Adverse events following immunization of COVID-19 (Covaxin) vaccine at a tertiary care center of India

The study aimed to assess the adverse events following COVID-19 vaccine (Covaxin) immunization at a tertiary care institution and also assess the predictors of the adverse events following immunization (AEFI). The prospective observational study was conducted in a tertiary care institute among the Covaxin beneficiaries between June 28 and September 6, 2021. A total of 1826 participants were assessed for any local or systemic adverse events after seven days of vaccination. A telephonic interview was conducted, and the beneficiaries were assessed according to the adverse event grading. A total of 1826 participants were assessed for AEFI, and 544 (29.8%) reported at least one of the AEFI. No severe adverse events were reported, and about 1.6% had moderate AEFI. Pain at the injection site (14.6%), fever (9.7%), and myalgia (5.9%) were the common adverse events reported by the participants. AEFI incidence was higher in the first dose (38.1%) when compared to the second dose (26.4%), and this finding was significant with a p < 0.001. The major factors associated with AEFI were female sex, history of an allergic reaction, presence of comorbidities, acute infection in the past 3 months, and intake of chronic medications. Precaution needs to be taken while vaccinating individuals having allergies, comorbidities, acute infection in the last 3 months, and individuals on chronic medication.

Mechanisms associated with the rapid decline in sea ice cover around a stranded ship in the Lazarev Sea, Antarctica

In the satellite data era starting from 1979, the extent of Antarctic sea ice increased moderately for the first 37 years. However, the extent decreased to record low levels from 2016 to 2020, with the drop being greatest in the Weddell and Lazarev Seas of the Southern Ocean. An important question for the scientific fraternity and policymakers is to understand what ocean-atmospheric processes triggered such a rapid decline in sea ice. We employ in-situ, satellite, and atmospheric reanalysis data to examine the causative mechanism of anomalous sea ice variability in the Lazarev Sea at a time of ice growth in the annual cycle (March-April 2019), when a cargo ship was stuck in extensive ice cover and freed following the unusual decline in sea ice. High-resolution Sentinel-1 synthetic aperture radar captured a distinct view of the ship location and track within extensive ice cover of fast sea ice, dense pack ice, and icebergs in the Lazarev Sea on 27 March 2019. Subsequently, the sea ice cover declined and reached the fourth lowest extent in the entire satellite record during April 2019 which was 25.6% lower than the long-term mean value of 2.65 × 10⁶ km². We show that the anomalous sea ice variability was due to the occurrence of eastward-moving polar cyclones, including a quasi-stationary explosive development that impacted sea ice through extreme changes in ocean-atmospheric conditions. The cyclone-induced dynamic (poleward propagation of ocean waves and ice motion) and thermodynamic (heat and moisture plumes from midlatitudes, ocean mixed layer warming) processes coupled with high tides provided a conducive environment for an exceptional decline in sea ice over the region of ship movement.

Perception of Employees Regarding the Quality Management System Implemented at a Tertiary Care Eye Hospital in North India: A Mixed-Methods Study

Background:

Quality management in healthcare is critical for hospitals and everyone in the loop —from physicians to support staff—needs to be aware of and involved in this process.

Objectives:

To assess the perception of employees about the quality management system (QMS) implemented at a tertiary care eye hospital in north India and to use it to identify scope for further improvement.

Methods:

This cross-sectional mixed-method study involved both questionnaire-based survey and an in-depth interview by a third party. The questionnaire had 12 questions to assess the changes in culture, infrastructure, environment, system, operation theatre and outpatient department. Employees shared their opinion about improvements brought by the QMS in eight years. Respondents were divided into five groups based on their job description: (i) doctors, (ii) technical staff (nursing/operation theatre/laboratory), (iii) optometrists/opticians/audiologists, (iv) patient care executives and (v) human resources/administration/others.

Results:

Of the 73 employees interviewed, 94.5% perceived an improved treatment and care process and 91.8% perceived improved treatment results. According to 83.6% of the employees, they were encouraged to report patient safety concerns and 71.2% saw improved incidence and adverse event management. The QMS has increased patient satisfaction according to 83%, while 91.8% felt it improved the profile of the hospital. The employees stated no negative effects of the QMS except a long waiting time of the patients and the duplication of paperwork.

Conclusion:

QMS has brought many positive changes across the hospital. Still, there is scope to reduce the patient waiting time and paperwork duplication.

Dysnatremia in Traumatic Brain Injury and its Association with Outcome

Background Traumatic brain injury on its own results in significant mortality and morbidity but it also contributes to complications that manifest as dysnatremia in the majority of cases. Objective The objective of this study is to assess the association of hyponatremia and hypernatremia with the severity of traumatic brain injury and its impact on mortality. Method This is a retrospective, descriptive, and analytic study conducted during a 1-year period from March 2018 to March 2019. The study population was selected from the patients presenting to the emergency department with TBI in the Upendra Devkota Memorial National Institute of Neurological and Allied Sciences, Bansbari, Kathmandu, Nepal. All the patients that fulfilled the inclusion criteria of age were enrolled in the study. Patients with known renal disease due to the higher incidence of electrolyte disbalance were excluded. Association of outcome with hyponatremia and hypernatremia were sought using chi-square, fisher exact test and independent t test using SPSS ver 20. Result Over a period of 1 year, 367 patients with traumatic brain injuries were treated in our hospital. Hyponatremia was seen among 55 patients (14.9%) and hypernatremia was seen among 22 patients (5.99%). The age range of patients included in the study was 16 to 87 with a mean age of 37.96 ± 16.512 years. The male to female ratio was calculated as 3.2:1. Mild, moderate, and severe head injuries were 286 (77.9%), 37 (10.1%), and 44 (12%) respectively. Surgical intervention was performed among 77(21%) individuals. Our series showed an association between the severity of traumatic brain injury and hyponatremia however didn't show an association between the severity of traumatic brain injury and the development of hypernatremia. Conclusion We concluded that the severity of head injury is associated with severity of hyponatremia but not with severity of hypernatremia. Similarly, a strong association existed between the severity of hypernatremia and outcome of patients. However, such association was not seen with hyponatremia.

Quality of life of people living with HIV/AIDS before and after receiving antiretroviral therapy

Background- HIV/AIDS is a chronic illness. Besides having serious morbidities, opportunistic infections, it also adversely affects quality of life of People Living with HIV/AIDS (QOL- PLHIV). Early and prompt initiation of antiretroviral therapy (ART) might improve quality of life of PLHIV in various domains like psychological, physical, environment level of independence, social relationship and spirituality/religion/personal beliefs. Material and methods- The study was conducted at a medical institute of North India. Patients attending ART centre of the institute for the treatment of HIV/AIDS were interviewed on WHOQOL-HIV questionnaire. Aim and objectives- To assess and compare quality of life of people living with HIV/AIDS at initiation and after 6 months of receiving antiretroviral therapy. Result- QOL-PLHIV was improved in various domains when assessed after six months of receiving ART. For physical domain mean score increased from 12.83 to 13.85, for psychological domain from 12.54 to 14.31, for level of independence from 12.95 to 13.21, for social relationship from 12.46 to 14.15, for environment domain from 11.98 to 13.15 and for spirituality/religion/personal belief mean score increased from 11.41 to 11.96. Respective standard deviation was decreased when compared from before initiation of ART to six months after receiving ART. Conclusion – Quality of life of people living with HIV/AIDS was improved significantly after receiving ART.

