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   Table of Contents - Current issue
Coverpage
December 2017
Volume 146 | Issue 6
Page Nos. 673-820

Online since Friday, April 13, 2018

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EDITORIAL  

Current status of the HIV epidemic & challenges in prevention Highly accessed article p. 673
Quarraisha Abdool Karim
DOI:10.4103/ijmr.IJMR_1912_17  PMID:29664022
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COMMENTARIES Top

Psoriasis & cardiovascular morbidity: The missing links? Highly accessed article p. 677
Satyaki Ganguly, Lopamudra Ray
DOI:10.4103/ijmr.IJMR_1714_17  PMID:29664023
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Fly ash-based Bacillus thuringiensis israelensis formulation: An ecofriendly approach p. 680
Sachin Tikar, Shri Prakash
DOI:10.4103/ijmr.IJMR_1679_16  PMID:29664024
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PERSPECTIVE Top

Combating antimicrobial resistance in India: Technical challenges & opportunities Highly accessed article p. 683
Rajesh Bhatia, Kamini Walia
DOI:10.4103/ijmr.IJMR_19_17  PMID:29664025
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REVIEW ARTICLES Top

Prenatal screening for genetic disorders: Suggested guidelines for the Indian Scenario p. 689
Shubha R Phadke, Ratna D Puri, Prajnya Ranganath
DOI:10.4103/ijmr.IJMR_1788_15  PMID:29664026
Prenatal testing is the best strategy for reducing the burden of genetic disorders and congenital disabilities that cause significant postnatal functional impairment. Universal prenatal screening is advisable for common genetic disorders and congenital anomalies such as Down syndrome, beta-thalassaemia and neural tube defects. Several prenatal-screening tests are now available for Down syndrome, but knowledge about the appropriate timing of the test and the need for pre- and post-test counselling may not be updated among the primary care physicians. There is also a considerable degree of confusion regarding the prenatal screening test to be chosen in each case, due to the availability of a number of new and advanced screening techniques. At present, there is no nation-wide consensus regarding the nature and timing of these prenatal-screening protocols. Due to the absence of any definite guidelines and the additional lacunae in the awareness regarding the appropriate prenatal screening in the country, the optimum benefits of these screening protocols are not reaching the population. This review focuses on the various prenatal screening and diagnostic tests that are available for common genetic conditions and congenital disabilities and attempts to outline the most cost-effective and gestational age-appropriate strategies for prenatal screening for the Indian healthcare set-up. The recommendations suggested would serve as a source guide for formulating prenatal-screening guidelines for reducing the incidence of common genetic disorders and congenital disabilities in India.
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Mycobacteria-derived biomarkers for tuberculosis diagnosis Highly accessed article p. 700
Magdalena Druszczynska, Sebastian Wawrocki, Rafal Szewczyk, Wieslawa Rudnicka
DOI:10.4103/ijmr.IJMR_1441_16  PMID:29664027
Tuberculosis (TB) remains an escalating problem worldwide. The current diagnostic methods do not always guarantee reliable diagnosis. TB treatment is a time-consuming process that requires the use of several chemotherapeutics, to which mycobacteria are becoming increasingly resistant. This article focuses on the potential utility of biomarkers of mycobacterial origin with potential implications for TB diagnosis. Properly standardized indicators could become new diagnostic tools, improving and streamlining the identification of Mycobacterium tuberculosis infection and the implementation of appropriate therapy. These markers can also potentially provide a quick confirmation of effectiveness of new anti-mycobacterial drugs and TB vaccines, leading to a possible application in practice.
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ORIGINAL ARTICLES Top

