Study of Z Boson Production in PbPb Collisions at √S(NN)=2.76 TeV

A search for Z bosons in the μ(+)μ(-) decay channel has been performed in PbPb collisions at √S(NN)=2.76  TeV with the CMS detector at the LHC, in a 7.2 μb(-1) data sample. The number of opposite-sign muon pairs observed in the 60-120 GeV/c(2) invariant mass range is 39, corresponding to a yield per unit of rapidity (y) and per minimum bias event of [33.8±5.5(stat)±4.4(syst)]×10(-8), in the |y|<2.0 range. Rapidity, transverse momentum, and centrality dependencies are also measured. The results agree with next-to-leading order QCD calculations, scaled by the number of incoherent nucleon-nucleon collisions.

Measurement of dijet angular distributions and search for quark compositeness in pp collisions at √s = 7 TeV

Dijet angular distributions are measured over a wide range of dijet invariant masses in pp collisions at √s = 7 TeV, at the CERN LHC. The event sample, recorded with the CMS detector, corresponds to an integrated luminosity of 36 pb⁻¹. The data are found to be in good agreement with the predictions of perturbative QCD, and yield no evidence of quark compositeness. With a modified frequentist approach, a lower limit on the contact interaction scale for left-handed quarks of Λ⁺ = 5.6 TeV (Λ⁻ = 6.7 TeV) for destructive (constructive) interference is obtained at the 95% confidence level.

Search for pair production of second-generation scalar leptoquarks in pp collisions at √s = 7 TeV

A search for pair production of second-generation scalar leptoquarks in the final state with two muons and two jets is performed using proton-proton collision data at √s = 7 TeV collected by the CMS detector at the LHC. The data sample used corresponds to an integrated luminosity of 34 pb⁻¹. The number of observed events is in good agreement with the predictions from the standard model processes. An upper limit is set on the second-generation leptoquark cross section times β² as a function of the leptoquark mass, and leptoquarks with masses below 394 GeV are excluded at a 95% confidence level for β = 1, where β is the leptoquark branching fraction into a muon and a quark. These limits are the most stringent to date.

Search for pair production of first-generation scalar leptoquarks in pp collisions at √s = 7 TeV

A search for pair production of first-generation scalar leptoquarks is performed in the final state containing two electrons and two jets using proton-proton collision data at √s = 7 TeV. The data sample used corresponds to an integrated luminosity of 33 pb⁻¹ collected with the CMS detector at the CERN LHC. The number of observed events is in good agreement with the predictions for the standard model background processes, and an upper limit is set on the leptoquark pair production cross section times β² as a function of the leptoquark mass, where β is the branching fraction of the leptoquark decay to an electron and a quark. A 95% confidence level lower limit is set on the mass of a first-generation scalar leptoquark at 384 GeV for β = 1, which is the most stringent direct limit to date.

Dijet azimuthal decorrelations in pp collisions at √s=7 TeV

Measurements of dijet azimuthal decorrelations in pp collisions at √s=7 TeV using the CMS detector at the CERN LHC are presented. The analysis is based on an inclusive dijet event sample corresponding to an integrated luminosity of 2.9 pb⁻¹. The results are compared to predictions from perturbative QCD calculations and various Monte Carlo event generators. The dijet azimuthal distributions are found to be sensitive to initial-state gluon radiation.

Measurement of the B(+) production cross section in pp collisions at sqrt[s]=7 TeV

Measurements of the total and differential cross sections dσ/dp(T)(B) and dσ/dy(B) for B(+) mesons produced in pp collisions at sqrt[s]=7  TeV are presented. The data correspond to an integrated luminosity of 5.8  pb(-1) collected by the CMS experiment operating at the LHC. The exclusive decay B(+)→J/ψK(+), with J/ψ→μ(+)μ(-), is used to detect B(+) mesons and to measure the production cross section as a function of p(T)(B) and y(B). The total cross section for p(T)(B)>5  GeV and |y(B)|<2.4 is measured to be 28.1±2.4±2.0±3.1  μb, where the first uncertainty is statistical, the second is systematic, and the last is from the luminosity measurement.

Measurement of the isolated prompt photon production cross section in pp collisions at √s=7 TeV

The differential cross section for the inclusive production of isolated prompt photons has been measured as a function of the photon transverse energy E(T)(γ) in pp collisions at √s=7  TeV using data recorded by the CMS detector at the LHC. The data sample corresponds to an integrated luminosity of 2.9  pb(-1). Photons are required to have a pseudorapidity |η(γ)|<1.45 and E(T)(γ)>21  GeV, covering the kinematic region 0.006<x(T)<0.086. The measured cross section is found to be in agreement with next-to-leading-order perturbative QCD calculations.

Lay perceptions of kala-azar, mosquitoes and bed nets in Bihar, India

OBJECTIVE

To describe the lay perception of kala-azar (KA) in an endemic area of Muzaffarpur District, Bihar, India: local names, symptoms, affected persons, perceived severity and modes of transmission, as well as perceived mosquito nuisance, modes of protection and use of bed nets.

METHODS

We held 16 focus group discussions (FGD) in eight remote villages with altogether 157 participants in March 2008. Separate FGDs were held according to gender, socio-economic status (SES) and with key informants.

RESULTS

Kala-azar is most commonly named pilahi. Poor people were said to be the most affected. Knowledge about symptoms was satisfactory. Fever and prolonged fever were the most stated symptoms. KA was perceived as a life-threatening disease with a heavy economic burden. Mosquito bites were perceived as the main mode of transmission but in lower socio-economic groups, non-vector-related explanations were also provided. The main modes of protection from mosquitoes mentioned were the use of fumes and bed nets. Season was the strongest factor influencing the use of bed nets and non-affordability for not owning them.

CONCLUSIONS

Although the sand fly is not recognised as the vector, the relatively good awareness of disease transmission by mosquitoes and the nuisance caused by their high density might be an entry point for adopting preventive measures to protect from mosquito bite and thereby indirectly preventing from KA. Educational campaigns targeted to the poorer segments of society are needed to enhance knowledge about KA, its mode of transmission, risks of getting infected and to increase bed net use.

Management of visceral leishmaniasis in rural primary health care services in Bihar, India

OBJECTIVE

In 2005 a visceral leishmaniasis (VL) elimination initiative was launched on the Indian subcontinent, with early diagnosis based on a rapid diagnostic test and treatment with the oral drug miltefosine as its main strategy. Several recent studies have signaled underreporting of VL cases in the region. Information on treatment outcomes is scanty. Our aim was to document VL case management by the primary health care services in India.