Net ecosystem CO2 exchange from jute crop (Corchorus olitorius L.) and its environmental drivers in tropical Indo-Gangetic plain using open-path eddy covariance technique

Present study is a maiden attempt to assess net ecosystem exchange (NEE) of carbon dioxide (CO₂) flux from jute crop (Corchorus olitorius L.) in the Indo-Gangetic plain by using open-path eddy covariance (EC) technique. Diurnal variations of NEE were strongly influenced by growth stages of jute crop. Daytime peak NEE varied from - 5 µmol m^-2 s^-1 (in germination stage) to - 23 µmol m^-2 s^-1 (in fibre development stage). The ecosystem was net CO₂ source during nighttime with an average NEE value of 5-8 μmol m^-2 s^-1. Combining both daytime and nighttime CO₂ fluxes, jute ecosystem was found to be a net CO₂ sink on a daily basis except the initial 9 days from date of sowing. Seasonal and growth stage-wise NEEs were computed, and the seasonal total NEE over the jute season was found to be - 268.5 gC m^-2 (i.e. 10.3 t CO₂ ha^-1). In different jute growth stages, diurnal variations of NEE were strongly correlated (R² > 0.9) with photosynthetic photon flux density (PPFD). Ecosystem level photosynthetic efficiency parameters were estimated at each growth stage of jute crop using the Michaelis-Menten equation. The maximum values of photosynthetic capacity (P_max, 63.3 ± 1.15 µmol CO₂ m^-2 s^-1) and apparent quantum yield (α, 0.072 ± 0.0045 µmol CO₂ µmol photon^-1) were observed during the active vegetative stage, and the fibre development stage, respectively. Results of the present study would significantly contribute to understanding of the carbon flux from the Indian agro-ecosystems, which otherwise are very sparse.

Anthropogenic arsenic menace in contaminated water near thermal power plants and coal mining areas of India

Coal mining and coal combustion in thermal power plants (TPPs) are the major anthropogenic sources of arsenic (As) contamination in many different industrial regions. In this study of industrial regions of West Bengal and Singrauli, it is observed that there is an anthropogenic contribution to the contamination from As-bearing coal. Up to 14.53 mg/kg of As is obtained in coal of West Bengal which also has very high average Fe concentration (16,095 mg/kg) along with high concentration of Cu, Mn and Hg. Similar observations are also found in Singrauli Industrial Region where 3.14 mg/kg of As with very high concentration of Fe 43,867 mg/kg along with high Cu, Mn and Hg concentration is found in coal samples. This low-grade bituminous coal contains arsenopyrite as observed by SEM-EDX. Arsenopyrite is converted to arsenolite upon combustion in these TPPs as observed in XRD. The fly ash has average As concentration of 1.53 mg/kg for West Bengal and 2.38 mg/kg for Singrauli Industrial Region and high concentration of toxic elements. The soil near these TPPs and mining areas is enriched in As, Fe, Hg, Cu and Mn. Not only As but high concentrations of Fe, Hg, Mn are also observed from analysis of water which relates to the anthropogenic inputs. The dissolution of arsenolite in reducing environments caused by periodic flooding releases As into water. Hence, the As contamination in the study area also has anthropogenic origin from coal consumption in TPPs.

Analysis of responses of the health care workers recovered from COVID-19 on convalescent plasma donation by apheresis: A single-center survey study

Background

The COVID‐19 convalescent plasma (CCP) has been tried as a therapy in moderate COVID‐19 pneumonia. Donation of CCP requires motivation from recovered patients. This study evaluated the response of such recovered health care workers (HCWs) when they were motivated for CCP donation.

Methods

An interview‐based survey was carried out with recovered HCWs as study participants between August 2020 and November 2020. A qualified social worker explained the details of CCP donation over a mobile call; he clarified all their doubts and motivated them for the plasma donation. Their responses were recorded as “interested” or “not interested” followed by analysis.

Results

We tried to call 624 recovered HCWs, but could not reach 213, and the final group available for the study was 411 participants. Of these 411, 186 were deferred. Finally, we analyzed a total of 225 responses. Eventually, 105 out of 225 HCWs (47%) were interested; there were no significant differences in responses among males and females and between different age groups (<.001) and the “doctors” designation category (P = .01) had a maximum number of “interested” responses. In multivariate logistic regression, only the “interested” responses of the doctors were significantly higher after adjusting the confounding effect of the “graduate and above” educational qualification category.

Conclusion

This study found that nearly half of the eligible HCWs were interested in CCP donation. The educational qualification and designation among the recovered HCWs had an impact on CCP donation interest. The doctors were more interested in CCP donation compared to others.

Influence of Brassica spp. rapeseed and canola meal, and supplementation of bioactive compound (AITC) on growth performance, intestinal-permeability, oocyst shedding, lesion score, histomorphology, and gene expression of broilers challenged with E. maxima

This study was performed to investigate the effect of feeding Brassica spp. including full-fat rapeseed, canola meal, and allyl isothiocyanate (AITC) to broiler chicken challenged with E. maxima. A total of 576 one-day old male broiler chicks were completely randomized to 8 treatments with 6 replicated cages and 12 birds per cage. The treatment diets consisted of nonchallenge control (NC, corn-SBM based diet), challenge control (CC), 10% rapeseed (10RS), 30% rapeseed (30RS), 20% canola (20CLM), 40% canola (40CLM), 500 ppm AITC (500AITC), and 1,000 ppm AITC (1000AITC). At d 14, all birds were challenged, except NC group, with a subclinical dose of E. maxima. Intestinal permeability was conducted on 5 d post-infection (dpi) and for oocyst shedding 5 to 6 dpi feces were pooled and collected. On 6 dpi, growth performance, lesion score, histomorphology, and gene expression were measured. The growth performance result showed that 10RS and 30RS groups had lower BW, BWG, FI, and higher FCR (P < 0.0001). During the challenge and overall periods, NC group had highest BW, BWG, and FI, and lowest FCR. The inclusion of canola meal showed lower performance during prechallenge period but was able to catch up BWG during challenge period. The AITC levels showed similar growth performance to CC group. Intestinal permeability for 20CLM, 40CLM, 500AITC and 1000AITC was similar to NC group, whereas CC, 10RS, and 30RS had higher permeability compared to NC (P < 0.0001). Oocyst shedding was significantly lower for 40CLM and NC, whereas all other treatments had higher oocyst shedding (P < 0.0001). All the challenged treatment groups had higher lesion score and microscore than NC (P < 0.0001). Histomorphology data showed that jejunum villus height (VH) for 1000AITC was similar to NC group, whereas CC group had the lowest VH (P = 0.01). The 30RS group had lower VH: crypt depth (CD) ratio in the jejunum and ileum. The gene expression at 6 dpi for claudin1, occludin, IL2, IL6, GLUT5, EAAT, BoAT, and LAT1 was significantly changed among the treatments. The results suggest that 30RS retards growth performance and deteriorate gut health during coccidiosis and should not be fed to chicken during the starter phase. Canola meal showed decline in growth prechallenge but maintained growth and intestinal health during the challenge period at 40% inclusion. AITC at 1,000 ppm showed similar growth as control group, but with improved gut health during the challenge period. Canola meal could be a good alternative to SBM especially during coccidiosis, whereas AITC needs to be tested vigorously in animal feeding regime.

A novel LOX3-null allele (lox3-b) originated in the aromatic Basmati rice cultivars imparts storage stability to rice bran

Rapid deterioration of rice bran due to the LOX3 enzyme catalysed oxidation of PUFA is the major bottleneck for its utilization in various downstream applications. In the present study, we have identified a set of nine novel LOX3-null rice accessions carrying a deletion of C residue in the exon2 causing a frameshift mutation resulting in a truncated non-functional LOX3 protein. Our study, further manifested the predominance of C deletion based LOX3-null allele, named lox3-b, in the aromatic rice germplasm particularly in the Indian Basmati rice group. The LOX3-null genotypes exhibited significantly reduced rancidity, after six months of storage. They also showed significantly lower percentage reduction of linoleic acid (LA), higher γ-oryzanol content and lower hexanal content. A functional dCAPS marker designed based on the deletion polymorphism clearly differentiated LOX3 and lox3-b alleles, and has the potential application in marker assisted rice breeding programmes to develop cultivars with better bran storability.