Dyslipidaemia & oxidative stress in patients of psoriasis: Emerging cardiovascular risk factors p. 708
Kumari Asha, Archana Singal, Suman Bala Sharma, Vinod Kumar Arora, Amitesh Aggarwal
DOI:10.4103/ijmr.IJMR_717_16  PMID:29664028
Background & objectives: Psoriasis is a recurrent hyper-proliferative skin disease which is often associated with free radical generation, abnormal lipid metabolism and increased inflammatory secretion that induce cardiovascular risk in these patients. The present study was intended to evaluate serum lipids, lipoprotein and oxidants-antioxidants status and to establish their relationship with atherogenic risk markers [oxidized low-density lipoprotein (oxLDL) and high-sensitivity C-reactive protein (hsCRP)] in patients with psoriasis. Methods: The study was conducted on 150 psoriasis patients and 150 age- and sex-matched healthy controls. Overnight fasting blood samples were obtained for lipids, lipoproteins, lipid oxidation and peroxidation products [oxLDL, malondialdehyde (MDA)], antioxidant enzymes [reduced glutathione (GSH) and total antioxidant status] levels and hsCRP estimations. Results: The mean levels of atherogenic lipids [total cholesterol (P<0.001), triacylglycerol (P<0.01)], lipid peroxidation products (P<0.001) and oxLDL and hsCRP (P<0.001) levels in patients with psoriasis were found to be significantly higher than those of healthy controls. On the other hand, ferric-reducing ability of plasma (FRAP, P<0.001) and antioxidant enzyme activities (reduced GSH, P<0.01) were significantly lower when compared to healthy controls. The plasma oxLDL was positively correlated to LDL cholesterol (P<0.001) and MDA (P<0.001) and negatively associated with antioxidant status in these patients. Serum MDA, FRAP and oxLDL were correlated with risk of atherosclerosis in the patients with psoriasis; however, no significant association was found between reduced GSH and hsCRP. Interpretation & conclusions: The study results suggest that LDL oxidation and reactive oxygen species in addition to inflammatory markers may play a pivotal role in inducing atherosclerosis in patients of psoriasis.
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Fly ash-based water dispersible powder formulation of Bacillus thuringiensis var. israelensis: Development & laboratory evaluation against mosquito immatures p. 714
Saravanan Tamilselvan, Arulsamy Mary Manonmani, Purushothaman Jambulingam
DOI:10.4103/ijmr.IJMR_651_15  PMID:29664029
Background & objectives: Bacillus thuringiensis var. israelensis (Bti) formulations are presently being used for insect control. In this study, a water dispersible powder (WDP) formulation using fly ash (FA) as a carrier material was developed and studied for its activity against the larval stages of major mosquito vector species. Methods: An indigenous isolate Bti (Vector Control Research Centre B17) was mass produced using a 100 l fermentor in soya-based medium. The bacterial biomass was mixed with lignite FA and made into WDP formulations. The most effective formulation was used for determining 50 per cent lethal concentration (LC50) against the larval stages of major mosquito vector species, effect on non-target organisms and mammalian systems using standard protocols. Results: Sixteen types of WDP formulations were prepared, of which the formulation containing bacterial biomass, FA and carboxymethyl cellulose was found to be the most effective. The LC50values of the formulation against Culex quinquefasciatus, Aedes aegypti and Anopheles stephensi larvae were 0.0417, 0.0462 and 0.1091 mg/l, respectively. The formulation was found to be safe to non-target organisms found associated with the mosquito larval stages and also to mammalian systems. Interpretation & conclusions: The study shows that FA can be effectively used to replace commercially available carrier materials used in biopesticidal formulations.
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Do practice gaps exist in evidence-based medication prescription at hospital discharge in patients undergoing coronary artery bypass surgery & coronary angioplasty? p. 722
Pradeep Pereira, Aditya Kapoor, Archana Sinha, Surendra K Agarwal, Shantanu Pande, Roopali Khanna, Nilesh Srivastava, Sudeep Kumar, Naveen Garg, Satyendra Tewari, Pravin Goel
DOI:10.4103/ijmr.IJMR_1905_15  PMID:29664030
Background & objectives: Prescription patterns of guideline-directed medical therapy (GDMT) after coronary artery bypass surgery [coronary artery bypass graft (CABG)] and percutaneous coronary intervention (PCI) at hospital discharge are often not optimal. In view of scarce data from the developing world, a retrospective analysis of medication advice to patients following CABG and PCI was conducted. Methods: Records of 5948 patients (post-PCI: 5152, post-CABG: 796) who underwent revascularization from 2010 to 2014 at a single tertiary care centre in north India were analyzed. Results: While age and gender distributions were similar, diabetes and stable angina were more frequent in CABG group. Prescription rates for aspirin 100 per cent versus 98.2 per cent were similar, while beta-blockers (BBs, 95.2 vs 90%), statins (98.2 vs 91.6%), angiotensin-converting enzyme inhibitors (89.4 vs 41.4%), nitrates (51.2 vs 1.1%) and calcium channel blockers (6.6 vs 1.6%) were more frequently prescribed following PCI. Despite similar baseline left ventricular ejection fraction (48.1 vs 51.1%), diuretics were prescribed almost universally post-CABG (98.2 vs 10.9%, P<0.001). Nearly all (94.4%) post-CABG patients received a prescription for clopidogrel. Patients undergoing PCI were much more likely to receive higher statin dose; 40-80 mg atorvastatin (72 vs <1%, P<0.001) and a higher dose of BB. Interpretation & conclusions: Significant differences in prescription of GDMT between PCI and CABG patients existed at hospital discharge. A substantial proportion of post-CABG patients did not receive BB and/or statins. These patients were also less likely to receive high-dose statin or optimal BB dose and more likely to routinely receive clopidogrel and diuretics. Such deviations from GDMT need to be rectified to improve quality of cardiac care after coronary revascularization.
