Socio-demographic study on extent of knowledge, awareness, attitude, and risks of zoonotic diseases among livestock owners in Puducherry region

AIM

This study was conducted to assess the extent of knowledge, awareness, attitude, and risks of zoonotic diseases among livestock owners in Puducherry region.

MATERIALS AND METHODS

A total of 250 livestock farmers were selected randomly from eight revenue villages. And each farmer was interviewed with a questionnaire containing both open- and close-ended questions on various aspects of zoonotic diseases, a total of 49 questionnaires were framed to assess the source and transmission of infection to the farmers and to test their knowledge and awareness about zoonotic diseases. The data collected were analyzed by chi-square test using software Graph pad prism, and results were used to assess the relationship between education level and zoonotic disease awareness; risk of zoonotic diseases and its relation with independent variables.

RESULTS

The present survey analysis represents that most of the respondents are belonging to the age group of 41-60 years. About 42.8% of respondents' household having a graduate. The most of the respondent are small-scale farmers and their monthly income was less than Rs. 10,000. About 61.2% of farmers were keeping their animal shed clean. About 29.6% of the respondents were ignorant about cleaning the dog bitten wound. Only 16.4% of respondents knew that diseases in animals can be transmitted to humans. Only 4.8%, 3.6%, 6.8%, and 22.4% of respondents knew about the zoonotic potential of diseases such as brucellosis, tuberculosis (TB), anthrax, and avian flu, respectively. Only 18% of the respondents were aware about zoonotic diseases from cattle. Regarding the list of zoonotic diseases contracted, 37.7% reported respiratory infection, 31.1% digestive disturbances, 15.5% had dermatological problem, and 15.5% reported indiscrete disease such as fever, body pain, and headache joint pain. From the respondent got the zoonotic disease (n=45), 51.2% of the respondent reported chronic infection and 48.8% of the respondent reported acute form of zoonotic infection. About 30% of the respondents' farm had an incidence of abortion. Our analyses showed that there was significant in educational level of respondents and treatment of dog bitten animals. Furthermore, there was statistical significance in occurrence of hand and foot lesions in the respondent and occurrence of foot-and-mouth disease outbreak in their animals.

CONCLUSION

From this study, it is concluded that involvement of educated family members in farming practices can create awareness and improve knowledge toward zoonotic disease. Further creation of awareness toward zoonotic diseases is of utmost important.

Rationale and efficacy of proteasome inhibitor combined with arsenic trioxide in the treatment of acute promyelocytic leukemia

Arsenic trioxide (ATO) mediates PML-RARA (promyelocytic leukemia-retinoic acid receptor-α) oncoprotein degradation via the proteasome pathway and this degradation appears to be critical for achieving cure in acute promyeloytic leukemia (APL). We have previously demonstrated significant micro-environment-mediated drug resistance (EMDR) to ATO in APL. Here we demonstrate that this EMDR could be effectively overcome by combining a proteasome inhibitor (bortezomib) with ATO. A synergistic effect on combining these two agents in vitro was noted in both ATO-sensitive and ATO-resistant APL cell lines. The mechanism of this synergy involved downregulation of the nuclear factor-κB pathway, increase in unfolded protein response (UPR) and an increase in reactive oxygen species generation in the malignant cell. We also noted that PML-RARA oncoprotein is effectively cleared with this combination in spite of proteasome inhibition by bortezomib, and that this clearance is mediated through a p62-dependent autophagy pathway. We further demonstrated that proteasome inhibition along with ATO had an additive effect in inducing autophagy. The beneficial effect of this combination was further validated in an animal model and in an on-going clinical trial. This study raises the potential of a non-myelotoxic proteasome inhibitor replacing anthracyclines in the management of high-risk and relapsed APL.

[Hypoxic lung failure]

Hypoxic lung failure is among the major indications for patients' referral to intensive care units either for surveillance or if necessary therapy. There are a vast number of pathophysiological causes of lung failure and the optimal treatment highly depends on the underlying pathology; therefore, no standard algorithm exists. So-called acute respiratory distress syndrome (ARDS) represents a very severe manifestation of hypoxemic lung failure that is of particular relevance for intensivists and is therefore the focus of this review. In addition to fundamental pathophysiology of lung injury, the article also focuses on established and modern treatment strategies. Moreover, we will briefly highlight innovative concepts of ARDS treatment that might become relevant in the future.

First off-time treatment prostate-specific antigen kinetics predicts survival in intermittent androgen deprivation for prostate cancer

BACKGROUND

Prostate-specific antigen (PSA) doubling time is relying on an exponential kinetic pattern. This pattern has never been validated in the setting of intermittent androgen deprivation (IAD). Objective is to analyze the prognostic significance for PCa of recurrent patterns in PSA kinetics in patients undergoing IAD.

METHODS

A retrospective study was conducted on 377 patients treated with IAD. On-treatment period (ONTP) consisted of gonadotropin-releasing hormone agonist injections combined with oral androgen receptor antagonist. Off-treatment period (OFTP) began when PSA was lower than 4 ng/ml. ONTP resumed when PSA was higher than 20 ng/ml. PSA values of each OFTP were fitted with three basic patterns: exponential (PSA(t) = λ.e(αt)), linear (PSA(t) = a.t), and power law (PSA(t) = a.t(c)). Univariate and multivariate Cox regression model analyzed predictive factors for oncologic outcomes.

