key driver in development, which leads to better quality of life. These pursuits can lead to discrimination, human rights violation, and injustice. The field of bioethics explores the ethical issues arising due to these advances in research and encompasses social, judicial, and environmental aspects affecting human beings. This brief review discusses the origin of bioethics, its principles, various international organizations, and their network involved in the development and propagation of guidelines on conducting biomedical research. [ABSTRACT FROM AUTHOR]

Entamoeba histolytica, the causative agent of intestinal and extraintestinal amebiasis, is a common parasitic cause of significant morbidity and mortality in the developing countries. Hence, early detection and differentiation of pathogenic E. histolytica from nonpathogenic/commensal Entamoeba spp (Entamoeba dispar/Entamoeba moshkovskii/ Entamoeba bangladeshi) plays a crucial role in clinical management of patients with amebiasis. Most diagnostic tests currently available do not reliably differentiate between the species of Entamoeba and are less sensitive, cumbersome to perform. Molecular-based methods are highly sensitive, easy to perform and differentiates the pathogenic Entamoeba from nonpathogenic species, serving the criteria for an ideal diagnostic test for amebiasis. Recently, microarray technology has been found to be a promising tool for the diagnostic and epidemiological evaluation of amebiasis. [ABSTRACT FROM AUTHOR]

Introduction: Cystic echinococcosis (CE) is a chronic zoonosis which presents with variable clinical manifestations. Currently the diagnosis of this disease is based on radiological findings and serological tests which lack specificity. Although antigen detection from the cyst fluid is the most specific, it is seldom done due to the complications involved. Detecting the presence of Echinococcus granulosus specific deoxyribonucleic acid (DNA) by the polymerase chain reaction (PCR) could provide a definitive diagnosis of CE. Materials and Methods: An in-house PCR assay was devised to detect E. granulosus specific DNA in serum, urine and hydatid cyst fluid. The ability of the PCR to detect E. granulosus in the above mentioned samples were observed in comparison with other antigen and antibody detection tests. Results: Serum samples from surgically confirmed patients of CE with ruptured cysts contained the corresponding DNA while the in the majority of cases who had an intact cyst had no DNA of E. granulosus in their serum. DNA of E. granulosus was not found to be excreted in urine. PCR performed equal to antigen detection ELISA while testing hydatid cyst fluid samples. Conclusions: Serum and urine might not serve as useful samples for the molecular diagnosis of cystic echinococcosis. However, PCR can be useful on serum samples to detect ruptured hydatid cysts and on hydatid cyst fluid to confirm the parasitic diagnosis. [ABSTRACT FROM AUTHOR]

Plasmodium knowlesi is the fifth species of Plasmodium recently identified to cause human malaria. Infections with P. knowlesi are currently being reported from South-East Asian countries and the incidence is on the rise with a possibility of spread to the geographically contiguous countries. P. knowlesi infections can result in a high degree of parasitemia causing severe malaria in a larger proportion of infected individuals. If detected early and treated with appropriate antimicrobials, these infections show a significant clinical improvement. The widely used microscopic methods usually misidentify P. knowlesi as the less pathogenic Plasmodium malariae leading to inadequate therapy and adverse clinical outcomes. The currently popular rapid immuno-chromatographic card tests have a very low sensitivity in diagnosing knowlesi malaria and can erroneously report P. knowlesi as other Plasmodia and vice-versa. At present molecular methods are the most efficacious in diagnosing P. knowlesi infections, but these tests can produce a false positive report in Plasmodium vivax infections and require expensive equipment and trained personnel. An ideal diagnostic test for P. knowlesi infections, which is potent, cost-effective and practically feasible in the resource limited setting is yet to be developed. [ABSTRACT FROM AUTHOR]

The unicellular protist Blastocystis has long been an unsolved puzzle for taxonomists, microbiologists and clinicians. Over the years, the organism has been bounced on and off the different branches of the tree of life due the possession of unique phenotypic characters intermediary to different organisms. The organism is polymorphic with only few of forms such as vacuolar, granular, amoeboid, and the cyst form being commonly known. However it could exist in other forms much more frequently than the widely known forms which could be missed by the unaware observer. Certain older concepts in the life cycle of Blastocystis although has been proven wrong are still being followed in various textbooks and other trustworthy internet sources. The causal role of Blastocystis in human disease has long been a subject of controversy. It is widely believed that certain subtypes of the organism are virulent. But this is not so as other factors are also involved in the clinical outcome of the infection. In these contexts, this review intends to shed light on the past misconceptions and the recent findings on the taxonomy, biology and the virulence of this organism. [ABSTRACT FROM AUTHOR]

The article presents a study aimed to evaluate the effects of genetic predesposition of diabetes on the serum RBP4 and its role in the development of insulin resistance (IR) in genetically high risk population. The study is conducted among healthy non-diabetic individuals aged from 18-22 years old whose parents are non-diabetis, non-hypertensive and do not have history of coronary heart diseases. The results of study show higher serum RBP-4 and its positive correlation with insulin.

