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Failure of conventional mosquito control strategies to curb the population of vectors have made the humans vulnerable to serious medical problems transmitted by them. This effect has been compounded by global climate change enabling the mosquitoes to cross geographical boundaries and cause trouble in regions where they were initially not found. As such, the scientific community has been compelled to devise alternative and innovative strategies of mosquito control that can be integrated with the conventional practices to implement multi-phasic approach of vector management. Culex quinquefasciatus is one such mosquito species that is reported to be one of the primary vectors of lymphatic filariasis and many other diseases of global health concern. However, not much is known about its breeding habitat ecology and microbial properties that have enabled the species to achieve reproductive success in urbanized habitats. The current investigation was carried out at Digha, West Bengal, India. The region, despite being endemic for lymphatic filariasis, has rarely been explored for its mosquito diversity and/or their breeding habitat characteristics. Therefore, these were attempted. For survey and sampling, seven villages were chosen, namely, Duttapur, Jatimati, Champabani, Padima, Gobindabasan, Bhagibaharampur and Palsandapur. The study showed that Cx. quinquefasciatus is the dominant mosquito species at the sampling sites with the highest density of their larvae being recorded from man-made structures like drains and pools close to human habitations and livestock. The study was, therefore, restricted to Cx. quinquefasciatus. Seasonal abundance showed that they were most prevalent in the monsoon followed by summer. The physicochemical characterization showed their larvae to prefer almost neutral pH (6.9 to 7.3), low chloride concentration (98 to 258 ppm) and turbidity. As far as other parameters are concerned, they were tolerant towards a wide range allowing them to adapt varied habitats in the study areas. The bacterial profiling of their natural habitat waters revealed the presence of Paenibacillus nanensis DGX1(OQ690670), Bacillus cereus DGX2(OQ690675), Bacillus sp. DGX3(OQ690700) and Escherichia coli DGX4(OQ690701). Bacillus cereus was found to have high oviposition attractant properties in oviposition assays. Bacillus cereus was also obtained from the midgut of third instar larvae indicating that they had entered from the surrounding medium and colonized the larval gut. Subsequent tests exhibited the roles of B. cereus in larval development. Numerous plant products have been reported either as insecticides for killing larvae or adult mosquitoes or as repellents for mosquito biting and the best alternatives for mosquito control. Larvicidal potential of emulsified neem oil formulation against the field collected 3rd instar larvae of Culex quinquefasciatus mosquito under laboratory conditions was also evaluated. The information thus obtained can be pooled to generate larval source markers and larval source management practices by altering their habitats that cannot be removed. Furthermore, the time of implementation of these strategies can also be planned., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Aim: Globally, walkathon, a type of community event involving walking a determined distance to raise awareness and/or collect donations for a social cause is gaining a lot of public attention. This study was conducted to understand the usefulness of walkathon in creating cancer awareness among the participants., Materials and Methods: This was a pre- and post-test study and was carried out on World Cancer Day on February 4, 2019 in Mangalore, Karnataka, India. The study subjects were the walkathon participants willing to be volunteers for the study. Differences in the answers were calculated by ascertaining the difference between the pretest and posttest using McNemar, Chi-square, or Fisher's exact test. A P < 0.05 was considered statistically significant., Results: Pretest scores indicated most volunteers were aware of the role of tobacco and alcohol in cancer, while most were unaware of the importance of fruits and consumption of vegetables and sedentary lifestyle in the development of cancer. Posttest showed a significant increase in knowledge gain (P = 0.003 to <0.001)., Conclusions: For the first time, this study shows Walkathon to be helpful in improving cancer knowledge in the participants. Walkathon is an inexpensive and joyful way to educate people and warrants further study on a range of medical and social themes affecting society to establish its usefulness in public health education., (Copyright © 2023 Copyright: © 2023 Journal of Cancer Research and Therapeutics.)

Objective: To study the correlation of objective parameters for diagnosing shock viz., perfusion index (PI), plethysmography variability index (PVI) and serum lactate (SL) with invasive blood pressure in late preterm and term infants with shock., Methods: Prospective observational study (diagnostic test) conducted at the neonatal intensive care unit of Kanchi Kamakoti CHILDS Trust Hospital, Chennai between June, 2018 and May, 2020. Term and late preterm neonates with shock were included in the study. PI, PVI, SL, SpO2 and heart rate were monitored. PI, PVI and SLL were recorded at 0,12, 24 and 72 hours of onset of shock. All the babies were followed up till discharge or death., Results: Total 78 neonates were enrolled in the study. At 0 hour, SL and PVI had negative correlation (P =0.002 and P=0.003) while PI had a weak-to-moderate positive correlation (P=0.002) with invasive blood pressure. SL ≥4.65 had a sensitivity of 75% and specificity of 75.8%, and PI <0.455 had a sensitivity of 65%, and specificity of 58.6% for predicting invasive hypotension. PVI ≥23.5 had a sensitivity of 90% and specificity of 63.8% in predicting invasive hypotension., Conclusion: PI has moderate positive correlation while SL and PVI have moderate negative correlation with invasive blood pressure. The cutoff values of SL ≥4.65, PI <0.45 and PVI ≥23.5 can predict invasive hypotension with good sensitivity and negative predictive value.

