Retinoic acid related orphan receptor α is a genetic modifier that rescues retinal degeneration in a mouse model of Stargardt disease and Dry AMD

Degeneration of the macula is associated with several overlapping diseases including age-related macular degeneration (AMD) and Stargardt Disease (STGD). Mutations in ATP Binding Cassette Subfamily A Member 4 (ABCA4) are associated with late-onset dry AMD and early-onset STGD. Additionally, both forms of macular degeneration exhibit deposition of subretinal material and photoreceptor degeneration. Retinoic acid related orphan receptor α (RORA) regulates the AMD inflammation pathway that includes ABCA4, CD59, C3 and C5. In this translational study, we examined the efficacy of RORA at attenuating retinal degeneration and improving the inflammatory response in Abca4 knockout (Abca4-/-) mice. AAV5-hRORA-treated mice showed reduced deposits, restored CD59 expression and attenuated amyloid precursor protein (APP) expression compared with untreated eyes. This molecular rescue correlated with statistically significant improvement in photoreceptor function. This is the first study evaluating the impact of RORA modifier gene therapy on rescuing retinal degeneration. Our studies demonstrate efficacy of RORA in improving STGD and dry AMD-like disease.

Observation of Seven Astrophysical Tau Neutrino Candidates with IceCube

We report on a measurement of astrophysical tau neutrinos with 9.7 yr of IceCube data. Using convolutional neural networks trained on images derived from simulated events, seven candidate ν_{τ} events were found with visible energies ranging from roughly 20 TeV to 1 PeV and a median expected parent ν_{τ} energy of about 200 TeV. Considering backgrounds from astrophysical and atmospheric neutrinos, and muons from π^{±}/K^{±} decays in atmospheric air showers, we obtain a total estimated background of about 0.5 events, dominated by non-ν_{τ} astrophysical neutrinos. Thus, we rule out the absence of astrophysical ν_{τ} at the 5σ level. The measured astrophysical ν_{τ} flux is consistent with expectations based on previously published IceCube astrophysical neutrino flux measurements and neutrino oscillations.

Mitigating abiotic stresses using natural and modified stilbites synergizing with changes in oxidative stress markers in aquaculture

In-depth mineralogical understanding and characterization are necessary to explore potential applications of clinoptilolites. In this study, the clinoptilolite collected from quarries and identified as stilbite microscopically and spectroscopically was subjected to physical and chemical treatments for the synthesis of modified stilbites, which were further evaluated for determining their removal efficiencies on ammonical contaminant in a predetermined concentration range from various source of aquaculture water namely fish pond, aquaponics and ornamental under laboratory condition. High-resolution transmission electron microscope results revealed that stilbite was rod-shaped in all forms but physically modified stilbite contains some nano-zeolite particles, synthesized probably due to heat treatment. The natural zeolite (stilbite) and microwave sodium acetate treated stilbite were found to be most effective in ammonia removal, hence both these products were further evaluated for the removal of cadmium and lead under laboratory conditions and for the ammonia removal in fish pond water under wet lab conditions. The results showed that these zeolites at 10-100 mg/L and 100-200 mg/L had a better removal efficiency of ammonical and metallic contaminants, respectively. Fish samples were taken at particular intervals to determine oxidative stress parameters, i.e., superoxide dismutase and catalase enzyme activities were found to be increased in control fish samples without treatment due to abiotic stress caused by higher ammonia concentration. The levels of oxidative stress markers are decreased in the treatments with zeolite-stilbite which brings to light its potential efficiency in alleviating stress in fish. This study revealed the potential of natural and abundantly available native zeolite-stilbite and its chemically modified form in relieving ammonical stress from the aquaculture system. This work has potential applications for the environmental management of aquaculture, ornamental fisheries, and aquaponics.

Mycotoxins’ Toxicological Mechanisms Involving Humans, Livestock and Their Associated Health Concerns: A Review

Mycotoxins are well established toxic metabolic entities produced when fungi invade agricultural/farm produce, and this happens especially when the conditions are favourable. Exposure to mycotoxins can directly take place via the consumption of infected foods and feeds; humans can also be indirectly exposed from consuming animals fed with infected feeds. Among the hundreds of mycotoxins known to humans, around a handful have drawn the most concern because of their occurrence in food and severe effects on human health. The increasing public health importance of mycotoxins across human and livestock environments mandates the continued review of the relevant literature, especially with regard to understanding their toxicological mechanisms. In particular, our analysis of recently conducted reviews showed that the toxicological mechanisms of mycotoxins deserve additional attention to help provide enhanced understanding regarding this subject matter. For this reason, this current work reviewed the mycotoxins’ toxicological mechanisms involving humans, livestock, and their associated health concerns. In particular, we have deepened our understanding about how the mycotoxins’ toxicological mechanisms impact on the human cellular genome. Along with the significance of mycotoxin toxicities and their toxicological mechanisms, there are associated health concerns arising from exposures to these toxins, including DNA damage, kidney damage, DNA/RNA mutations, growth impairment in children, gene modifications, and immune impairment. More needs to be done to enhance the understanding regards the mechanisms underscoring the environmental implications of mycotoxins, which can be actualized via risk assessment studies into the conditions/factors facilitating mycotoxins’ toxicities.

Microalgal competence in urban wastewater management: phycoremediation and lipid production

The present study was conducted to assess the strain aptness, phycoremediation potential and lipid yield in microalgae Chloroccocum humicola and Oscillatoria sp. Results revealed that microalgae treated with different concentration of wastewater (25%, 50%, 75% and 100%) recovered nutrients (Nitrogen: 50.55-85.90%, Phosphorus: 69.98-93.72%) and removed heavy metals (24.17-88.10%) from wastewater. Microalgae C. humicola showed significant reduction in physico-chemical parameters of wastewater at 25% and 50% respectively with considerable increase in lipid production (1.61 folds) at 50% wastewater concentration. In order to counterbalance the wastewater induced toxicity, both microalgae exhibited stimulated antioxidants viz., proline (1.26-4.04 folds), ascorbic acid (1.01-9.21 folds), cysteine (1.44-4.92 folds), catalase (0.99-3.63 folds), superoxide dismutase (1.15-1.43 folds) and glutathione reductase (1.43-6.67 folds) at different wastewater concentrations. Further, Fourier transforms infrared spectroscopy spectral elucidation of Chloroccocum humicola at 50% reflected high lipid peak in the regions 3000-2800 cm^-1 as compared to Oscillatoria sp. Thus, growth characteristics, biochemical responses and lipid yield presented the suitability of the Chloroccocum humicola to be used in phycoremedation, resource recovery as well as lipid production, which may be further utilized as potent feedstock for third generation energy demand.