Revealing the effect of seed phosphorus concentration on seedling vigour and growth of rice using mutagenesis approach

The harvested plant products, specifically, the grains of cereals are major drivers of soil phosphorus (P) depletion. However, the breeding or biotechnology efforts to develop low P seeds have not been attempted because of possible adverse effects on seedling vigour and crop establishment. Several studies have contradictory observations on influence of seed P on seedling vigour. Lack of appropriate genetic material has been the major bottleneck in reaching the consensus. In this study, we used 30 EMS induced mutants of rice cultivar Nagina22 to understand the role of seed P on seedling vigour and associated physiological processes. Seedling vigour, morpho-physiological characteristics, acid phosphatases, alpha-amylase, and expression of P transporter genes were analyzed in seedlings obtained from seeds of high and low grain P mutants. The study suggests that seed P has a significant role on seedling vigour, chlorophyll content and photosynthesis process of young seedlings, and P transport from roots. Notably, we identified few mutants such as NH4791, NH4785, NH4714, NH4663, NH4614, and NH4618 which showed least influence of low seed P on seedling vigour and other metabolic processes. Therefore, these mutants can be used in breeding programs aiming for development of low P grains. Also, these and other identified mutants can be used to decipher the genetic and molecular mechanisms regulating the differential response of seed P on germination, seedling vigour and several other physiological processes influencing the crop growth and establishment.

Cross-sectional study on prevalence and consequences of screen time on physical and mental health in children in the era of COVID-19

Background: With the ongoing growth and expansion of digital media and COVID-19 pandemic, children are inclining more and more toward spending time on digital media as compared to outdoor sports, leading to poor physical and mental growth. Developed nations have already set up a screen time guideline which is yet to be established in developing nations. This study was conducted with the objectives of identifying the needs of screen time guidelines and to study the impact of screen time on mental and physical health in children. Aims and Objectives: This study aims to check the screen time in children aged 2–18 and find the health consequences both physical and psychological in those children. Materials and Methods: A cross-sectional study on children aged 2–18 years was conducted between 2019 and 2020. Parents were asked to fill a pre-structured questionnaire. Impact on health physical and mental were assessed by pediatrician and psychologist. Results: A total of 155 children were enrolled in the study. Mean child hours in children aged 2–5 years, 5–10 years, and 10–18 years were 4 h, 5.83 h, and 6.29 h on week days and 5.64 h, 5.76 h, and 7.69 h on weekends, respectively. More than one-third of children had age of onset of screen time below 2 years of age. About 70% of children had malnutrition. Only 18% of parents were aware of concept of screen free days. Screen time had negative impact on health (P=0.0001) and on behavior of child (P=0.001). Average increase in screen time during COVID-19 was nearly 3 times the pre-COVID era. Conclusion: This study has paved the way for the need of larger study and development of guidelines on impact of screen time on children in developing nations where screen time guidelines is yet to be set more so in era of COVID 19 pandemic.

Investigating the S-parameter (|S₁₁|) of CPW-fed antenna using four different dielectric substrate materials for RF multiband applications

<abstract> <p>This article aims to examine the |S₁₁| parameter of a multiband Coplanar Waveguide (CPW)-fed antenna. The proposed square-shaped antenna-1 (Ant.1) and antenna-2 (Ant. 2) are primarily composed of three ground terminal stubs: Terminal-1 (T1), Terminal-2 (T2), and Terminal-3 (T3), all of which have an inverted L-shaped radiating patch. The proposed antennas' resonance frequencies (<italic>f_r</italic>) can be adjusted by the electrical dimension and length of the stub resonators, the dielectric constant (ε<italic>_r</italic>) of substrate materials, and their appropriate thicknesses. It will have an impact on their return loss (|S₁₁|), Impedance Bandwidth (IBW), radiation pattern, and antenna performance in terms of frequency characteristics, as demonstrated in this article. The proposed structure based on Flame-Retardant fiber glass epoxy (FR4) substrate covered a wideband frequency range from 1.5 to 3.2 GHz, (IBW = 1.7 GHz) and from 3.4 to 3.65 GHz (IBW = 0.25 GHz). The total IBW is 1.95 GHz, at S₁₁ ≤ −10 dB with three resonance frequencies of values <italic>f_r1</italic> = 1.75, <italic>f_r2</italic> = 2.65, and <italic>f_r3</italic> = 3.50 GHz) for triple-band applications. The results are compared with the research work reported earlier. The proposed Ant.1 ensured, dual and triple band applications whereas the proposed Ant. 2 ensured dual, triple and quad bands applications with reasonable antennas' sizes similar to the earlier reported works. Furthermore, the impacts of various substrate materials as well as different lengths of multi-stub resonators on the operating bands and resonance frequency are thoroughly explored and analyzed for these antennas.</p> </abstract>

Influence of rapeseed, canola meal and glucosinolate metabolite (AITC) as potential antimicrobials: effects on growth performance, and gut health in Salmonella Typhimurium challenged broiler chickens

Poultry is the major sources of foodborne salmonellosis. Antibiotic resistance and a surge in zoonotic diseases warrant the use of natural alternatives. Glucosinolates (GLs) are naturally occurring antimicrobial compounds in rapeseed and canola. This study investigated the effect of feeding rapeseed, canola meal, and allyl isothiocyanate (AITC; Brassica secondary metabolites) on growth performance (GP), gut health, and the potential antimicrobial activity against nalidixic acid-resistant Salmonella Typhimurium (STNR) in chickens. A total of 640 one-day-old male Cobb 500 broilers were randomly allocated to 8 treatments with 8 replicated cages and 10 birds per cage. Dietary treatments were nonchallenge control (NC, corn-SBM based), challenge (Salmonella) control (CC), 10% rapeseed (10RS), 30% rapeseed (30RS), 20% canola meal (20CLM), 40% canola meal (40CLM), 500 ppm AITC (500AITC), and 1,500 ppm AITC (1500AITC). On d 1, all the birds except NC were orally challenged with STNR (7 log CFU/bird). The chickens were reared for 21 d, and their FI and BW were recorded weekly. Salmonella cecal colonization and fecal shedding were quantified, whereas organ translocation (OT) of STNR to the spleen, liver, and kidney was tested on 0, 3, 6, 13, and 20-d postchallenge (dpc). Data were subjected to one-way ANOVA, and the means were separated by Duncan's test, except mortality and OT data analyzed after transformation by square root of (n +1) (P < 0.05). Overall, feeding 30RS resulted in reduced BW (P = 0.003), BWG (P = 0.003), and FI (P = 0.001) compared to CC, 500AITC, and 1500AITC. Similarly, feeding 20CLM resulted in lower BW and BWG compared to CC (P < 0.05) and increased FCR compared to 1500AITC (P = 0.03). Feeding CC resulted in higher mortality compared to NC and 30RS (P = 0.03). Cecal colonization of STNR was reduced (P < 0.0001) for 30RS on 6 dpc and 500AITC on 6 and 13 dpc (P < 0.0001). Although no difference in gut permeability was observed 6 dpc (P > 0.05), OT of STNR population was the highest for CC in the spleen (P = 0.05). In the liver, 10RS showed reduced OT compared to 20CLM on 13 dpc (P = 0.03), whereas 30RS showed the lowest OT on 6 dpc in the kidney. Fecal shedding was lowest for 30RS on 6 dpc (P = 0.004). Histomorphology showed 30RS had the highest duodenum (P = 0.01) and jejunum (P = 0.02) villus height (VH) and VH to crypt depth (CD) ratio compared to the other treatments, whereas 1500AITC showed similar results to 30RS. Both 30RS and 1500AITC contained comparatively higher functional GL metabolites and were able to maintain gut health. Including higher levels of rapeseed or AITC in poultry feed can reduce Salmonella colonization in the feces and their translocation to other organs.

The burden & contributing factors of psychological distress across India during the COVID pandemic

The unprecedented COVID-19 pandemic spread rapidly and engulfing the entire world, forcing people to stay home, muting the hustle and bustle of modern world with tide of fear for contracting disease and death. This brutal disease has infected millions of people worldwide, many lost their job, world economies have ravaged and many more uncountable consequences.

OBJECTIVE

To assess the psychological distress due to COVID-19 outbreak and to determine contributing factors towards psychological distress.

