Search

Resistance to antimycobacterial agents consistently remains a major obstacle to end TB in India. Geographical prevalence data regarding drug-resistant evolutionary genetics of M. tuberculosis (MTB) remains sparse in India. Our objective was to determine the genotypic drug resistance mutation pattern for Rifampicin and Isoniazid of MTB isolates to gain an understanding of the prevailing molecular epidemiology of drug-resistant tuberculosis. In this study 2528 M. tuberculosis DNA isolates from presumptive DRTB suspects received at the nodal TB reference laboratory in Kerala were tested for Rifampicin and Isoniazid resistance by sequence-based diagnostic Line Probe assay (LPA). Geographical prevalence and associations of rpoB, katG, inhA resistance codons was analyzed from January 2019 to March 2020. Among the 2528 DNA samples subjected for Rifampicin and Isoniazid resistance determination by LPA, 146 (5.8%) isolates were resistant to both drugs. Isoniazid mono-resistance was found in 164 (6.5%) and Rifampicin mono-resistance in 38 (1.5%) isolates. The most frequent rpoB mutation was S531L (60.32%) followed by S531W/L533P mutations seen in 8.15% of the isolates. S315T1 KatG mutation was seen in 97.33% of Isoniazid resistant isolates. 84.68% isolates with rpoB S531L mutation were found to be multidrug-resistant. 82.9% of isolates with rpoB S531L mutation showed katG S315T1 mutation. Mono isoniazid-resistant isolates were significantly higher compared to mono rifampicin-resistant isolates among the DNA isolates studied in our region. The molecular epidemiological pattern most frequently associated with multidrug resistance was rpoB S531L which was significantly associated with the co-presence of S315T1 mutation.

BACKGROUND: The first national severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serosurvey in India, done in May-June, 2020, among adults aged 18 years or older from 21 states, found a SARS-CoV-2 IgG antibody seroprevalence of 0·73% (95% CI 0·34-1·13). We aimed to assess the more recent nationwide seroprevalence in the general population in India. METHODS: We did a second household serosurvey among individuals aged 10 years or older in the same 700 villages or wards within 70 districts in India that were included in the first serosurvey. Individuals aged younger than 10 years and households that did not respond at the time of survey were excluded. Participants were interviewed to collect information on sociodemographics, symptoms suggestive of COVID-19, exposure history to laboratory-confirmed COVID-19 cases, and history of COVID-19 illness. 3-5 mL of venous blood was collected from each participant and blood samples were tested using the Abbott SARS-CoV-2 IgG assay. Seroprevalence was estimated after applying the sampling weights and adjusting for clustering and assay characteristics. We randomly selected one adult serum sample from each household to compare the seroprevalence among adults between the two serosurveys. FINDINGS: Between Aug 18 and Sept 20, 2020, we enrolled and collected serum samples from 29 082 individuals from 15 613 households. The weighted and adjusted seroprevalence of SARS-CoV-2 IgG antibodies in individuals aged 10 years or older was 6·6% (95% CI 5·8-7·4). Among 15 084 randomly selected adults (one per household), the weighted and adjusted seroprevalence was 7·1% (6·2-8·2). Seroprevalence was similar across age groups, sexes, and occupations. Seroprevalence was highest in urban slum areas followed by urban non-slum and rural areas. We estimated a cumulative 74·3 million infections in the country by Aug 18, 2020, with 26-32 infections for every reported COVID-19 case. INTERPRETATION: Approximately one in 15 individuals aged 10 years or older in India had SARS-CoV-2 infection by Aug 18, 2020. The adult seroprevalence increased approximately tenfold between May and August, 2020. Lower infection-to-case ratio in August than in May reflects a substantial increase in testing across the country. FUNDING: Indian Council of Medical Research.