Surveillance-based estimation of the malaria disease burden in a low endemic state of Punjab, India, targeted for malaria elimination

BACKGROUND

The state of Punjab in India qualifies for malaria elimination because the number of cases reported through routine surveillance is in decline. However, surveillance system prevalence mainly provides malaria trends. Therefore, a prospective epidemiological study was designed to estimate the malaria burden in the state.

METHODS

District-wise annual parasite incidence (API) was used for identification of three strata, representing high, moderate and low API zones. A total of 0.9 million people from nine districts was under malaria surveillance for 1 y. The weighted estimates of API for the three regions was calculated and combined to give an estimate of API for the total population of the state.

RESULTS

Based upon the primary data generated, malaria cases from high, moderate and low malaria-endemic areas were estimated to be 3727, 904 and 106, respectively. Further, the total number of malaria cases in the state was estimated to be 4737 (95% CI 4006 to 5469) cases per annum.

CONCLUSION

Actual burden of malaria in the state of Punjab, India, is about seven to eight times higher than that reported by routine surveillance activities. However, the state still qualifies for malaria elimination but needs vigorous efforts to strengthen the active surveillance and reporting system along with implementation of effective control strategies to achieve malaria elimination.

Mycotoxins Affecting Animals, Foods, Humans, and Plants: Types, Occurrence, Toxicities, Action Mechanisms, Prevention, and Detoxification Strategies-A Revisit

Mycotoxins are produced by fungi and are known to be toxic to humans and animals. Common mycotoxins include aflatoxins, ochratoxins, zearalenone, patulin, sterigmatocystin, citrinin, ergot alkaloids, deoxynivalenol, fumonisins, trichothecenes, Alternaria toxins, tremorgenic mycotoxins, fusarins, 3-nitropropionic acid, cyclochlorotine, sporidesmin, etc. These mycotoxins can pose several health risks to both animals and humans, including death. As several mycotoxins simultaneously occur in nature, especially in foods and feeds, the detoxification and/or total removal of mycotoxins remains challenging. Moreover, given that the volume of scientific literature regarding mycotoxins is steadily on the rise, there is need for continuous synthesis of the body of knowledge. To supplement existing information, knowledge of mycotoxins affecting animals, foods, humans, and plants, with more focus on types, toxicity, and prevention measures, including strategies employed in detoxification and removal, were revisited in this work. Our synthesis revealed that mycotoxin decontamination, control, and detoxification strategies cut across pre-and post-harvest preventive measures. In particular, pre-harvest measures can include good agricultural practices, fertilization/irrigation, crop rotation, using resistant varieties of crops, avoiding insect damage, early harvesting, maintaining adequate humidity, and removing debris from the preceding harvests. On the other hand, post-harvest measures can include processing, chemical, biological, and physical measures. Additionally, chemical-based methods and other emerging strategies for mycotoxin detoxification can involve the usage of chitosan, ozone, nanoparticles, and plant extracts.

Prevalence of submicroscopic malaria in low transmission state of Punjab: A potential threat to malaria elimination

Background & objectives

Submicroscopic malaria infections with low parasite density serve as a silent reservoir for maintaining residual transmission in the population. These infections should be identified and targeted to be eliminated for sustained malaria control. The conventional methods of diagnosis such as light microscopy and rapid diagnostic kits often fail to detect low density infections. Therefore, the more sensitive molecular techniques should be employed to detect low density infections. The objectives of the study was to explore the prevalence of sub-microscopic infections in low transmission areas of Punjab using highly sensitive molecular tool.

Methods

A total of 1114 finger prick blood samples were collected through active surveillance and tested for malaria diagnosis using light microscopy, RDT and PCR. Nested PCR amplification was performed using a pair of Plasmodium genus-specific primers from the 18S rRNA small subunit gene (18S rRNA). The amplified PCR products were analysed using a 2% agarose gel, stained with ethidium bromide and observed under transilluminator.

Results

Test positive rate (TPR) by microscopy, RDT and PCR was 4.4, 3.95 and 5.75%, respectively. Microscopy and RDT failed to detect mixed infections whereas 0.26% cases were found to be mixed infection in PCR. Compared to LM and RDT, PCR has detected 1.3% additional positive cases. However, of the total positive cases detected by PCR, 23.4% infections were found to be submicroscopic, which could not be detected by conventional methods of diagnosis.

Interpretation & conclusions

The molecular study revealed the existence of submicroscopic malaria cases in the study population which would have remained undetected by conventional methods of diagnosis. This is particularly important because Punjab state is in malaria elimination phase and targeted to achieve elimination in 2021. However, such undetected parasite positive cases may pose bigger problem any time due to continued transmission. Therefore, application of more sensitive diagnostic tools like PCR and LAMP with conventional methods may be much more useful in case detection particularly in low transmission settings for malaria elimination.

Virulence typing and antibiotic susceptibility profiling of thermophilic Campylobacters isolated from poultry, animal, and human species

Background and Aim:

Campylobacteriosis finds its place among the four important global foodborne illnesses. The disease, though self-limiting, needs antibacterial therapy in extraintestinal complications. Therefore, the present study was designed to estimate the prevalence of thermophilic Campylobacters in poultry, animals, and humans of the Kumaon region of Uttarakhand.

Materials and Methods:

A total of 609 samples comprising of poultry ceca (n=116), poultry droppings (n=203), and feces of pigs (n=71), cattle (n=61), sheep (n=19), goat (n=17), human beings (n=88), and laboratory animals (n=34) (rats, rabbits, and guinea pigs) were collected. The thermophilic Campylobacters, Campylobacter jejuni and Campylobacter coli were confirmed using multiplex polymerase chain reaction. The isolates were also screened for the presence of virulence genes, and their antibiotic susceptibility testing was done against eight antibiotics.

Results:

An overall prevalence of 6.24% was revealed with highest from poultry ceca (15.52%), followed by poultry droppings (5.91%), cattle feces (4.92%), human stools (3.40%), and pig feces (2.82%). The virulence genes, namely cadF, flaA, virB11, and pldA, were present in 38 (100%), 37 (97.37%), 7 (18.42%), and 14 (36.84%) isolates, respectively. All the isolates were resistant to nalidixic acid, while all were sensitive to erythromycin and co-trimoxazole.