RESULTS

Only 45% of the analyzed OFTPs were exponential. Linear and power law PSA kinetics represented 7.5% and 7.7%, respectively. Remaining fraction of analyzed OFTPs (40%) exhibited complex kinetics. Exponential PSA kinetics during the first OFTP was significantly associated with worse oncologic outcome. The estimated 10-year cancer-specific survival (CSS) was 46% for exponential versus 80% for nonexponential PSA kinetics patterns. The corresponding 10-year probability of castration-resistant prostate cancer (CRPC) was 69% and 31% for the two patterns, respectively. Limitations include retrospective design and mixed indications for IAD.

CONCLUSION

PSA kinetic fitted with exponential pattern in approximately half of the OFTPs. First OFTP exponential PSA kinetic was associated with a shorter time to CRPC and worse CSS.

[Plasma exchange in treatment refractory septic shock : Presentation of a therapeutic add-on strategy]

Sepsis is defined as a systemic inflammatory response of the body to an infection. Besides anti-infective drugs and removal of the site of infection, no specific therapeutics that target the overwhelming host response are available. Clinical researchers are currently evaluating the extracorporeal elimination of circulating cytokines. Modern adsorbing techniques have increasingly been used for this purpose allowing an unselective but highly effective removal of the vast majority of circulating cytokines but also fail to replace used protective factors in patients' plasma. Therapeutic plasma exchange (TPE) however might represent a novel method to remove pathologically elevated cytokines and simultaneously to replace protective plasmatic factors. Here we report the case of a septic shock patient treated with TPE and review the available literature with respect to TPE as an adjunctive therapy in sepsis.

Macrophage and microglial plasticity in the injured spinal cord

Macrophages in the injured spinal cord arise from resident microglia and from infiltrating peripheral myeloid cells. Microglia respond within minutes after central nervous system (CNS) injury and along with other CNS cells signal the influx of their peripheral counterpart. Although some of the functions they carry out are similar, they appear to be specialized to perform particular roles after CNS injury. Microglia and macrophages are very plastic cells that can change their phenotype drastically in response to in vitro and in vivo conditions. They can change from pro-inflammatory, cytotoxic cells to anti-inflammatory, pro-repair phenotypes. The microenvironment of the injured CNS importantly influences macrophage plasticity. This review discusses the phagocytosis and cytokine-mediated effects on macrophage plasticity in the context of spinal cord injury.

When one becomes more: minimum renal artery length in laparoscopic live donor nephrectomy

BACKGROUND

Laparoscopic donor nephrectomy may convert short main arteries into multiple arteries, increasing the technical challenge of implantation. We evaluated our experience to identify factors predictive of multiple arteries after laparoscopic nephrectomy.

METHODS

All laparoscopic nephrectomies from the start of our program in November 2002 until June 2013 were studied, and preoperative imaging reviewed for donor artery length and multiplicity together with operative findings.

RESULTS

A total of 287 consecutive laparoscopic live donor nephrectomies (64 right and 223 left nephrectomies) were studied. Renal artery length was measured from preoperative donor magnetic resonance or computed tomography angiogram and nephrectomy performed using a laparoscopic stapling device. Nine left kidneys with a single artery (6, 7, 9, 10, 11, 12, 13, 14, and 16 mm in length) and five right kidneys with a single artery (5, 13, 15, 20, and 26 mm) on imaging resulted in multiple renal arteries at implantation. Complex renal vein anatomy was associated with multiple arteries following retrieval.

CONCLUSION

A main renal artery length of more than 16 mm on the left and 26 mm on the right is unlikely to result in multiple arteries to implant. The possibility of multiple arteries should be borne in mind when the donor renal artery is short.

Novel alginate-based nanocarriers as a strategy to include high concentrations of hydrophobic compounds in hydrogels for topical application

The cutaneous penetration of hydrophobic active molecules is of foremost concern in the dermatology and cosmetic formulation fields. The poor solubility in water of those molecules limits their use in hydrophilic forms such as gels, which are favored by patients with chronic skin disease. The aim of this work is to design a novel nanocarrier of hydrophobic active molecules and to determine its potential as an ingredient of a topical form. The nanocarrier consists of an oily core surrounded by a protective shell of alginate, a natural polysaccharide isolated from brown algae. These calcium alginate-based nanocarriers (CaANCs) were prepared at room temperature and without the use of organic solvent by an accelerated nanoemulsification-polymer crosslinking method. The size (hydrodynamic diameter ~200 nm) and surface charge (zeta potential ~ - 30 mV) of the CaANCs are both compatible with their application on skin. CaANCs loaded with a fluorescent label were stable in model hydrophilic galenic forms under different storage conditions. Curcumin was encapsulated in CaANCs with an efficiency of ~95%, fully retaining its antioxidant activity. The application of the curcumin-loaded CaANCs on excised human skin led to a significant accumulation of the active molecules in the upper layers of the skin, asserting the potential of these nanocarriers in active pharmaceutical and cosmetic ingredients topical delivery.