METHODS

We took a random sample of all VL patients registered in rural primary health care (PHC) facilities of Muzaffarpur district, Bihar, India during 2008. Patients were traced at home for an interview and their records were reviewed. We recorded patient and doctor delay, treatment regimens, treatment outcomes and costs incurred by patients.

RESULTS

We could review records of all 150 patients sampled and interview 139 patients or their guardian. Most patients (81%) had first presented to unqualified practitioners; median delay before reaching the appropriate primary healthcare facility was 40 days (IQR 31-59 days). Existing networks of village health workers were under-used. 48% of VL patients were treated with antimonials; 40% of those needed a second treatment course. Median direct expenditure by patients was 4000 rupees per episode (IQR 2695-5563 rupees), equivalent to almost 2 months of household income.

CONCLUSION

In 2008 still critical flaws remained in VL case management in the primary health care services in Bihar: obsolete use of antimonials with high failure rates and long patient delay. To meet the target of the VL elimination, more active case detection strategies are needed, and village health worker networks could be more involved. Costs to patients remain an obstacle to early case finding.

Comparative evaluation of spectroscopic models using different multivariate statistical tools in a multicancer scenario

Cancer is now recognized as one of the major causes of morbidity and mortality. Histopathological diagnosis, the gold standard, is shown to be subjective, time consuming, prone to interobserver disagreement, and often fails to predict prognosis. Optical spectroscopic methods are being contemplated as adjuncts or alternatives to conventional cancer diagnostics. The most important aspect of these approaches is their objectivity, and multivariate statistical tools play a major role in realizing it. However, rigorous evaluation of the robustness of spectral models is a prerequisite. The utility of Raman spectroscopy in the diagnosis of cancers has been well established. Until now, the specificity and applicability of spectral models have been evaluated for specific cancer types. In this study, we have evaluated the utility of spectroscopic models representing normal and malignant tissues of the breast, cervix, colon, larynx, and oral cavity in a broader perspective, using different multivariate tests. The limit test, which was used in our earlier study, gave high sensitivity but suffered from poor specificity. The performance of other methods such as factorial discriminant analysis and partial least square discriminant analysis are at par with more complex nonlinear methods such as decision trees, but they provide very little information about the classification model. This comparative study thus demonstrates not just the efficacy of Raman spectroscopic models but also the applicability and limitations of different multivariate tools for discrimination under complex conditions such as the multicancer scenario.

Search for stopped Gluinos in pp collisions at square root s=7 TeV

The results of the first search for long-lived gluinos produced in 7 TeV pp collisions at the CERN Large Hadron Collider are presented. The search looks for evidence of long-lived particles that stop in the CMS detector and decay in the quiescent periods between beam crossings. In a dataset with a peak instantaneous luminosity of 1×10(32) cm-2 s-1, an integrated luminosity of 10 pb-1, and a search interval corresponding to 62 hours of LHC operation, no significant excess above background was observed. Limits at the 95% confidence level on gluino pair production over 13 orders of magnitude of gluino lifetime are set. For a mass difference mg - mχ1(0) >100 GeV/c2, and assuming BR(g→gχ1(0))=100%, mg < 370 GeV/c2 are excluded for lifetimes from 10 μs to 1000 s.

Search for quark compositeness with the dijet centrality ratio in pp collisions at √s=7 TeV

A search for quark compositeness in the form of quark contact interactions, based on hadronic jet pairs (dijets) produced in proton-proton collisions at √s=7 TeV, is described. The data sample of the study corresponds to an integrated luminosity of 2.9 pb(-1) collected with the CMS detector at the LHC. The dijet centrality ratio, which quantifies the angular distribution of the dijets, is measured as a function of the invariant mass of the dijet system and is found to agree with the predictions of the standard model. A statistical analysis of the data provides a lower limit on the energy scale of quark contact interactions. The sensitivity of the analysis is such that the expected limit is 2.9 TeV; because the observed value of the centrality ratio at high invariant mass is below the expectation, the observed limit is 4.0 TeV at the 95% confidence level.

SSTR2-based reporters for assessing gene transfer into non-small cell lung cancer: evaluation using an intrathoracic mouse model

The most common cause of cancer-related deaths in North America is lung cancer, 85% of which is non-small cell lung cancer (NSCLC). Gene therapy is a promising approach, but has been hindered by lack of methods for localizing and quantifying gene expression in vivo. Human somatostatin receptor subtype-2 (SSTR2)-based reporters can be used to follow gene expression in vivo using ligands with greater affinity for this subtype. NSCLCs can express SSTR subtypes, which may interfere with SSTR2-based reporters. We assessed whether a SSTR2-based reporter can serve as a reporter of gene transfer into NSCLCs. SSTR subtype expression was assessed in NSCLC cell lines A549, H460, and H1299 using RT-PCR. After infection with an adenovirus containing hemagglutinin-A-tagged-SSTR2 (Ad-HA-SSTR2) or control insert, expression was assessed by immunologic techniques and binding to clinically-approved (111)In-octreotide. In vivo, after magnetic resonance (MR) imaging, intrathoracic H460 tumors were injected with Ad-HA-SSTR2 or control virus (n = 6 mice/group) under ultrasound guidance. Intravenous injection of (111)In-octreotide 2 days later was followed by planar and single-photon emission computed tomography (SPECT) imaging. Biodistribution into tumors was assessed in vivo using anatomic MR and functional gamma-camera images and ex vivo using excised organs/tumors. In human lung tumor samples (n = 70), SSTR2 expression was assessed using immunohistochemistry. All three NSCLC cell lines expressed different SSTR subtypes, but none expressed SSTR2. Upon Ad-HA-SSTR2 infection, HA-SSTR2 expression was seen in all three cell lines using antibodies targeting the HA domain or (111)In-octreotide targeting the receptor domain (p < 0.05). Intrathoracic tumors infected with Ad-HA-SSTR2 were clearly visible by gamma-camera imaging; expression was quantified by both in vivo and ex vivo biodistribution analysis and demonstrated greater uptake in tumors infected with Ad-HA-SSTR2 compared with control virus (p < 0.05). Immunohistochemistry found that 78% of NSCLCs are negative for and 13% have low levels of SSTR2 expression. It is concluded that SSTR2-based reporters can serve as reporters of gene transfer into NSCLCs.