Field trials were conducted for three years during kharif season of 2014, 2015 and 2016 to evaluate the integrated pest management (IPM) module against pinworm (Tuta Absoluta) in tomato in comparison with farmer’s practice. Seasonal incidence studies revealed that population increased gradually from September and touched its peak during December (28.00 adults/trap). The insect was found to be higher at the fruit maturity stage and infestation found decreased with increase in temperature. IPM module reduced the cost of cultivation by Rs. 9615.66 ha-1 and the net returns were increased by Rs. 53282.00 per hectare. The average benefit cost ratio was improved with 2.39 in treatment compared to farmers practice 1.92. The results based on pooled data showed that reduction in the fruit damage by Tuta absoluta and good yields is due to the integrated management strategy taken up by installing pheromone traps 2 weeks after transplanting by which awareness on timely spraying of Azadirachtin 1500ppm @ 5ml/lt or combination of Azadirachtin with Chlorantraniliprole 18.5% SC @ 0.3 ml or Flubendiamide 480 SC @0.3ml or Indoxacarb 14.5% SC @ 1.75ml carried in practicing farmers field based on ETL level of adult catches and burning of infested plants and remnants of the crop immediately after the fruits have been harvested also found effective in managing the pest.

AIM The purpose of this study was to evaluate force systems to bring about the en masse retraction of maxillary anterior teeth having reduced bone levels using finite element analysis. MATERIALS AND METHODS This is a prospective study. Three-dimensional finite element models of maxillary dentition having normal alveolar bone level and 2, 4, and 6 mm bone loss with first premolar extraction were constructed from a spiral CT scan of a skull. Archwire and brackets were modeled on the facial surfaces of teeth. Retraction force of 175 gm was applied from an orthodontic mini-implant placed bilaterally between the second premolar and first molar and 12 mm above plane of the archwire to anterior retraction hook (ARH) fixed at two heights of 6 and 10 mm above the archwire. RESULTS Maximum displacement and periodontal ligament (PDL) stress were calculated for different combinations of bone levels and ARH. As the bone loss increased, the tipping tendency, amount of intrusion, and maximum von Mises stress in PDL also increased, showing a direct correlation. CONCLUSION To minimize tipping and PDL stress, the height of ARH should be increased in alveolar bone loss conditions to allow retraction force to pass through or even above the center of resistance of anterior teeth. Even then, pure bodily retraction may not be achieved, but tipping tendency can be reduced. Nevertheless, it may not be suitable to increase ARH beyond a limit owing to chances of irritation to the vestibular mucosa. Alternative methods should be contemplated to reduce the tipping behavior. CLINICAL SIGNIFICANCE The alternative is to apply a lighter retraction force to reduce lingual tipping. A higher counter-moment in the archwire or bracket can also be incorporated.

Background: Repeated cross-sectional serosurveys in the same geographic area establish the trend of the evolving pandemic. We present the findings of the third round of a national serosurvey to estimate the seroprevalence of SARS-CoV-2 infection among the general population and health care workers of India. Methods: We conducted the third population-based serosurvey between Dec 18, 2020 and Jan 6, 2021 in the same 700 villages or wards from 70 districts in 21 states across India, which were selected for the first and second serosurveys. We enrolled from each district, at least 400 individuals aged ≥ 10 years from general population and 100 HCWs from sub-district level public health facilities. Serum samples from general population were tested for the presence of IgG antibodies against nucleocapsid (N) and spike protein (S1-RBD) of SARS-CoV-2 using the Abbott and Siemens assays respectively, whereas sera from HCWs were tested for anti-S1-RBD. For general population, sera positive for either of the antibodies were considered positive, while sera positive for anti-S1-RBD were considered as positive for HCW. Weighted seroprevalence estimates were adjusted for sensitivity and specificity of respective assays. Findings: Of the 28,598 sera from general population, 4585 (16%) had IgG antibodies against N, 6647 (23.2%) against S1-RBD and 7436 (26%) against either. The weighted and assay characteristic adjusted seroprevalence against either of the antibodies was 24.1 (95%CI: 23.0% to 25.3%). Seroprevalence was lower in rural areas (21.4%, 95% CI: 20.3% to 22.6%) compared to urban non-slum (29.4%, 95% CI: 26.9% - 32.1%) and slum areas (34.6%, 95% CI: 31.0% to 38.3%). Among 7385 HCWs, the seroprevalence of anti-S1-RBD IgG antibodies was 25.6% (95% CI: 23.5% to 27.8%). Interpretation: Nearly one in four individuals aged 10 years or older from general population as well as HCWs were exposed to SARS-CoV-2 by December 2020 amounting to 271 million infections in India. Funding Statement: Indian Council of Medical Research Declaration of Interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare no competing interests Ethics Approval Statement: The project was approved by Institutional Human Ethics Committee at ICMR-National Institute of Epidemiology.

