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   2017| July  | Volume 146 | Issue 1  
    Online since November 22, 2017

 
 
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ORIGINAL ARTICLES
Investigation of the risk factors for pulmonary tuberculosis: A case–control study among Saharia tribe in Gwalior district, Madhya Pradesh, India
Jyothi Bhat, VG Rao, RK Sharma, M Muniyandi, Rajiv Yadav, MK Bhondley
July 2017, 146(1):97-104
DOI:10.4103/ijmr.IJMR_1029_16  PMID:29168465
Background & objectives: Prevalence of pulmonary tuberculosis (PTB) is known to be high in the indigenous tribal community Saharia in Madhya Pradesh, India. The risk factors for PTB are not well known among them. This study was done to determine various risk factors associated with PTB in the indigenous community Saharia. Methods: A prevalence survey was conducted among Saharias of Gwalior district of Madhya Pradesh. The population surveyed was 12,123 which was the source of cases and controls for the present study. All the bacillary-positive cases and controls in the ratio of 1:5 were included in the survey. Data were collected by the trained health workers from the patients and controls using a semi-structured pre-coded and pre-tested questionnaire which included data on risk factors including demographic factors, host-related factors and household factors. The individuals were also screened for diabetes mellitus and HIV. Results: Malnutrition and history of asthma were associated with an increased risk of PTB. More than 56 per cent cases were attributed to malnutrition and 12 per cent attributed to asthma. Low family income, alcohol consumption and smoking were the other contributors. The risk was higher in males as compared to females. Interpretation & conclusions: The study emphasized that the main contributors were social factors. Nutrition supplementation, especially in tuberculosis (TB) patients and integrated approach to improve their living conditions are needed to control TB in this community.
  6 1,011 328
New Delhi metallo-β-lactamase - type carbapenemases producing Escherichia coli isolates from hospitalized patients: A pilot study
Shyam Sunder Grover, Ananya Doda, Nupur Gupta, Inderjeet Gandhoke, Jyoti Batra, Charoo Hans, Shashi Khare
July 2017, 146(1):105-110
DOI:10.4103/ijmr.IJMR_594_15  PMID:29168466
Background & objectives: Resistances to carbapenem group of antimicrobials among Escherichia coli due to production of carbapenemases, especially the New Delhi metallo-β-lactamase (NDM) types, pose serious challenges in the treatment of infections in healthcare settings. This study was undertaken to detect NDM producing E. coli isolates from hospitalized patients with urinary tract infection (UTI). Methods: A total of 30 non-repetitive isolates of E. coli from hospitalized patients with clinical suspicion of UTI were subjected to antimicrobial susceptibility testing. Screening for the production of extended-spectrum β-lactamases (ESBL) was carried out by minimum inhibitory concentration (MIC) test strip ESBL followed by phenotypic confirmation by double-disc synergy test. Phenotypic confirmation of carbapenemase production was carried out by MIC test strip metallo-β-lactamases. Molecular identification of the blaNDM gene was carried out by polymerase chain reaction (PCR) and sequencing of the amplified fragment. Results: Seventeen of the 30 isolates were detected as ESBL producers, of which three were found to be carbapenemase producers. NDM genes were detected by PCR followed by gene sequencing in all three isolates positive for ESBL as well as carbapenemase. The amino acid sequence of the three isolates showed complete identity to the reference sequences of NDM-1, NDM-4 and NDM-8, respectively. Interpretation & conclusions: Our study showed the circulation of NDM variants among the clinical isolates of E. coli that were producers of ESBL as well as carbapenemase.