Search for dijet resonances in 7 TeV pp collisions at CMS

A search for narrow resonances in the dijet mass spectrum is performed using data corresponding to an integrated luminosity of 2.9 pb⁻¹ collected by the CMS experiment at the Large Hadron Collider. Upper limits at the 95% confidence level are presented on the product of the resonance cross section, branching fraction into dijets, and acceptance, separately for decays into quark-quark, quark-gluon, or gluon-gluon pairs. The data exclude new particles predicted in the following models at the 95% confidence level: string resonances, with mass less than 2.50 TeV, excited quarks, with mass less than 1.58 TeV, and axigluons, colorons, and E6 diquarks, in specific mass intervals. This extends previously published limits on these models.

First measurement of Bose-Einstein correlations in proton-proton collisions at √s=0.9 and 2.36 TeV at the LHC

Bose-Einstein correlations have been measured using samples of proton-proton collisions at 0.9 and 2.36 TeV center-of-mass energies, recorded by the CMS experiment at the CERN Large Hadron Collider. The signal is observed in the form of an enhancement of pairs of same-sign charged particles with small relative four-momentum. The size of the correlated particle emission region is seen to increase significantly with the particle multiplicity of the event.

Transverse-momentum and pseudorapidity distributions of charged hadrons in pp collisions at square root of s = 7 TeV

Charged-hadron transverse-momentum and pseudorapidity distributions in proton-proton collisions at square root of s = 7  TeV are measured with the inner tracking system of the CMS detector at the LHC. The charged-hadron yield is obtained by counting the number of reconstructed hits, hit pairs, and fully reconstructed charged-particle tracks. The combination of the three methods gives a charged-particle multiplicity per unit of pseudorapidity dN(ch)/dη|(|η|<0.5) = 5.78 ± 0.01(stat) ± 0.23(syst) for non-single-diffractive events, higher than predicted by commonly used models. The relative increase in charged-particle multiplicity from square root of s = 0.9 to 7 TeV is [66.1 ± 1.0(stat) ± 4.2(syst)]%. The mean transverse momentum is measured to be 0.545 ± 0.005(stat) ± 0.015(syst)  GeV/c. The results are compared with similar measurements at lower energies.

Comparative studies on the extraction of metagenomic DNA from the saline habitats of Coastal Gujarat and Sambhar Lake, Rajasthan (India) in prospect of molecular diversity and search for novel biocatalysts

Extraction of total DNA from a given habitat assumes significance in metagenomics, due to the requirement of inhibitor free and high quality metagenome in good quantity for applications in molecular biology. DNA extraction and its quality assessment for PCR applications from saline soils of Coastal Gujarat and Sambhar Soda Lake, Rajasthan in India is described in a comparative manner. The mechanical and soft lysis methods were simple and efficient for rapid isolation of PCR amplifiable total genomic DNA. The results are significant as only few extreme environments, particularly saline habitats are explored for their metagenomic potential.

Risk factors for visceral leishmaniasis in India: further evidence on the role of domestic animals

OBJECTIVE

Studies investigating risk factors for visceral leishmaniasis (VL) on the Indian Subcontinent have shown contradictory results related to the role of domestic animals. In some studies having animals in or around the house was a risk factor, in others it was protective. We investigated the specific hypothesis that keeping domestic animals inside the house at night is a risk factor for VL.

METHODS

Individually matched case-control study. All patients with VL diagnosed in the study area in Bihar, India between March 1st, 2007 and December 1st, 2008 were eligible. For each case, we selected two random controls, with no history of previous VL; matched on sex, age group and neighbourhood. Patients and controls were subjected to a structured interview on the main exposure of interest and potential confounders; a conditional logistic regression model was used to analyse the data.

RESULTS

We enrolled 141 patients and 282 controls. We found no significant associations between VL and keeping domestic animals inside the house (OR of 0.88 for bovines and 1.00 for 'any animal') or ownership of domestic animals (OR of 0.97 for bovines and 1.02 for 'any animal'). VL was associated with housing conditions. Living in a thatched house (OR 2.60, 95% CI 1.50-4.48) or in a house with damp floors (OR 2.60, 95% CI 1.25-5.41) were risk factors, independently from socio economic status.

CONCLUSION

Keeping animals inside the house is not a risk factor for VL in Bihar, India. Improving housing conditions for the poor has the potential to reduce VL incidence.

Household cost-of-illness of visceral leishmaniasis in Bihar, India

OBJECTIVE

To determine the cost of kala-azar (KA) to patients in Bihar, India.

METHOD

A semi-structured questionnaire was used to collect costs of illness--direct (medical; non-medical) and indirect costs (work days lost). After screening the community known to be endemic for visceral leishmaniasis (VL), households (HHs) with VL were recruited which reported a case of KA who received treatment between September 2005 and September 2006. The total costs were calculated as a summation of individual costs category. Medians were estimated for the total and for each of the cost categories.

RESULT

Data from 171 HHs and 183 patients revealed that median age of patients with KA was 18; 59% were men; 33% were employed; household size was 7; household median monthly income was $38. The median total costs per patient were $127, equal to >3 months of income, of which medical care comprised $83 (provider fees $13, medicines $50, diagnostics $9, hospital stay $30); and food and transport comprised $33. Patients also lost almost 2 weeks of work time during illness and even after recovery.

CONCLUSION

Despite provision of free/subsidized medicines, diagnostics, and hospital stay at public and Non-Governmental Organization facilities, the impoverished HHs of Bihar with a case of KA incur high expenditures. Easier access to, and more use of free public health services, plus innovative health financing schemes, are urgently required.

Determinants of bednet ownership and use in visceral leishmaniasis-endemic areas of the Indian subcontinent

OBJECTIVE

To document ownership and use of bednets with its determinants in the visceral leishmaniasis (VL)-endemic region where mainly non-insecticide impregnated nets are available through commercial channels, and bednets are being considered as a leishmaniasis vector control measure.

METHODS

In August-September 2006, semi-structured household (HH) questionnaires and observation guides were used in a random sample of 1330 HHs in VL-endemic districts of India and Nepal to collect data on VL knowledge, HH socio-economic status, bednet ownership and use patterns. An asset index was constructed to allow wealth ranking of the HH. A binary logistic response General Estimating Equations model was fitted to evaluate the determinants of bednet ownership and use.

RESULTS

The proportion of HHs with at least one bednet purchased on the commercial market was 81.5% in India and 70.2% in Nepal. The bednets were used in all seasons by 50.6% and 54.1% of the Indian and Nepalese HH owning a bed net. There was striking inequity in bednet ownership: only 38.3% of the poorest quintile in Nepal owned at least one net, compared to 89.7% of the wealthiest quintile. In India, the same trend was observed though somewhat less pronounced (73.6%vs. 93.7%). Multivariate analysis showed that poverty was an important independent predictor for not having a bednet in the HH [OR 5.39 (2.90-10.03)].

