Indan Journal of Medical Research Indan Journal of Medical Research Indan Journal of Medical Research Indan Journal of Medical Research
  Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Reader Login 
  Home Print this page Email this page Small font sizeDefault font sizeIncrease font size Users Online: 5929       
Export selected to
Reference Manager
Medlars Format
RefWorks Format
BibTex Format
  Citation statistics : Table of Contents
   2016| July  | Volume 144 | Issue 1  
    Online since November 3, 2016

  Archives   Previous Issue   Next Issue   Most popular articles   Most cited articles
Hide all abstracts  Show selected abstracts  Export selected to
  Cited Viewed PDF
Undernutrition & tuberculosis in India: Situation analysis & the way forward
C Padmapriyadarsini, M Shobana, M Lakshmi, T Beena, Soumya Swaminathan
July 2016, 144(1):11-20
DOI:10.4103/0971-5916.193278  PMID:27834321
Undernutrition and tuberculosis (TB) are linked and have a bidirectional relationship. Undernutrition increases the risk of TB which in turn, can lead to malnutrition. Undernutrition not only is a risk factor for progression of latent TB infection to active disease, but also increases the risk of drug toxicity, relapse and death once TB develops. The dietary intake of TB patients in the country is inadequate. Nutritional supplementation in patients with TB is associated with faster sputum conversion, higher cure and treatment completion rates, significant gain in body weight and body composition as well as better performance status. The Government of India has various social support schemes (including nutrition supplementation schemes) and policies, at the Centre as well as State levels. Here we discuss some successful examples and suggest a few solutions to address this gap; like considering TB patients as a vulnerable group for "Targeted Public Distribution System" and providing extra rations for the duration of treatment. Recommendations for the research community, civil societies, government organizations, non-governmental and corporate sector on the actions needed to achieve the goals of the End TB Strategy are also provided. Ultimately, reduction of TB burden in India and its elimination will require improving the nutritional status of the community as a whole.
  11 3,411 899
Epidemiology & risk factors of scrub typhus in south India
George M Varghese, Deepa Raj, Mark R Francis, Rajiv Sarkar, Paul Trowbridge, Jayaprakash Muliyil
July 2016, 144(1):76-81
DOI:10.4103/0971-5916.193292  PMID:27834329
Background & objectives: Scrub typhus is a major public health threat in South and Southeastern Asian countries including India. Understanding local patterns of disease and factors that place individuals at risk is pivotal to future preventive measures against scrub typhus. The primary aim of this study was to identify specific epidemiological and geographical factors associated with an increased risk of developing scrub typhus in this region. Methods: We mapped 709 patients from Tamil Nadu, Andhra Pradesh and Telangana who were admitted to the Christian Medical College (CMC) Hospital, Vellore, Tamil Nadu, India, for the period 2006-2011, assessed seasonality using monthly counts of scrub typhus cases, and conducted a case-control study among a subset of patients residing in Vellore. Results: The geographic distribution of cases at CMC Hospital clusters around the Tamil Nadu-Andhra Pradesh border. However, distinct hotspots clearly exist distal to this area, near Madurai and the coast in Tamil Nadu, and in the Northeast of Andhra Pradesh. Seasonally, the highest numbers of cases were observed in the cooler months of the year, i.e. September to January. In the case-control analysis, cases were more likely to be agricultural laborers (OR 1.79, 95% CI 1.01 - 3.15), not wear a shirt at home (OR 4.23, 95% CI 1.12 - 16.3), live in houses adjacent to bushes or shrubs (OR 1.95, 95% CI 1.08 - 3.53), and live in a single room home (OR 1.75, 95% CI 1.02 - 3.01). On binary logistic regression, the first three of these variables were statistically significant. Interpretation & conclusions: With the growing number of cases detected in India, scrub typhus is fast emerging as a public health threat and further research to protect the population from this deadly infection is essential. Health education campaigns focusing on the agricultural workers of Southern India, especially during the cooler months of the year, can serve as an important public health measure to control infection.