Ethnopharmacological Relevance: Antidesma acidum Retz, a perennial herb is known for its anti-diabetic potential among the traditional health care providers of the tribal communities of Manipur, India. Scientific validation of the ancient knowledge on traditional use of this plant with the help of modern tools and techniques can promote further research and its use in health care., Aim of the Study: Type 2 Diabetes (T2D) is a complex metabolic disorder and linked with hyperglycemia occurring from insufficiency in insulin secretion, action, or both. The aim of this study was to scientifically validate the traditional myth behind the uses of this plant material against diabetes. More specifically, it was aimed to determine the effect of methanolic extract of A. acidum leaves and/or any of its bioactive phytochemical(s), in enhancing insulin sensitization and subsequently stimulating the insulin signaling cascade of glucose metabolism., Materials and Methods: Methanol was used for extraction from the leaf powder of A. acidum followed by bioactivity guided fractionation and isolation of most active component. Biological evaluation was performed to determine the glucose uptake ability against insulin resistance in skeletal muscle (L6) cells. To understand the detailed mechanism of actions of the purified compound, several molecular biology and structural biology experiments such as Western blot, siRNA transfection assay and molecular docking study were performed., Results and Discussion: Bioactivity guided isolation of pure compound and spectral data analysis led us to identify the active component as Kaempferol 3-O-rutinoside (KOR) for the first time from the leaf of A. acidum. Over expression of NAD-dependent histone deacetylase, Sirtuin 1 (SIRT1) was observed following KOR treatment. SIRT1 plays an important role in the metabolic pathway and over expression of SIRT implies that it involves in insulin signaling directly or indirectly. Molecular docking and simulation study showed the strong involvement between KOR and SIRT1.Treatment with KOR resulted in significant over expression of SIRT1followed by upregulation of insulin-dependent p-IRS, AKT and AMPK signaling molecules, and stimulation of the GLUT4 translocation, which ultimately enhanced the glucose uptake in sodium palmitate-treated insulin resistant L6 myotubes. Further, the effect of KOR on IRS1, AKT and AMPK phosphorylation, GLUT4 translocation, and glucose uptake was attenuated in SIRT1-knockdown myotubes., Conclusion: Overall, the results of this study suggest that Kaempferol 3-O-rutinoside is the active component presents in the leaf of A. acidum which increases glucose consumption by inducing SIRT1 activation and consequently improves insulin sensitization. These results may find future applications in drug discovery research against T2DM., Competing Interests: Declaration of competing interest The authors declared no conflict of interest., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Introduction: Secondary food allergies due to cross-reactivity between pollen and food allergens are a significant health burden in India. Prevalence of cross-reactivity varies by region, and particularly in West Bengal, it remains unexplored. The present study investigated sensitivities of pollen-related food allergy (PFA) patients of West Bengal by empirically determining co-sensitization patterns., Methods: The present study retrospectively analysed 1,310 pollen-allergic (PA) patients from the Allergy and Asthma Research Centre, West Bengal. A questionnaire survey was performed to record patients' demographic and clinical features and categorized into seasonal and perennial ones. All patients were subjected to the skin prick test and specific IgE for evaluation of sensitivity against 16 pollen and 16 food allergens. Co-relation and principal component analysis (PCA) was performed to determine co-sensitivity., Results: Seasonal allergic patients were comparatively higher than perennial ones. PFA patients were mostly sensitive to eggplant (n = 387), while Azadirachta indica (n = 341) was predominant sensitizer among pollen allergen sources. Cynodon dactylon showed maximum significant positive correlation with banana, orange, peanut, pineapple, cucumber, eggplant, potato, tomato, and wheat. In the seasonal group, Cynodon dactylon-specific IgE in PFA patients (median = 4.60 kU/L) was significantly higher from that of PA ones (median = 3.44 kU/L). Among 32 allergens tested, 27 were placed in first two dimensions of the PCA biplot., Conclusion: The present study established that co-sensitivity between pollen and food allergen sources were predominant in allergic patients of West Bengal. The co-sensitization patterns among unrelated allergen sources may be due to possible expression of biologic cross-reactivity to similar allergens., (© 2022 S. Karger AG, Basel.)

Vegetation dynamics is an important aspect for determining climate change trends. The present study delineates to examine spatiotemporal changes of vegetation cover in Pindari valley (Kumaun Himalaya) from the 1972 to 2018 timeline. The study includes the calculation of vegetation spectral indices of normalized vegetation index (NDVI), extraction of different vegetation classes, and statistical analysis of the Mann-Kendall (MK) test on historical metrological data (especially precipitation and temperature) of the study site. For the statistical analysis of metrological data, the power data access viewer datasets have been used. The central feature classes of the study are grassland, scrubland, and forest cover. The results revealed that the region's forest cover significantly decreased by 24.74 sq. km from 1972 to 2018, increased in grassland cover by 17.84 sq. km, respectively, and a slight increase in scrubland class by 3.13 sq. km for the study period. The calculated NDVI shows significant changes over the study location; it has been noticed that the maximum values of the NDVI decreased by 0.24, and the minimum values show growth of about 0.047. The analysis indicates that climatic parameters such as precipitation and temperature are the main limiting factors affecting vegetation growth. The annual mean maximum temperature showed a decreasing trend. The estimated results show an increase in annual rainfall and annual minimum temperature, while the decreasing trend is observed in the case of maximum annual temperature. Objectives of the study are (1) spatiotemporal analysis of the vegetation cover, (2) identification of the main causes of change in the vegetation cover, and (3) statistical trend analysis of long-term metrological data. The outcome of the presented research work would be beneficial for the proper management and monitoring of the forest ecosystem., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: The assessment of newborns' heart rate (HR) in the delivery room is one of the important steps to ascertain the need for initiation and continuation of resuscitation. At present, ECG is the "gold standard" to monitor neonatal HR in the delivery room. However, various limitations with the use of ECG exist. Furthermore, in developing countries, ECG may not be universally available in delivery rooms., Objective: To compare the accuracy and HR acquisition time of portable Doppler ultrasound (PDU) versus electrocardiogram (ECG) in newborns., Methods: This multicenter, prospective, observational study across five centers in India between January and September 2017 included neonates more than 34 weeks of gestation ( n  = 131) delivered by cesarean section. The accuracy of HR recorded by PDU (HR PDU ) versus that by ECG (HR ECG ) was the primary outcome. Secondary outcomes included time to acquisition of an audible and/or visible signal and device application., Results: Mean (±SD) gestational age and birthweight were 37.7 (±1.2) weeks and 2954 (±457) g, respectively. The mean (±SD) visible HR PDU was 158 (±21) bpm versus HR ECG of 161.3 (±20) bpm ( p  = .07) which were comparable. The median (1st, third quartile) time to acquisition of audible HR PDU (76 [51, 91] s), was significantly shorter than that of HR ECG (96.5 [74.2, 118] s; p  < .001)., Conclusion: Portable Doppler has similar accuracy to ECG and is faster in acquiring the signal.