Cystic echinococcosis and human cysticercosis have recently been included in the list of "neglected tropical diseases" by the World Health Organization (WHO). Both are zoonoses which are prevalent throughout the world and lead to considerable mortality, morbidity, and economic losses as well. This review deals with the disease burden of these two neglected cestode infections. Diagnostic modalities with their specific advantages and disadvantages have also been discussed. Recent developments in immunodiagnostic assays for the two diseases have been dealt with. Various control strategies including the use of veterinary vaccines have been highlighted. [ABSTRACT FROM AUTHOR]

Background: Leukoplakia is a common, potentially premalignant lesion with malignant transformation rate from 1 to 17% with highest transformation rate for the lesions on the floor of the mouth, soft palate and tongue. One of the main etiological factors is consuming areca nut and its commercial preparations which generate high levels of reactive oxygen species during their metabolism. So the aim of this present study is to evaluate the plasma levels of antioxidant vitamins, antioxidant mineral zinc, glutathione and total antioxidant status (TAS) in leukoplakia patients. Materials and Methods: For this cross-sectional study, we selected 23 newly diagnosed oral leukoplakia patients of both sexes within the age group 28–40 years and the same number of age and sex matched healthy individuals without having history of any systemic illness were selected as control group. In both the groups, we measured plasma antioxidant vitamins A, C, E, antioxidant mineral zinc, GSH and TAS. Student’s t test was applied and the P value <0.001 was considered as statistically significant. Results: We observed very low levels of antioxidant vitamins A, C, E, antioxidant mineral zinc and antioxidant metabolite GSH (P<0.001) and at the same time we also observed very poor (TAS) (P<0.001) in leukoplakia patients when compared to patients in control group. Conclusion: The consumption of tobacco or areca quid which contains high copper levels creates an oxidative stress like environment during their metabolism, might play a major role in causation and propagation of oral leukoplakia. [ABSTRACT FROM AUTHOR]

Background: Several serological assays are used for detection of a hydatid antigen in serum for diagnosis of cystic echinococcosis (CE). However, it requires technical expertise and is associated with the risk of acquiring blood-borne infections. Of late, interests have been shifted to other body fluids like urine, saliva, tear drops as alternate specimens in the diagnosis of CE. Aim: The aim of the study was to evaluate the dot enzyme-linked immunosorbent assay (Dot-ELISA) and electro-immunotransfer blot (EITB) for detection of a hydatid antigen in the urine for diagnosis of CE. Materials and Methods: 100 ml of urine samples were collected from the patients with confirmed CE (n=30), patients with suspected CE (n=30), patients with other diseases (n=30) and healthy controls (n=30). A hydatid antigen in urine was detected by Dot-ELISA and EITB using only polyclonal antibodies raised against a complete homogenate hydatid (CHH) antigen in rabbits. Results and Conclusions: The Dot-ELISA using polyclonal antibodies showed a sensitivity of 53.33% and specificity of 96.66%, whereas EITB showed a sensitivity of 46.66%. The Dot-ELISA and EITB employing polyclonal antibodies showed no significant difference in sensitivity (P=0.426). Hence, the Dot-ELISA being a simple procedure can be used for detection of a hydatid antigen in urine for diagnosis of CE. [ABSTRACT FROM AUTHOR]