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Association of −330 interleukin-2 gene polymorphism with oral cancer p. 730
Prithvi Kumar Singh, Vijay Kumar, Mohammad Kaleem Ahmad, Rajni Gupta, Abbas Ali Mahdi, Amita Jain, Jaishri Bogra, Girish Chandra
DOI:10.4103/ijmr.IJMR_1949_15  PMID:29664031
Background & objectives: Cytokines play an important role in the development of cancer. Several single-nucleotide polymorphisms (SNPs) of cytokine genes have been reported to be associated with the development and severity of inflammatory diseases and cancer predisposition. This study was undertaken to evaluate a possible association of interleukin 2 (IL-2) ( 330A>C) gene polymorphisms with the susceptibility to oral cancer. Methods: The SNP in IL-2 (−330A>C) gene was genotyped in 300 oral cancer patients and in similar number of healthy volunteers by polymerase chain reaction (PCR)-restriction fragment length polymorphism and the association of the gene with the disease was evaluated. Results: IL-2 (−330A>C) gene polymorphism was significantly associated with oral cancer whereas it was neither associated with clinicopathological status nor with cancer pain. The AC heterozygous genotype was significantly associated with oral cancer patients as compared to controls [odds ratio (OR): 3.0; confidence interval (CI): 2.14-4.20; P<0.001]. The C allele frequency was also significantly associated with oral cancer (OR: 1.80; CI: 1.39-2.33; P<0.001). IL-2 (−330A>C) gene polymorphism was also associated with oral cancer in tobacco smokers and chewers. Interpretation & conclusions: Our results showed that oral cancer patients had significantly higher frequency of AA genotype but significantly lower frequency of AC genotype and C allele compared to controls. The IL-2 AC genotype and C allele of IL-2 (−330A>C) gene polymorphisms could be potential protective factors and might reduce the risk of oral cancer in Indian population.
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Expression of p53 & epidermal growth factor receptor in glioblastoma p. 738
Sameera Karnam, Radhika Kottu, Amit Kumar Chowhan, Prasad Chandramouleswara Bodepati
DOI:10.4103/ijmr.IJMR_1179_15  PMID:29664032
Background & objectives: Glioblastoma (GB) is the most frequent brain tumour, manifesting at any age, with a peak incidence between 45 and 75 years. Primary and secondary GBs constitute relatively distinct disease entities in evolution, in expression profiles and in therapeutic response. Histopathologically, primary and secondary GBs are indistinguishable. The aim of this investigation was to study the immunohistochemical (IHC) expression of p53 and epidermal growth factor receptor (EGFR) in GB with the objective of categorizing the morphological variants of GB into primary and secondary based on the presence of low-grade areas and knowing the variable expression of p53 and EGFR in primary and secondary GB. Methods: A total of 28 patients with GB were studied and categorized into primary and secondary based on the presence of low-grade areas, i.e. discernible astrocytic morphology, gemistocyte and oligodendroglia. Tumours with the presence of combination of the above features or any one of the above features were taken as secondary GB, whereas tumours with highly pleomorphic areas were considered as primary GB. IHC was done on the representative tissue blocks for p53 and EGFR. Results: Majority of the patients were in the fifth and sixth decades of life with a mean age of 46.96±13 yr with male preponderance (male:female 2.5:1). Mean age of presentation was 48.93±12 yr in primary and 44.69±15 yr in secondary GB. All cases of GB were classified into primary (53.57%) and secondary (46.43%) based on morphology. EGFR was more frequently expressed than p53. Based on IHC, 50 per cent of cases were classified into primary, three per cent into secondary and 47 per cent as unclassified. Interpretation & conclusions: Histopathological features, i.e. presence of low-grade areas, may play a role in classifying GB into primary and secondary. EGFR has a pivotal role in gliomagenesis. Combination of p53 and EGFR alone may not be sufficient to clarify GB into primary and secondary.
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Ischaemic heart disease mortality in Serbia, 1991-2013; a joinpoint analysis p. 746
Milena Ilic, Irena Ilic
DOI:10.4103/ijmr.IJMR_1935_15  PMID:29664033