Conclusion:

It was concluded that the animals and humans in the region harbored the thermophilic Campylobacters which may contribute to the human illness. Resistance shown among the isolates may complicate the antimicrobial therapy.

Sodium chloride incites reactive oxygen species in green algae Chlorococcum humicola and Chlorella vulgaris: Implication on lipid synthesis, mineral nutrients and antioxidant system

In the present study, microalgae Chlorococcum humicola and Chlorella vulgaris were grown in different concentrations of NaCl (25-1000 mM) to elucidate its impact on morphology, lipid synthesis, minerals status and antioxidative responses. Scanning Electron microscopy showed distorted cell morphology and increased cell size by 33.52% (C. humicola) and 27.79% (C. vulgaris) at 100 mM NaCl. Energy Dispersive Spectroscopy data revealed reduction in mineral contents (C, S, Fe, Mg, Si, Mn and Zn) by 14-54% in both algae. Further, C. humicola was found to have high lipid content than C. vulgaris under NaCl regime. The activities of superoxide dismutase, catalase and glutathione reductase were increased by 2.5-5 folds in both algae as compared to control. The increased level of ascorbate, cysteine and proline in both algae indicated tolerance against salinity. Thus, C. humicola and C. vulgaris may exhibit dual benefits viz., high lipid production and reclamation of sodic soil.

Regulation of oxidative stress and mineral nutrient status by selenium in arsenic treated crop plant Oryza sativa

The present study was conducted to examine the impact of selenium (Se) on mineral nutrient status and oxidative stress in crop plant Oryza sativa treated with arsenic (As). Scanning electron microscopy (SEM) coupled with Energy dispersive x-ray spectroscopy (EDS) study revealed the morphological deformities in leaf veins along with granular deposition on the leaf surface. The EDS analysis exhibited loss of elements (S, Si, Cl, K, Ca, Fe and Cu) in As(III) treatment in rice roots as compared to untreated root. In the case of As(III) treated shoot, changes in elements content in term of percent atomic weight was K (1.17-0.90%), Cl (1.04-24.75%), Na (0.65-3.52%) and S (0.49-2.52%) when compared with untreated shoot. The result of EDS analysis showed that As limits the concentration of important mineral elements present in the rice root and shoot. Rice plant treated with Se (10µM) and sub lethal dose of As(III) (60µM) showed better growth responses in term of root, shoot length (11.4% and 10.71%, respectively), biomass (11.7%), reduced malonyldialdehyde content (35.14%) and stimulated antioxidant level indicating better As tolerance potential against As. Further, a selenium dependent significant reduction in As accumulation was also observed in root (14.24%) and shoot (23.78%) of rice plant when compared with plant treated with As alone. This study highlights the potential of Se to ameliorate the ecotoxicological risks associated with the As buildup in agricultural land.

Designing and construction of simulated constructed wetland for treatment of sewage containing metals

A simulated horizontal flow constructed wetland (CW) has been designed with gravel medium and aquatic plants Typha latifolia and Polygonum hydropiper to assess its performance efficiency for sewage treatment. Monitoring of fully developed CW revealed a high removal of nutrients and metals from sewage after treatment at varying retention times. The percent (%) removal of biological oxygen demand, total dissolved solids, total suspended solids, PO₄-P and total nitrogen in CW planted with T. latifolia were 88.20, 61.9, 72.12, 74.23 and 66.78%; however, with P. hydropiper, reductions were 79.47, 53.47, 55.46, 60.40 and 52.87%, respectively, at 8 d retention time. In addition, T. latifolia and P. hydropiper accumulated substantial amount of metals in their tissues particularly in roots. T. latifolia root accumulated maximum amount of Zn (40.44 µg/g dw) followed by Cu (39.24 µg/g dw), Pb (37.78 µg/g dw) and Cr (19.95 µg/g dw) as compared to P. hydropiper, which was 17.85, 33.43, 36.19 and 9.67 µg/g dw, respectively. Further, plant-specific high translocation factor (>1) of metals were observed at different retention times. Results suggest that simulated CW may be applied as an ecofriendly and low-cost tool to treat sewage before discharge into a fresh water body.

Augmentation of arsenic enhances lipid yield and defense responses in alga Nannochloropsis sp

The present study was conducted with microalga Nannochloropsis sp. to evaluate its tolerance responses and biofuel perspectives under different arsenic regime (0-1000μM As(III)). Results showed that optimal biomass (61.00±3.72mg/L/d) and lipid productivity (20.27mg/L/d) were obtained in culture treated with 100μM As(III) in comparison to other treatments. In addition, fatty acid profile of alga was in accordance with European biodiesel standards (EN 14214), which reflects good oxidative stability of oil. High antioxidants viz., ascorbic acid, GSH and cysteine tolerance responses as well as lipid yield at 100μM As(III), opens a new insight in the field of algal biology. Thus, microalgae Nannochloropsis sp. may be employ in remediation as well as biodiesel production.

Arsenic and other heavy metal accumulation in plants and algae growing naturally in contaminated area of West Bengal, India

The present study was conducted to quantify the arsenic (As) and other heavy metal concentrations in the plants and algae growing naturally in As contaminated blocks of North-24-Pargana and Nandia district, West Bengal, India to assess their bioaccumulation potential. The plant species included five macrophytes and five algae were collected from the nine selected sites for estimation of As and other heavy metals accumulated therein by using Inductively Coupled Plasma Mass Spectrophotometer (ICP-MS). Results revealed that maximum As concentration (117mgkg(-1)) was recorded in the agricultural soil at the Barasat followed by Beliaghat (111mgkg(-1)) sites of North-24-Pargana. Similarly, concentration of selenium (Si, 249mgkg(-1)), lead (Pb, 79.4mgkg(-1)), chromium (Cr, 138mgkg(-1)) was also found maximum in the soil at Barasat and cadmium (Cd, 163mgkg(-1)) nickel (Ni, 36.5mgkg(-1)) at Vijaynagar site. Among the macrophytes, Eichhornia crassipes found more dominating species in As contaminated area and accumulate As (597mgkg(-1)) in the shoot at kanchrapara site. The Lemna minor found to accumulate maximum As (735mgkg(-1)) in the leaves at Sonadanga and Pistia stratiotes accumulated minimum As (24.5mgkg(-1)) in the fronds from Ranaghat site. In case of diatoms, maximum As (760mgkg(-1)) was accumulated at Kanchrapara site followed by Hydrodictiyon reticulatum (403mgkg(-1)) at the Ranaghat site. High concentration of As and other heavy metal in soil indicates long term effects of irrigation with contaminated ground water, however, high concentration of heavy metals in naturally growing plants and algae revealed their mobilization through leaching and possible food chain contamination. Therefore, efficient heavy metal accumulator macrophytes Eichhornia crassipes, Lemna minor, Spirodela polyrhiza may be exploited in removing metals from contaminated water by developing a plant based treatment system. However, As accumulator algal species may be used as a bioresource for understanding algae mediated As detoxification and bioindication studies.