Skin cancer is a major health issue in the present day especially melanoma skin cancer. In general most of the skin cancers are cured if they are detectedin the early stage. With the rapid growth of skin cancer, there is a need for an automated computerized diagnosis mechanism of skin cancer in the early stage is required. Many of the skin cancer images have similar visual characteristics. It is an important challenging task to extract the features from the skin cancer images. The automated computerized diagnosis mechanism helps to improve the accurate analysis of skin diseases which helps the dermatologists to accelerate the diagnostic time and improve the better treatment for the patients. This paper mainly presents the comparative study on traditional image processing and current technologies of different image processing techniques for skin cancer image classification, preprocessing techniques, Feature extraction, and image segmentation datasets.

Background & objectives: Population-based seroepidemiological studies measure the extent of SARS-CoV-2 infection in a country. We report the findings of the first round of a national serosurvey, conducted to estimate the seroprevalence of SARS-CoV-2 infection among adult population of India. Methods: From May 11 to June 4, 2020, a randomly sampled, community-based survey was conducted in 700 villages/wards, selected from the 70 districts of the 21 States of India, categorized into four strata based on the incidence of reported COVID-19 cases. Four hundred adults per district were enrolled from 10 clusters with one adult per household. Serum samples were tested for IgG antibodies using COVID Kavach ELISA kit. All positive serum samples were re-tested using Euroimmun SARS-CoV-2 ELISA. Adjusting for survey design and serial test performance, weighted seroprevalence, number of infections, infection to case ratio (ICR) and infection fatality ratio (IFR) were calculated. Logistic regression was used to determine the factors associated with IgG positivity. Results: Total of 30,283 households were visited and 28,000 individuals were enrolled. Population-weighted seroprevalence after adjusting for test performance was 0.73 per cent [95% confidence interval (CI): 0.34-1.13]. Males, living in urban slums and occupation with high risk of exposure to potentially infected persons were associated with seropositivity. A cumulative 6,468,388 adult infections (95% CI: 3,829,029-11,199,423) were estimated in India by the early May. The overall ICR was between 81.6 (95% CI: 48.3-141.4) and 130.1 (95% CI: 77.0-225.2) with May 11 and May 3, 2020 as plausible reference points for reported cases. The IFR in the surveyed districts from high stratum, where death reporting was more robust, was 11.72 (95% CI: 7.21-19.19) to 15.04 (9.26-24.62) per 10,000 adults, using May 24 and June 1, 2020 as plausible reference points for reported deaths. Interpretation & conclusions: Seroprevalence of SARS-CoV-2 was low among the adult population in India around the beginning of May 2020. Further national and local serosurveys are recommended to better inform the public health strategy for containment and mitigation of the epidemic in various parts of the country.

Background: The first round of national serosurvey in India was conducted in May-June 2020 among adults from 21 States. The second serosurvey was conducted in August-September 2020 to estimate the nationwide seroprevalence for SARS-CoV-2 infection in the general population aged ten years and above. Methods: The household serosurvey was conducted among individuals aged ten years and above in the same 700 villages and wards from 70 districts selected during the first serosurvey. Blood samples were tested using the Abbott SARS-CoV-2 IgG assay. Seroprevalence was estimated after applying the sampling weights and adjusting for clustering and assay characteristics. In order to compare the adult seroprevalence between the two surveys, we randomly selected one adult serum sample from each household. Findings: The weighted and adjusted prevalence of infection among 29,082 individuals aged ten years and above was 6·6% (95% CI: 5·8% - 7·4%). The seroprevalence among adults was 7·1% (95% CI: 6·2% – 8·2%). Seroprevalence was similar across age groups, sex, and occupation. Seroprevalence was highest in urban slum areas followed by urban non-slum and rural areas. We estimated a cumulative 74·3 million infections in the country, with 26 – 32 infections for every reported COVID-19 case by August 2020. Interpretation: Nearly one in 15 individuals aged ten years and above had SARS-CoV-2 infection by August 2020. The adult seroprevalence increased ten times between May and August 2020. Lower infection to case ratio in August compared to May reflects a substantial increase in testing across the country. Funding: The study was funded by the Indian Council of Medical Research, New Delhi, India. The study sponsor was involved in reviewing the study design, writing of the manuscript and the decision to submit the paper for publication. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The authors obtained written informed consent from individuals aged 18 years and older. We obtained assent from children aged between 10–17 years, and written informed consent from their parents or guardians prior to the survey. The Central Ethics Committee of Health Research of Indian Council of Medical Research and the Institutional Human Ethics Committee of ICMR-National Institute of Epidemiology, Chennai approved the study protocol.