METHOD

A cross-sectional survey was conducted between 12th May to 20th June 2020 & 1537 valid responses were received. Modified K10 scale was used to assess psychological distress. Binary logistic regression analysis was used to determine extent of relationship between the contributing factors and psychological distress scale by estimating the odds of having significant stress with P ≤ 0.05.

RESULT

A total of 1537 valid responses were obtained. The overall psychological distress score was 19.79 ± .75 which implies mild psychological distress. Analysis of degree of psychological distress revealed 815 (53.0%) with no psychological distress, 385 (25.0%) mild, 194 (12.6%) moderate and 143 respondents (9.3%) had severe degree of psychological distress. Females psychological distress was 1.448 times as compared to male (CI 0.191-10.986). The odds of having significant psychological distress for above 60 years as compared to 16-30 years. Shop owner & business man had more stress in compared to professionals (OR 1.176, CI 0.058-2.362). As compared to married, the psychological distress was 13.203 times higher among divorcee/separated (0.786-221.787) and 3.629 times higher among unmarried (0.376-35.054).

CONCLUSION

This study showed 39.2% of the subject had psychological distress which is quite high. So, government and other policy makers have to develop strategy to relieve psychological distress among Indian population.

Efficiency and kinetics of Assam crude oil degradation by Pseudomonas aeruginosa and Bacillus sp

We report kinetics of Assam crude oil degradation by Pseudomonas aeruginosa AKS1 and Bacillus sp. AKS2, both isolated from Assam refinery sediments. The isolates exhibited appreciable degrees of hydrophobicity, emulsification index and biosurfactant production. Crude oil degradation efficiency of isolates was assessed in (1) liquid medium amended with 1% v/v crude oil and (2) microcosm sediments (125 mg crude oil/ 10 g sand). In liquid culture, biodegradation rate (k) and half-life (t_1/2) values were found to be 0.038 day^-1 and 18.09 days for P. aeruginosa AKS1, and 0.020 day^-1 and 33.97 days in case of Bacillus sp. AKS2, respectively. In microcosm sediments, the estimated k and t _1/2 values were 0.014 day^-1 and 50 days for P. aeruginosa AKS1, and 0.011 day^-1 and 61.34 days in case of Bacillus sp. AKS2. The level of nutrient treatment in microcosm sand sediment was 125 µg N and 62.5 µg P/g sediment in case of P. aeruginosa AKS1 and 375 µg N and 37.5 µg P/g sediment in case of Bacillus sp. AKS2. In microcosms without inorganic nutrients, values of k and t_1/2 were found to be 0.007 day^-1 and 100 days for P. aeruginosa AKS1 and for Bacillus sp. AKS2, the respective values were 0.005 day^-1 and 150.68 days. Our data provides important information for predictive hydrocarbon degradation in liquid medium and contaminated sediments.

Antibiotic resistance in patients with chronic ear discharge awaiting surgery in Nepal

SETTING

Biratnagar Eye Hospital, Biratnagar, Nepal, which offers ear surgery for chronic suppurative otitis media (CSOM).

OBJECTIVE

In patients with CSOM awaiting surgery, to determine the 1) sociodemographic characteristics 2) bacterial isolates and their antibiotic resistance patterns and 3) characteristics of those refused surgery, including antibiotic resistance.

DESIGN

A cohort study using hospital data, January 2018-January 2020.

RESULTS

Of 117 patients with CSOM and awaiting surgery, 64% were in the 18-35 years age group, and 79% were cross-border from India. Of 118 bacterial isolates, 80% had Pseudomonas aeruginosa and 16% had Staphylococcus aureus. All isolates showed multidrug resistance to nine of the 12 antibiotics tested. The lowest antibiotic resistance in P. aeruginosa was for vancomycin (29%) and moxifloxacin (36%), and for S. aureus, this was vancomycin (9%) and amikacin (17%). Fourteen (12%) patients underwent surgery: myringoplasty (n = 7, 50%), cortical mastoidectomy with tympanostomy (n = 4, 29%) and modified radical mastoidectomy (n = 3, 21%). Those infected with P. aeruginosa and with resistance to over six antibiotics were significantly more likely to be refused for surgery.

CONCLUSION

Patients awaiting ear surgery were predominantly infected with multidrug-resistant P. aeruginosa and were consequently refused surgery. This study can help inform efforts for improving surgical uptake and introducing cross-border antimicrobial resistance surveillance.

Hospital-Based Contact Tracing of Patients With COVID-19 and Health Care Workers During the COVID-19 Pandemic in Eastern India: Cross-sectional Study

Background

The contact tracing and subsequent quarantining of health care workers (HCWs) are essential to minimizing the further transmission of SARS-CoV-2 infection and mitigating the shortage of HCWs during the COVID-19 pandemic situation.

Objective

This study aimed to assess the yield of contact tracing for COVID-19 cases and the risk stratification of HCWs who are exposed to these cases.

Methods

This was an analysis of routine data that were collected for the contact tracing of COVID-19 cases at the All India Institute of Medical Sciences, Bhubaneswar, in Odisha, India. Data from March 19 to August 31, 2020, were considered for this study. COVID-19 cases were admitted patients, outpatients, or HCWs in the hospital. HCWs who were exposed to COVID-19 cases were categorized, per the risk stratification guidelines, as high-risk contacts or low-risk contacts

Results

During contact tracing, 3411 HCWs were identified as those who were exposed to 360 COVID-19 cases. Of these 360 cases, 269 (74.7%) were either admitted patients or outpatients, and 91 (25.3%) were HCWs. After the risk stratification of the 3411 HCWs, 890 (26.1%) were categorized as high-risk contacts, and 2521 (73.9%) were categorized as low-risk contacts. The COVID-19 test positivity rates of high-risk contacts and low-risk contacts were 3.8% (34/890) and 1.9% (48/2521), respectively. The average number of high-risk contacts was significantly higher when the COVID-19 case was an admitted patient (number of contacts: mean 6.6) rather than when the COVID-19 case was an HCW (number of contacts: mean 4.0) or outpatient (number of contacts: mean 0.2; P=.009). Similarly, the average number of high-risk contacts was higher when the COVID-19 case was admitted in a non–COVID-19 area (number of contacts: mean 15.8) rather than when such cases were admitted in a COVID-19 area (number of contacts: mean 0.27; P<.001). There was a significant decline in the mean number of high-risk contacts over the study period (P=.003).

Conclusions

Contact tracing and risk stratification were effective and helped to reduce the number of HCWs requiring quarantine. There was also a decline in the number of high-risk contacts during the study period. This indicates the role of the implementation of hospital-based, COVID-19–related infection control strategies. The contact tracing and risk stratification approaches that were designed in this study can also be implemented in other health care settings.

Polymorphisms in vitamin D receptor, toll-like receptor 2 and Toll-Like receptor 4 genes links with Dengue susceptibility

Host genetic factors are known to determine disease susceptibility in dengue virus infection. Therefore, in this study association of gene polymorphisms of Vitamin D Receptor [rs731236 (Taq) and rs7975232 (Apa1)], Toll-like receptor 2 [rs5743708 (Arg735Gln) and rs5743704 (Pro631His)] and Toll-like receptor 4 [rs4986790A/G(Asp299Gly13843) and rs4986791 C/T(Thr399Ile)] were studied in cases with dengue as compared to controls. Total 98 cases of confirmed dengue virus infection and 98 age, sex and geographically matched healthy controls were enrolled and their genetic polymorphisms for the above mentioned regions were studied by Sanger sequencing. Mutant genotypes CC of VDR rs731236 (Taq1) [(OR 3.808, p value =0.02, CI 1.160-12.498)], GG of VDR rs7975232 (Apa1) [(OR 3.485, p value =0.02, CI 1.162-10.45)] and heterozygous genotypes of TLR4 rs4986790 A/G Asp299Gly [OR 2.40, p value= 0.02, CI 1.12-5.14], TLR4 rs4986791 C/T Thr399Ile [OR 2.09, p value=0.02, CI 1.12-5.14] were found to be significantly more in cases with dengue virus infection as compared to the controls. Also, at these positions mutant alleles were observed in significantly higher number of cases than controls. The values for C allele at VDR rs731236 (Taq1) were OR 1.86, p value 0.009, CI 1.162-3.001; for allele G at rs7975232( Apa1) were OR 2.71, p value 0.006, CI 1.196-2.98 for allele G at TLR4s rs4986790 A/G Asp299Gly were OR 2.35, p value 0.009, CI 1.23-4.50 and for allele T at rs4986791 C/T Thr399Ile were OR 2.36, p value=0.006, CI 1.28-4.38. VDR and TLR4 but not TLR2 gene polymorphisms were found to be associated with dengue susceptibility in Indian population.