Little is known about genetic factors and mechanisms underlying shrimp allergy. Genome-wide association studies identified HLA class-II and IL13 genes as highly plausible candidates for shrimp allergy. The present study was designed to investigate potential associations of HLA-DQ rs9275596, IL13 rs20541, and IL13 rs1800925 polymorphisms with challenge-proven shrimp allergy using the data from 532 people of West Bengal, India; selected on basis of positive skin prick test, elevated specific IgE and medical history. Risk genotypes, i.e., HLA-DQ rs9275596 CC, IL13 rs20541 AA, and IL13 rs1800925 TT, were found to be significantly associated with challenge positive shrimp allergy (P = 0.04, 0.01, and 0.03, respectively). Distribution of genotypes for HLA-DQ and IL13 polymorphisms in allergic and control subjects showed significant difference between younger (20-40 years) and older (> 40 years) age group (P = 0.006). Risk genotypes significantly associated with elevated shrimp-specific IgE. IL13 TA haplotype significantly associated with shrimp allergy and elevated specific IgE (P = 0.02). Synergistic effect of IL13 TA haplotype-HLA-DQ rs9275596 CC genotype interaction significantly elevated specific IgE (P = 0.03). The present study suggests that HLA-DQ and IL13 polymorphisms pose major risk for shrimp allergic patients in West Bengal, India and thus could be helpful for early target-specific therapeutic intervention in near future.

Introduction: Darjeeling tea of India is one of the most famous beverages globally. However, a large amount of tea crop is damaged every year by the attack of mites., Objectives: The study aimed to determine the changes in different pigments and biochemical components of tea leaves due to mite infestation., Materials and Methods: We used UV-visible and Fourier-transform infrared (FTIR) spectroscopy simultaneously to understand the damages in pigment contents of the leaves of tea (Camellia sinensis (L.) Kuntze) due to attack of phytophagus mite, Oligonychus coffeae Nietner. Furthermore, chemical analysis of infested tea leaves was also performed to compare the nutrients of the plants, namely total phenol, protein and soluble sugar., Results: The UV-visible study reveals severe reduction of the pigments such as chlorophyll (Chl), carotenoids and xanthophylls in the tea leaf due to mite infestation. The findings of the FTIR study, also shows variation in different physiochemical components in the leaf Chl. The sugar and protein content of the infested leaves have been reduced compared to uninfested ones. Results in the case of tea leaves plucked during first (March) and third (November) flushes show similar trends., Conclusion: The increase in phenolic and alcoholic components and decrease in Chl contents may affect the quality of Darjeeling tea. The extent of damages done by the pests measured here could aid the pest management in tea gardens., (© 2019 John Wiley & Sons, Ltd.)

Fungal resistance against frequently used antifungal medicines used for invasive candidiasis and other fungal infections is directing scientist for searching and developing novel antifungal drugs. An endophytic fungal strain Alternaria tenuissima OE7 has been isolated from leaves of Ocimum tenuiflorum L. which showed antifungal activity against numbers of human pathogenic fungi including Trichophyton rubrum, Microsporum gypseum, Aspergillus parasiticus, A. flavus, A. fumigates, Candida albicans and C. tropicalis. Thermostable, non-proteinacious antifungal metabolites produced zones of inhibition against all pathogenic fungi tested. The ethyl acetate extract of the cell free supernatant was found inhibitory to the radial growth and conidial germination of T. rubrum and M. gypseum. It also showed cidal mode of action against C. albicans at a concentration of 1.0 mg/ml. Most interestingly, inhibition of biofilm formation and hyphal development of C. albicans were observed upon treatment with EA fraction at comparatively lower concentrations (100-500 μg/ml). Release of intracellular contents from treated cells of Candida and scanning electron microscopic observation suggested cellular disruptions by antifungal metabolites. Checkerboard study revealed synergy between EA fraction of OE7 (150 μg/ml) and fluconazole (30 μg/ml) with ƩFIC of 0.45. Two active fractions viz. band 'C' and band 'G' derived after thin layer chromatographic analysis showed inhibitory activity against C. albicans with MIC values of 80 μg/ml and 130 μg/ml respectively. GCMS analysis suggested presence of numbers of compounds in each active fraction. Overall observations attest the prospective role of the isolate OE7 as a potent candidate for the production of antifungal metabolites against human pathogenic fungi., (Copyright © 2019 Elsevier GmbH. All rights reserved.)