  9 1,714 439
Effect of lamotrigine, levetiracetam & topiramate on neurobehavioural parameters & oxidative stress in comparison with valproate in rats
Sudhir Chandra Sarangi, Ashish Kumar Kakkar, Ritesh Kumar, Yogendra Kumar Gupta
July 2016, 144(1):104-111
DOI:10.4103/0971-5916.193296  PMID:27834333
Background & objectives: Though newer antiepileptic drugs are considered safer than conventional antiepileptics, the effects of lamotrigine, levetiracetam and topiramate on neurobehavioural functions are yet to be established. This study evaluated neurobehavioural parameters and oxidative stress markers in brain tissue of rats treated with lamotrigine, levetiracetam and topiramate compared to sodium valproate . Methods: Five groups of male Wistar rats were treated respectively with normal saline (control), sodium valproate (370 mg/kg), lamotrigine (50 mg/kg), levetiracetam (310 mg/kg) and topiramate (100 mg/kg) for 45 days. Neurobehavioural parameters were assessed using elevated plus maze (EPM), actophotometer, rotarod, passive avoidance and Morris water maze (MWM) at baseline and at the end of treatment. Oxidative stress parameters [malondialdehyde (MDA), reduced glutathione (GSH) and superoxide dismutase (SOD)] were estimated in rat brain at the end of treatment. Results: Valproate and lamotrigine showed no significant effect on learning and memory in passive avoidance and MWM tests. However, levetiracetam and topiramate reduced retention memory significantly as compared to control (P<0.01) and lamotrigine (P<0.05) groups. Performances on EPM, rotarod and actophotometer were not significantly different between the groups. In comparison to control group, MDA was higher in the levetiracetam and topiramate (360.9 and 345.9 nmol/g of homogenized brain tissue, respectively) groups. GSH and SOD activity were significantly reduced by valproate and levetiracetam treatment. Lamotrigine did not induce significant oxidative stress. Interpretation & conclusions: Long-term and therapeutic dose treatment with levetiracetam and topiramate significantly impaired learning and memory, which was not seen with valproate and lamotrigine in rats. Levetiracetam, topiramate and valproate augmented oxidative stress, whereas lamotrigine has little effect on it. These antiepileptic drugs are used in clinical practice, hence pharmaco- vigilance studies are required to evaluate their safety profile.
  6 1,120 418
Association of CTG repeat polymorphism in carnosine dipeptidase 1 (CNDP1) gene with diabetic nephropathy in north Indians
Ashok K Yadav, Nisha Sinha, Vinod Kumar, Anil Bhansali, Pinaki Dutta, Vivekanand Jha
July 2016, 144(1):32-37
DOI:10.4103/0971-5916.193280  PMID:27834323
Background & objectives: CNDP1 gene, present on chromosome 18q22.3-23, encodes carnosinase, the rate-limiting enzyme in hydrolysis of carnosine to ß-alanine and L-histidine. Linkage of CTG trinucleotide (leucine) repeat polymorphism in CNDP1 gene with diabetic nephropathy has been observed in several populations. However, this association is conflicting and population-dependent. We investigated this association in type 2 diabetes mellitus (T2DM) patients with and without nephropathy in north India. Methods: A total of 564 individuals [199 T2DM without nephropathy (DM), 185 T2DM with nephropathy (DN) and 180 healthy individuals (HC)] were enrolled. CNDP1 CTG repeat analysis was done by direct sequencing of a 377 base pair fragment in exon 2. Results: The most frequent leucine (L) repeats were 5L-5L, 6L-5L and 6L-6L. 5L-5L genotype frequency was reduced in DN (24.3%) as compared to DM (34.7%, P=0.035) and HC (38.4%, P=0.005). Similarly, 5L allele frequency was lower in DN (46.8%) as compared to DM (57.3%, P=0.004) and HC (60.5%, P<0.001). The genotype and allelic frequencies were similar in DM and HC groups. No gender specific difference was observed in the genotype or allelic frequencies between groups. Interpretation & conclusions: Compared to healthy individuals and those with diabetes but no kidney disease, patients with diabetic nephropathy exhibited lower frequencies of 5L-5L genotype and 5L allele of CNDP1 gene, suggesting that this allele might confer protection against development of kidney disease in this population.