CONCLUSION

Given the inequity in commercial bednet ownership, free distribution of insecticide-treated bednets to the general population seems imperative to achieve a mass effect on vector density.

Assessment of various methods for extraction of metagenomic DNA from saline habitats of coastal Gujarat (India) to explore molecular diversity

AIMS

To develop total DNA extraction protocol from saline soil for further metagenomic applications.

METHODS AND RESULTS

The protocols combine the application of mechanical (Beads and Sonicator) and Soft Lysis (SDS and enzymes) method for the isolation of total DNA from saline soil of coastal Gujarat followed by its quantification and purity assessment. The quality and purity of metagenomic DNA was quite consistent and reliable, although it contained residual concentartions of humic acid. The extracted DNA was used to successfully amplify 16S rRNA region. The amplicons were suitable for further applications such as diversity-based analysis by denaturing gradient gel electrophoresis (DGGE).

CONCLUSIONS

The methods appear to have wide applicability in investigating molecular diversity and exploring functional genes from the total DNA.

SIGNIFICANCE AND IMPACT OF THE STUDY

The protocol is simple, short and facilitates rapid isolation of PCR amplifiable total genomic DNA from saline soil. The method yielded good quality of the DNA suitable for metagenomic studies. The results are also significant as only few extreme environments, particularly saline habitats, are explored for their metagenomic potential.

Wash resistance and residual efficacy of long-lasting polyester netting coated with alpha-cypermethrin (Interceptor) against malaria-transmitting mosquitoes in Assam, northeast India

Malaria is endemic in Assam, northeast India, with low-to-moderate transmission of the causative parasites, mostly by Anopheles minimus. Plasmodium falciparum is the predominant parasite (>60%), with remaining cases being due to P. vivax. As an alternative intervention for malaria control, long-lasting insecticidal nets [Interceptor coated with alpha-cypermethrin 10% suspension concentrate (SC), 0.667% w/w, 0.2g/m(2)] underwent field evaluation for laboratory wash resistance and residual efficacy in field conditions against malaria-transmitting mosquitoes. Based on entomological observations, the Interceptor net intervention was the most effective, corresponding to the lowest mosquito vector density in experimental villages. There was virtual disappearance of A. minimus in Interceptor net villages in contrast to the untreated net intervention and the no-net control. Contact cone bioassay tests revealed 100% mortality in the A.minimus group of mosquito species in the community using the Interceptor net, which was consistent during the follow-up monitoring period (October 2006 to April 2007) in field conditions. Similar levels of mortality were observed in laboratory-washed nets compared with unwashed nets, and wash resistance was consistent even after the 20th serial wash at fortnightly intervals. Community compliance and acceptance of the Interceptor net was high, with decreased nuisance due to biting mosquitoes and other household insect pests being reported.

Characterization of phenolic compounds in some Indian mango cultivars

Mangoes (Mangifera indica) are rich in phenolic acids as detected by high-performance liquid chromatography. The phenolics have prominent medicinal properties. Among six important commercial mango cultivars (Deshi, Langra, Chausa, Mallika, Dashahari and Amrapali) tannic acid was maximal in Mallika, while gallic acid was maximal in Chausa and all other varieties. Caffeic acid was maximal in Langra followed by Chausa and Amrapali. Many of the pharmacological properties attributed to mango might be due to the presence of phenolic acids in fairly significant amounts.

Laboratory studies on mosquito larvicidal efficacy of aqueous & hexane extracts of dried fruit of Solanum nigrum Linn

BACKGROUND & OBJECTIVE

Aqueous and organic solvent extracts of plants/plant parts were effective in killing the mosquito larvae. Comparative efficacy of the aqueous and hexane extracts of dried fruit of Solanum nigrum was tested against five laboratory colonized strains of mosquito species, namely Anopheles culicifacies species A, An. culicifacies species C, An. stephensi, Culex quinquefasciatus and Aedes aegypti to assess the possibility for use of these extracts for their control.

METHODS

Concentrations of aqueous extract of dried fruit in the range of 62.5 to 2000 ppm and hexane extract of dried fruit in the range of 0.781 to 150 ppm were used in bioassays. The mortality data were subjected to log probit regression analysis to determine the median lethal concentrations (LC(50) and LC(90)) to kill 50 and 90 per cent of the treated larvae of the respective species.

RESULTS

All the five species registered 100 per cent mortality in larval bioassays at 1000 ppm with aqueous extract and at 100 ppm with hexane extract of dried fruit. In bioassays with aqueous extract An. culicifacies species A registered the lowest LC(50) of 208.5 ppm (range-208.5-359 ppm for different mosquito species) while with hexane extract, An. stephensi registered the lowest LC(50) of 6.25 ppm (6.25- 17.63 ppm for different mosquito species). The LC(50) of aqueous extract was 13-39 fold higher than the values of hexane extract of dried fruit for different species. The calculated LC(90) for hexane extract of dried fruit for different species was in the range of 43.38-95.28 ppm.

INTERPRETATION & CONCLUSION

Hexane extract showed good mosquito larvicidal efficacy than that of the aqueous extract. The calculated LC(90) for the extract for different species was below 100 ppm and could be effective for comprehensive control of disease vectors.

Relative performance of academic departments using DEA with sensitivity analysis

The process of liberalization and globalization of Indian economy has brought new opportunities and challenges in all areas of human endeavor including education. Educational institutions have to adopt new strategies to make best use of the opportunities and counter the challenges. One of these challenges is how to assess the performance of academic programs based on multiple criteria. Keeping this in view, this paper attempts to evaluate the performance efficiencies of 19 academic departments of IIT Roorkee (India) through data envelopment analysis (DEA) technique. The technique has been used to assess the performance of academic institutions in a number of countries like USA, UK, Australia, etc. But we are using it first time in Indian context to the best of our knowledge. Applying DEA models, we calculate technical, pure technical and scale efficiencies and identify the reference sets for inefficient departments. Input and output projections are also suggested for inefficient departments to reach the frontier. Overall performance, research performance and teaching performance are assessed separately using sensitivity analysis.

The poorest of the poor: a poverty appraisal of households affected by visceral leishmaniasis in Bihar, India

OBJECTIVE

To provide data about wealth distribution in visceral leishmaniasis (VL)-affected communities compared to that of the general population of Bihar State, India.