Emerging protozoal pathogens have become a major threat to human health. The number of protozoal pathogens causing human disease has been on the rise since the last two to three decades. Significant increase in the number of immunocompromised people, increase in international travel, deforestation, and widespread urban dwellings are some of the factors contributing to this changing epidemiology of protozoal diseases. Apart from Naegleria and Acanthamoeba, other free-living amoebae like Balamuthia and Sappinia are being reported to cause meningoencephalitis in humans. Plasmodium knowlesi, a zoonotic malarial parasite, has become a major cause of human malaria in Southeast Asia. Trypanosoma evansi and Trypanosoma lewisi, which normally infect horses and rodents respectively, have been reported to cause human trypanosomiasis in India. Balantidium coli is emerging as an important cause of dysentery especially in the immunocompromised population. In India, where a significant proportion of population lives in close proximity to cattle and pigs, B. coli can emerge as a significant pathogen in cases of dysentery, especially in the immunocompromised population. Babesia microti has become an important cause of transfusion transmitted babesiosis (TTB) in countries like the United States. As Babesia can be misdiagnosed as Plasmodium and blood transfusion is becoming common in India, it is necessary to develop diagnostic tests to rule out this pathogen in blood donors. Increased awareness among clinicians, pathologists, and microbiologists along with other factors like constant surveillance, improved diagnostic tests, and a high index of suspicion are important to detect and properly treat such emerging protozoal pathogens in humans. [ABSTRACT FROM AUTHOR]

Background: Simple and rapid latex-based diagnostic tests have been used for detecting specific antigens or antibodies in several diseases. Aims: The aim of the present study was to standardize and evaluate the latex agglutination test (LAT) for the detection of Taenia solium metacestode antigen in the cerebrospinal fluid (CSF) and serum for the diagnosis of neurocysticercosis (NCC). Settings and Design: The study was conducted at Department of Microbiology, Jawaharlal Institute of Post graduate medical education and research after obtaining informed consent from the study subjects. Materials and Methods: In the present study, CSF and serum samples were collected from clinically suspected NCC, CT/MRI proven cases of NCC, non-cysticercal central nervous system infection control and from healthy control subjects. CSF was not collected from healthy controls. Polyclonal antisera raised in rabbits against porcine T. solium metacestode complete homogenate antigen, was used in the LAT to detect the antigen in the specimens. Statistical Analysis Used: The statistical analysis was carried out using Epi Info. The sensitivity, specificity, positive predictive value, and negative predictive value of the LAT were calculated. Results: The LAT exhibited sensitivity of 64.7% and specificity of 85.7% with CSF samples and sensitivity of 52.08% and specificity of 96% with serum samples. Conclusions: Results of the present study shows that the LAT can be employed as a moderately sensitive and specific test for the detection of T. solium metacestode antigen in the CSF and serum specimens for the diagnosis of NCC in poorly equipped laboratories. [ABSTRACT FROM AUTHOR]

Neurocysticercosis (NCC) is difficult to diagnose clinically because of its varied clinical presentation. However, an accurate diagnosis is possible only after suspicion on epidemiological grounds, proper interpretation of the clinical data, analysis of the findings on imaging studies, and specific immunological tests on the serum and cerebrospinal fluid (CSF). The diagnosis of NCC by any single parameter thus continues to remain difficult. In the past, detection of NCC was based on autopsy studies and histological confirmation. In recent times, the advent of imaging methods such as computed tomography and magnetic resonance imaging have provided excellent non-invasive tools for easy detection of NCC. Nevertheless, an imaging technique of the brain, although useful, is not considered as a gold standard for the diagnosis of NCC. Serological tests are being increasingly used in adjunct with imaging techniques, to aid the diagnosis of NCC. Immunodiagnostic techniques include detection methods for specific antibodies and for circulating parasite antigens in the serum and CSF. Currently, many of the immunodiagnostic tests, including the enzyme-linked immunosorbent assay and enzyme immunotransfer blot, use purified native antigens for the immunodiagnosis of NCC. Nevertheless, the main problem with the use of native cysticercal antigens is that the native proteins often show cross reactions with sera from humans infected with other parasites. The preparation of native antigens also demand a constant supply of parasitic material from the intermediate host pig. In order to overcome the problems in using native antigens, the recombinant antigens or synthetic peptides, which can be produced under stable conditions, are being evaluated for the serodiagnosis of NCC. [ABSTRACT FROM AUTHOR]

Aim: Pathophysiology of Eustachian tube significantly affects the result of middle ear reconstructive surgery. The aim of this study is to ascertain the relevance of preoperative assessment of tubal function on the results of myringoplasty and to correlate the outcome of surgery with the tubal function gradings. Materials and Methods: A total of 58 cases of dry central perforation of tympanic membrane were divided into two groups. In control group A, pre-operative Eustachian tube function was not checked. In Test group B, pre-operative Eustachian tube function was checked by modified inflation-deflation test using impedance audiometer. Results: Success was assessed at 4th month postoperatively on the basis of intact drum. The results between both groups were compared using Chi-square test. There was no statistically significant difference (P< 0.05) between the control and the test group. Conclusion: The capability to reduce an applied negative pressure correlates well with the successful result of a tympanic membrane graft. However, failure to equilibrate negative pressure does not discriminate between success and failure of this operative procedure. [ABSTRACT FROM AUTHOR]