Clinico-microbiological description and evaluation of rapid lateral flow immunoassay and PCR for detection of Burkholderia pseudomallei from patients hospitalized with sepsis and pneumonia: A twenty-one months study from Odisha, India

Establishing a diagnosis of melioidosis based on clinical grounds is difficult in hospitalized patients with sepsis or community acquired pneumonia (CAP). We aimed to ascertain the prevalence, clinico-epidemiological and laboratory profile of melioidosis in hospitalized patients with sepsis or CAP, and to evaluate the diagnostic utility of rapid lateral flow immunoassay (LFI) and PCR in comparison with culture. In all patients with sepsis or CAP, blood, sputum/throat swab, and urine sample were subjected to culture along with other samples based on clinical presentation. In addition, PCR assay targeting the type III secretion system 1 (TTS1) and LFI was performed. Thirty-three (33/196, 17%) out of the total 196 cases were diagnosed as melioidosis by culture. The prevalence of melioidosis in patients who had only sepsis without CAP, had both sepsis and CAP, had CAP without sepsis was 31% (26/84), 22 % (4/18) and 3%(3/94) respectively. All the LFI or PCR positive cases were culture positive from at least one or more samples (blood/sputum/urine/pus). The sensitivity, specificity, positive predictive value and negative predictive value of TTS1 PCR was 78% (18/23 melioidosis patients), 100% (34/34 non-melioidosis patients), 100% (18/18 melioidosis patients) and 87% (34/39 non-melioidosis patients). The sensitivity, specificity, positive predictive value and negative predictive value of Rapid LFI was 91% (21/23 melioidosis patients), 100% (22/22 non-melioidosis patients), 100% (21/21 melioidosis patients) and 91% (22/24 non-melioidosis patients). On sample wise stratification of LFI and TTS1 with respect to culture, plasma/serum samples showed the highest discordance by PCR (9/55, 16.3%) and LFI (11/35, 31.4%). The lowest discordance was noted in respiratory tract samples (2/32, 6.2%) by PCR and pus/body fluids samples (2/14, 14.2%) by LFI and these findings are in line with previous published literature. The clinical utility of PCR and LFI needs to be further validated in a large scale study for early diagnosis of septicaemic melioidosis.

Effectiveness of a short-structured training programme on knowledge of healthcare providers and programme managers involved in maternal and child health programmes in Odisha, India: a quality improvement study

OBJECTIVE

To evaluate the effectiveness of training programme on knowledge related to new interventions proposed under India Newborn Action Plan (INAP) and Integrated Action Plan against Pneumonia and Diarrhoea (IAPPD).

DESIGN

Quality improvement study with pre-evaluation and post evaluation.

SETTING

The study was conducted in 17 districts of Odisha, India.

PARTICIPANTS AND INTERVENTIONS

The participants were healthcare providers and programme managers involved in maternal and child health programmes. Intervention was a short-structured (8 hours) training delivered to 127 batches with expected participation of 30 trainees in each batch. Training was divided into four modules covering new interventions related to INAP and IAPPD like causes of neonatal death, kangaroo mother care (KMC), feeding of low birthweight (LBW) infants, use of injection gentamicin, identification of possible serious bacterial infection (PSBI), identification and management of pneumonia and diarrhoea and key interventions for maternal health. Various modalities of teaching-learning method were used.

OUTCOME MEASURES

Pretraining and post-training knowledge assessment was done with a pretested tool consisting of 15 items. Each item carried equal weightage in calculation of knowledge score thus maximum possible knowledge score was 15. Feedback assessment was also done after the training.

RESULTS

The mean (SD) knowledge score significantly improved to 10.24 (2.24) after training as compared with 4.73 (1.94) before training, p<0.001 (n=982). There was significant improvement in knowledge for majority of the components namely causes of neonatal death (61.9% vs 28.1%), KMC (68.0% vs 54.6%), feeding of LBW infants (77.7% vs 6.9%), use of injection gentamicin (69.7% vs 11.2%), identification of PSBI (69.5% vs 59.5%). The improvement in knowledge score was more when healthcare providers and programme managers had provided a favourable response on feedback.

CONCLUSION

Systematic pretest and post-test assessment coupled with feedback assessment can ensure the effectiveness of training programmes offered in programmatic settings.

Mental health implications of COVID-19 pandemic and its response in India

INTRODUCTION

Mental health concerns and treatment usually take a backseat when the limited resources are geared for pandemic containment. In this global humanitarian crisis of the COVID-19 pandemic, mental health issues have been reported from all over the world.

OBJECTIVES

In this study, we attempt to review the prevailing mental health issues during the COVID-19 pandemic through global experiences, and reactive strategies established in mental health care with special reference to the Indian context. By performing a rapid synthesis of available evidence, we aim to propose a conceptual and recommendation framework for mental health issues during the COVID-19 pandemic.

METHODS

A search of the PubMed electronic database and google scholar were undertaken using the search terms 'novel coronavirus', 'COVID-19', 'nCoV', SARS-CoV-2, 'mental health', 'psychiatry', 'psychology', 'anxiety', 'depression' and 'stress' in various permutations and combinations. Published journals, magazines and newspaper articles, official webpages and independent websites of various institutions and non-government organizations, verified social media portals were compiled.

RESULTS

The major mental health issues reported were stress, anxiety, depression, insomnia, denial, anger and fear. Children and older people, frontline workers, people with existing mental health illnesses were among the vulnerable in this context. COVID-19 related suicides have also been increasingly common. Globally, measures have been taken to address mental health issues through the use of guidelines and intervention strategies. The role of social media has also been immense in this context. State-specific intervention strategies, telepsychiatry consultations, toll free number specific for psychological and behavioral issues have been issued by the Government of India.

CONCLUSION

Keeping a positive approach, developing vulnerable-group-specific need-based interventions with proper risk communication strategies and keeping at par with the evolving epidemiology of COVID-19 would be instrumental in guiding the planning and prioritization of mental health care resources to serve the most vulnerable.

Evaluation of BenzoDODA grafted polymeric resin for rapid and reliable assaying of plutonium in sediment samples

The paper reports a new rapid radioanalytical procedure for the determination of plutonium (Pu) in sediments by solid phase extraction chromatography (SPEC) using Bis-(2-ethylhexyl) carbamoyl methoxy phenoxy-bis-(2-ethylhexyl) grafted resin, abbreviated as Benzodioxodiamide (BenzoDODA) grafted resin. The resin was synthesized and evaluated for its sorption behaviour towards Pu in batch and column mode to determine its efficacy for selective recovery of Pu from sediment samples. The analytical procedure was based on the radiochemical separation of samples by acid digestion, followed by preconcentration of actinides by co-precipitation with Fe(OH)₃ and finally selective recovery of Pu by SPEC using a column filled with BenzoDODA grafted resin. Pu was then radiometrically assayed by preparing alpha disc sources with electro-deposition followed by alpha spectrometry. The method was further validated with IAEA reference materials. This method gives reliable and reproducible results for the activity concentration of Pu in sediment samples within 24 h.

Experience from a COVID-19 screening centre of a tertiary care institution: A retrospective hospital-based study

BACKGROUND

The COVID-19 pandemic continues to be a significant public health concern across the whole world, including India. In the absence of any specific treatment or vaccine against COVID-19, the role of efficient testing and reporting has been uncontested so far as the number of cases is rising daily. In order to strengthen the screening activities and to prevent nosocomial infection, facility-based screening centres have been designed and operated at various levels of healthcare, including tertiary care institutions.