Studies on sustainability of simulated constructed wetland system for treatment of urban waste: Design and operation

New system configurations and wide range of treatability make constructed wetland (CW) as an eco-sustainable on-site approach of waste management. Keeping this view into consideration, a novel configured three-stage simulated CW was designed to study its performance efficiency and relative importance of plants and substrate in purification processes. Two species of submerged plant i.e., Potamogeton crispus and Hydrilla verticillata were selected for this study. After 6 months of establishment, operation and maintenance of simulated wetland, enhanced reduction in physicochemical parameters was observed, which was maximum in the planted CW. The percentage removal (%) of the pollutants in three-stage mesocosms was; conductivity (60.42%), TDS (67.27%), TSS (86.10%), BOD (87.81%), NO3-N (81.28%) and PO4-P (83.54%) at 72 h of retention time. Submerged macrophyte used in simulated wetlands showed a significant time dependent accumulation of toxic metals (p ≤ 0.05). P. crispus accumulated the highest Mn (86.36 μg g(-1) dw) in its tissue followed by Cr (54.16 μg g(-1) dw), Pb (31.56 μg g(-1) dw), Zn (28.06 μg g(-1) dw) and Cu (25.76 μg g(-1) dw), respectively. In the case of H. verticillata, it was Zn (45.29), Mn (42.64), Pb (22.62), Cu (18.09) and Cr (16.31 μg g(-1) dw). Thus, results suggest that the application of simulated CW tackles the water pollution problem more efficiently and could be exploited in small community level as alternative and cost effective tools of phytoremediation.

Amelioration of arsenic toxicity in rice: Comparative effect of inoculation of Chlorella vulgaris and Nannochloropsis sp. on growth, biochemical changes and arsenic uptake

The present study was conducted to assess the responses of rice (Oryza sativa L. var. Triguna) by inoculating alga; Chlorella vulgaris and Nannochlropsis sp. supplemented with As(III) (50µM) under hydroponics condition. Results showed that reduced growth variables and protein content in rice plant caused by As toxicity were restored in the algae inoculated plants after 7d of treatment. The rice plant inoculated with Nannochloropsis sp. exhibited a better response in terms of increased root, shoot length and biomass than C. vulgaris under As(III) treatment. A significant reduction in cellular toxicity (thiobarbituric acid reactive substances) and antioxidant enzyme (SOD, APX and GR) activities were observed in algae inoculated rice plant under As(III) treatment in comparison to uninoculated rice. In addition, rice treated with As(III), accumulated 35.05mgkg(-1)dw arsenic in the root and 29.96mgkg(-1)dw in the shoot. However, lower accumulation was observed in As(III) treated rice inoculated with C. vulgaris (24.09mg kg(-1)dw) and Nannochloropsis sp. (20.66mgkg(-1)dw) in the roots, while in shoot, it was 20.10mgkg(-1)dw and 11.67mgkg(-1)dw, respectively. Results demonstrated that application of these algal inoculum ameliorates toxicity and improved tolerance in rice through reduced As uptake and modulating antioxidant enzymes. Thus, application of algae could provide a low-cost and eco-friendly mitigation approach to reduce accumulation of arsenic in edible part of rice as well as higher yield in the As contaminated agricultural field.

Constructed wetland as an ecotechnological tool for pollution treatment for conservation of Ganga river

With aim to develop an efficient and ecofriendly approach for on-site treatment of sewage, a sub-surface flow constructed wetland (CW) has been developed by raising potential aquatic macrophytes; Typha latifolia, Phragmites australis, Colocasia esculenta, Polygonum hydropiper, Alternanthera sessilis and Pistia stratoites in gravel as medium. Sewage treatment potential of CW was evaluated by varying retention time at three different stages of plant growth and stabilization. After 6 months, monitoring of fully established CW indicated reduction of 90%, 65%, 78%, 84%, 76% and 86% of BOD, TSS, TDS, NO3-N, PO4-P and NH4-N, respectively in comparison to inlet after 36 h of retention time. Sewage treatment through CW also resulted in reduction of heavy metal contents. Thus, CW proved an effective method for treatment of wastewater and may be developed along river Ganga stretch as an alternative technology. Treated water may be drained into river to check further deterioration of Ganga water quality.

Skin stem cell hypotheses and long term clone survival--explored using agent-based modelling

Epithelial renewal in skin is achieved by the constant turnover and differentiation of keratinocytes. Three popular hypotheses have been proposed to explain basal keratinocyte regeneration and epidermal homeostasis: 1) asymmetric division (stem-transit amplifying cell); 2) populational asymmetry (progenitor cell with stochastic fate); and 3) populational asymmetry with stem cells. In this study, we investigated lineage dynamics using these hypotheses with a 3D agent-based model of the epidermis. The model simulated the growth and maintenance of the epidermis over three years. The offspring of each proliferative cell was traced. While all lineages were preserved in asymmetric division, the vast majority were lost when assuming populational asymmetry. The third hypothesis provided the most reliable mechanism for self-renewal by preserving genetic heterogeneity in quiescent stem cells, and also inherent mechanisms for skin ageing and the accumulation of genetic mutation.

Comparative organoleptic quality of Indian major carps collected from pond and reservoir

An attempt was made to distinguish the possible organoleptic differences between the pond reared and wild fish species of reservoirs and correlate these with the physicochemical characteristics of water bodies. The texture was found to firmer in wild varieties of fishes than pond reared fish, with best in Catla catla followed by Labeo rohita and Cirrhinus mrigala. All the cultured fishes had lighter colour than wild fish species which were darker in appearance. Comparatively, higher dissolved oxygen and transparency levels with low temperature and alkalinity levels were found in reservoirs. Hydrobiologically, the efficient ecosystem of reservoir was responsible for stronger texture and dark colouration in wild fish species. The fishes from reservoir exhibit tendency to lead active and agile life, comparatively the fishes from ponds are docile. Reservoirs have the potential of enhanced quality fish production.