  3 972 249
CLINICAL IMAGES
Complete response of metastatic gastric cancer to chemoimmunotherapy
Kenji Ina, Ryuichi Furuta
July 2017, 146(1):141-141
DOI:10.4103/ijmr.IJMR_132_16  PMID:29168471
  2 477 138
ORIGINAL ARTICLES
Bisphenol A-induced ultrastructural changes in the testes of common marmoset
Tushara Vijaykumar, Dipty Singh, Geeta R Vanage, Rohit V Dhumal, Vikas D Dighe
July 2017, 146(1):126-137
DOI:10.4103/ijmr.IJMR_927_15  PMID:29168469
Background & objectives: Bisphenol A (BPA) is an endocrine disruptor that is widely used in the manufacture of polycarbonate plastics, epoxy resins and dental sealants. It is known to have adverse effects on spermatogenesis in rodents. This study was aimed to evaluate the effects of BPA in adult common marmoset owing to its similarities with human spermatogenesis. Methods: Sixteen marmosets were divided into four groups (n=4 per group) and given oral doses of BPA (2.5, 12.5 and 25 μg/kg BW/day) for 70 days to cover two spermatogenic cycles, and the control group received only vehicle (honey). Testes were processed for histological and transmission electron microscopy studies. Results: Histology of the testis showed sloughing of germ cells into the lumen, increase in interstitial space and vacuolation of Sertoli cell cytoplasm. Ultrastructural analysis of the testis revealed several degenerative effects on the basement membrane, Sertoli cells, Leydig cells and other developing germ cells in the 12.5 and 25 μg/kg BW/day groups as compared to control. Interpretation & conclusions: The observed ultrastructural changes caused by BPA in testicular morphology might be indicative of a perturbed sperm production. Considering the genetic and spermatogenic similarities of common marmoset (Callithrix jacchus) and humans, the study findings are of significance. Further studies are, however, needed to elucidate the mechanism of action.
  2 673 182
Study of stem cell homing & self-renewal marker gene profile of ex vivo expanded human CD34+ cells manipulated with a mixture of cytokines & stromal cell-derived factor 1
Jyoti Kode, Navin Khattry, Ashish Bakshi, Vasanti Amrutkar, Bhausaheb Bagal, Rohini Karandikar, Pallavi Rane, Nobutaka Fujii, Shubhada Chiplunkar
July 2017, 146(1):56-70
DOI:10.4103/ijmr.IJMR_1319_15  PMID:29168461
Background & objectives: Next generation transplantation medicine aims to develop stimulating cocktail for increased ex vivo expansion of primitive hematopoietic stem and progenitor cells (HSPC). The present study was done to evaluate the cocktail GF (Thrombopoietin + Stem Cell factor + Flt3-ligand) and homing-defining molecule Stromal cell-derived factor 1 (SDF1) for HSPC ex vivo expansion. Methods: Peripheral blood stem cell (n=74) harvests were analysed for CD34hiCD45lo HSPC. Immunomagnetically enriched HSPC were cultured for eight days and assessed for increase in HSPC, colony forming potential in vitro and in vivo engrafting potential by analyzing human CD45+ cells. Expression profile of genes for homing and stemness were studied using microarray analysis. Expression of adhesion/homing markers were validated by flow cytometry/ confocal microscopy. Results: CD34hiCD45lo HSPC expansion cultures with GF+SDF1 demonstrated increased nucleated cells (n=28, P<0.001), absolute CD34+ cells (n=8, P=0.021) and increased colony forming units (cfu) compared to unstimulated and GF-stimulated HSPC. NOD-SCID mice transplanted with GF+SDF1-HSPC exhibited successful homing/engraftment (n=24, P<0.001). Microarray analysis of expanded HSPC demonstrated increased telomerase activity and many homing-associated genes (35/49) and transcription factors for stemness/self-renewal (49/56) were significantly upregulated in GF+SDF1 stimulated HSPC when compared to GF-stimulated HSPC. Expression of CD44, CXCR4, CD26, CD14, CD45 and soluble IL-6 in expanded cultures were validated by flow cytometry and confocal microscopy. Interpretation & conclusions: Cocktail of cytokines and SDF1 showed good potential to successfully expand HSPC which exhibited enhanced ability to generate multilineage cells in short-term and long-term repopulation assay. This cocktail-mediated stem cell expansion has potential to obviate the need for longer and large volume apheresis procedure making it convenient for donors.