  6 859 253
Attenuation of quorum sensing-regulated behaviour by Tinospora cordifolia extract & identification of its active constituents
Viraj C Gala, Nithya R John, Ashok M Bhagwat, Ajit G Datar, Prashant S Kharkar, Krutika B Desai
July 2016, 144(1):92-103
DOI:10.4103/0971-5916.193295  PMID:27834332
Background & objectives: The pathogenicity of the nosocomial pathogens, Pseudomonas aeruginosa and Acinetobacter baumannii is regulated by their quorum sensing (QS) systems. The objective of the present study was to examine the effect of the cold ethyl acetate extract of Tinospora cordifolia stem on virulence and biofilm development in the wild type and clinical strains of P. aeruginosa and A. baumannii. The study was further aimed to identify the probable active constituents in the plant extract. Methods: P. aeruginosa virulence factors viz., LasA protease, LasB elastase and pyocyanin production were analyzed spectrophotometrically. Biofilm formation was studied using crystal violet staining-microtitre plate assay. The plant extract was fractionated using silica gel column chromatography and the most active fraction was derivatized using silylation and analyzed by gas chromatography-mass spectrometry (GC-MS). In silico testing of the molecules identified in GC-MS was performed, for binding to the P. aeruginosa LasI and LasR proteins, to predict the QS inhibitory molecules. Results: The plant extract inhibited three major virulence factors in P. aeruginosa; it exhibited enhanced biofilm formation in P. aeruginosa while decreased biofilm development in A. baumannii. The most active fraction obtained from column chromatography, exhibited suppression of virulence as well as biofilm in both the organisms. Docking scores were calculated for all the molecules identified in GC-MS, and high docking scores were obtained for 2,3,4-triacetyloxybutyl acetate, methyl 16-methyl heptadecanoate, 2-(5-ethenyl-5-methyloxolan-2-yl)propan-2-ol, methyl hexadecanoate and 2-methoxy-4-vinyl phenol. Interpretation & conclusions: The compounds showing high docking scores could probably be the QS inhibitors. These molecules can be screened further for the development of new anti-infective drugs.
  5 1,295 333
Factors associated with utilization of antenatal care services among tribal women: A study of selected States
Tulsi Adhikari, Damodar Sahu, Saritha Nair, Kalyan B Saha, Ravendra K Sharma, Arvind Pandey
July 2016, 144(1):58-66
DOI:10.4103/0971-5916.193284  PMID:27834327
Background & objectives: Despite various efforts by the Government of India, utilization of antenatal care (ANC) services continues to be low among women from rural areas particularly those belonging to the Scheduled Tribes. The present study was undertaken to examine the factors associated with the utilization of ANC services among women in four States including Rajasthan, Odisha, Chhattisgarh and Madhya Pradesh which constitute a good share of tribal population of the country. Methods: Data from third round of District Level Household and Facility Survey, 2007-08 (DLHS-3) have been used. Bivariate and multivariate analyses (logistic regression model) were used to study the association between the utilization of ANC services and the independent variables at individual, household and village levels along with the motivational factors (motivation by health workers and family members). Results: The utilization of ANC services among Scheduled Tribes women varied from about 4 per cent in Madhya Pradesh and Rajasthan to 10-14 per cent in Chhattisgarh and Odisha. Utilization was highest among those women with level of education 9th class and above (15-28%) and those women who visited health facility for pregnancy confirmation test (9-27%). Across the States, women who visited health facility for pregnancy testing (adjusted odds ratio, AOR = 1.5-2.5; P<0.001) except in Madhya Pradesh; registration of pregnancy (AOR = 2.1-4.5; P<0.01) and sought treatment of pregnancy related problems (AOR = 1.5-1.8; P<0.06) except in Rajasthan, were more likely to avail complete ANC services than their counterparts. Interpretation & conclusions: The utilization of antenatal care among Scheduled Tribe women across four States was very poor. The reasons behind non-utilisation include both socio-economic and health system factors. For improving ANC utilization among tribes, these factors need to be addressed with special emphasis on woman's educational attainment of high school and above. In addition, the study highlighted the need to create awareness among both pregnant tribal women as well as her family members on the importance of early ANC care.