METHODS

After extensive disease risk mapping, 16 clusters with high VL transmission were selected in Bihar. An exhaustive census of all households in the clusters was conducted and socio-economic household characteristics were documented by questionnaire. Data on the general Bihar population taken from the National Family Health Survey of India were used for comparison. An asset index was developed based on Principal Components Analysis and the distribution of this asset index for the VL communities was compared with that of the general population of Bihar.

RESULTS

83% of households in communities with high VL attack rates belonged to the two lowest quintiles of the Bihar wealth distribution. All socio-economic indicators showed significantly lower wealth for those households.

CONCLUSION

Visceral leishmaniasis clearly affects the poorest of the poor in India. They are most vulnerable, as this vector-born disease is linked to poor housing and unhealthy habitats. The disease leads the affected households to more destitution because of its impact on household income and wealth. Support for the present VL elimination initiative is important in the fight against poverty.

Hybrid cross-linked polyaniline-WO3 nanocomposite thin film for NO(x) gas sensing

Nanocomposite thin film of cross-linked polyaniline [CLPANI, derived from polyaniline and aniline formaldehyde condensate (AFC)] and WO3 has been fabricated using vacuum thermal evaporation technique. X-ray diffraction pattern of as-grown film shows broad reflections of polymer along with mixed reflection of nonhydrated and hydrated WO3 nanoparticles. The scanning electron microscopy studies reveal uniform dispersion of WO3 nanoparticles in CLPANI network. The broadening of the absorption band at 320 nm corresponding to PANI and AFC-WO3 nanocomposite is attributed to cross-linking between the polymeric units. The NO(x) gas sensing characteristics of vacuum deposited CLPANI-WO3 thin film have been studied by measuring the change in resistance with respect to time. The sensor can be operated at room temperature, resulting in extended shelf life of the sensor. The response time and recovery time of the sensor operated at room temperature have been experimentally determined as 30 s and 11 minutes respectively.

Percutaneous balloon valvuloplasty for congenital pulmonary valve stenosis in adults

BACKGROUND

Although pulmonary valvular stenosis is not uncommon in adults, there are few reports of percutaneous pulmonary valvuloplasty in adults, despite the possibility of avoiding heart surgery.

AIM

This report describes the experience in adult patients undergoing this procedure and evaluates its effectiveness and tolerance.

METHODS

Over an 8-year period (1989-1997), pulmonary valvuloplasty was considered in 22 adult patients [8 men, 14 women; mean age 28.0 years +/- standard deviation (SD) 10.3; range 16-46 years] with congenital pulmonary valve stenosis. Sixteen patients were asymptomatic with pulmonary systolic murmurs, although 6 patients presented with dyspnea. Before the procedure, the mean transpulmonary valve gradient was 53.2 +/- 24.8 mmHg SD, with a mean right ventricular systolic pressure of 74.6 +/- 28.4 mmHg SD, and mean pulmonary artery pressure was 21.4 +/- 6.4/10.2 +/-3.9 mmHg.

RESULTS

The procedure was successful in 19 patients (6 men, 13 women) and was well tolerated and free of complications. Following the procedure, the mean transvalvular gradient was 15.5 +/- 11.5 mmHg, with a mean right ventricular systolic pressure of 40.5 +/- 13.6 mmHg and a mean pulmonary systolic pressure of 24.3 +/- 7.4 mmHg. This represented mean fall in transpulmonary valve gradient of 42.4 +/- 22.0 mmHg (paired t-test, p < 0.0001). After a mean follow-up of 20.1 months (13.4 SD), most patients remained well and asymptomatic, although two patients required repeat valvuloplasty.

CONCLUSION

Pulmonary valvuloplasty is a well tolerated and effective treatment for pulmonary valve stenosis in adults, with few complications and no need for surgery. This procedure should be considered as the primary treatment of adult patients with pulmonary valve stenosis.

Novel efficient and secure medical data transmission on WiMAX

This paper discusses an improved technique for bandwidth-efficient and secure transmission of medical records over simulated orthogonal frequency division multiplexing (OFDM)-based Worldwide Interoperability for Microwave Access (WiMAX)/IEEE 802.16 physical layer. Medical data compaction along with security has been achieved by embedding electrocardiogram (ECG) data into Haar wavelet coefficients of an x-ray image that is transmitted over the channel. The compaction ratio and peak signal-to-noise ratio (PSNR) between the transmitted and received x-ray images for visual clinical performance have been evaluated. It is shown that 12.5% data compaction along with true reception of ECG signal can be achieved for channel signal-to-noise ratio (SNR) >or= 9.6 dB while the achieved PSNR was 55.97 dB. The PSNR value is well above the minimum acceptable 35 dB level, making it potentially useful for secure and bandwidth-efficient transmission of clinical records.

Correlation between biofilm production and multiple drug resistance in imipenem resistant clinical isolates of Acinetobacter baumannii

PURPOSE

To study the qualitative and quantitative methods for the investigation of biofilm formation and to examine the correlation between biofilm and antibiotic resistance among the clinical isolates of Acinetobacter baumannii . We also verified the association between biofilm and presence of extended spectrum beta-lactamases, particularly, bla PER-1 .

METHODS

A total of 55 isolates were subjected to susceptibility testing by disc diffusion method for 13 clinically relevant antibiotics. Screening for biofilm production was done by both qualitative and quantitative methods through tube and microtitre plate assay respectively. The presence of bla PER-1 was checked by PCR.

RESULTS

A. baumannii isolates showed very high resistance (>75%) to imipenem, cephotaxime, amikacin and ciprofloxacin. Only cefoperazone, netillin and norfloxacin were found to be effective agents. Results of microtitre and tube methods were concordant with 34 isolates (62%) showing biofilm formation. Resistance to four antibiotics such as amikacin (82% vs. 17.6%, P < 0.001), cephotaxime (88% vs. 11%, P P < 0.001), ciprofloxacin (70% vs. 29%, P =0.005) and aztreonam (38% vs. 11%, P =0.039) was comparatively higher among biofilm producers than non-biofilm producers. Microtitre assay additionally detected 14 weakly adherent isolates. Only 11 isolates had bla PER-1 gene and among these two were strong biofilm producers, while remaining were weakly adherent isolates.

CONCLUSION

Microtitre plate method was found to be a more sensitive method for biofilm detection. This study demonstrates a high propensity among the clinical isolates of A. baumannii to form biofilm and a significant association of biofilms with multiple drug resistance. Presence of bla PER-1 appears to be more critical for cell adherence than for biofilm formation.