Chromate tolerance and accumulation in Chlorella vulgaris L.: role of antioxidant enzymes and biochemical changes in detoxification of metals

A concentration-dependent increase in activity of antioxidant enzymes (catalase, ascorbate peroxidase, glutathione, superoxide dismutase) and carotenoid, MDA level have been observed in the green alga Chlorella vulgaris following chromium exposure at different concentrations (0.01-100 μg ml(-1)). Simultaneously, decrease in growth rate, chlorophyll and protein contents was observed. In case of ascorbate peroxidase, glutathione peroxidase and superoxide dismutase a bell shaped dose response was evident, however, lipid peroxidation followed a linear relationship along with catalase activity, which could be used as biomarker of Cr toxicity and played important role in providing tolerance and subsequently, high accumulation potential of chromium in C. vulgaris. In present investigation, the green alga C. vulgaris respond better under chromium stress in terms of tolerance, growth and metal accumulating potential at higher concentration of Cr (VI) which could be employed in decontamination of chromium for environmental cleanup.

Biomonitoring of metals in Ganga water at different ghats of Haridwar: implications of constructed wetland for sewage detoxification

An assessment of Ganga river water quality at different ghats of Haridwar, showed high TDS (782.15 mg L(-1)) and BOD (21.76 mg L(-1)) levels at the mixing points of sewage discharge channels and the water was found to be contaminated with appreciable amounts of toxic metals; Cu, Pb, Zn, Cr and Mn (0.178, 0.566, 0.199, 0.177 and 0.160 mg L(-1)). The Ganga water supported exuberant growth of algae and aquatic macrophytes in littoral zone of river, which accumulated appreciable amount of metals in their tissues. Results showed possibility of using metal accumulation potential of plants and algae for monitoring low level of metal contamination vis-a-vis their use in renovating sewage by treating into especially designed constructed wetland.

Evaluation of Vitreous Substitutes in Managing Complicated Vitreo-retinal Surgeries

BACKGROUND

Vitreous substitutes presently in use for intraoperative tamponade are perfluorocarbon liquids (PFCL) and for post operative tamponade are silicon oil (SO), sulphur hexafluoride (SF6) and perfluorocarbon gas (PFC). Several factors are important for a thorough understanding of each of these vitreous substitutes. The absorption or necessity for removal, indications for use (including clinical studies and special surgical methods), additives and complications of use have to be considered.

METHODS

Three port standard pars plana vitrectomy was performed in 60 consecutive cases requiring intra-vitreal intervention. PFCL was used intra-operatively in 30 cases (PFCL group and X group). The eyes were implanted with SO (silicon oil subgroup), PFC (C3F8 sub-group) and SF6 (SF6 sub-group) in twenty cases each. Apart from best corrected visual acuity (BCVA), the retinal status and the longevity of gas when used, changes and reaction in both the anterior and posterior segments were noted.

RESULT

The difference of postoperative BCVA in the PFCL and non-PFCL groups was statistically significant with p < 0.001. In both the PFCL and non-PFCL groups the difference between preoperative and postoperative BCVA was statistically significant with p < 0.0001. All three vitreous substitutes studied are effective given the case where they had been utilised.

CONCLUSION

PFCL is invaluable in the management of complicated retinal detachment (RD). Where a vitreous microsurgery is indicated, the visual outcome is good. SF6 is useful for short-term tamponade. Silicon oil and C3F8 are useful for longer tamponade.

Effect of 0.5 mm larger donor corneal size on intraocular pressure following penetrating keratoplasty

BACKGROUND

Glaucoma can develop after penetrating keratoplasty resulting in irreversible loss of vision. The incidence of post-penetrating keratoplasty glaucoma varies from 31% in the early postoperative period to 29% after three months. Various factors are responsible for the rise of intraocular pressure (IOP). This study was carried out to evaluate the effect of 0.5 mm larger donor corneal size on IOP following penetrating keratoplasty.

METHODS

Patients were divided into two groups: group I was phakic and group II consisted of aphakic and pseudophakic patients. The same surgical technique was used for obtaining and suturing the donor graft. The viscoelastics and the postoperative regime also remained the same in all cases. IOP was measured by the rebound tonometer.

RESULTS

The incidence of postoperative raised IOP in the first seven days in the phakic group was found to range from 16 mmHg to 25 mmHg and IOP in the aphakic/pseudophakic group ranged from 16 mmHg to 42 mmHg. The IOP in the phakic group after three weeks of surgery was around 12.3 mmHg and that in the pseudophakic/aphakic group was 14.8 mmHg-16.2 mmHg. In aphakic patients, IOP was controlled in the first six months with eyedrops Timolol 0.5% and tablet acetazolamide which was given only for short periods. IOP settled to < 12 mmHg with timolol 0.5% after six months. In the pseudophakic patients, IOP became normal by six months. These were inclusive of patients who had undergone anterior reconstruction and/or vitrectomy.

CONCLUSION

The study proves that keeping the donor corneal size 0.5 mm larger does not affect IOP and that aphakia itself is a factor responsible for rise of IOP due to anterior chamber angle compression.

Ocular Lesions Associated with Human Immunodeficiency Virus Infection

INTRODUCTION

This study was undertaken to document the various ocular manifestations in human immunodeficiency virus (HIV) infected individuals and to correlate such findings with CD4+ T lymphocyte levels in individuals with ocular manifestations.

METHODS

A total of 150 patients known to be HIV positive referred to a tertiary level army hospital were included in this cross sectional study. All patients underwent complete ophthalmic evaluation. CD4+ count was done only in patients in whom ocular lesions were noted.

RESULT

Most patients (54.66%) were in the 31-40 years age group. Majority of patients (84.66%) were males. Infection was sexually acquired in 91.33% by heterosexual mode. Majority of cases (34%) examined had presented within 12-18 months of being detected positive for HIV. Ocular involvement was present in 76 (50.66%) cases and the commonest ocular lesion encountered was cytomegalovirus (CMV) retinitis in 23 (30.26%) cases. CD4+ count less than 50 cells/µl was consistently associated with ocular manifestations in 36.84% of HIV positive patients.