  2 1,106 216
Potential benefit of optimizing atrioventricular & interventricular delays in patients with cardiac resynchronization therapy
Bozena Urbanek, Krzysztof Kaczmarek, Artur Klimczak, Jan Ruta, Michal Chudzik, Katarzyna Piestrzeniewicz, Pawel Ptaszynski, Jerzy Krzysztof Wranicz
July 2017, 146(1):71-77
DOI:10.4103/ijmr.IJMR_1560_14  PMID:29168462
Background & objectives: The clinical benefit of optimization (OPT) of atrioventricular delay (AVD) and interventricular delay (VVD) in cardiac resynchronization therapy (CRT) remains debatable. This study was aimed to determine the influence of AVD and VVD OPT on selected parameters in patients early after CRT implantation and at mid-term follow up (FU). Methods: Fifty two patients (61±10 yr, 23 males) with left bundle branch block, left ventricular ejection fraction (LVEF) ≤35 per cent and heart failure were selected for CRT implantation. Early on the second day (2DFU) after CRT implantation, the patients were assigned to the OPT or the factory setting (FS) group. Haemodynamic and electrical parameters were evaluated at baseline, on 2DFU after CRT and mid-term FU [three-month FU (3MFU)]. Echocardiographic measures were assessed before implantation and at 3MFU. The AVD/VVD was deemed optimal for the highest cardiac output (CO) with impedance cardiography (ICG) monitoring. Results: On 2DFU, the AVD was shorter in the OPT group, LV was paced earlier than in FS group and CO was insignificantly higher in OPT group. At 3MFU, improvement of CO was observed only in OPT patients, but the intergroup difference was not significant. At 3MFU in OPT group, reduction of LV in terms of LV end-diastolic diameter (LVeDD), LV end-systolic diameter, LV end-diastolic and systolic volume with the improvement in LVEF was observed. In FS group, only a reduction in LVeDD was present. In OPT group, the paced QRS duration was shorter than in FS group patients. Interpretation & conclusions: CRT OPT of AVD and VVD with ICG was associated with a higher CO and better reverse LV remodelling. CO monitoring with ICG is a simple, non-invasive tool to optimize CRT devices.
  2 630 161
REVIEW ARTICLE
Newer direct-acting antivirals for hepatitis C virus infection: Perspectives for India
Varun Gupta, Ashish Kumar, Praveen Sharma, Anil Arora
July 2017, 146(1):23-33
DOI:10.4103/ijmr.IJMR_679_15  PMID:29168457
Approximately three per cent of the world's population (170-200 million people) is chronically infected with hepatitis C virus (HCV) and almost 500,000 people die each year (mostly in lower middle-income countries) from complications secondary to HCV infection. In India, HCV infection imposes a considerable burden of mortality, morbidity and healthcare costs. In the last two decades, the treatment of HCV has evolved from interferon (IFN)-based therapies with or without ribavirin (RBV) to pegylated-IFN (PEG-IFN) and RBV-based therapies that were better tolerated by patients. However, the introduction of oral drugs, which specifically target virus-specific proteins, has now revolutionized the treatment of chronic HCV. These agents are known as direct-acting antivirals (DAAs). These drugs have resulted in very high HCV cure rates even with reduced treatment duration and an excellent tolerability by the patients compared to PEG-IFN- and RBV-based therapies. In India, sofosbuvir (SOF), one of the most effective DAAs, has been made available at a compassionate price; thus only those DAA-based management strategies, which contain SOF are adopted in India. Here, we review different DAAs and their possible roles in different genotypes and stages of liver disease, stressing upon the role of SOF. An attempt has also been made to devise strategies using SOF for the most prevalent genotypes in our country (genotypes 3 and 1) and cirrhosis.