Evaluation of Tribulus terrestris Linn (Zygophyllaceae) acetone extract for larvicidal and repellence activity against mosquito vectors

Acetone extracts of leaves and seeds from the Tribulus terrestris (Zygophyllaceae) were tested against mature and immature different mosquito vectors under laboratory condition. The extract showed strong larvicidal, properties 100 per cent mortality in the 3rd-instar larvae was observed in the bioassays with An. culicifacies Giles species A, An. stephensi Liston, Culex quinquefasciatus Say and Aedes aegypti Linn, against 200 ppm of the leaf acetone extract and 100 ppm seed acetone extract. The LC50 values of leaf acetone extract estimated for 3rd-instars An. culicifacies species A, An. stephensi, Cx. quinquefasciatus and Ae. aegypti after 24 hour of exposure were 117, 124, 168 and 185 ppm respectively. The LC50 values of seed acetone extract estimated for 3rd-instars An. culicifacies species A, An. stephensi, Cx. quinquefasciatus and Ae. aegypti after 24 hour of exposure were 100, 72, 91 and 91 ppm respectively. It is confirmed from the LC50 values that the seed acetone extract of T. terrestris is more effective compared to leaf extracts. A significant (P<0.004) higher concentration of acetone extract leaf was required to kill equal number of larvae i.e. against acetone extract of seed. The seed acetone extract showed strong repellent activity against adults mosquitoes. Per cent protection obtained against Anopheles culicifacies species A 100% repellency in 1 h, 6 h; Anopheles stephensi 100% repellency in 0 h, 4 h, 6 h; and Culex quinquefasciatus 100% repellency in 0 h, 2 h, 4 h, at 10% concentration respectively. Against Deet- 2.5% An. culicifacies Giles species A has shown 100% repellency in 1 h, 2 h, 6 h, An. stephensi Liston 99% repellency in 4 h, and Culex quinquefasciatus Say has shown 100% repellency in 1 h, 2 h.

Chemotaxonomic variability in Zizyphus mouritiana varieties and its pharmacological properties in relation to human health

Twenty varieties of ber (Zizyphus mouritiana), namely umaran, katha, bilayati, kaithli, ZG-3, gola, safeda rohtak, takadi, tikari, banarasi karaka, seo, sonaur-2, sonaur-3, ilaichi, mundia murahra, pathan, kakrola gola, seb, golden yellow and chhuhara, were investigated for the presence of phenolic acids in stem bark, leaves and fruits using high performance liquid chromatograph. Results indicated the presence of tannic (retention time (Rt.) 2.76 min), gallic (Rt. 2.86 min), caffeic (Rt. 3.12 min), vanillic (Rt. 3.26 min), ferulic (Rt. 3.42 min), chlorogenic (Rt. 4.16 min) and cinnamic acids (Rt. 4.45 min) in varying amounts in different parts in of these varieties. In fruits of seven varieties, namely, kaithly, sonaur-2, sonaur-3, mundia murahra, pathan, golden yellow and chhuhara, oxalic acid (Rt. 3.00 min) was also detected. Pharmacological properties of phenolic acids of fruits in relation to human health and the possible implications of different phenolic acids in chemotaxonomy of different varieties of ber are discussed.

Effectiveness of red cell osmotic fragility test with varying degrees of saline concentration in detecting beta-thalassaemia trait

INTRODUCTION

This study was performed with the objective of determining the efficacy of naked eye single tube red cell osmotic fragility test (NESTROFT) as a screening test for beta-thalassaemia trait, and to standardise a saline concentration which could give best results with minimum error and maximum sensitivity and specificity.

METHODS

Five concentrations (0.35 percent, 0.36 percent, 0.37 percent, 0.38 percent and 0.39 percent) of buffered saline solutions were used. NESTROFT was applied to three groups of subjects: 24 normal individuals, 87 subjects with genetically-proven beta-thalassaemia trait and 13 patients with proven iron-deficiency anaemia.

RESULTS

The results demonstrated that 0.36 percent was the best saline concentration for NESTROFT. It could detect 97.7 percent of heterozygous beta-thalassaemia patients, compared to 94.25 percent, 91.95 percent, 88.51 percent and 82.76 percent detection rates obtained with 0.35 percent, 0.37 percent, 0.38 percent and 0.39 percent saline concentrations, respectively. Specificity of NESTROFT with 0.36 percent saline was also higher at 83.3 percent, whereas that of 0.35 percent, 0.37 percent, 0.38 percent and 0.39 percent was 79.17 percent, 79.17 percent, 70.83 percent and 62.5 percent, respectively. This test with 0.36 percent saline concentration was also positive for three (23.08 percent) patients with iron-deficiency anaemia.

CONCLUSION

NESTROFT done with 0.36 percent buffered saline solution provides more accurate results compared to the other concentrations tested. Since the test is sensitive, cost-effective, rapid and reliable, it may be considered as the single screening test to be used in areas with limited laboratory facilities and economic resources.

Body Mass Index and Obesity : Tailoring "cut-off" for an Asian Indian Male Population

BACKGROUND

Obesity/overweight is a recognized risk factor for a host of disorders. The disease risk stratification is commonly based on the Quetelets Index (Body Mass Index- BMI), a surrogate measure of fatness. The currently used BMI cut-offs to classify people as overweight or obese in Armed Forces have been defined in studies on Caucasian populations. However, because of differences in body structure and composition in different ethnic, socioeconomic, cultural and regional groups the correspondence between BMI and body fat content varies between populations. We conducted this pilot study in the Indian Navy to define BMI cut-offs for overweight and obesity using body fat content derived from Skin Fold Thickness as the standard.

MATERIAL AND METHODS

The study was conducted on 121 volunteers from a naval hospital staff in the age range of 18 to 47 years. The mean age, height, weight, BMI, body fat in the study group was 26.73 years (± 5.5098), 168.56 cm (± 6.1034), 65.92 Kg (± 10.2746), 23.17 Kg/m(2) (± 3.0265) and 19.91% (± 4.831) respectively.

RESULTS

The prevalence of overweight/obesity was 20.66% by BMI and 47.11% by body fat content. Receiver operating characteristic (ROC) curve analysis defined a BMI of 23.85 kg/m(2) as the cut off for overweight with a sensitivity of 70.2% (95% CI 56.6 - 81.6) and 87.5% specificity (95% CI 76.8-94.4) and a BMI of 24.38 kg/m(2)with 90% sensitivity (95% CI 68.3-98.5) and 81.2% specificity (95% CI 72.2-88.3) for obesity.