House dust mites (HDMs) are the major constituents of house dust (HD). HD and HDM sensitization is well documented worldwide. Storage mite (SM) sensitization is presently lacking from India. The present study evaluated the sensitization of both HDM and SM among 372 allergic rhinitis patients reported to the Allergy and Asthma Research Center of Kolkata metropolitan, India. HD samples were collected from the patients' home and analyzed for the major constituent mites. HD and six constituent mites Dermatophagoides pteronyssinus (DP), Dermatophagoides farina Hughes (Acari: Pyroglyphidae) (DF), Blomia tropicalis (BT), Acarus siro Linnaeus (Acari: Acaridae) (AS), Lepidoglyphus destructor (LD), and Tyrophagus putrescentiae (Schrank) (Acari: Acaridae) (TP) are tested for the allergenic potential through Skin Prick Test (SPT). Three SMs, namely AS, LD, and TP, were newly included in the mite SPT extract for the first time in Kolkata. In total, 330 patients showed significant positive SPT toward any one allergen tested. HD was the major elicitor exhibiting 92.42% response. Individuals of age group 15-40 were the worst sufferers. DF showed the highest sensitization (87.87%) among the dust mites. The SMs also contributed significantly to prove their sensitizing potential. SPT rates for AS, LD, and TP were 33, 25, and 18%, respectively. SPT grades and total Immunoglobulin E (IgE) were positively correlated for each of the allergens. Most of the patients were multi-sensitized (95%) and represented markedly high total IgE levels (>500 IU/ml). Three SMs proved to be significant allergens for the studied population. The sensitization toward these SMs is first time reported from India and can be recommended for inclusion of routine SPT for better outcome in the future., (© The Author(s) 2018. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

India is experiencing rapid population ageing in recent years. One of the most concomitant issues is the choice of health care services among the elderly, leading to its impact on the magnitude of health expenditure. Applying Andersen's Health Behavioural Model, this study identifies the predictors of the choice of inpatient health care services among the Indian elderly between private and public services. It also examines the nature of interregional disparity in the choice of health care services. Using NSSO data, the results suggest that the elderly belonging to upper caste and having higher levels of education, higher incomes, larger family size, and needing surgery are likely to choose private health care, while those experiencing higher economic dependence, chronic diseases, and higher duration of hospitalisation tend to prefer public inpatient services. The magnitude and significance of these factors, however, vary across regions. The findings of the study provide an understanding of the preferences of the India's geriatric population over hospital services, which may help policymakers better understand their health care needs., (© 2018 John Wiley & Sons, Ltd.)

Objective: Diabetic nephropathy (DN) remains the most common cause of end stage renal disease (ESRD) as the burden of diabetes increases worldwide. Only 25 to 40% of patients with type 2 diabetes mellitus (T2DM) develop diabetic nephropathy irrespective of glycemic control so there should be a specific genetic basis for the development of diabetic nephropathy., Methods: We have collected venous blood samples from 50 cases (Diabetic nephropathy) and 20 controls (T2DM without nephropathy) diagnosed by spot urine albumin creatinine ratio (ACR). DNA was isolated from processed samples. PCR study and sequencing was done to detect polymorphism of rs2237897 in KCNQ1 gene., Results: Statistically significant difference was found when the allelic frequencies between the two groups were compared (p=0.03), with the C allele having a 2.4 fold higher risk of having diabetic nephropathy (risk ratio, RR )= 1.16, 95%CI of RR = 1.01 to 1.3, Odds Ratio (OR) =2.4; 95% CI of OR =1.06 to 4.6). Chi-square analysis showed a significant difference in genotype frequency of rs2237897 (χ2 = 4.63, p=0.03) in Diabetic nephropathy subjects, compared with that of controls., Conclusions: This study suggested that, KCNQ1 being an established type 2 diabetes gene, genetic variation in this gene may contribute to susceptibility to diabetic nephropathy and the C allele is the risk allele for diabetic nephropathy, which is different from Japanese population where the T allele was the risk allele., (© Journal of the Association of Physicians of India 2011.)

India is the home to around 15-20 million asthmatics, and asthma prevalence is increasing in Indian metropolitan area, including Kolkata, West Bengal. Complex interactions of genetic and environmental factors are involved in asthma. Genome-wide search for susceptible loci regulating IgE response (atopy) have identified a candidate gene CD14 which is most important in the context of allergic responses of respiratory system. This study was aimed to investigate the role of house dust and house dust mites in development of bronchial asthma and to explore the possible association of candidate gene CD14 with disease manifestation among Kolkata patient population. Skin-prick test was done among 950 asthmatic patients against 8 aeroallergens, including house dust and house dust mites and total serum IgE and allergen-specific IgE were measured. Polymerase chain reaction-restriction fragment length polymorphism was done in patients and nonasthmatic control (n = 255 in each) to characterize a functional polymorphism, C(-159)T, of CD14, a positional candidate gene for allergy. We identified house dust as the most common aeroallergen sensitizer among atopic patients in Kolkata followed by Dermatophagoides pteronyssinus and Dermatophagoides farinae Hughes (Acari: Pyroglyphidae) mites. Patient's sera contain significantly higher IgE level than that of control. Allergen-specific IgE antibody test revealed that 76.36% patients had specific IgE antibody against D. pteronyssinus mite. There was a significant difference in the distribution of alleles and genotypes for CD14 polymorphism with an increase in disease severity. So, in Kolkata, house dust mite is a common aeroallergen and D. pteronyssinus is predominant among mites. The present study revealed that bronchial asthma has a genetic background., (© The Author(s) 2017. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Positivity of microscopy and culture was greater (P < 0.0001) in men with urethral discharge syndrome (65.8%) than in women with vaginal/cervical discharge (0.5%), indicating that basic diagnostic tests may not be cost-effective for diagnosis of vaginal/cervical discharge syndrome. Microscopy when compared with culture showed sensitivity, specificity, positive predictive value and negative predictive value of 95.4%, 77.6%, 84.6%, and 95.3%, in men, whereas in women, it was 77.8%, 99.9%, 92.1%, and 99.9%, respectively.