  2 1,928 398
COMMENTARIES
Molecular epidemiology of tuberculosis: Opportunities & challenges in disease control
Mandira Varma-Basil, Deepthi Nair
July 2017, 146(1):11-14
DOI:10.4103/ijmr.IJMR_941_17  PMID:29168455
  1 665 311
ORIGINAL ARTICLES
Strontium chloride hexahydrate as a candidate molecule for long-term treatment of allergic rhinitis
Emine Elif Altuntas, Nergiz Hacer Turgut, Kasım Durmuş, Ömer Tamer Doǧan, Melih Akyol
July 2017, 146(1):121-125
DOI:10.4103/ijmr.IJMR_894_15  PMID:29168468
Background & objectives: Neurogenic inflammation plays a role in the pathophysiology of allergic rhinitis (AR). Strontium salts are highly effective in reducing the sensory irritation. This study was aimed to investigate the efficacy of strontium chloride (SC) on AR symptoms based on the duration of SC use before the symptoms begin. Methods: Wistar albino rats (n=18) were randomly divided into three groups: Group 1, received 1μg mometasone furoate (MF); Group 2, three per cent SC; and Group 3 received five per cent SC (2 μl/site). Drugs were administered to the each nasal cavity for three weeks every morning. On the days 7, 14 and 21, histamine dihydrochloride (HD) 5 μmol (2 μl/site) was administered and the frequencies of nasal rubbing and sneezing were counted for 15 min. Results: After 7, 14 and 21 day medication period, the groups were compared in terms of the frequency of sneezing and nasal rubbing following HD. There was a significant difference among the groups in terms of the frequency of sneezing on the day 7 (P<0.05). Intragroup comparisons for the nasal rubbing showed significance (P<0.05). In Group 3, there was a decrease in the number of nasal rubbings on the day 14 and 21; however, the difference was not significant. Interpretation & conclusions: Our results showed that three and five per cent SC were less effective than MF for sneezing during the first week, but the efficiency was equal to that of MF after the first 14 days. Long-term use of SC was as effective as MF on nasal rubbing. SC can be as effective as MF on both sneezing and nasal rubbing on regular use over three weeks.
  1 488 131
Antipsychotic treatment, psychoeducation & regular follow up as a public health strategy for schizophrenia: Results from a prospective study
Channaveerachari Naveen Kumar, Jagadisha Thirthalli, Kudumallige K Suresha, Basappa K Venkatesh, Udupi Arunachala, Bangalore N Gangadhar
July 2017, 146(1):34-41
DOI:10.4103/ijmr.IJMR_838_15  PMID:29168458
Background & objectives: In low- and middle-income countries such as India, a feasible public health strategy could be to ensure continuous antipsychotics and psychoeducation for those with schizophrenia. Whether such a strategy favourably influences its course and outcome is not well-studied. The objectives of this study were to examine these issues in a cohort of patients with schizophrenia in a rural south Indian taluk (an administrative block). This cohort was part of a community intervention programme running in the place since the past one decade. Methods: A total of 201 patients were assessed after an average of four years of follow up. Psychopathology, disability and course of illness were assessed using Positive and Negative Syndrome Scale (PANSS), Indian Disability Evaluation and Assessment Scale (IDEAS) and Psychiatric and Personal History Schedule (PPHS), respectively. Interventions included ensuring continuous antipsychotic treatment and low-intensity psychoeducation. Results: One hundred and forty two [70.6%; 95% confidence interval (CI): 64.35-76.95] of the 201 patients achieved clinical remission by the end of follow up period (four years); 140 (69.6%; 95% CI: 63.29-76.07) had satisfactory outcome (42.3% best outcome and 27.4% intermediate outcome). There was a significant reduction in the proportion of patients with disability [134/201 (66.7%) at baseline; 55/201 (27.3%) at follow up; P<0.01]. Best course pattern and least disability were seen in patients with best treatment adherence. Interpretation & conclusions: Treatment with antipsychotics and psychoeducation can favourably influence the course of schizophrenia and reduce disability in a substantial proportion of patients. Structured psychosocial interventions may be indicated in the significant minority who show suboptimal outcome with this strategy.