Background & objectives: Ischaemic heart disease (IHD) has been one of the leading causes of mortality in the world. In many European countries the mortality rates due to IHD have been rising rapidly. This study was aimed to assess the IHD mortality trend in Serbia. Methods: A population-based cross-sectional study analyzing IHD mortality in Serbia in the period 1991-2013 was carried out based on official data. The age-standardized rates (ASRs, per 100,000) were calculated using the direct method, according to the European standard population. Joinpoint analysis was used to estimate the average annual percentage change (AAPC) with the corresponding 95 per cent confidence interval (CI). Results: More than 253,000 people (143,420 men and 110,276 women) died due to IHD in Serbia during the observed period, and most of them (over 160,000 people) were patients with myocardial infarction (MI). Average annual ASR for IHD was 113.6/100,000. There was no overall significant trend for mortality due to IHD (AAPC=+0.1%, 95% CI −0.8-1.0), but there was one joinpoint: the trend significantly increased by +2.3 per cent per year from 1991 to 2006 and then significantly decreased by −6.4 per cent from 2006 to onwards. Significantly decreased mortality trends for MI in both genders were observed: according to the comparability test, mortality trends in men and women were parallel (final selected model failed to reject parallelism, P=0.0567). Interpretation & conclusions: No significant trend for mortality due to IHD was observed in Serbia during the study period. The substantial decline of mortality from IHD seen in most developed countries during the past decades was not observed in Serbia. Further efforts are required to reduce mortality from IHD in Serbian population.
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Incidence & prognosis of acute kidney injury in individuals of snakebite in a tertiary care hospital in India p. 754
Ramulu Pulimaddi, Amruth Rao Parveda, Balkishan Brahmanpally, Paul Marx Kalakanda, K Ramakrishna, Venkata Ramana Devi Chinnapaka
DOI:10.4103/ijmr.IJMR_1581_16  PMID:29664034
Background & objectives: The snakebites are considered to be an occupational hazard in agriculture workers and the snake handlers, resulting in a considerable morbidity, mortality and economical implications. This study was conducted to determine the incidence, clinical presentation, renal injury and clinical outcome in snakebite victims who developed acute kidney injury (AKI). Methods: This hospital-based prospective, observational study was done on 100 cases who were admitted for the management of snakebite and found to develop AKI in a tertiary care hospital at Hyderabad, India. Renal function tests, complete blood picture, urine routine examination, ultrasound examination of abdomen and coagulation profile were done and the prognosis was assessed by noting recovery, mortality, morbidity and/or progress to chronic stage. Results: A total of 100 patients with a mean age of 43.80±12.63 yr (range 18-70); 62 males and 38 females were studied. All had bites on lower limbs. A total of 86 patients arrived in the hospital within 24 h, and 14 arrived after 24 h. Oliguria was found in 60, bleeding tendencies in 64, haemodynamic instability noted - tachycardia in 86. Systolic blood pressure (BP) was <120 mm Hg in 68 and BP was not recordable in four patients. Twelve patients were in stage III kidney disease and needed haemodialysis. Of the 100 cases of snakebite-induced acute kidney failure, 86 recovered and six died. On follow up, after six months eight patients developed chronic kidney failure. Interpretation & conclusions: A cascade of events tends to occur in severe haemotoxic envenomation such as bleeding disorders, hypotension/circulatory shock, intravascular haemolysis, disseminated intravascular coagulation and acute respiratory disease syndrome (ARDS). The findings of this study showed that early hospitalization, quick antisnake venom administration and adequate supporting care provided promising results.
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Out-of-pocket expenditure for hospitalization in Haryana State of India: Extent, determinants & financial risk protection p. 759
Deepshikha Sharma, Shankar Prinja, Arun Kumar Aggarwal, Pankaj Bahuguna, Atul Sharma, Saroj Kumar Rana
DOI:10.4103/ijmr.IJMR_2003_15  PMID:29664035
Background & objectives: India aspires to achieve universal health coverage, which requires ensuring financial risk protection (FRP). This study was done to assess the extent of out-of-pocket (OOP) expenditure and FRP for hospitalization in Haryana State, India. Further, the determinants for FRP were also evaluated. Methods: Data collected as a part of a household level survey conducted in Haryana 'Concurrent Evaluation of National Rural Health Mission: Haryana Health Survey' were analyzed. Descriptive analysis was undertaken to assess socio-demographic characteristics, hospitalization rate, extent and determinants of OOP expenditure and FRP. Prevalence of catastrophic health expenditure (CHE) (more than 40% of non-food expenditure) and impoverishment (Int$ 1.25) were estimated. Multivariate logistic regression was used to assess determinants of FRP. Results: Hospitalization rate was found to be 3106 persons or 3307 episodes per 100,000 population. Median OOP expenditure on hospitalization was ₹ 8000 (USD 133), which was predominantly attributed to medicines (37%). Prevalence of CHE was 25.2 per cent with higher prevalence amongst males [odds ratio (OR)=1.30], those belonging to scheduled caste and scheduled tribes (OR=1.35), poorest 20 per cent households (OR=3.05), having injuries (OR=4.03) and non-communicable diseases (OR=3.13) admitted in a private hospital (OR=2.69) and those who were insured (OR=1.74). There was a 12 per cent relative increase in poverty head count due to OOP payments on healthcare. Interpretation & conclusions: Our findings showed that hospitalization resulted in significant OOP expenditure, leading to CHEs and impoverishment of households. Impact of OOP expenditures was inequitably more on the vulnerable groups. OOP expenditure may be curtailed through provision of free medicines and diagnostics and removal of any form of user charges.
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Genotype-phenotype relationship of CCL5 in pulmonary tuberculosis infection in Sahariya tribe: A pilot study p. 768
Gunja Mishra, Satish S Poojary, Sanjay Jain, Pramod Kumar Tiwari
DOI:10.4103/ijmr.IJMR_1582_15  PMID:29664036