Antimicrobial susceptibility testing of 258 Neisseria gonorrhoeae isolates by Etest determined that 60.1% were multidrug resistant (MDR), while 5% of the strains had decreased susceptibility to currently recommended extended-spectrum cephalosporins (ESCs). Among these, 84.5% of MDR strains and 76.9% of strains that had decreased susceptibility to ESCs were susceptible to gentamicin. No MDR isolate was resistant to gentamicin. These in vitro results suggest that gentamicin might be an effective treatment option for the MDR strains and in dual therapy for gonorrhea. However, further research regarding the clinical treatment outcomes is essential., (Copyright © 2016, American Society for Microbiology. All Rights Reserved.)

Otosclerosis (OTSC) is a late-onset hearing disorder characterized by increased bone turnover in the otic capsule. Disturbed osteoprotegerin expression has been found in the otosclerotic foci which may have an important role in the pathogenesis of OTSC. To identify the genetic risk factors, we sequenced the coding region and exon-intron boundaries of the OPG gene in 254 OTSC patients and 262 controls. Sequence analysis identified five known polymorphisms c.9C>G, c.30+15C>T, c.400+4C>T, c.768A>G, and c.817+8A>C. Testing of these SNPs revealed sex specific association with c.9C>G in males and c.30+15C>T in females after multiple correction. Furthermore, meta-analysis provided evidence of association of the c.9C>G polymorphism with OTSC. In secondary analysis, we investigated the mRNA expression of OPG and associated genes RANK and RANKL in otosclerotic tissues compared to controls. Expression analysis revealed significantly missing/reduced OPG expression only in otosclerotic tissues. However, the signal sequence polymorphism c.9C>G has shown no effect on OPG mRNA expression. In conclusion, our results suggest that the risk of OTSC is influenced by variations in the OPG gene along with other factors which might regulate its altered expression in otosclerotic tissues. Further research is warranted to elucidate the mechanisms underlying these observations., (© 2015 John Wiley & Sons Ltd/University College London.)

Coal in India is extracted generally by semi-mechanized and mechanized underground mining methods. The Bord and Pillar (B & P) mining method still continues to be popular where deployment of manual miners is more than that of other mining methods. The study is conducted at haulage based mine of Eastern Coalfields of West Bengal. Underground miners confront with a lot of hazards like extreme hostile environment, awkward working posture, dust, noise as well as low luminosity. It is difficult to delay the onset of fatigue. In order to study the physiological responses of trammers, various parameters like working heart rates, net cardiac cost and relative cardiac cost including recovery heart rate patterns are recorded during their work at site. Workload classification of trammers has been done following various scales of heaviness. The effect of environment on the physiological responses has been observed and suitable recommendations are made. The work tasks are bound to induce musculoskeletal problems and those problems could be better managed through rationalizing the work-rest scheduling.

Background: Actinomycetes have provided a wealth of bioactive secondary metabolites with interesting activities such as antimicrobial, antiviral and anticancer. The study aims at isolation, characterization and the antimicrobial potentiality of Streptomyces sannanensis SU118 obtained from Phoomdi, a unique habitat of Loktak Lake of Manipur, India., Results: An actinomycete strain isolated from Phoomdi soil of Loktak Lake of Manipur, India was identified as Streptomyces sannanensis SU118. It is a Gram-positive filamentous bacterium which exhibits antimicrobial activity only against Gram-positive bacteria, while Gram-negative organisms were not affected. Glucose Soyabean meal broth was found to be the suitable medium for antibiotic production at 28°C for seven days of incubation. The antimicrobial agent produced by the strain was extracted with ethyl acetate as solvent and purified by thin layer chromatography. Screening and bioassay - guided fractionation of the ethyl acetate extract from the culture filtrate led to the isolation of an active potential compound (R f value 0.56) with λmax 275.0 nm which has got the lowest minimum inhibitory concentration (0.5 μg/ml) against Staphylococcus aureus MTCC 96 and Staphylococcus aureus (clinical isolate), whereas highest (3.0 μg/ml) was recorded against Mycobacterium smegmatis MTCC 6 and Bacillus circulans MTCC 8074., Conclusion: This study has therefore uncovered the potential of exploring virgin untapped habitats in the Indo-Burma biodiversity hot spot region as reservoir of promising antimicrobial metabolite producer. These results highlighted the scope for further characterization of the metabolite and could be a candidate in the generation of new antimicrobial agents.

Background: Polymorphisms in TLR4 may change the function of the protein and alter the efficiency of immune response of host to infection. The high relevance of host gene polymorphisms with outcome of Mycobacterium leprae infection led us to study the genetic association of TLR4 G896A polymorphism in order to identify its risk among contacts of affected leprosy patients., Methods: For case-control study design a total of 628 individuals were recruited; 17 multicase leprosy families which included 32 case-parent trios were considered for family-based study. Genotyping was done using PCR-RFLP method., Results: In case-control study AA genotype was positively associated while GA genotype was negatively associated with leprosy. In family based transmission disequilibrium test (TDT) analysis allele G was found to be over transmitted to the affected individuals., Conclusion: Case-control study suggests that homozygous AA genotype may confer susceptibility and heterozygous GA genotype may confer resistance to leprosy, while allele A was observed to increase risk and that of allele G may confer resistance to leprosy. No strong transmission disequilibrium was detected in family-based TDT analysis, possibly due to lower number of trios. In contrast to case-control data allele G was over transmitted to the affected ones in TDT analysis. To conclude, the frequencies of genotypes in household contacts were almost the same as in leprosy patients, suggesting that contacts with AA genotype may be at higher risk of leprosy and may therefore require prophylactic inputs.