CONCLUSION

This study showed the whole spectrum of ocular lesions in HIV positive cases from CMV retinitis to adnexal lesions. No case of ocular Kaposi's sarcoma was seen in this study.

5-Fluoro-Uracil and Low Molecular Weight Heparin in the Management of Proliferative Vitreo-retinopathy

BACKGROUND

Proliferative vitreo-retinopathy (PVR) is the most common cause of failed repair of a primary rhegmatogenous retinal detachment (RRD). The success rates for the surgery of complicated RRD has doubled with improved vitreous techniques from 35-40% to approximately 65-75% at six months. However, despite these advances, recurrent vitreo-retinal traction leads to re-detachment in more than one-fourths of the initially successful cases. The use of adjunctive treatments to prevent cellular proliferation holds promise for the prevention of PVR or recurrences after surgery. One focus has been on the use of intra-vitreal antimetabolites to prevent the occurrence of PVR.

METHODS

Thirty patients of complicated retinal detachment associated with PVR, C1 or more were managed by vitreo-retinal (VR) surgery with the addition of 250 μg / ml of 5-fluorouracil (5FU) and 1 IU / ml of low molecular weight heparin (LMWH) to the vitreous infusion. The patients were examined for any evidence of PVR till 180 days as also for any systemic or other ophthalmic complication.

RESULT

Out of the 30 cases in the study group, 25 (83.34%) cases had retinal settlement at the end of six weeks, which is similar to the outcomes of conventional VR surgery. There was no case of any serious complication.

CONCLUSION

The addition of LMWH and 5FU did not enhance the outcome of VR surgery.

Removal of Pb(II) ions from aqueous solution by adsorption using bael leaves (Aegle marmelos)

Biosorption of Pb(II) on bael leaves (Aegle marmelos) was investigated for the removal of Pb(II) from aqueous solution using different doses of adsorbent, initial pH, and contact time. The maximum Pb loading capacity of the bael leaves was 104 mg g(-1) at 50 mg L(-1) initial Pb(II) concentration at pH 5.1. SEM and FT-IR studies indicated that the adsorption of Pb(II) occurs inside the wall of the hollow tubes present in the bael leaves and carboxylic acid, thioester and sulphonamide groups are involved in the process. The sorption process was best described by pseudo second order kinetics. Among Freundlich and Langmuir isotherms, the latter had a better fit with the experimental data. The activation energy E(a) confirmed that the nature of adsorption was physisorption. Bael leaves can selectively remove Pb(II) in the presence of other metal ions. This was demonstrated by removing Pb from the effluent of exhausted batteries.

Field evaluation of ZeroFly--an insecticide incorporated plastic sheeting against malaria vectors & its impact on malaria transmission in tribal area of northern Orissa

BACKGROUND & OBJECTIVES

Insecticide incorporated plastic sheeting is a new technology to control mosquitoes in emergency shelter places and also temporary habitations in different locations. Therefore, field studies were conducted to assess the efficacy of ZeroFly plastic sheeting treated with deltamethrin on prevailing disease vectors Anopheles culicifacies and An. fluviatilis and its impact on malaria transmission in one of the highly endemic areas of Orissa.

METHODS

The study was conducted in Birkera block of Sundargarh district, Orissa state. The study area comprised 3 villages, which were randomized as ZeroFly plastic sheet, untreated plastic sheet and no sheet area. ZeroFly plastic sheets and untreated plastic sheets were fixed in study and control villages respectively covering all the rooms in each household. Longitudinal studies were conducted on the bioefficacy with the help of cone bioassays, monitoring of the mosquito density through hand catch, floor sheet and exit trap collections and fortnightly domiciliary active surveillance in all the study villages.

RESULTS

In ZeroFly plastic sheeting area, there was a significant reduction of 84.7 per cent in the entry rate of total mosquitoes in comparison to pre-intervention phase. There was 56.2 per cent immediate mortality in total mosquitoes in houses with ZeroFly sheeting. The overall feeding success rate of mosquitoes in the trial village was only 12.5 per cent in comparison to 49.7 and 51.1 per cent in villages with untreated plastic sheet and no sheet respectively. There was a significant reduction of 65.0 and 70.5 per cent in malaria incidence in ZeroFly plastic sheeting area as compared to untreated plastic sheet and no sheet area respectively.

INTERPRETATION & CONCLUSIONS

Our study showed that introduction of ZeroFly plastic sheets in a community-based intervention programme is operationally feasible to contain malaria especially in the high transmission difficult areas.

Primary 360° Broad Buckling in Retinal Detachment

BACKGROUND

Chronic rhegmatogenous retinal detachment behaves like proliferative vitreo-retinopathy (PVR) even without evidence of the same. Surgery could be done either with conventional buckling procedures where the extent of buckling is determined by the number and location of the breaks or by primary vitreous surgery. In this study these cases were managed with primary 360°encircling broad buckle without a vitreous procedure.

METHODS

210 eyes, with rhegmatogenous retinal detachment of more than six months duration and with PVR up to C3 (CP3 focal) were subjected to buckling surgery. Trans-scleral cryopexy of the breaks, 360°encircling buckle with a 276 - 279 tire and subretinal fluid drainage was performed.

RESULT

Most (85.74%) of the eyes showed anatomical retinal re-attachment.

CONCLUSION

Primary broad encircling buckling can be conducted successfully in cases of long standing retinal detachment.

Field evaluation of Olyset nets: a long-lasting insecticidal net against malaria vectors Anopheles culicifacies and Anopheles fluviatilis in a hyperendemic tribal area of Orissa, India

A village-scale trial was conducted on the efficacy of Olyset nets: a long-lasting insecticidal net (LLIN) factory treated with 2% wt:wt permethrin against malaria vectors Anopheles culicifacies Giles and Anopheles fluviatilis James, in Sundargarh District, Orissa, India. The study area comprised 22 villages that were randomized into three clusters and designated as Olyset net, untreated net, and no net clusters. Baseline studies showed that both vector species were 100% susceptible to permethrin. Results of wash resistance and bioefficacy of Olyset nets showed 100% mortality in An. culicifacies up to 11 washings, whereas 100% mortality was observed in An. fluviatilis even after 20 washings. The median knock-down time for these species ranged between 4.55-6.00 and 4.45-5.45 min, respectively, during 1 yr of intervention. In the Olyset net study area, there was a significant reduction of 80.6, 94.1, and 76.7% in the entry rate of An. culicifacies, An. fluviatilis, and other anopheline species, respectively, with an overall reduction of 63.5% in total mosquitoes. Floor sheet collections in houses with Olyset nets indicated 39% immediate mortality in total mosquitoes. The overall feeding success rate of mosquitoes in the trial village was only 18.0% in comparison to 44.2 and 79.1% in villages with untreated nets and no nets, respectively. A significant reduction was also recorded in parity rate and human blood index of vector species in the Olyset net area. This study showed that Olyset nets are an effective personal protection tool that can be used in a community-based intervention program.