  5 1,621 462
Lack of association between FokI polymorphism in vitamin D receptor gene (VDR) & type 2 diabetes mellitus in the Tunisian population
Imen Mahjoubi, Amani Kallel, Mohamed Hédi Sbaï, Bochra Ftouhi, Meriam ben Halima, Zeineb Jemaa, Moncef Feki, Hedia Slimane, Riadh Jemaa, Naziha Kaabachi
July 2016, 144(1):46-51
DOI:10.4103/0971-5916.193282  PMID:27834325
Background & objectives: The impact of several environmental and genetic factors on diabetes is well documented. Though the association between the vitamin D receptor (VDR) gene polymorphisms and type 2 diabetes mellitus (T2DM) has been analyzed in different ethnic groups, the results have been inconsistent. The aim of this study was to evaluate the possible association between VDR FokI polymorphism and genetic susceptibility to T2DM in Tunisian population. Methods: A total of 439 unrelated patients with T2DM and 302 healthy controls were included in the study. Genomic DNA was extracted from blood and genotyped for the single nucleotide polymorphism (SNP) of FokI (T/C: (rs2228570) by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) analysis. Results: The genotype distribution and the relative allelic frequencies for the FokI polymorphism were not significantly different between T2DM and controls: in T2DM patients the frequencies of the CC, CT, and TT genotypes were 52.6, 41.0, and 6.1 per cent, respectively, and in controls the genotype frequencies were 55.6, 38.7, and 5.6 per cent, respectively. In our study, the TT genotype of the FokI polymorphism was not associated with T2DM (OR =1.19, 95% CI 0.63 - 2.25, P=0.577). Interpretation & conclusions: Our study showed no significant association of the FokI polymorphism in the vitamin D receptor gene with type 2 diabetes mellitus in Tunisian population.
  3 1,065 360
A novel indirect ELISA for diagnosis of dengue fever
Rohan Narayan, Senthil Raja, Senthil Kumar, Mohana Sambasivam, Raja Jagadeesan, Kavita Arunagiri, Kaveri Krishnasamy, Gunasekaran Palani
July 2016, 144(1):128-133
DOI:10.4103/0971-5916.193300  PMID:27834337
Background & objectives: Dengue fever (DF) is associated with significant morbidity and mortality in the tropical and sub-tropical regions of the world. Since there are no effective antiviral drugs for treatment, clinicians often rely on the accurate diagnosis of dengue fever to begin supportive therapy at early stages of the illness. The objective of this study was to develop an in-house dengue virus serotype 2 (DENV-2) non-structural protein- 5 (NS5) based indirect ELISA. Methods: DENV-2 was raised in Vero cells and the viral proteins were separated and subsequently the NS5 protein was eluted. Serum samples from primary and secondary dengue fever patients; and acute and convalescent samples from Japanese encephalitis (JE) and West Nile virus (WNV) cases were used to validate the ELISA. Results: The assay was found to be 100 per cent specific in detecting DENV-2 specific antibodies from patient's serum. However, in terms of sensitivity, the assay could detect IgM antibodies only from 90 per cent of the primary dengue samples. The IgM/IgG ratio of the primary and secondary samples was 7.24 and 0.64, respectively. Interpretation & conclusions: The results indicate that the DENV-2 NS5 ELISA is dengue group specific and can be used to differentiate dengue infection from other circulating Flavivirus infections. This NS5 ELISA can also be used to distinguish between primary and secondary dengue fever on the basis of IgM/IgG ratios. Further studies with larger sample sizes and different DENV serotypes are required to validate the ELISA.