To investigate the origins, evolution and patterns of spread of HPAI H5N1 outbreaks in Bangladesh, we performed a phylogenetic reconstruction analysis using Bayesian methods. The analysis was conducted using 81 hemagglutinin (HA) gene sequences from the H5N1 viruses isolated in Bangladesh from 2007 to 2011, together with 264 publicly available HA sequences of clade 2.2, 2.3.2 and 2.3.4 retrieved from GenBank. Our study provides evidence that clade 2.2.2 viruses that caused outbreaks in Bangladesh were lineages independent from the viruses introduced earlier into India. Furthermore, the Bangladesh clade 2.2.2 descendents subsequently spread to India and Bhutan. This has implications for avian influenza control in southern Asia suggesting multiple routes of entry of the virus including one pathway that spread to neighboring countries via Bangladesh., (Copyright © 2013 Elsevier B.V. All rights reserved.)

In recent years, genome wide association studies have discovered a large number of gene loci that play a functional role in innate and adaptive immune pathways associated with leprosy susceptibility. The immunological control of intracellular bacteria M. leprae is modulated by NOD2-mediated signaling of Th1 responses. In this study, we investigated 211 clinically classified leprosy patients and 230 ethnically matched controls in Indian population by genotyping four variants in NOD2 (rs9302752A/G), LRRK2 (rs1873613A/G), RIPK2 (rs40457A/G and rs42490G/A). The LRRK2 locus is associated with leprosy outcome. The LRRK2 rs1873613A minor allele and respective rs1873613AA genotypes were significantly associated with an increased risk whereas the LRRK2 rs1873613G major allele and rs1873613GG genotypes confer protection in paucibacillary and leprosy patients. The reconstructed GA haplotypes from RIPK2 rs40457A/G and rs42490G/A variants was observed to contribute towards increased risk whereas haplotypes AA was observed to confer protective role. Our results indicate that a possible shared mechanisms underlying the development of these two clinical forms of the disease as hypothesized. Our findings confirm and validates the role of gene variants involved in NOD2-mediated signalling pathways that play a role in immunological control of intracellular bacteria M. leprae.

Madura foot is a deep mycosis commonly seen in tropical and subtropical countries such as India. Its incidence is likely to rise in temperate regions as well, due to the increase in worldwide travel. The cases presented here are all agricultural workers from a rural part of northern India who had induration, fibrosis and minimal discharge from sinuses over the foot. Although culture remains the gold standard diagnostic test, this case report highlights the importance of histopathology in the early diagnosis and differentiation of common causative agents in Madura foot as repeated cultures are sometimes negative. Thus for mycetomas in which causative infectious agents cannot be isolated, histology may prove beneficial by avoiding inadvertent use of combined antifungal and antimicrobial agents so that a correct therapeutic modality can be decided, prognostic outcome be explained to the patient, and a preventable cause of deformity and disability can be identified and treated at an early stage.

Sigmoid volvulus is a serious surgical emergency and a common cause of large bowel obstruction in India. Patients present with abdominal pain, distension and obstipation and abdominal skiagram usually reveals the characteristic omega sign. Non-operative detorsion with early elective sigmoidectomy is the procedure of choice where gut viability is not in doubt and features of peritonitis are absent. The objective of this study was to demonstrate the most suitable procedure for management of patients with sigmoid volvulus needing emergency surgery. Results revealed a high incidence of burst abdomen and anastomotic leak as well as a high mortality rate in patients undergoing resection with primary anastomosis without proximal colostomy. Mortality was least with Hartmann's procedure although there was a higher incidence of wound infection. Thus, in the hospital setting, we consider Hartmann's procedure to be the best emergency surgical procedure for sigmoid volvulus as it limits mortality to the least.

Carcinoma stomach still remains a major killer cancer all over the world. Delay in early diagnosis or lack of awareness, infrastructure etc. is the major factor for late presentation in developing countries. This work was carried out to study the prevalence of carcinoma stomach in a tertiary referral centre in Eastern India and its corroboration with endoscopic findings. The aim is to create an awareness regarding early diagnosis of this monstrous killer. The study was conducted on 8706 symptomatic patients attending for upper GI endoscopy, of which 165 patients were found to have adenocarcinoma of stomach and 8 patients with other stomach neoplasms. The age, sex, religious status and economic background were analysed. The endoscopic findings, histological nature and grading, site of the lesions vis-à-vis clinical signs and symptoms were analysed and statistically reviewed. Of the total 165 cases of carcinoma stomach, highest number of cases (24.8%) were among 40-49 years of age, followed by 50-59 years (23.7%). The male sex (67.6%) and patients with low socio-economic background (75.7%) were the worst sufferer. On gross microscopic findings of endoscopy, ulcero-proliferative lesions were highest (80.8%) and antrum was the commonest (46.8%) site of neoplastic lesions. Histologically, adenocarcinoma (95.4%) was commonest. The significant symptoms of presentation were pain abdomen (84%), weight loss (89%), anorexia (86%), gastric outlet obstruction (40%) while signs were anaemia (100%), epigastric tenderness (60%), lump abdomen and gastric outlet obstruction (40%). We found a large number of neoplastic lesions in endoscopy series with the highest number in males at forty. This implies a gross economic fall out on the family. The interesting finding of antral growth differs from western series. Liberal use and availability of endoscopy may help in detecting the lesions early with better outcome.