Background & objectives: Sahariya, a primitive tribe of Central India, has shown significantly increased incidence of pulmonary tuberculosis (PTB). Our previous study on Sahariya showed a significant association of −403G>A single nucleotide polymorphism (SNP) of CCL5 with susceptibility to PTB. Hence, this study was aimed to analyze a genotype-phenotype relationship of this disease-associated SNP to develop a potential diagnostic marker for TB in this tribe. Methods: The present study was carried out on 70 plasma samples from Sahariya tribe, wherein the plasma CCL5 level was determined using a commercially available ELISA kit. Results: The level of CCL5 decreased significantly in patients who were on therapy/completed their therapy [inactive TB patient/inactive PTB (IPTB)], particularly with AA genotype of −403G>A (P=0.046). The level, with AA genotype, was also found to gradually decrease in sputum 3+ and 1+/2+ than in sputum-negative samples. Similarly, the CCL5 level was found to be higher in sputum-positive/active TB patients than in IPTB group and healthy controls. Interpretation & conclusions: Our results suggested that the CCL5 level was influenced collectively not only by the genotypes of −403G>A SNP and bacillary load but also by the treatment. Thus, CCL5 may be considered for the development of a diagnostic marker and also as an indicator of recovery.
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Provider-initiated HIV testing & counselling in incident tuberculosis cases under National TB Programme conditions at a tertiary care teaching hospital in Tirupati, south India p. 774
Alladi Mohan, J Harikrishna, D Prabath Kumar, N Dinesh Kumar, Prerna S Sharma, B Siddhartha Kumar, K V S Sarma
DOI:10.4103/ijmr.IJMR_639_15  PMID:29664037
Background & objectives: As sparse published data are available regarding burden of human immunodeficiency virus (HIV) infection in incident tuberculosis (TB) cases at tertiary care teaching hospitals under National TB Programme conditions from India, the present study was designed to assess the proportion of referred registered TB patients who had actually undergone HIV testing and HIV-seropositivity in these. Methods: This was a study of provider-initiated HIV testing and counselling in patients registered for the treatment under Revised National TB Control Programme (RNTCP) of Government of India at a tertiary care teaching hospital in Tirupati, south India, during 2012-2013. Results: Between January 2012 and June 2013, 610 adult patients registered under RNTCP who were referred to Integrated Counselling and Testing Centre for HIV testing, were prospectively studied. Of these, 458 patients (75%) [mean age: 38.6±16.3 yr; 295 (64.4%) males] underwent HIV testing; HIV-co-infection was present in 21 (4.6%) patients. A significantly higher proportion of HIV co-infection was evident in PTB compared with EPTB [13/179 (7.2%) vs 8/279 (2.8%); respectively, P=0.038] and in previously treated patients compared to new patients [6/51 (11.8%) vs 15/407 (3.7%); respectively, P=0.009]. Interpretation & conclusions: The findings of this study showed that a higher proportion of TB patients underwent HIV testing (75%) compared to the national figure of 63 per cent in 2013-2014. HIV seropositivity (4.6%) in TB patients who underwent HIV testing was similar to the five per cent figure observed at national level during 2013-2014. The HIV status of 25 per cent of patients with incident TB still remained unknown, suggesting a need for better integration and co-ordination for effective management of HIV-TB co-infection.
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Cedrus deodara: In vitro antileishmanial efficacy & immumomodulatory activity p. 780
Shyam Narayan, Chandreshwar Prasad Thakur, Shiv Bahadur, Meenakshi Thakur, Shashi Nath Pandey, Ajit Kumar Thakur, Dipendra K Mitra, Pulok K Mukherjee
DOI:10.4103/ijmr.IJMR_959_16  PMID:29664038
Background & objectives: The existing antileishmanial drugs for complete cure of visceral leishmaniasis (kala-azar) are limited. The available drugs are either toxic or less effective leading to disease relapse or conversion to post-kala-azar dermal leishmaniasis. Several herbal extracts have been shown to have antileishmanial activity, but a herbal drug may not always be safe. In the present study, the extract of Cedrus deodara leaves has been standardized and tested for immunomodulatory antileishmanial activities. Methods: The extracts of C. deodara leaves with different solvents such as benzene, chloroform, ethyl acetate and methanol were made by soxhlation process. Solvents were removed under reduced pressure and temperature using rotary evaporator. The antileishmanial bioassay test was performed with in vitro maintained parasites. Immunomodulatory activity of different extracts was tested by flow cytometry. Standardization of the effective fraction was performed with Linalool as a marker compound through reverse-phase high-performance liquid chromatography. Results: The extract with the use of benzene solvent showed strong antileishmanial activities within a dose 25-200 μg/ml culture with non-significant haemolytic activities and significant immunomodulant activities against the host cells. Linalool was found to be 1.29 per cent in the effective extract of C. deodara. Interpretation & conclusions: The antileishmanial activity of C. deodara, as assessed by bioassay testing on Leishmania donovani parasites and immunomodulatory effect of benzene extract of leaves on host cells indicated that it might be a potential new safe therapeutic target to cure the visceral leishmaniasis.
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CORRESPONDENCES Top