  1 847 262
p40 & thyroid transcription factor-1 immunohistochemistry: A useful panel to characterize non-small cell lung carcinoma-not otherwise specified (NSCLC-NOS) category
Ritika Walia, Deepali Jain, Karan Madan, Mehar C Sharma, Sandeep R Mathur, Anant Mohan, Venkateswaran K Iyer, Lalit Kumar
July 2017, 146(1):42-48
DOI:10.4103/ijmr.IJMR_1221_15  PMID:29168459
Background & objectives: Accurate histopathological subtyping of non-small cell lung carcinoma (NSCLC) is essential for targeted therapeutic agents. Immunohistochemistry (IHC) is helpful in identification of different tumour subtypes. In this study two marker approaches, one each for glandular and squamous cell differentiation was applied to maximize the proportion of accurately subtyped NSCLC not otherwise specified (NOS) tumours on small biopsy samples. Methods: Two hundred and sixty three consecutive lung biopsies of primary lung carcinoma were prospectively studied. These were subtyped first morphologically and then by IHC for p40 and thyroid transcription factor-1 (TTF-1). The diagnosis of NSCLC-NOS before and after addition of IHC was evaluated. Results were correlated and validated with morphologically proven cases and matched surgical specimens. Results: Based on morphology, only 140 of the 263 (53.2%) cases of NSCLC were characterized, whereas 123 (46.7%) were classified as NSCLC-NOS type. With addition of IHC (p40 and TTF-1), the latter category reduced to 14.4 per cent and a sum of 225 (85.5%) cases were accurately subtyped into squamous cell carcinoma, adenocarcinoma and adenosquamous carcinoma. p40 showed 100 per cent sensitivity and specificity for squamous differentiation whereas TTF-1 showed sensitivity of 85.3 per cent and specificity of 98.1 per cent. Ninety per cent correlation of morphologic subtypes was achieved with matched resected specimens. Interpretation & conclusions: Our results showed that an approach of using only a two-antibody panel (p40 and TTF-1) might help in reduction of diagnostic category of NSCLC-NOS significantly and contribute in saving tissue for future molecular testing.
  1 985 224
Molecular & genetic characteristics of Mycobacterium tuberculosis strains circulating in the southern part of West Siberia
Oksana Pasechnik, Maya Alexandrovna Dymova, Vladimir Leonidovich Stasenko, Aleksey Igorevich Blokh, Marina Petrovna Tatarintseva, Lyubov Pavlovna Kolesnikova, Maksim Leonidovich Filipenko
July 2017, 146(1):49-55
DOI:10.4103/ijmr.IJMR_162_16  PMID:29168460
Background & objectives: A complicated epidemiological situation characterized by significantly high tuberculosis (TB) morbidity is observed in West Siberia. This study was aimed to investigate the genetic characteristics of Mycobacterium tuberculosis circulating in the southern part of West Siberia (in the Omsk region). Methods: From March 2013 to January 2015, 100 isolates of M. tuberculosis were obtained from patients with pulmonary TB living in the Omsk region. Drug susceptibility testing was performed on Lowenstein-Jensen medium (absolute concentration method). Genetic typing of isolates was carried out by variable number tandem repeats of mycobacterial interspersed repetitive units (MIRU-VNTR) typing and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. The genetic types and characteristics of cluster strains were determined using 15 MIRU-VNTR loci. Results: Thirty six VNTR types were found. Twenty six (26.0%) isolates had a unique profile, and the remaining 74 were grouped in 10 clusters containing from 2 to 23 isolates. The Beijing genotype was found in 72 isolates, 61 (85.0%) of which were part of five clusters that included two large clusters containing 23 isolates. Other genetic families, such as Latin-American Mediterranean (LAM, 11.0%), S family (2.0%) and Haarlem (4.0%), were also detected. The genetic family of 11 isolates could not be determined. Six different VNTR profiles were found in these non-classified isolates. Only 16 per cent of isolates were sensitive to anti-TB drugs. The katG315 (94.8%) and rpoB531 (92.2%) mutations were identified in 77 multidrug-resistant M. tuberculosis isolates. Interpretation & conclusions: This study showed that the M. tuberculosis population in the Omsk region was heterogeneous. The Beijing genotype predominated and was actively spreading. The findings obtained point to the need for the implementation of more effective preventive measures to stop the spread of drug-resistant M. tuberculosis strains.