  3 1,671 418
Comparison of dietary profile of a rural south Indian population with the current dietary recommendations for prevention of non-communicable diseases (CURES 147)
Narasimhan Sowmya, Nagarajan Lakshmipriya, Kokila Arumugam, Sivasankari Venkatachalam, Parthasarathy Vijayalakshmi, Vaidya Ruchi, Gunasekaran Geetha, Ranjit Mohan Anjana, Viswanathan Mohan, Kamala Krishnaswamy, Vasudevan Sudha
July 2016, 144(1):112-119
DOI:10.4103/0971-5916.193297  PMID:27834334
Background & objectives: Despite the rising prevalence of non-communicable diseases (NCDs) in rural India, data on the dietary profile of the rural Indian population in relation to the recommendations for prevention of NCDs are scarce. This study was conducted to assess the dietary intake of a rural south Indian population in relation to the current dietary recommendations for the prevention of NCDs. Methods: The dietary profiles of 6907 adults aged ≥ 20 yr, from a cluster of 42 villages in Kancheepuram district of Tamil Nadu State in southern India, were assessed using a validated food frequency questionnaire. Results: The prevalence of general obesity was 27.4 per cent and that of abdominal obesity, 14.0 per cent among this rural population. The median daily energy intake of the population was 2034 (IQR 543) kcals. More than 3/4 th of the calories (78.1%) were provided by carbohydrates. Refined cereals, mainly polished rice, was the major contributor to total calories. About 45 per cent of the population did not meet WHO recommendation for protein due to low intake of pulses, flesh foods and dairy products and more than half (57.1%) exceeded the limit of salt intake; 99 per cent of the population did not meet WHO recommendations for fruits and vegetables and 100 per cent did not meet the requirement of n-3 poly unsaturated fatty acids. Interpretation & conclusions: The dietary profile of this rural south Indian population reflected unhealthy choices, with the high consumption of refined cereals in the form of polished white rice and low intake of protective foods like fruits, vegetables, n-3 poly and monounsaturated fatty acids. This could potentially contribute to the increase in prevalence of NCDs like diabetes, hypertension and cardiovascular diseases in rural areas and calls for appropriate remedial action.
  3 1,346 338
Scrub typhus in hilly regions of north east India
Siraj A Khan, Vinotsole Khamo, Helen J Uriah, Trishna Bora, Prafulla Dutta
July 2016, 144(1):138-140
DOI:10.4103/0971-5916.193302  PMID:27834339
  2 984 258
A PCR-RFLP method for detection of the LNPEP encoding human insulin-regulated aminopeptidase (IRAP) rs4869317 polymorphism
María Jesús Ramírez-Expósito, José Manuel Martínez-Martos, Teresa Palomeque, Pedro Lorite
July 2016, 144(1):120-123
DOI:10.4103/0971-5916.193298  PMID:27834335
Background & objectives: Insulin regulated aminopeptidase (IRAP) has been related to certain pathologies such as breast cancer, Alzheimer΄s disease and septic shock. IRAP is encoded by the leucyl/cystinyl aminopeptidase (LNPEP) gene. The genetic variation in the LNPEP gene has been analyzed in relation with the mortality and vasopressin clearance in septic shock. The LNPEP rs4869317 SNP (single nucleotide polymorphism) was the most significantly associated SNP with vasopressinase activity, being TT genotype associated with increased mortality. The objective of the present study was to develop a simple method to allow a quick and affordable genotyping for the rs4869317 SNP of LNPEP gene. Methods: Blood DNA samples were obtained from randomly selected healthy volunteers (n=28). A pair of primers was designed to amplify an 834 bp region of the LNPEP gene containing the rs4869317 SNP. The two alleles (T or A) were detected by digestion of the PCR products with the PacI restriction endonuclease. This enzyme only cuts the PCR products when the adenine is present in the SNP. Results: All individuals showed RFPL (restriction fragment length polymorphism) fragments for the expected genotypes (TT, TA or AA). The methodology was validated by sequencing of the amplified DNAs from several 'T/T' and 'A/A' homozygotes and 'T/A' heterozygotes. The results from both methods showed agreement. Interpretation & conclusions: The PCR-RFLP is a simple and reliable method that allows a quick genotyping for the rs4869317 SNP of LNPEP gene. The study of this polymorphism could be useful in future investigations to analyze the role of genetic variants of IRAP in several physiological/pathological conditions.