Cisplatn is one of the chemotherapy for the treatment of triple‐negatve breast cancer (TNBC), but its effectveness is limited because of the phenomenon of chemoresistance. miR‐638 was shown to regulate chemoresistance; however, it has never been validated in the cisplatn‐resistant tumor from patents. This present study aimed to identfy the key gene regulatory networks of miR‐638 and evaluate the potental role of the miR‐638 and its targets as potental prognosis biomarkers for cisplatn‐resistance triple‐negatve breast cancer patents. The miR‐638 target was obtained from the miRecords database while the mRNA of chemoresistance biomarker candidate was obtained from the GSE18864 of GEO database, which is mRNA of cisplatn‐resistance TNBC patents. CCND1 and FZD7 are potental candidates for cisplatn chemoresistance biomarkers in patents with TNBC. Moreover, a Kaplan‐Meier survival plot showed that breast cancer patents with low mRNA levels of FZD7 had signifcantly worse overall survival than those in higher mRNA expression group. Taken together, miR‐638 plays a role in cisplatn resistance mechanism through a mechanism involving its target gene CCND1 and FZD7 . Overall, miR‐638, CCND1 , and FZD7 are candidates for cisplatn biomarker resistance in TNBC.

Dengue Fever (DF) may evolve into two life threatening forms—Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS). DHF is associated with increased vascular permeability and plasma leakage causing thrombocytopenia and loss of clotting factors into the third space and may result in bleeding initially due to thrombocytopenia and later due to disseminated intravascular coagulation (DIC), often as a terminal event. Prompt recognition and treatment of minor bleeds in DF children with incipient DIC with component therapy may be associated with improved survival while failure to do so is usually catastrophic. A sensitive marker for early DIC is the presence of D-dimer (DD) in the blood. To determine the correlation between the severity of thrombocytopenia and early DIC in children with DHF. The impact of additional factors like age and shock will also be evaluated. Case control prospective study of 60 DHF sero -positive children (1–15 years) with thrombocytopenia. After clinical evaluation they were divided into two equal groups based on the degree of thrombocytopenia (more than/less than 30,000/mm3). PT/APTT and DD levels were estimated in all children of both groups and statistical correlation was done. There was no significant difference in the DD levels between the two groups. However, children in either group, presenting with clinical features of shock and thrombocytopenia had significantly higher DD levels. Empirical component therapy in children with DHF based purely on their low platelet counts may not be justified. However, in DHF children with thrombocytopenia and features of shock, aggressive component therapy may prevent subsequent bleeding and may be justified.

In a resource-poor country like India, where the health-care systems are difficult to access, overburdened, and unaffordable to many, the impact of the coronavirus disease 2019 (COVID-19) pandemic can be devastating. The increased burden of serious health-related suffering can impact the well-being of health-care workers, patients, and their families alike. The elderly, the frail, the vulnerable, and those with multiple comorbidities are disproportionately affected. Palliative care, with its comprehensive and inclusive approach, has much to offer in terms of alleviating the suffering, particularly those caused by the distressing physical and psycho-socio-spiritual symptoms, the complex medical decision-making, end-of-life care issues, and grief and bereavement, and needs to be integrated into the pathway of care provision in COVID-19. Psychosocial issues contribute to and amplify suffering and are often underestimated and undertreated and not accessible to many. Empowering frontline professionals in the core concepts of psychosocial support and palliative care thus becomes an absolute necessity. This quick review was done by a group of palliative care physicians and mental health experts from India to develop recommendations for physical and psychosocial care in the context of COVID-19. This review was done as part of that process and highlights the role and challenges of the psychosocial domain of palliative care in the context of COVID-19 situation in India.