Miners fitness test was assessed in terms of determination of maximum aerobic capacity by an indirect method following a standard step test protocol before going down to mine by taking into consideration of heart rates (Telemetric recording) and oxygen consumption of the subjects (Oxylog-II) during exercise at different working rates. Maximal heart rate was derived as 220-age. Coal miners reported a maximum aerobic capacity within a range of 35-38.3 mL/kg/min. It also revealed that oldest miners (50-59 yrs) had a lowest maximal oxygen uptake (34.2 ± 3.38 mL/kg/min) compared to (42.4 ± 2.03 mL/kg/min) compared to (42.4 ± 2.03 mL/kg/min) the youngest group (20-29 yrs). It was found to be negatively correlated with age (r = -0.55 and -0.33 for younger and older groups respectively) and directly associated with the body weight of the subjects (r = 0.57 - 0.68, P ≤ 0.001). Carriers showed maximum cardio respiratory capacity compared to other miners. Indian miners VO(2 max) was found to be lower both compared to their abroad mining counterparts and various other non-mining occupational working groups in India.

Thirty-nine healthy carriers (23-57 years of age) were investigated in underground manual coal mines in West Bengal, India during two different work spells of a single work shift. We compared physiological strain of workers <40 and > or =40 years of age. For both groups, mean heart rate was 124-133 beats/min, with a mean corresponding relative cardiac cost of 50-66%. Maximum aerobic capacities were estimated indirectly, following a standard step test protocol. Average oxygen consumption was 1.07-1.1 l/min, with an energy expenditure of 5.35-5.5 kcal/min among both age groups. Acceptable levels of physiological strain were well encroached, and older workers faced the maximum burden. The tasks studied were heavy to very heavy in nature. The weight of load carriage at a spontaneously chosen speed and the prevailing environmental conditions merit serious attention. There is extreme need of ergonomic interventions in reducing the postural load and musculoskeletal discomforts in this population.

Objective: Osteoporosis is common in prostate cancer (CaP) patients both before and after institution of androgen deprivation therapy and is associated with significant morbidity. Lactose intolerance (LI) can affect bone mass but has not been studied in this group of patients. The objective of this study was to compare the incidence of LI in CaP patients with that in the general population and to identify factors affecting lactose intolerance in CaP patients., Material and Methods: Fifty-five men with CaP planned for bilateral orchidectomy were enrolled in the study and their baseline characteristics including age, weight, height, body mass index (BMI), prostate-specific antigen, serum calcium profile, lactose tolerance status, physical activity, alcohol intake and smoking, bone mineral density and calcium intake were registered. The data on lactose tolerance in these patients were compared with those of 81 age-matched controls (data taken from the available database)., Results: The incidence of LI in CaP patients was significantly less than that in the control group (36.2% and 58.3%, respectively, p = 0.027). A significantly greater number of CaP patients in the lactose-tolerant group had a calcium intake of >1500 mg/day (p = 0.03) and that of milk >500 ml/day (p = 0.05) than those in the intolerant group. Age >70 years, BMI <25 kg/m2, height >163 cm, lower physical activity and co-abuse of alcohol and smoking significantly correlated with the presence of LI (p < or = 0.05). Patients with serum calcium <9 mg/dl had higher fasting breath H2 levels and a higher proportion had a BMI >25 kg/m2 and weight >65 kg., Conclusions: The incidence of LI in CaP patients is less than that in the general population despite a higher incidence of osteoporosis, indicating a complex etiology of CaP-related osteoporosis. Certain physical characteristics and personal habits are important in determining lactose-tolerant status.

Aims: To study the profile of irritable bowel syndrome (IBS), and the frequency of such symptoms among the general population, in India., Methods: In this prospective, multi-center study, data were obtained from 2785 patients with chronic lower gastrointestinal symptoms (complainants) with no alarm feature and negative investigations for organic causes visiting physicians at 30 centers, and from 4500 community subjects (non-complainants), using separate questionnaires., Results: Most complainants were middle-aged (mean age 39.4 years) and male (1891; 68%). The common symptoms were: abdominal pain or discomfort (1958; 70%), abdominal fullness (1951; 70%); subjective feeling of constipation (1404 of 2656; 53%), or diarrhea (1252 of 2656, 47%), incomplete evacuation (2134; 77%), mucus with stools (1506; 54%), straining at stools (1271; 46%), epigastric pain (1364; 49%) and milk intolerance (906; 32%). Median stool frequency was similar in patients who felt they had constipation or those who felt they had diarrhea. Information to subtype symptoms using standard criteria was available in 1301 patients; of these, 507 (39%) had constipation-predominant IBS ( 3 3 stools/day) and 744 (57%) had indeterminate symptoms. Among non-complainants, most subjects reported daily defecation frequency of one (2520 [56%]) or two (1535 [34%]). Among non-complainants, 567 (12.6%) reported abdominal pain, 503 (11%) irregular bowel, 1030 (23%) incomplete evacuation, 167 (4%) mucus and 846 (18%) straining at stools; a combination of abdominal pain or discomfort relieved by defecation, and incomplete evacuation was present in 189/4500 (4.2%) community subjects., Conclusions: Most patients with IBS in India are middle-aged men, and have a sense of incomplete evacuation and mucus with stools. Abdominal pain or discomfort is frequent but not universal. Importantly, stool frequency was similar irrespective of whether the patients felt having constipation or diarrhea. Most (90%) non-complainant subjects had 1 or 2 stools per day; symptoms complex suggestive of IBS was present in 4.2% of community subjects.

Ninety-eight healthy underground coal miners aged between 23-58 years were studied during their activity period. Physiological strain of different category of miners in terms of heart rate was monitored continuously with heart rate monitor that revealed the tasks as heavy to very heavy for them. Oxygen consumption was measured directly by using oxylog-2 machine that corresponded to metabolic costs for different activities ranging from 4.96 kcal/min to 5.47 kcal/min. The mean relative aerobic strain varied from 47.4%-56.8%--depicting acceptable level of physical strain was well encroached by the miners who irrespective of ages and categories showed poor recovery responses. This entails that miners are exerting themselves beyond their capacities where inevitably older workforce face the maximum burden.