Background: Cysticercosis is the most common differential diagnosis for epilepsy. The present study was carried out to assess the serological response among patients with epileptic seizures visiting JIPMER Hospital Puducherry. Materials and Methods: A total of 934 serum samples were collected from patients with epileptic seizures. A standardized questionnaire was designed to obtain information on the demographic, socioeconomic, environmental, and behavioral characteristics related to the transmission of infection. An enzyme-linked immunosorbent assay (ELISA) was used to detect the anti-Taenia solium larval stage IgG antibodies. Samples found reactive and inconclusive by ELISA were further tested by the enzyme immunotransfer blot (EITB). Results: The frequency of antibodies in the serum samples of the above-mentioned population was 16.2% by EITB. Anti-Taenia solium larval stage antibodies were detected in serum samples of 163 patients, out of which 27 (16.56%) patients belonged to the 0 - 15-year age group, 82 (50.30%) patients were in the 16 - 40-year age group, and 52 (31.90%) patients were above 41 years, respectively. Although the sera from males had higher OD values than those from females, the difference was not statistically significant. Out of 163 seropositive by ELISA, 152 (93.25%) were found to be positive by EITB. Out of the 152, 61 (40.13%) were farmers and 79 (51.97%) were office or factory workers. Conclusions: In conclusion, the results indicate a probable endemic situation and a high prevalence of cysticercosis in patients with epileptic seizures. Living in poor sanitary conditions seems to be an important factor related to human cysticercosis in Puducherry and the neighboring districts of Tamil Nadu. [ABSTRACT FROM AUTHOR]

Entameba histolytica causes amebiasis, which includes both intestinal and extraintestinal amebiasis. E. histolytica causes 34 million to 50 million symptomatic cases of amebiasis worldwide every year, causing 40 thousand to 100 thousand deaths annually. E. histolytica, the pathogenic species of amebae is indistinguishable in its cyst and trophozoite stages from those of E. moshkovskii, a free-living ameba, and E. dispar, a non-invasive ameba, by microscopy, except in cases of invasive disease, where E. histolytica trophozoite may contain ingested red blood cells, but such a finding is rarely seen. This leads to a confusing scenario for the definite identification and differentiation of E. histolytica from E. moshkovskii and E. dispar by conventional microscopy, in the diagnosis of intestinal amebiasis. The advent of molecular methods such as multiplex PCR and real time PCR have facilitated a better and accurate diagnosis of E. histolytica, E. moshkovskii, and E. dispar in stool, urine, saliva, and other specimens. Multiplex PCR for the diagnosis of amebic liver abscess, using urine and saliva as clinical specimens, has been used, and the results have been encouraging. Real-time PCR is a new and a very attractive methodology for laboratory diagnosis of amebiasis, because of its characteristics that eliminate post-PCR analysis, leading to a shorter turnaround time. Microarray-based approaches represent an attractive diagnostic tool for the detection and identification of amebae in clinical and epidemiological investigations. Development of vaccines against amebiasis is still in its infancy. However, in recent years, progress has been made in the identification of possible vaccine candidates, the route of application, and the understanding of the immune response, which is required for protection against amebiasis. Thus, it is just a matter of time, and hopefully, amebiasis vaccine for human trials will be available in the next few years. [ABSTRACT FROM AUTHOR]

Published scientific research breeds the development of clinical management guidelines and pathways. Currently, scholarly proficiency is assessed using numerous primitive metrics for incentives that can kindle publication of hoax or flawed research content. Such flawed data can lead to wastage of resources, time, and most importantly harm to the society. Authors, editors, and peer reviewers need to be genuine in conducting, analyzing, and publication of scientific research. Institutions need to be aware and utilize advanced metrics to assess the scientific reputation of researchers. This short review discusses in brief the common authorship and editorial ethical issues encountered in scientific publication and the newer metrics available for the assessment of scholarly excellence. Editors and peer reviewers need to be acquainted with the common ethical issues and follow consensus international guidelines on publication ethics to tackle them appropriately. [ABSTRACT FROM AUTHOR]