Plerixafor (PLX) injections are administered to patients with cancers of lymphocytes (non-Hodgkin’s lymphoma) and plasma cells (multiple myeloma). The main objective of the current study was to develop a short reverse phase chromatographic method for the simultaneous quantification of PLX and its impurities, in an injection formulation, to reduce the time required for these quality tests. Furthermore, the present work describes the role of nonalkyl branched nonquaternary ion pair reagent in improving the peak shape and reducing column equilibration time. The separation of PLX and its related substances is pH dependent (optimum pH = 2.50) and was achieved on an octadecylsilyl (C18) column. The method was validated for its intended purpose in accordance with the current regulatory guidelines for validation. The proposed method can be applied for quality control, release, and stability analyses of active pharmaceutical ingredient, PLX, as well as finished products, PLX injections.

Background: Diabetes mellitus (DM) is a metabolic disorder precipitating micro and macro vascular complications and peripheral vascular diseases. Normal lung mechanism and gas exchange are influenced by integrity of pulmonary connective tissues and microvasculature. Abnormality in either of these two structural components of lung leads to variations in lung functions. Objective: This study was conducted to document lung function patterns by spirometry in patients with Type 1 DM. Materials and Methods: This cross-sectional study was conducted in Bangalore, India. Patients in the age group of 1-18 years diagnosed with Type 1 DM between December 2009, and January 2011 were included. Data regarding respiratory symptoms, age, height and weight of each patient with Type 1 DM was collected. The children were trained to use spirometers. Multiple readings of forced expiratory volume in one second and forced vital capacity were obtained until consistent, and the best reading was recorded and analyzed for any association. Results: A total of 51 children with Type 1 DM were studied, of whom 24 children were males, with a mean age of 14.06 ± 3.25 years, the minimum age being 5 years and a maximum being 18 years. 25 children (49%) with Type 1 DM were found to have pulmonary dysfunction, of which 19 children (76%) had restrictive lung pattern, and six children (24%) had obstructive pattern. Conclusion: Spirometry evaluation showed that restrictive lung pattern was very common in children with Type 1 DM, and there is scope for further study. Key words: Obstructive pulmonary pattern, Pulmonary function tests, Restrictive pulmonary pattern, Type 1 diabetes mellitus

Web is a context in which traditional Information Retrieval methods are challenged. Given the volume of the Web and its speed of change, the coverage of modern web search engines is relatively small. Search engines attempt to crawl the web exhaustively with crawler for new pages, and to keep track of changes made to pages visited earlier. The centralized design of crawlers introduces limitations in the design of search engines. It has been recognized that as the size of the web grows, it is imperative to parallelize the crawling process. Contents other then standard documents (Multimedia content and Databases etc) also makes searching harder since these contents are not visible to the traditional crawlers. Most of the sites stores and retrieves data from backend databases which are not accessible to the crawlers. This results in the problem of hidden web. This paper proposes and implements DCrawler, a scalable, fully distributed web crawler. The main features of this crawler are platform independence, decentralization of tasks, a very effective assignment function for partitioning the domain to crawl, and the ability to cooperate with web servers. By improving the cooperation between web server and crawler, the most recent and updates results can be obtained from the search engine. A new model and architecture for a Web crawler that tightly integrates the crawler with the rest of the search engine is designed first. The development and implementation are discussed in detail. Simple tests with distributed web crawlers successfully show that the Dcrawler performs better then traditional centralized crawlers. The mutual performance gain increases as more crawlers are added.

The impacts caused by tobacco extend beyond the well - reported links with cancer, heart disease and respiratory illnesses. It also can cause family breakdown, low self esteem, p oor social relationship, impotence, ulcers and fertility problems and it does not harm only smokers. Passive smoking causes l ung cancer and is linked to death, glue ear and asthma in children. The review of literature showed that most of the researches tal k about the consumption of tobacco and its influence on cancer and other related diseases. However there are few studies (Kandel, 2002; Gupta, 2004; Singh, 2004; Kumar, 2008) which cover social and psychosocial factors of tobacco consumption and its effect s on people. These studies revealed that tobacco not only harms the individual but also the family, community and the whole society. In this paper attempt has been made to review tobacco consumption amon g children in India as well as other western countrie s to understand the present scenario.