  2 630 99
Distribution trends & antibiogram pattern of Salmonella enterica serovar Newport in India
Y Kumar, N Gupta, VB Vaish, S Gupta
July 2016, 144(1):82-86
DOI:10.4103/0971-5916.193293  PMID:27834330
Background & objectives: Salmonellosis is a major public health concern worldwide. Besides typhoidal salmonellae, infections due to non-typhoidal serovars of Salmonella are also associated with high morbidity and mortality leading to huge economic losses. Among non-typhoidal serovars, Salmonella Newport has been reported as a major cause of foodborne infections resulting in outbreaks due to consumption of contaminated food items. Little data related to this serovar are available from India leading to the scarcity of information on the distribution trends of this important serovar in the country. Therefore, an effort was made in the present study to generate data on distribution trends and antibiogram of S. Newport in the country. Methods: S. Newport isolates received at the National Salmonella and Escherichia Centre at Kasauli, India, during January 2010 to December 2013 were analysed for their distribution trends and antibiogram data were also generated using standard methods. Results: In the present study, S. Newport isolates were received from eight s0 tates and one union territory of the country and highest proportion of S. Newport isolates were found to be from humans (53.61%) followed by animals (27.84%) and food (18.56%). S. Newport isolates exhibited resistance to all drugs used in the present study except chloramphenicol, ciprofloxacin and cefuroxime. Interpretation & conclusions: Considering distribution of this important serovar of Salmonalla and its wide range of reservoirs, steps towards formulation and execution of efficient surveillance programmes should be taken.
  2 1,009 249
A structural, epidemiological & genetic overview of Klebsiella pneumoniae carbapenemases (KPCs)
CH Swathi, Rosy Chikala, KS Ratnakar, V Sritharan
July 2016, 144(1):21-31
DOI:10.4103/0971-5916.193279  PMID:27834322
Klebsiella pneumoniae carbapenemases (KPCs) are plasmid encoded carbapenem hydrolyzing enzymes which have the potential to spread widely through gene transfer. The instability of upstream region of blaKPC accelerates emergence of different isoforms. Routine antibiotic susceptibility testing failed to detect KPC producers and some commercial kits have been launched for early identification of KPC producers. Notable among the drugs under development against KPC are mostly derivatives of polymixin; ß-lactamase inhibitor NXL104 with combination of oxyimino cephalosporin as well as with ceftazidime; a novel tricyclic carbapenem, LK-157, potentially useful against class A and class C enzymes; BLI-489-a bicyclic penem derivative; PTK-0796, a tetracycline derivative and ACHN-490. Combination therapy might be preferable to control KPC infections in immediate future. Clinicians are likely to opt for unconventional combinations of antibiotics to treat KPC infections because of unavailability of alternative agents. The KPCs have become endemic in many countries but there is no optimal treatment recommendation available for bacteria expressing KPCs. Reports of outbreaks involving KPCs have focused mainly on laboratory identification, empirical treatment outcomes and molecular epidemiology. This review includes information on the emergence of KPC variants, limitations of phenotyping methods, available molecular methods for identification of the KPC variants and treatment options highlighting the drugs under development.
  2 1,985 713
The genetics of post-polio syndrome - much to be unravelled!
Radha Saraswathy
July 2016, 144(1):9-10
DOI:10.4103/0971-5916.193277  PMID:27834320
  1 893 303
Hair dye poisoning: Retrospective analyses of patients admitted to ICU at a rural hospital in India
Laura Sanchez, Harish Handyal, Shanmugamari Kannan, Siddalingeshwara , Gerardo Alvarez-Uria, Laura Gavalda, Xavier Corbella
July 2016, 144(1):134-137
DOI:10.4103/0971-5916.193301  PMID:27834338
  1 1,371 272
Evaluation of symptoms & spirometry in children treated for asthma
Shobi Anandi, Milind S Tullu, Keya Lahiri
July 2016, 144(1):124-127
DOI:10.4103/0971-5916.193299  PMID:27834336
Background & objectives: Spirometry plays an important role in the assessment and long term monitoring of patients with asthma. Difficulty in performing spirometry in children has resulted in a paucity of Indian studies using spirometry regularly for research in the paediatric population. This study was undertaken to assess the clinical improvement and changes in spirometric measurements with treatment in children with newly diagnosed asthma and to compare the changes in the symptom score and spirometric measurements. Methods: This prospective study included 32 children between 6 to 12 yr of age (enrolled over a period of one year with follow up of six months) who were newly diagnosed as cases of asthma on the basis of symptoms and medical history. Baseline symptom score and spirometric measurements were determined at the first visit. The children were treated and followed up at six weeks, three and six months of initiating treatment. Symptom score and spirometric measurements were repeated at every visit. Results: Significant improvement in symptom score was evident at six weeks of therapy ( P<0.05) while the lung function parameters FEV 1 (forced expiratory volume in 1 second) and FVC (forced vital capacity) showed significant improvement at three months of therapy. Peak expiratory flow rate (PEFR) was found to improve at six months. There was a positive linear correlation between the changes in symptom score and FEV 1, FVC and PEFR with treatment. Interpretation & conclusions: Symptomatic improvement became apparent before the improvement in spirometric parameters in children with asthma (after treatment initiation).