CONCLUSION

The results of our study suggest lower BMI cut offs for overweight and obesity in Indian populations than those recommended by WHO.

Development of an immortalised, post-pubertal gonadotrophin-releasing hormone neuronal cell line

Gonadotrophin-releasing hormone (GnRH) is important in reproduction, although some of the mechanisms for its synthesis and release remain elusive. Progress in understanding the GnRH neurone has been hampered by the limited number and diffuse distribution of the neurone in the mammalian brain. Several stable GnRH-expressing cell lines have been developed using in vivo expression of the simian virus 40 T Antigen (TAg), and they have been helpful for the study of gene expression and neuronal function. However, expression of an immortalising gene may interfere with normal cellular function. We developed a novel GnRH-secreting cell line transgenic mouse model suitable for targeted transformation in post-pubertal mice using a tetracycline-regulated TAg transgene. This clonal cell line, GRT, expresses neuronal markers and GnRH. GRT cells grown in medium containing tetracycline-free serum express increasing mRNA levels of GnRH associated with declining levels of TAg expression. The novelty and ultimately the usefulness of this cell line is that TAg expression, which could affect the GnRH neuronal phenotype, can be regulated by tetracycline.

Salt dependent resistance against chemical denaturation of alkaline protease from a newly isolated haloalkaliphilic Bacillus sp

Only few enzymes from haloalkaliphiles are biochemically characterized for their kinetic behaviour and stability. In view of this realization, an alkaline protease from Bacillus sp. AH-6, displaying salt-dependent resistance against chemical denaturation by Urea and Guanidium hydrochloride was investigated for denaturation and in vitro protein folding. The crude enzyme was highly resistant against urea (8 M) denaturation up to 72 h; however, on purification, it turned sensitive and got denatured within 2 h. Interestingly, the purified enzyme regained the resistance in the presence of NaCl. Effective refolding of the purified enzyme was achieved with glycerol; however, other approaches such as lower protein concentrations, rapid dilution and slow removal of the denaturant did not further add to refolding. The results are important from the viewpoint that only few enzymes from haloalkaliphilic bacteria are characterized. Since the resistance against chemical denaturation is a rare phenomenon, the findings would enrich the knowledge on protein stability and denaturation. Besides, such biocatalysts would definitely have novel applications under harsh chemical environments.

High resolution two-dimensional gel electrophoresis of structural proteins of baculoviruses of Autographa californica and Porthetria (lymantria) dispar

The structural polypeptides of baculoviruses of Autographa californica (AcMNPV) and Porthetria dispar (PdMNPV) were analyzed by two-dimensional (2-D) gel electrophoresis. Purified proteins were solubilized in urea-NP40 mix and separated by isoelectric focusing in the first dimension; electrophoresis in the presence of sodium dodecyl sulfate (SDS) separated proteins by molecular weight in the second dimension. Eighty-one acidic polypeptides ranging in molecular weight from 13,500 to 86,000 Da were resolved in AcMNPV enveloped virions. The predominant polypeptide had a molecular weight of 41,500 and was considered to be the major capsid protein. Nucleocapsids from AcMNPV were resolved into 64 polypeptides. At least 11 of the polypeptides, including most of the high molecular weight proteins, that were not resolved in nucleocapsids were considered to be envelope proteins. For PdMNPV enveloped virions, there were 95 acidic polypeptides ranging in molecular weight from 13,500 to 85,500. The predominant polypeptide had a molecular weight of 46,500 Da. Polyhedral proteins (polyhedrin) isolated from protease-inactivated polyhedra and separable into a single major polypeptide (approx. 31,000) on one-dimensional SDS-polyacrylamide gel electrophoresis were resolved into six polypeptides for both viruses. All six polyhedrin polypeptides had the same molecular weight, but their isoelectric points ranged from pH 5.3 to 5.9 for AcMNPV and from pH 5.7 to 6.2 for PdMNPV. These six polypeptides were also detected when protease-inactivated or noninactivated whole polyhedra were analyzed directly by 2-D electrophoresis. It is assumed that not all the observed baculovirus polypeptides were unique species. Some proteins, especially the polyhedrin polypeptides, appeared to be related and had altered mobilities as a consequence of post-translational modifications.

Temporal and spatial regulation of CRE recombinase expression in gonadotrophin-releasing hormone neurones in the mouse

Gonadotrophin-releasing hormone (GnRH) neurones located within the brain are the final neuroendocrine output regulating the reproductive hormone axis. Their small number and scattered distribution in the hypothalamus make them particularly difficult to study in vivo. The Cre/loxP system is a valuable tool to delete genes in specific cells and tissues. We report the production of two mouse lines that express the CRE bacteriophage recombinase in a GnRH-specific manner. The first line, the GnRH-CRE mouse, contains a transgene in which CRE is under the control of the murine GnRH promoter and targets CRE expression specifically to GnRH neurones in the hypothalamus. The second line, the GnRH-CRETeR mouse, uses the same murine GnRH promoter to target CRE expression to GnRH neurones, but is modified to be constitutively repressed by a tetracycline repressor (TetR) expressed from a downstream tetracycline repressor gene engineered within the transgene. GnRH neurone-specific CRE expression can therefore be induced by treatment with doxycycline which relieves repression by TetR. These GnRH-CRE and GnRH-CRETeR mice can be used to study the function of genes expressed specifically in GnRH neurones. The GnRH-CRETeR mouse can be used to study genes that may have distinct roles in reproductive physiology during the various developmental stages.

Gold nanoparticle-polyaniline composite films for glucose sensing

Gold nanoparticles (AuNPs) have been self-assembled onto electrochemically deposited polyaniline (PANI) films on indium-tin-oxide (ITO) coated glass plates to fabricate glucose biosensor. The covalent immobilization of glucose oxidase (GOx) in the near vicinity of gold nanoparticles has been obtained using N-ethyl-N'-(3-dimethylaminopropyl) carbodiimide (EDC)/N-hydroxysuccinimide (NHS), chemistry between amino groups of PANI and COOH groups of GOx. These AuNPs-PANI/ ITO and GOx/AuNPs-PANI/ITO composite films have been characterized using Fourier transform infra red (FTIR) and cyclic voltammetry (CV) techniques, respectively. The fast electron transfer from the modified PANI surface to electrode is indicated by the observed increase in amperometric response current of these GOx/AuNPs-PANI/ITO bioelectrodes. These GOx/AuNPs-PANI/ITO bioelectrodes exhibit response time of 10 s, linearity from 50 to 300 mg/dl and show value of apparent Michaelis-Menten constant (Km(app)) of 2.2 mM.