Management of Nucleus and IOL Drop

BACKGROUND

Thirty six cases of lenticular nucleus drop following phacoemulsification and 43 cases of posterior dislocation of intraocular lens (IOL) inclusive of two paediatric cases were managed by a modified vitrectomy procedure without using perfluorocarbon liquid (PFCL).

METHODS

In these cases the incision was placed inferotemporally at pars plana. The limbal sites of the earlier cataract surgery were utilised as the other two ports. In either case adequate vitrectomy was performed first. In cases of nuclear drop, the nucleus was impaled (speared) with a micro vitreo retinal blade and brought into the anterior chamber from where it was delivered out. In cases of IOL drop the same was picked up by an intra-vitreal forceps.

RESULT

Of the 77 adult cases treated 57 (74%) of the eyes had a visual recovery of 6/18 or more.

CONCLUSION

Prompt surgical management in cases of nuclear drop or posterior dislocation of IOL yields good results.

Field evaluation of a previously untested strain of biolarvicide (Bacillus thuringiensis israelensis H14) for mosquito control in an urban area of Orissa, India

A previously untested strain of Bacillus thuringiensis israelensis (Bti) serotype H14 (ID No. VCRC B17) has been evaluated under field conditions in an urban area of Rourkela city, India for its impact on the larval density of different mosquito species in a variety of habitats. The persistence of the biolarvicide used in an aqueous solution varied in different habitats. The lowest field application rate of 0.5 ml/m2 remained effective for about 10-12 days and provided 80-100% reduction in larval abundance of anopheline species, including Anopheles culicifacies breeding in unpolluted water bodies. However, in stagnant polluted waters in drains and cesspools supporting culicine breeding, the biocide at the same rate persists for 5-6 days only. An application rate of 1 ml/m2 to stagnant drains and cesspools, resulted in 84-100% reduction in the larval population of Culex quinquefasciatus over a period of 2 wk. Based on the field observations, an operational dose of 0.5 ml/m2 at fortnightly intervals is suggested for clean water sources supporting anopheline breeding. However, to control breeding of culicine mosquitoes in stagnant and polluted waters, an operational dose of 1 ml/m2 at fortnightly intervals is required. The study showed that Bti serotype H14 (VCRC B17) is a suitable biolarvicide that can be used against different mosquitoes in different types of urban habitats.

Wash resistance and bioefficacy of Olyset net--a long-lasting insecticide-treated mosquito net against malaria vectors and nontarget household pests

During recent years, long-lasting insecticide-treated nets (LLINs) have been developed to overcome the problems of low retreatment rates, washing, and erratic dose of the insecticide resulting in the dilution of efficacy of the conventional insecticide-treated mosquito nets. These nets are treated at factory level with insecticide either incorporated into or coated around fibers. Olyset net, a polyethylene net with 2% permethrin incorporated within fibers, is one type of LLIN. Therefore, these nets were evaluated for their wash resistance and bioefficacy against malaria vectors Anopheles culicifacies Giles and Anopheles fluviatilis James (Diptera: Culicidae) and other nontarget species. Cone bioassay tests produced 100% mortality in these two vector species with 3-min exposure. Results of the bioassays on washed nets showed 100% mortality in An. fluviatilis even after 20 washings, whereas in An. culicifacies 100% mortality up to 11 washings and 80% mortality up to 20 washings were observed. Cone bioassay tests also were performed on nontarget mosquito species Culex quinquefasciatus Say; house fly, Musca domestica L.; American cockroach, Periplaneta americana (L.); head louse, Pediculus humanus capitis De Geer; and bed bug, Cimex lectularius L. with 30-min exposure. Except for bed bugs, 100% mortality was observed in these nontarget species after 24-h recovery period. In bed bugs, only 25% mortality was observed. The density of An. culicifacies and An. fluviatilis was significantly reduced in houses with Olyset nets compared with those with untreated nets or no nets. Thus, it may be concluded that Olyset nets are highly effective against malaria vectors and moderately against other nontarget household insects.

Effectiveness of mosquito nets treated with a tablet formulation of deltamethrin for malaria control in a hyperendemic tribal area of Sundargarh District, Orissa, India

A village-scale trial on the efficacy of mosquito nets treated with a tablet formulation of deltamethrin (K-OTAB) against malaria in comparison to untreated nets or no net was conducted in Sundargarh District of Orissa, India, which is characterized by perennial transmission with Plasmodium falciparum accounting for more than 80% of malaria cases. Three villages with similar topographical and epidemiological situations were selected and randomly assigned to 3 arms of the study: treated net, untreated net, and no net. Distribution of nets, based on a sleeping pattern survey, was carried out to cover 100% of the population in treated-net and untreated-net villages. Longitudinal and cross-sectional surveys were conducted to measure malaria incidence, prevalence, and splenomegaly. Malaria incidence was reduced by 64.3% in the village with treated nets, 45.2% in the village with plain nets, and 21.4% in the control village without nets. Comparison of malaria incidence data after 1 year of intervention showed significant difference between villages with treated net vs. untreated net (P < 0.05) and treated net vs. no net (P < 0.005). The incidence of clinical attack rate due to P. falciparum was significantly lower in the population using treated nets than in those using untreated nets and no nets. However, no age-specific protective efficacy of treated nets or untreated nets was observed. A significant reduction occurred in spleen rate and parasite rate in children aged 2-9 years using treated nets or untreated nets. An overall significant reduction was found in parasite rate in the total population using treated and untreated nets as compared to nonusers.