  1 1,006 276
Intricacies of using temperature of different niches for assessing impact on malaria transmission
Poonam Singh, Yogesh Yadav, Shweta Saraswat, Ramesh C Dhiman
July 2016, 144(1):67-75
DOI:10.4103/0971-5916.193285  PMID:27834328
Background & objectives: The influence of temperature on the life cycle of mosquitoes as well as on development of malaria parasite in mosquitoes is well studied. Most of the studies use outdoor temperature for understanding the transmission dynamics and providing projections of malaria. As the mosquitoes breed in water and rest usually indoors, it is logical to relate the transmission dynamics with temperature of micro-niche. The present study was, therefore, undertaken to understand the influence of different formats of temperature of different micro-niches on transmission of malaria for providing more realistic projections. Methods: The study was conducted in one village each of Assam and Uttarakhand s0 tates of India. Temperatures recorded from outdoor (air) as well as indoor habitats (resting place of mosquito) were averaged into daily, fortnightly and monthly and were used for determination of transmission windows (TWs) for Plasmodium vivax (Pv) and P. falciparum (Pf) based on minimum temperature threshold required for transmission. Results: The daily temperature was found more useful for calculation of sporogony than fortnightly and monthly temperatures. Monthly TWs were further refined using fortnightly temperature, keeping in view the completion of more than one life cycle of malaria vectors and sporogony of malaria parasite in a month. A linear regression equation was generated to find out the relationship between outdoor and indoor temperatures and R [2] to predict the percentage of variation in indoor temperature as a function of outdoor temperature at both localities. Interpretation & conclusions: The study revealed that the indoor temperature was more than outdoors in stable malarious area (Assam) but fluctuating in low endemic area like Uttarakhand. Transmission windows of malaria should be determined by transforming outdoor data to indoor and preferably at fortnightly interval. With daily recorded temperature, sporogonic and gonotrophic cycles can also be calculated which is otherwise not possible with monthly data. The study highlights that the projections made for malaria in view of climate change need to be seen with limitation of difference in outdoor and indoor temperatures at different locations, highlighting the need for local data generation at least at sub-district level.
  1 705 196
Technological advances in the treatment of type 1 diabetes
AG Unnikrishnan
July 2016, 144(1):144-145
  - 419 169
Neonatal pharmacology and nutrition update
Samir Malhotra
July 2016, 144(1):145-146
  - 268 141
Translational neurosonology
Bejoy Thomas
July 2016, 144(1):146-146
  - 234 78
Acro-osteolysis & calcinosis in scleroderma
Sujith V Cherian, Elena Thampy
July 2016, 144(1):141-142
DOI:10.4103/0971-5916.193303  PMID:27834340
  - 508 142
Zosteriform type in-transit metastasis of melanoma
Faruk Tas
July 2016, 144(1):143-143
DOI:10.4103/0971-5916.193304  PMID:27834341
  - 624 157
The (CTG)n repeat polymorphism in CNDP1 gene: New insights into an old molecule
Kátia G Santos
July 2016, 144(1):6-8
DOI:10.4103/0971-5916.193276  PMID:27834319
  - 668 245
Combating the wrath of viral hepatitis in India
Sandeep Satsangi, Radha K Dhiman
July 2016, 144(1):1-5
DOI:10.4103/0971-5916.193275  PMID:27834318
  - 11,553 635
Validation of ICMR index for identification of dental fluorosis in epidemiological studies
Ashima Goyal, Mahesh Verma, GS Toteja, K Gauba, Vikrant Mohanty, Utkal Mohanty, Rupinder Kaur
July 2016, 144(1):52-57
DOI:10.4103/0971-5916.193283  PMID:27834326