METHODS

The present study has been planned with an objective to understand the patient profile and evaluate the functioning of COVID-19 screening OPD (CS-OPD) at a tertiary care hospital. In this hospital-based retrospective study, data from individuals visiting the COVID-19 screening OPD during the period from 17th March 2020 to 31st July 2020 were collected. We documented and analysed relevant demographic, epidemiological and clinical characteristics of the patients.

RESULTS

A total of 10,735 patients visited the COVID-19 screening OPD during the defined study period of which 3652 individuals were tested. The majority of the patients, i.e., 65.67% (7050) were male and in the 15-59 years age group (84.68%). The most common symptoms among patients visiting CS-OPD was cough (9.86%). Of the total, 17.17% (1843) of patients reported to the CS-OPD with a contact history of COVID-19-positive patient. On the other hand, 13.49% (1448) of patients were with either domestic or international travel history. The overall testing rate and positivity rate for CS-OPD during this period were found to be 34.02% and 7.94%, respectively.

CONCLUSION

The clinical, demographic and epidemiological characteristics of patients visiting CS-OPD varied across the study period depending upon the containment and testing strategy. The CS-OPD played a crucial role in preventing nosocomial infection and maintaining non-COVID care at the tertiary care hospital.

C-ARM Guided Angiogram/Angioplasty for Selected Failed Arterio Venous Fistula. A Report of a Procedure at University Hospital of Nepal

End Stage Renal Disease is a last stage of Chronic Kidney Disease which is characterized by Glomerular Filtration rate of less than 15 ml/min/1.73 m2 . Hemodialysis is the most commonly used modality for treatment of Chronic Kidney disease. Among the access for hemodialysis arteriovenous fistula is the most common modality. However most common problems of fistula are significant stenosis of more than 50% which is characterized by limb swelling, pigmentation, tortuous veins, and difficulty maintaining flow during dialysis from AV fistula. These can be managed either by minimal intervention or with surgical intervention. Very few hospitals in Nepal and other countries have an angiographic suite to perform minimal intervention include angiogram with angioplasty. So in this case we try to address the use of C-Arm to perform angiogram or fistulogram and even angioplasty for the management of significant stenosis or complications of arteriovenous fistula.

The dilemma of COVID-19 vaccination among Health Care Workers (HCWs) of Uttar Pradesh

Background: Immediately after the outbreak of COVID-19 pandemic, with an unprecedented cooperation between biomedical, pharmaceutical, technological, and political sectors, new vaccines were developed and approved in record times. However, doubts were raised on their efficacy and adverse effects. Globally, it was agreed that the first recipients for vaccines would be the health care workers (HCWs). Logically, it was bound to raise some concerns and result in hesitancy among the HCWs. Aims: The current study was planned to study the proportion of HCWs having hesitancy towards COVID-19 vaccination and factors effecting it. Settings and Design: Cross-sectional study conducted among HCWs of Uttar Pradesh. Methods and Material: The survey was conducted both in online and offline mode and attempted by 254 HCWs eligible for receiving COVID-19 vaccine. Statistical analysis used: t-test, chi-square test, proportion, mean, SD Results: Vaccine hesitancy was present in 35.8% HCWs. Only social factors like caste (p=0.023) and religion (p<0.001) were found to be significantly associated with vaccine hesitancy. Gender, type of health worker, fear of COVID-19 infection, fear of lethality or pre-existing diseases did not affect vaccine hesitancy. The maximum number of HCWs (71.4%) were hesitant because they were unsure of the side-effects followed by the reason of being unsure about its effect on their own health (53.8%). When asked about their attitude towards compulsory COVID-19 vaccination for HCWs, should it be made mandatory by the government, 42.9% were in favour and 40.6% were against any such mandate. Conclusions: The study concluded that social factors like religion and caste are more deterministic for vaccine hesitancy.

Prevalence of dementia and its associated risk factors among elderly patient attending Outpatient Department of a tertiary care hospital in Lucknow

Background: Dementia is a broad category of brain diseases that causes a chronic, progressive and gradual decrease in cognitive function i.e. ability to think and remember that is great enough to affect a person’s daily functioning beyond what might be expected from normal ageing. According to American Psychiatric Association, “Dementia is a syndrome caused by a variety of brain illnesses that affect memory, thinking, behaviour and the ability to perform everyday activities”. Aim & Objectives: To assess the prevalence of dementia among the patients above 60 years of age attending the outpatient department of Tertiary care super specialty hospital. To assess the risk factors associated with occurrence of dementia in patients attending outpatient department of Tertiary care super specialty hospital. Settings and Design: Study design: - Cross-sectional observational study. Study area: - Tertiary care super-specialty hospital. Study setting: - Outpatient department (OPD)of Tertiary care super specialty hospital. Methods and Material: Study population: - Patients above 60 years of age and attending Outpatient Department of the tertiary care super specialty hospital. Duration of Study: - 4 months.  Sample size:- 223 elderly participants from the registration counter of the Outpatient Department of tertiary care hospital. Statistical analysis used: Data was analysed using SPSS, version 24.0. Univariate Logistic Regression, Multivariate Logistic Regression, Odds Ratio. Results: The study was conducted on a total of 223 patients out of which only 210 patients completed the questionnaire and matched our criteria. Thus, 210 patients are analysed for the result. In our study which included the patients above 60 years of age out of which the maximum participants (52.4%) were of age group 65-75. In our study 66.2% participants had normal cognitive functioning while 33.8% of total participants were found to have dementia. Out of these 33.8% participants having impaired cognitive functioning, 13.8% and 20% had severe and borderline dementia respectively. Dementia was found to be more common in females. Conclusions: Statistically significant association of dementia has been found with female gender, rural residence, joint family and a greater number of family members, poor education, pan masala consumption, daytime drowsiness, and problem in sleep pattern, social intolerance and frequent fights.

In Situ Fabrication of Activated Carbon from a Bio-Waste Desmostachya bipinnata for the Improved Supercapacitor Performance

Herein, we demonstrate the fabrication of highly capacitive activated carbon (AC) using a bio-waste Kusha grass (Desmostachya bipinnata), by employing a chemical process followed by activation through KOH. The as-synthesized few-layered activated carbon has been confirmed through X-ray powder diffraction, transmission electron microscopy, and Raman spectroscopy techniques. The chemical environment of the as-prepared sample has been accessed through FTIR and UV-visible spectroscopy. The surface area and porosity of the as-synthesized material have been accessed through the Brunauer-Emmett-Teller method. All the electrochemical measurements have been performed through cyclic voltammetry and galvanometric charging/discharging (GCD) method, but primarily, we focus on GCD due to the accuracy of the technique. Moreover, the as-synthesized AC material shows a maximum specific capacitance as 218 F g^-1 in the potential window ranging from - 0.35 to + 0.45 V. Also, the AC exhibits an excellent energy density of ~ 19.3 Wh kg^-1 and power density of ~ 277.92 W kg^-1, respectively, in the same operating potential window. It has also shown very good capacitance retention capability even after 5000th cycles. The fabricated supercapacitor shows a good energy density and power density, respectively, and good retention in capacitance at remarkably higher charging/discharging rates with excellent cycling stability. Henceforth, bio-waste Kusha grass-derived activated carbon (DP-AC) shows good promise and can be applied in supercapacitor applications due to its outstanding electrochemical properties. Herein, we envision that our results illustrate a simple and innovative approach to synthesize a bio-waste Kusha grass-derived activated carbon (DP-AC) as an emerging supercapacitor electrode material and widen its practical application in electrochemical energy storage fields.