Village-scale evaluation of mosquito nets treated with a tablet formulation of deltamethrin against malaria vectors

A field trial was carried out in the Sundargarh district of Orissa, India on the efficacy of mosquito nets treated with a tablet formulation of deltamethrin (K-O TAB) against malaria vectors. Treated nets were used in one village, and in the two control villages, one used untreated nets and the other used indoor spraying with DDT, without nets. In this area the primary malaria vectors are Anopheles culicifacies Giles sensu lato (Diptera: Culicidae) and An. fluviatilis James s.l., which are both endophagic and endophilic, and fully susceptible to deltamethrin. Treatment of a 10-m(2) mosquito net with one of the tablets gave a deltamethrin deposit of 25 mg/m(2). Bioassays repeated on domestically used nets over 7 months showed persistence of almost 100% mortality of An. fluviatilis, whereas An. culicifacies showed a decline from 100% to 71% mortality over this period, after which the nets were re-treated and bioassays were not continued. The sum of collections of mosquitoes resting in village houses and those in exit traps and dead on floor sheets showed a reduction in the numbers of the two vector species due to the treated nets, compared with untreated or no nets, but no reduction in other anophelines or Culex species. Large proportions of the collections of the vector and non-vector anophelines were dead on the floor sheets, but among Culex, mortality was delayed. Treated and untreated nets reduced the proportion of anophelines that had blood-fed; the treated nets did so more effectively than the untreated in the case of An. culicifacies and of Culex mosquitoes. In rooms with treated nets a larger proportion of the total collections [dead + live] were in the exit traps, which can be attributed to the excito-repellent effect of deltamethrin. It is easier to pack and handle tablets of insecticide than liquid concentrate and the use of one tablet per net may be preferable to making up a large volume of diluted insecticide and dipping many nets at a time.

A New Flavanone, Reflexin, From Cuscuta reflexa and Its Selective Sensing of Nitric Oxide

A new compound, reflexin, 5-hydroxy-7-methoxy-6-(2,3-epoxy-3-methylbutyl)-flavanone, is isolated from the stems of Cuscuta reflexa along with three other known compounds. This new compound has good potential for application especially in the photoactivity of reflexin. It was found to be sensitive to glutathione, forming a fluorescent product that is utilized for sensing nitric oxide (NO). The lowest detection limit of NO analysis was found to be 0.05 micro/M.

Antioxidant property of Smilex china Linn

Smilex china Linn. (Smilacaceae Syn Liliaceae) has special pharmacognostic feature as its root is multiseriate, with sclerenchymatic pericycle. The alcoholic extract of rhizome of S. china shows significant protection against FeSO4 induced lipid peroxidation in rat liver homogenate, but has no effect on the rate of oxidation of reduced glutathione. This fraction scavenges the superoxide and hydroxyl radicals, but the effect was more towards the removal of superoxide than that of hydroxyl radicals. Thus it could be concluded that rhizome of S. china has strong antioxidant property.

Field trial of Bacillus sphaericus strain B-101 (serotype H5a, 5b) against filariasis and Japanese encephalitis vectors in India

A large-scale operational field trial was conducted from June 1993 to October 1994 to evaluate the efficacy of Bacillus sphaericus (strain B-101, serotype H5a,5b) for control of the vectors of filariasis (Culex quinquefasciatus) and Japanese encephalitis (Cx. tritaeniorhynchus and Cx. vishnui) in Rourkela city. Application of B. sphaericus, when sprayed at 1 g/m2 in storm drains, wastewater pools, abandoned masonry tanks, peripheral paddy fields, ditches, and other small water collections and at 4 g/m2 in domestic septic tanks, significantly reduced larval and pupal counts (P < 0.0001) and significantly reduced the percentage of habitats containing larvae (3rd-4th instars) (P < 0.0001) as compared with routine antilarval measures. This in turn resulted in a reduction in the indoor density of disease vectors in particular and a reduction in mosquito nuisance in general. The trial demonstrated that B. sphaericus has good potential for use against disease vectors and mosquito breeding in polluted as well as clean waters.

OUR EXPERIENCE OF IOL IMPLANTATION IN PAEDIATRIC AGE GROUP

Forty eyes of 35 patients in paediatric age group suffering from congenital/traumatic cataracts were operated. Posterior chamber intra ocular lens (PC IOL) implantation was carried out and followed for four years. Twenty one eyes (52.5%) showed visual recovery of 6/18 or better. Forward thrust was the commonest per operative complication. Uveitis and pupillary distortion were the common post operative complications. PC IOL implantation appears to be safe and promising procedure.

Lack of effect of islet amyloid polypeptide in causing insulin resistance in conscious dogs during euglycemic clamp studies

In this study, we administered constant intravenous infusions of human islet amyloid polypeptide (hIAPP) to conscious dogs during euglycemic glucose-clamp studies. The doses of hIAPP used (5 and 50 pmol.kg-1.min-1) raised the circulating IAPP levels approximately 12- and 50-fold above basal levels, respectively. Studies were conducted at two different insulin infusion rates, resulting in steady-state plasma insulin levels of approximately 600 and 2800 pM. According to our results, the hIAPP infusions did not lead to any measurable change in the insulin-stimulated glucose disposal rate at either insulin infusion rate. Additionally, we observed no effect of IAPP on hepatic glucose production. Although we did not observe any effect of hIAPP on any of the aspects of glucose or insulin metabolism measured, we did find a consistent hypocalcemic effect of this peptide at the 50-pmol.kg-1.min-1 infusion rate. Shortly after the onset of hIAPP infusion, serum calcium levels fell by 10-15% and remained at these levels throughout the course of the hIAPP infusion. In summary, 1) infusion of hIAPP at doses of 5 or 50 pmol.kg-1.min-1 in conscious dogs raised the circulating IAPP level 12- to 50-fold above basal; 2) during these infusion studies, no effect of hIAPP was observed on any of the aspects of glucose or insulin homeostasis measured; 3) 50 pmol.kg-1.min-1 hIAPP lead to a prompt reduction in plasma calcium concentrations with intravenous administration.

Cystic nephroma: an emerging entity

Cystic nephroma is a rare lesion, but there has been an increased number of cases reported in the recent literature. Most cases have been discovered incidentally either on routine examination or during radiological investigations. There are two peaks of incidence, one in childhood and one in middle age and the condition is often wrongly presumed to be a malignant tumor. Cystic nephroma is a benign neoplasm and it can be confidently diagnosed using modern imaging techniques and tissue analysis. Classically, the treatment of cystic nephroma has been simple nephrectomy, although a few cases have been treated by enucleation. Simple nephrectomy is the treatment of choice in children as the diagnosis in the young is less exact and a cure is assured. In some adult patients it is reasonable to pursue a conservative policy with regular clinical and ultrasound examinations.

Intra-operative air testing: an audit on rectal anastomosis

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