  1 533 248
Sustained progress, but no room for complacency: Results of 2015 HIV estimations in India
Arvind Pandey, Neeraj Dhingra, Pradeep Kumar, Damodar Sahu, D.C.S. Reddy, Padum Narayan, Yujwal Raj, Bhavna Sangal, Nalini Chandra, Saritha Nair, Jitenkumar Singh, Laxmikant Chavan, Deepika Joshi Srivastava, Ugra Mohan Jha, Vinita Verma, Shashi Kant, Madhulekha Bhattacharya, Pushpanjali Swain, Partha Haldar, Lucky Singh, Taoufik Bakkali, John Stover, Savina Ammassari
July 2017, 146(1):83-96
DOI:10.4103/ijmr.IJMR_1658_16  PMID:29168464
Background & objectives: Evidence-based planning has been the cornerstone of India's response to HIV/AIDS. Here we describe the process, method and tools used for generating the 2015 HIV estimates and provide a summary of the main results. Methods: Spectrum software supported by the UNAIDS was used to produce HIV estimates for India as a whole and its States/Union Territories. This tool takes into consideration the size and HIV prevalence of defined population groups and programme data to estimate HIV prevalence, incidence and mortality over time as well as treatment needs. Results: India's national adult prevalence of HIV was 0.26 per cent in 2015. Of the 2.1 million people living with HIV/AIDS, the largest numbers were in Andhra Pradesh, Maharashtra and Karnataka. New HIV infections were an estimated 86,000 in 2015, reflecting a decline by around 32 per cent from 2007. The declining trend in incidence was mirrored in most States, though an increasing trend was detected in Assam, Chandigarh, Chhattisgarh, Gujarat, Sikkim, Tripura and Uttar Pradesh. AIDS-related deaths were estimated to be 67,600 in 2015, reflecting a 54 per cent decline from 2007. There were variations in the rate and trend of decline across India for this indicator also. Interpretation & conclusions: While key indicators measured through Spectrum modelling confirm success of the National AIDS Control Programme, there is no room for complacency as rising incidence trends in some geographical areas and population pockets remain the cause of concern. Progress achieved so far in responding to HIV/AIDS needs to be sustained to end the HIV epidemic.
  1 1,119 201
BOOK REVIEWS
Manual of tuberculosis
DJ Christopher
July 2017, 146(1):142-142
DOI:10.4103/0971-5916.219022  
  - 189 119
Pain in psychiatric disorders
Koushik Sinha, Sudhir K Khandelwal
July 2017, 146(1):142-143
DOI:10.4103/0971-5916.219023  
  - 275 119
Immuno-Oncology
Swapna Chaudhuri
July 2017, 146(1):144-145
DOI:10.4103/0971-5916.219024  
  - 215 116
COMMENTARIES
Role of primary care in the management of schizophrenia
Manjeet Singh Bhatia, Rashmita Saha
July 2017, 146(1):5-7
DOI:10.4103/ijmr.IJMR_1557_16  PMID:29168453
  - 813 281
Minimalistic immunohistochemical approach to non-small cell carcinoma of the lung in small biopsies in the context of the 2015 WHO Classification of Lung Cancer
Neelaiah Siddaraju
July 2017, 146(1):8-10
DOI:10.4103/ijmr.IJMR_1069_17  PMID:29168454
  - 543 193
CORRESPONDENCE
Seroepidemiology of parvovirus B19 among different age groups & pregnant women in India
Rajlakshmi Viswanathan, Babasaheb V Tandale, Manisha S Tamayachekar, Santoshkumar M Jadhav, Kirtee A Khutwad, Kiran R Munne
July 2017, 146(1):138-140
DOI:10.4103/ijmr.IJMR_1847_15  PMID:29168470
  - 697 172
EDITORIAL
Third-trimester tenofovir to prevent mother-to-child hepatitis B virus transmission
Blaire E Burman, Manan A Jhaveri, Kris V Kowdley
July 2017, 146(1):1-4
DOI:10.4103/ijmr.IJMR_315_17  PMID:29168452
  - 1,653 1,001
ORIGINAL ARTICLES
Temporal trends of intestinal parasites in patients attending a tertiary care hospital in south India: A seven-year retrospective analysis
Ira Praharaj, Rajiv Sarkar, Sitara Swarna Rao Ajjampur, Sheela Roy, Gagandeep Kang
July 2017, 146(1):111-120
DOI:10.4103/ijmr.IJMR_1236_14  PMID:29168467