Background & objectives: The Indian Council of Medical Research (ICMR) formulated a Task Force on dental fluorosis and recommended the subgroup to develop a simplified index for identification and grading of dental fluorosis to be used by the health workers. This study was conducted to pre-test the 'ICMR Index for Dental Fluorosis' in the field to check its reliability and reproducibility. Methods: A total of 600 photographs were taken, 150 in each grade of fluorosis by screening 14-17 yr school children from eight schools of Hisar (Haryana) and South west Delhi. Eighty photographs were finalized (20 in each grade) before calibration to be used for training of field workers. Calibration exercise was conducted involving the five member survey team on 100 diagnosed cases of dental fluorosis. The members again screened 74 children with dental fluorosis in the field to categorize in to different grades of fluorosis for assessment of inter-examiner reliability. Results: The ICMR criteria showed more difference in agreement in very mild and mild categories during calibration. The inter-examiner reliability (κ) ranged from 0.59-1. The criteria was further modified and inter- examiner reliability (κ) found to be 0.83-0.98 which was almost perfect agreement. Interpretation & conclusions: The tool developed by the ICMR to assess dental fluorosis can be used in a field set up by non-dental personnel reliably with high degree of reproducibility.
  - 1,244 324
Assay for identification of heterozygous single-nucleotide polymorphism (Ala67Thr) in human poliovirus receptor gene
Shyam Sundar Nandi, Deepa Kailash Sharma, Jagadish M Deshpande
July 2016, 144(1):38-45
DOI:10.4103/0971-5916.193281  PMID:27834324
Background & objectives : It is important to understand the role of cell surface receptors in susceptibility to infectious diseases. CD155 a member of the immunoglobulin super family, serves as the poliovirus receptor (PVR). Heterozygous (Ala67Thr) polymorphism in CD155 has been suggested as a risk factor for paralytic outcome of poliovirus infection. The present study pertains to the development of a screening test to detect the single nucleotide (SNP) polymorphism in the CD155 gene. Methods: New primers were designed for PCR, sequencing and SNP analysis of Exon2 of CD155 gene. DNAs extracted from either whole blood (n=75) or cells from oral cavity (n=75) were used for standardization and validation of the SNP assay. DNA sequencing was used as the gold standard method. Results: A new SNP assay for detection of heterozygous Ala67Thr genotype was developed and validated by testing 150 DNA samples. Heterozygous CD155 was detected in 27.33 per cent (41/150) of DNA samples tested by both SNP detection assay and sequencing. Interpretation & conclusions: The SNP detection assay was successfully developed for identification of Ala67Thr polymorphism in human PVR/CD155 gene. The SNP assay will be useful for large scale screening of DNA samples.
  - 727 178
Evaluation of colorimetric nitrate reductase assay for rapid detection of methicillin resistance in clinical isolates of Staphylococcus aureus
N Niveditha, Sujatha Sistla
July 2016, 144(1):87-91
DOI:10.4103/0971-5916.193294  PMID:27834331
Background & objectives: Methicillin resistant Staphylococcus aureus (MRSA) remains a major cause of health care-associated infections. Rapid detection of MRSA facilitates the early initiation of appropriate treatment and infection control. Hence, the present study was undertaken to standardize and evaluate the performance of rapid colorimetric nitrate reductase assay (NRA) for determining methicillin resistance in S.aureus. Methods: A total of 160 clinical isolates of S. aureus, (80 each of methicillin susceptible and methicillin resistant) were included in the study. Minimum inhibitory concentration (MIC) was determined by NRA and reference broth micro dilution (BMD) methods. Results of NRA were compared with BMD and analyzed. Results: For MRSA, the MIC values ranged from 4 to ≥ 16 μg/ml and for MSSA, ≤ 0.5 to 2 μg/ml. Category and essential agreement for NRA as compared with BMD were found to be 99.4 and 89.7 per cent, respectively. No minor or major discrepancy was observed. A single resistant isolate showed very major discrepancy. Interpretation & conclusions: Colorimetric NRA being an inexpensive test requiring no special equipment can be employed as an alternative method for rapid detection of MRSA in resource limited settings.
  - 694 220