Fear and anxiety among COVID-19 Screening Clinic Beneficiaries of a tertiary care hospital of Eastern India

India is one among the most affected countries in the COVID-19 pandemic. The increasing number of cases in India and the fear of COVID-19 infection is causing fear and anxiety. Fear and anxiety related to COVID-19 the community dwellers are less studied. This study was conducted to assess the fear and anxiety related to COVID-19 among the people seeking COVID-19 screening test. The cross-sectional study was conducted on a sample of 398 participants aged 18 years and above who attended the screening clinic of a tertiary care hospital of eastern India. Participants were assessed using Coronavirus Anxiety Scale (CAS) and Fear of COVID-19 scale which are validated screening scales. Result showed that 20.4 % of the participants were having anxiety due to COVID-19. The mean fear score was 17.87 ± 4.48. Females, Middle aged, housewives, less educated, symptomatic, co-morbid and people under institutional quarantine were having more fear. People with COVID-19 related anxiety faced more fear. These findings suggest the need for screening anxiety in COVID-19 screening clinics. People with high levels of COVID related anxiety and fear are at risk for developing psychiatric disorders hence need targeted approach to address their mental health.

ADSL Deficiency - The Lesser-Known Metabolic Epilepsy in Infancy

Adenylosuccinate lyase deficiency is a rare inherited disorder of purine metabolism causing severe neurological impairment ranging from early-onset neonatal epileptic encephalopathy to progressive psychomotor retardation and autism in later life. Diagnostic workup involves the measurement of toxic succinyl purines in body fluids and gene sequencing. The authors describe a 13-mo-old girl with compound heterozygous variants in the ADSL gene, presenting as early-onset seizures, severe neurological impairment, development delay, and hypotonia. Neuroimaging revealed cerebral atrophy, delayed myelination and diffusion restriction in bilateral basal ganglia, thalamus and periventricular white matter. The present case highlights ADSL deficiency as a rare cause of metabolic epilepsy that needs timely recognition and prevention of unnecessary investigations.

Performance of cytology, acid-fast bacilli smear, gene Xpert and mycobacterial cultures in endobronchial ultrasound-transbronchial needle aspiration aspirate in diagnosing mediastinal tuberculous lymphadenitis

BACKGROUND

Diagnosis of isolated mediastinal tuberculosis (TB) can be challenging. Endobronchial ultrasound (EBUS) increases the diagnostic yield by direct sonographic visualization of mediastinal and hilar lymph nodes. With the advent of molecular techniques such as Gene Xpert, their addition to the cytology and cultures increases the diagnostic yield and detection of rifampicin resistance (RR) which helps change the effective therapeutic regimen immediately.

MATERIALS AND METHODS

Prospective analysis of all patients undergoing EBUS-guided transbronchial needle aspiration (EBUS-TBNA) with a clinical possibility of TB in isolated mediastinal lymphadenopathy patients at a tertiary care referral center between June 2016 and January 2018. All patients had at least five passes from each node of which two passes from each lymph node sampled in 2 ml of saline for culture and Gene Xpert for microbiologic, pathologic, and molecular analysis as per hospital protocol.

RESULTS

Out of 60 patients, 44 were diagnosed to have mediastinal tuberculous lymphadenitis, 8 sarcoidosis, 2 malignancies, and 6 reactive lymphadenitis. TBNA cytology was positive in 40/44 patients (90.9%), out of which 18 patients were culture positive with the sensitivity of 100%, specificity 47.6%, positive predictive value (PPV) 45%, and negative predictive value (NPV) 100%, (P value 0.011). TBNA acid-fast bacilli (AFB) smear was positive in 20/44 patients (45.45%) out of which 12 were culture positive, with sensitivity of 67%, specificity 80.95%, PPV 60%, NPV 85% (P value 0.011). TBNA Gene Xpert was positive in 30/44 patients (68.2%), out of which 6 (13.63%) showed RR-TB and two were cytology negative. Sixteen patients where culture positive with sensitivity of 88.89%, specificity 66.67%, PPV 53.33%, NPV 93.33% (P value of 0.005). TBNA AFB culture was positive in 18/44 patients (40.9%).

CONCLUSION

EBUS-TBNA is an effective and safe diagnostic tool for intrathoracic TB, especially for mediastinal tuberculous lymphadenitis. The combination of various tests increases the diagnostic yield. Mediastinal nodal aspirates traditionally believed to be paucibacillary can still be captured by Gene Xpert.

Knowledge, Attitude and Practice Regarding COVID-19 and its Impact on Dentistry: A Cross-sectional Survey among Nepalese Dentists

Background Coronavirus Disease, 2019 (COVID-19) is a highly infectious respiratory disease with high transmissibility. Dentists are at inherent risk because of aerosol generating procedures exposing dentists to the respiratory and oral secretions of the patients. Objective To assess the knowledge, awareness, and practice (KAP) of the Dentists to combat the pandemic which could help shape future guidelines and policies to be implemented in dental settings. Method This cross-sectional descriptive study included series of multiple-choice questions distributed online, assessing dentists' KAP towards COVID-19, its impact on dentistry and their psychological well-being. Statistical analysis was performed using SPSS (Statistical Package for Social Sciences) version 20 for mac Operating System (OS). Descriptive statistics was performed, and frequencies of responses were reported in proportion. Non-parametric tests of independence and Chi-square test were performed to see the association between the categorical variables. Result Around 84% of the respondents accurately answered mode of transmission, 68% inquired about the travel history while only 49% measured the body temperature. Also, only 42% were receiving salary. A statistically significant difference concerning impact and practice during the COVID-19 was observed between general practitioner and specialist working at different work places. Conclusion Majority of Dentists have good knowledge and awareness but there were certain pitfalls in attitude and practice level calling out for more efficient training programs, precise guidelines, and treatment protocols to put into practice. Also, the mental distress and the financial impact subjected upon dentist require to be further explored determining the association between their mental health during and post COVID-19 outbreak.

Genetic structuring of Drosophila bipectinata in Indian natural populations based on the distribution of cosmopolitan inversions

Genetic differentiation among different natural populations of a species depends upon the environmental factors and the evolutionary forces that operate on them. In this study, seven Indian natural populations of D. bipectinata, two from north and five from south India, have been studied for their chromosomal inversion polymorphism. A total of nine paracentric autosomal inversions were recorded from these seven places but only three of them, present on the 2L, 2R and 3L were found to be cosmopolitan in distribution. In all the populations, the frequency of standard gene arrangement was found to be high than their respective cosmopolitan inversion gene arrangement. The average heterozygosity (H_o) of cosmopolitan inversions increases from north to south. There is a latitudinal cline in the distribution of three cosmopolitan inversion arrangements because their frequency increases with the decreasing latitude, i.e. from north to south India. A comparison of the genetic profile of two north Indian and five south Indian natural populations of D. bipectinata reveals the role of natural selection as well as bottleneck effect in the genetic structuring of these populations which may be due to their varying ecological conditions to which they are constantly encountered. Further, the presence of all kinds of paracentric inversions in individual populations was analysed following Poisson distribution to see whether these inversions occur randomly in natural populations or not and the results indicate that north Indian populations show the random occurrence of these inversions than the populations derived from the south.

Impact of arsenic-polluted groundwater on soil and produce quality: a food chain study

The experiment was conducted to assess the impact of arsenic (As)-contaminated groundwater irrigation on soil health and crop quality. Geo-referenced groundwater, soil, and crop produce samples were collected from the middle Gangetic plains of Maner block of Patna and were analyzed for As content. The result showed that long-term application of As-contaminated groundwater (0.017 to 0.677 mg L^-1) buildup significant amount of As in the soil (0.41 to 8.66 mg kg^-1). A significant correlation (r² = 0.922) was also observed between As content in groundwater and the soil. The content of As in groundwater also affected crop quality and accumulated metal content in different crop parts. Total As content in crop samples ranged from 0.010 to 0.963 μg g^-1 of dry weight. The average As content in crop followed order: oilseeds > cereals > vegetables > pulses. Therefore, produce quality should be monitored frequently for As uptake as there is a great chance of As accumulation in food crops. Hence, these approaches are useful for the formulation of policy guidelines for the management of As-containing groundwater and routine risk assessment of As-contaminated soils.