Fabrication and characterization of polyaniline-znO hybrid nanocomposite thin films

Polyaniline (PANI)-ZnO nanocomposite thin film has been successfully fabricated on glass substrates by using vacuum deposition technique. The as-grown PANI-ZnO nanocomposite thin films have been characterized using X-ray diffraction, Scanning Electron Microscopy, Atomic Force Microscopy, UV-visible spectrophotometer and Fourier Transform Infrared (FTIR) spectroscopy, respectively. X-ray diffraction of as-grown film shows the reflection of ZnO nanoparticles along with a broad peak of PANI. The surface morphology of nanocomposite films has been investigated using scanning electron microscopy and atomic force microscopy. The hypsochromic shift of the UV absorption band corresponding to pi-pi* transition in polymeric chain of PANI and a band at 504 cm(-1) due to ZnO nanoparticles has been observed in the FTIR spectra. The hydrogen bonding between the imine group of PANI and ZnO nanoparticle has been confirmed from the presence of the absorbance band at 1151 cm(-1) in the FTIR spectra of the nanocomposite thin films.

Distribution of malocclusion types among thumb suckers seeking orthodontic treatment

The present study was conducted to evaluate the influence of thumb sucking and its duration on the type of malocclusion. A total of 410 North Indian individuals between ages 12-30 years, 161 males and 249 females were examined. A specially designed proforma was used to record the detailed history of the individual. Among the etiological factors it was found that history of thumb sucking was present in 13.9% and significantly related to Class II div 1 malocclusion. When thumb sucking exceeded 18 months, it was found statistically significant (P < 0.1) in Class II skeletal malocclusion, in open bite (P < 0.1) and in extreme overjet (P < 0.5).

CONCLUSION

If thumb sucking is not treated early, it can cause skeletal Class II malocclusion, anterior open bite and excessive overjet.

Polyaniline Langmuir-Blodgett film based cholesterol biosensor

Cholesterol oxidase (ChOx) has been covalently linked to Langmuir-Blodgett (LB) monolayers of polyaniline (PANI)-stearic acid (SA) prepared onto indium-tin-oxide (ITO) coated glass plates via glutaraldehyde (Glu) chemistry. These ChOx/Glu/PANI-SA LB film/ITO electrodes have been characterized by FT-IR, cyclic voltammetry, and scanning electron microscopy, respectively. The results of response measurements carried out on these bioelectrodes using linear sweep voltammetry (LSV) reveal linearity from 25 to 400 mg/dL of cholesterol concentration with sensitivity of 88.9 nA mg(-1) dL. The linear regression analysis of bioelectrode reveals standard deviation and correlation coefficient of 0.737 microA and 0.9988, respectively. The low value of the Michaelis-Menten constant of these bioelectrodes obtained as 1.21 mM for the immobilized enzyme indicates increased interaction between ChOx and cholesterol in the PANI-SA LB film.

Performance evaluation of cement stabilized fly ash-GBFS mixes as a highway construction material

Fly ash and granulated blast furnace slag (GBFS) are major by-products of thermal and steel plants, respectively. These materials often cause disposal problems and environmental pollution. Detailed laboratory investigations were carried out on cement stabilized fly ash-(GBFS) mixes in order to find out its suitability for road embankments, and for base and sub-base courses of highway pavements. Proctor compaction test, unconfined compressive strength (UCS) test and California Bearing Ratio (CBR) test were conducted on cement stabilized fly ash-GBFS mixes as per the Indian Standard Code of Practice. Cement content in the mix was varied from 0% to 8% at 2% intervals, whereas the slag content was varied as 0%, 10%, 20%, 30% and 40%. Test results show that an increase of either cement or GBFS content in the mixture, results in increase of maximum dry density (MDD) and decrease of optimum moisture content (OMC) of the compacted mixture. The MDD of the cement stabilized fly ash-GBFS mixture is comparably lower than that of similarly graded natural inorganic soil of sand to silt size. This is advantageous in constructing lightweight embankments over soft, compressible soils. An increase in percentage of cement in the fly ash-GBFS mix increases enormously the CBR value. Also an increase of the amount of GBFS in the fly ash sample with fixed cement content improves the CBR value of the stabilized mix. In the present study, the maximum CBR value of compacted fly ash-GBFS-cement (52:40:8) mixture obtained was 105%, indicating its suitability for use in base and sub-base courses in highway pavements with proper combinations of raw materials.

Amphotericin B Treatment for Indian Visceral Leishmaniasis: Response to 15 Daily versus Alternate-Day Infusions

BACKGROUND

For patients with Indian visceral leishmaniasis, amphotericin B deoxycholate is usually given as 15 alternate-day infusions of 1 mg/kg over 30 days (total dose, 15 mg/kg); daily treatment with 1 mg/kg for 20 days (total dose, 20 mg/kg) is also used. This study was done to address the unsettled therapeutic questions of administration schedule (alternate-day vs. daily administration) and dose (1 vs. 0.75 mg/kg) and to determine whether the duration of amphotericin B treatment in Bihar, India, can be shortened to 15 days.

METHODS

To compare alternate-day versus daily administration and 1-mg/kg versus 0.75-mg/kg doses and to determine whether the duration of treatment could be abbreviated, Indian subjects randomly received 15 infusions of 1 mg/kg (group A; 245 patients) or 0.75 mg/kg (group B; 244 patients) on alternate days or 1 mg/kg (group C; 500 patients) or 0.75 mg/kg (group D; 496 patients) daily. Noninferiority testing compared 6-month cure rates using a 5% margin.

RESULTS

Overall, 1439 of the 1485 subjects completed treatment and responded. Treatment interruptions (nephrotoxicity) but not infusion-associated reactions or study removals were more common with daily administration. Final cure rates at 6 months were similar: group A, 234 patients (96%; 95% confidence interval [CI], 92%-98%); group B, 225 patients (92%; 95% CI, 88%-95%); group C, 483 patients (97%; 95% CI, 95%-98%); and group D, 476 patients (96%; 95% CI, 94%-97%; P>.05).

CONCLUSIONS

Provided that the serum creatinine level is repeated once, daily treatment with amphotericin B, 0.75 mg/kg for 15 days (total dose, 11.25 mg/kg), is efficient and effective for visceral leishmaniasis in India.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT00310505.