Use of rabbit antibodies raised against Norovirus GII.4 virus-like particles for diagnosis of Norovirus infection p. 788
Ruta Kulkarni, Kavita Lole, Shobha D Chitambar
DOI:10.4103/ijmr.IJMR_463_16  PMID:29664039
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Acute encephalitis or encephalopathy: What next? p. 791
Benny P Cherian
DOI:10.4103/ijmr.IJMR_1684_17  PMID:29664040
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Authors' response p. 792
Jai Prakash Narain, Akshay C Dhariwal, C Raina MacIntyre
DOI:10.4103/0971-5916.230130  PMID:29664041
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Validity of Broselow tape for estimating weight of Indian children p. 794
Mahmood Dhahir Al-Mendalawi
DOI:10.4103/ijmr.IJMR_1274_17  PMID:29664042
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Authors' response p. 794
Vivek Shah, Sandeep B Bavdekar
DOI:10.4103/ijmr.IJMR_1520_17  PMID:29664043
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CLINICAL IMAGE Top

Tuberculosis of the shoulder: 'Caries sicca' p. 796
Vipul Vijay, Raju Vaishya
DOI:10.4103/ijmr.IJMR_946_16  PMID:29664044
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BOOK REVIEWS Top

Acute kidney injury - From diagnosis to care p. 798
Habir Singh Kohli
DOI:10.4103/0971-5916.230145  
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Next-generation nutritional biomarkers to guide better health care p. 799
Indu Mani, Anura V Kurpad
DOI:10.4103/0971-5916.230146  
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Advanced therapies in pediatric endocrinology and diabetology p. 801
Viveka Jyotsna
DOI:10.4103/0971-5916.230147  
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PANEL OF REVIEWERS (2017) Top

Panel of Reviewers (2017) p. 803
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