Clinicoepidemiological profile of trauma patients admitting to the emergency department of a tertiary care hospital in eastern India

Context:

Trauma is an immediate cause of patients flowing to the emergency department of any hospital. Besides epidemiology, clinical profile and treatment strategy forms an important aspect to reflect the gap in the existing public sector health-care system and the requirement.

Aims:

To evaluate the clinicoepidemiological profile of trauma patients admitting to an apex trauma hospital in east India.

Settings and Design:

A prospective observational study was performed during the time period of December 2018 to July 2019 on trauma patients admitted to the Trauma and Emergency department.

Methods and Material:

Patient's demographic profile, injury type, mechanism, the vehicle involved in the accident, and transportation were recorded. Various trauma scores (clinical) and outcome measures were recorded.

Statistical Analysis Used:

Statistical analysis was done by R version 3.6.1.

Results:

Male: female ratio was 407:93 with the 21–30 age group predominantly. 2–6 PM was the most common time of injury and ambulance was the predominant mode of transport (58%). Road traffic injury (RTI) accounted for 75% victims; two-wheelers (68%) dominated over others. Thirty percent (drivers 18%, pillion riders 12%) were wearing helmet; 41% were wearing seat belts (drivers 34%, passenger 12%). Twenty-five percent of drivers consumed alcohol. The median ± Interquartile range of injury severity score (ISS), revised trauma and trauma score and injury severity score were 17 (11–26), 7.8 (4.1–7.8), and 98.41 (95.95–99.30), respectively. Extremity injury (54% fractures) and head injury (50%) were the frontrunners in the pattern of injury, with half of the victims were polytrauma (ISS > 15).

Conclusions:

The injury was prominently RTI and the trauma victims/patients were young male drivers on two wheelers. The focus should be directed to make use of safety measures among the youth.

Malicious and Benign Webpages Dataset

Web Security is a challenging task amidst ever rising threats on the Internet. With billions of websites active on Internet, and hackers evolving newer techniques to trap web users, machine learning offers promising techniques to detect malicious websites. The dataset described in this manuscript is meant for such machine learning based analysis of malicious and benign webpages. The data has been collected from Internet using a specialized focused web crawler named MalCrawler [1]. The dataset comprises of various extracted attributes, and also raw webpage content including JavaScript code. It supports both supervised and unsupervised learning. For supervised learning, class labels for malicious and benign webpages have been added to the dataset using the Google Safe Browsing API.1 The most relevant attributes within the scope have already been extracted and included in this dataset. However, the raw web content, including JavaScript code included in this dataset supports further attribute extraction, if so desired. Also, this raw content and code can be used as unstructured data input for text-based analytics. This dataset consists of data from approximately 1.5 million webpages, which makes it suitable for deep learning algorithms. This article also provides code snippets used for data extraction and its analysis.

Assessment of clinical and behavioral profile of clients attending integrated counseling and testing centers of a tertiary care institute in Eastern India: A secondary data analysis

Introduction

Integrated counseling and testing center (ICTC) forms the major forum under the National AIDS Control Organization (NACO) for counseling and testing of HIV-suspected patients. ICTC setup in a tertiary care institute also provides a chance for opportunistic screening of large number of individuals.

Aims

The study was done to assess and to profile the ICTC clients with respect to their seropositivity rate, their biological and behavioral risk factors, and seroconcordance rate.

Methodology

We did a secondary analysis of routine health data collected in the ICTC in the formats prescribed by the NACO.

Statistical Data Analysis

The data were entered into MS Excel and analyzed using SPSS version 22.

Results

Majority of the clients of ICTC were in the age group of 35-49 years. Seropositivity among client-initiated group (11.9%) was much higher compared to provider-initiated group (0.3%). None of the pregnant women were found to be positive. Heterosexual route was most common form of transmission in both provider-initiated and client-initiated groups. Seroconcordance rate was 43.4% in our study.

Conclusion

The ICTC of a tertiary care center attracted a huge number of patients. The seropositivity in our study was greater than those generated by sentinel surveillance system. A well-functioning ICTC can help in detecting a large number of cases and also provide a forum for counseling and education about risk factors of HIV.

DEVELOPMENT OF OPTICALLY STIMULATED LUMINESCENCE BADGE READER SYSTEM FOR INDIVIDUAL MONITORING OF RADIATION WORKERS

A new Optically Stimulated Luminescence Badge Reader (OSBARE-1) system has been designed and developed for application in the individual monitoring dosimetry. This badge reader system utilizes the 470-nm light of a blue LED for CW-OSL readout with the help of PMT photon counting module. The developed reader system can process four element 24 OSLD cards within 25 min. These four-element OSLD card consists of the Teflon embedded indigenously developed dosimetric grade α-Al2O3:C phosphor. The minimum measurable dose (MMD) was found to be ~26 μGy for these OSLD cards with reproducibility of ~1.12%. The various operational parameters such as variation in the dark counts, OSL scattering background counts and reproducibility have been studied in detailed for this reader system. The dosimetric studies performed on this developed reader system found to have a great potential for the OSLD-based large-scale personnel monitoring program for the radiation workers.

Indian agriculture, air pollution, and public health in the age of COVID

Emerging evidence supports the intuitive link between chronic health conditions associated with air pollution and the vulnerability of individuals and communities to COVID-19. Poor air quality already imposes a highly significant public health burden in Northwest India, with pollution levels spiking to hazardous levels in November and early December when rice crop residues are burned. The urgency of curtailing the COVID-19 pandemic and mitigating a potential resurgence later in the year provides even more justification for accelerating efforts to dramatically reduce open agricultural burning in India.

Agricultural labor, COVID-19, and potential implications for food security and air quality in the breadbasket of India

To contain the COVID-19 pandemic, India imposed a national lockdown at the end of March 2020, a decision that resulted in a massive reverse migration as many workers across economic sectors returned to their home regions. Migrants provide the foundations of the agricultural workforce in the 'breadbasket' states of Punjab and Haryana in Northwest India.There are mounting concerns that near and potentially longer-term reductions in labor availability may jeopardize agricultural production and consequently national food security. The timing of rice transplanting at the beginning of the summer monsoon season has a cascading influence on productivity of the entire rice-wheat cropping system. To assess the potential for COVID-related reductions in the agriculture workforce to disrupt production of the dominant rice-wheat cropping pattern in these states, we use a spatial ex ante modelling framework to evaluate four scenarios representing a range of plausible labor constraints on the timing of rice transplanting. Averaged over both states, results suggest that rice productivity losses under all delay scenarios would be low as compare to those for wheat, with total system productivity loss estimates ranging from 9%, to 21%, equivalent to economic losses of USD $674 m to $1.48 billion. Late rice transplanting and harvesting can also aggravate winter air pollution with concomitant health risks. Technological options such as direct seeded rice, staggered nursery transplanting, and crop diversification away from rice can help address these challenges but require new approaches to policy and incentives for change.

A case series of unusual presentations of Burkitt's lymphoma

Context

Burkitt's lymphoma (BL) is one of the fastest growing malignancies. It is the most common subtype of Non-Hodgkin's lymphoma in childhood. It has three major subtypes - endemic, sporadic, and immunodeficiency-associated types.

Aims

This study aims to study the clinicomorphologic features of this disease entity and to find optimal imaging technique for such cases.

Setting and Design

A retrospective observational study in a tertiary care center of academic and research potential.

Subjects and Methods

We are presenting three unusual cases of sporadic type of BL who presented initially as localized right iliac fossa mass mimicking as acute appendicitis. Initially, localized presentation progressed to diffuse abdominal mass lesions causing intestinal obstruction.

Results

These cases had emphasized the importance of accurate diagnosis by the ultrasonography (USG) or computed tomography (CT) scan for early diagnosis so as to manage such cases simply by early appropriate medical treatment.

Conclusion

In this article, we will discuss the clinical and imaging features of BL with the role of USG, CT scan and positron emission tomography/CT in the abdominopelvic imaging of pediatric patients.