Cardiovascular load of underground shovelers was assessed in terms of heart rate changes at work in haulage coalmines. Twenty underground shovelers of two different age groups (those of age 31-39 and those of age 40-49) served as subjects. Working heart rate was significantly higher (p < 0.01) in the older group (138.2 beats/min) than in the younger group (130.4 beats/min). Though the net cardiac cost did not differ significantly between the groups (64.8 beats/min and 69.4 beats/min in younger and older groups, respectively), difference in the relative cardiac cost (54.17% and 64.86% in younger and older groups, respectively) proved to be highly significant (p < 0.001). The heart rate up to the third minute of recovery showed significant differences between the groups (p < 0.01). While analysis of physiological responses indicated that the task was very strenuous irrespective of age, cardiac strain was found to be more excessive in the older subjects if continued. The arduous nature of the working environment in the coalfaces was also reported.

Background: An extremely high prevalence of stomach cancer was observed in Mizoram (India), where the population consumes uncommon food. The relation of food habits and stomach cancer was examined in this study., Methods: A hospital-based case-control study was conducted during 2001-2004 to determine the risk factors among 329 patients with histologically confirmed stomach cancer and 658 matched controls. Food habits were determined by personal interview., Results: An elevated risk of stomach cancer was observed with frequent consumption of sa-um [odds ratio (OR) 3.4] (sa-um is fermented pork fat, a traditional food) and with frequent consumption of smoked dried salted meat (OR 2.8) and fish (OR 2.5). Soda (alkali), used as a food additive, increased the risk of stomach cancer (OR 2.9). Helicobacter pylori infection was not found to be an independent risk factor for carcinogenesis of stomach cancer in this study. However, when H. pylori infection interacted with consumption of sa-um or smoked dried meat, it showed a significant association., Conclusion: Peculiar food habits in Mizoram might be associated with the high prevalence of stomach cancer in Mizoram along with other factors. H. pylori infection might increase the risk of stomach cancer, or it may play a role as a promoter of stomach cancer in Mizoram.

Thirty healthy trammers were examined in underground haulage mines during their normal activity. Physiological strain in terms of heart rate (HR) varied between 101.6 and 104.7 beats/min with mean net cardiac cost of 33.06 and 34.06 beats/min for younger and older groups respectively. The average relative cardiac cost was lower for younger subjects than for older ones. Oxygen consumption (VO2) was measured with an Oxylog-II machine (UK); subsequently values were estimated. Maximum aerobic capacity was estimated with an indirect method following a standard step test protocol. The responses revealed that the average VO2 during the activity was 0.75 and 0.8 L/min, which corresponded to energy expenditure (EE) of 3.8 and 3.97 Kcal/min for younger and older subjects respectively. The workload in terms of HR and EE was moderate, whereas the aerobic strain experienced by aged workers was above the acceptable level.

The incidence of stomach cancer in India is lower than that of any other country around the world. However, in Mizoram, one of the north-eastern state of India, a very high age-adjusted incidence of stomach cancer is recorded. A hospital-based case-control study was carried out to identify the influence of tobacco use on the risk of developing stomach cancer in Mizoram. Among the cases, the risk of stomach cancer was significantly elevated among current smokers [odds ratio (OR), 2.3; 95% confidence interval (95% CI), 1.4-8.4] but not among ex-smokers. Higher risks were seen for meiziol (a local cigarette) smokers (OR, 2.2; 95% CI, 1.3-9.3). The increased risk was apparent among subjects who had smoked for >or=30 years. The increased risk was significant with 2-fold increase in risk among the subjects who smoked for >or=11 pack-years. The risk increased with increasing cumulative dose of tobacco smoked (mg). Tuibur (tobacco smoke-infused water), used mainly in Mizoram, was seemed to increased the risk of stomach cancer among current users in both univariate and multivariate models (OR, 2.1; 95% CI, 1.3-3.1). Tobacco chewer alone (OR, 2.6; 95% CI, 1.1-4.2) showed significant risk. Tobacco use in any form [smoking and smokeless (tuibur and chewing)] increased the risk of stomach cancer in Mizoram independently after adjusting for confounding variables.

A study to assess the wastage factor of oral polio vaccine (OPV) in the Pulse Polio Immunization (PPI) programme of the Government of India was undertaken by the Indian Council of Medical Research (ICMR) at approximately 31,000 immunization booths all over the country. The study was conducted through the network of 31 Human Reproduction Research Centres (HRRCs) and other ICMR institutes. Wastage at the point of administration of OPV was estimated to be 14.5% with a wastage factor of 1.17 which is well below the assumed wastage of 33% and the corresponding wastage factor of 1.5 in the PPI programme. The wastage and wastage factor as estimated in the present study were also less than the wastage of 25% and the wastage factor of 1.33 recommended by the World Health Organization. Minimum wastage (6.3%) at Kanchipuram and maximum wastage (22.1%) at Kanpur were observed. Further, the wastage of unopened vials and vials during use was also observed following colour changes on the vaccine vial monitor (VVM), indicating poor cold-chain maintenance at the immunization site. In total, 13 booths reported wastage of nine or more unopened vials, whereas 19 booths reported wastage of nine or more vials during use because of colour changes on VVM. Other reasons for wastage of vaccine were also observed from a sample of booths. The technology of introducing VVM on OPV vials for monitoring the cold-chain proved useful in situations in which mass vaccination programmes such as PPI are carried out.