Background & objectives: Intestinal parasitic infections and their associated complications are a major cause of morbidity in the developing world. This retrospective study was done to assess the prevalence of intestinal parasitic infections among patients in a tertiary healthcare setting and to analyze age-, gender- and time-related trends in the prevalence of these intestinal parasites over a seven year period (2006-2012). Methods: The presence of various intestinal parasites in a tertiary care setting over a seven year period in different age groups was determined by performing routine stool microscopy. Modified acid-fast staining was performed for stool samples collected from children less than five years of age for the detection of intestinal coccidian parasites. Statistical analysis was carried out to analyze age-related trends in relation to the prevalence of commonly detected intestinal parasites. Seasonal fluctuations in parasite prevalence were evaluated by performing harmonic regression analysis. Results: A total of 257,588 stool samples were received over the seven year period for examination. The highest percentage of intestinal parasites was in the 6-10 yr age group. Among the intestinal parasites, Giardia intestinalis had the highest prevalence across most age groups, except in those above 60 yr of age where hookworm became more prevalent. A significant decreasing trend with age was observed for G. intestinalis, whereas for hookworm and Strongyloides stercoralis, an increasing trend with age was seen. Significant linear temporal trends were observed for parasites such as G. intestinalis, Entamoeba histolytica and Ascaris lumbricoides. Interpretation & conclusions: While G. intestinalis was more common in the younger age groups, certain soil-transmitted helminths such as hookworm and S. stercoralis showed a higher prevalence in the older populations. Significant temporal trends and seasonality were observed for some of the common intestinal parasites.
  - 778 239
A preliminary study of natural history of mild traumatic brain injury by using multidimensional approach
Ashok Munivenkatappa, Bhagavatula Indira Devi, Dhaval P Shukla, Jamuna Rajeswaran
July 2017, 146(1):78-82
DOI:10.4103/ijmr.IJMR_1245_14  PMID:29168463
Background & objectives: Spectrum of post-traumatic symptoms is frequent among mild traumatic brain injury (mTBI) patients. They account for symptoms in 30-80 per cent of patients during 3-4 months and 20-30 per cent of patients six months post-injury. There are no studies from India in this area. The present longitudinal study was conducted to evaluate the natural recovery of post-traumatic symptoms in mTBI patients. Methods: Twenty five mTBI patients presenting with initial Glasgow coma scale score of 15 were recruited initially 2-3 wk post-injury. All patients were followed up twice, after 3-4 and 6-7 months. The patients were evaluated with neuropsychological test, post-traumatic symptoms and quality of life after injury. Results: Sustained attention and sensory registration were first to improve. Memory and executive domains improved partially until three months and then after complete recovery. However, a few facets of learning/memory did not improve even at six months. The post-traumatic symptoms decreased since baseline from 76 to 52 per cent at 3-4 months and further to 28 per cent at 6-7 months. The quality of life improved partially from baseline till 3-4 months and much more by 6-7 months. Interpretation & conclusions: The study findings showed the course of changes in cognition, traumatic symptoms and quality of life since the time of injury till 6-7 months post-injury. Though majority of post-traumatic symptoms recovered after mTBI without any intervention, but residuals were not uncommon.
  - 608 177
VIEWPOINT
Shifting gears from embryonic to very small embryonic-like stem cells for regenerative medicine
Deepa Bhartiya
July 2017, 146(1):15-21
DOI:10.4103/ijmr.IJMR_1485_16  PMID:29168456
  - 792 251
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