Neonatal Intensive Care Unit Admissions among Preterm Babies in a Tertiary Care Centre: A Descriptive Cross-sectional Study

Introduction:

Preterm babies are born before 37 completed weeks of gestation. It is an important cause of neonatal morbidity and mortality. This study aimed to find out the prevalence of neonatal intensive care unit admissions among preterm babies in a tertiary care centre.

Methods:

A descriptive cross-sectional study on a total of 133 preterm infants was conducted in a tertiary care centre from November, 2020 to April, 2021 with ethical approval from the Institutional Review Committee (Reference number: 380). Preterm babies who met the eligibility criteria were included in the study. Convenience sampling was done. Data were analysed using the Statistical Package for the Social Sciences version 20.0. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data.

Results:

Out of 133 preterm babies, 54 (40.60%) (32.25-48.95 at 95% Confidence Interval) had neonatal intensive care unit admissions. Hyaline membrane disease was the most common illness in preterm neonates 34 (62.96%) followed by neonatal sepsis 20 (37.03%).

Conclusions:

The prevalence of neonatal intensive care unit admissions among preterm babies in our study was similar to other studies done in similar settings. Preterm newborns are significantly vulnerable and maternal risk factors should be taken into account. Anticipated preterm deliveries should have mandatory institutional delivery and adequate postnatal care is needed to improve the outcomes of preterm babies.

Patterns of Clinically Identifiable Congenital Defects in Neonates

BACKGROUND

The study is aimed at highlighting the pattern of congenital defect in a tertiary care hospital. Congenital anomalies are recognized as a growing cause of neonatal morbidity and mortality in developing countries and a major cause of distress to parents.

METHODS

This was a prospective descriptive study conducted between September 2019 and August 2020 with the objective to determine the types of congenital anomalies among live born neonates at Manipal Teaching Hospital (MTH), Pokhara and to determine their immediate outcome. Neonatal and maternal characteristics were noted.

RESULTS

Twenty four out of 2515 live births had congenital anomalies during the study period, giving an incidence rate of 9.42 congenital anomalies per 1000 live birth per year. Single system involvement was seen in 79.2 % cases, remaining 5 (20.8%) neonates had involvement of more than one system; 54.2% of these newborns were discharged, 33.3% expired, 8.3% left against medical advice and 4.2% were referred out.

CONCLUSIONS

This study highlights the importance of clinical examination of neonates to detect anomalies in our setting.

Association of TYRP1 with hypoxia and its correlation with patient outcome in uveal melanoma

PURPOSE

Molecular mechanisms of uveal melanoma development in association with high pigmentation are unclear. Tyrosinase Related Protein (TYRP1) is not only one of the important melanogenesis marker that contributes to melanin synthesis, but can also prevents the melanocyte death. The induction of melanogenesis leads to induction of HIF-1α which can affect the behavior of melanoma cells and its surrounding environment. The aim of our study was to determine the expression of TYRP1 and HIF-1α at the protein and RNA level and determine its prognostic significance.

METHODS

In the present study, the expression of TYRP1 and HIF-1α was investigated on 61 formalin-fixed paraffin-embedded choroidal melanoma samples by immunohistochemistry. Fresh 50 samples were validated by real-time PCR. Results were correlated with clinicopathological parameters and Kaplan-Meier was performed to determine the prognostic significance.

RESULTS

High immunoexpression of TYRP1 and HIF-1α was present in 61 and 54% of patients, respectively. Both TYRP1 and HIF-1α correlated well with high pigmentation and BAP1 (BRCA1 Associated Protein-1) loss (p < 0.05) at IHC level as well as transcriptional level. There was reduced metastatic free survival in patients with necrosis and this was statistically significant (p = 0.010).

CONCLUSION

Our findings indicate that TYRP1 can be used as a potential biomarker in the development of targeted therapy in UM. Further studies on melanogenesis markers associated with TYRP1 could provide us a better understanding in this field.

Effect of 3,3'-Diindolylmethane on Pulmonary Injury Following Thoracic Irradiation in CBA Mice

The molecule 3,3'-diindolylmethane (DIM) is small, a major bioactive metabolite of indole-3 carbinol (13C), and a phytochemical compound from cruciferous vegetables released upon exposure to the gut acid environment. DIM is a proposed anti-cancer agent and was previously demonstrated to prevent radiation damage in the bone marrow and the gastrointestinal tract. Here we investigated the effect of DIM on radiation-induced injury to the lung in a murine model through untargeted metabolomics and gene expression studies of select genes. CBA mice were exposed to thoracic irradiation (17.5 Gy). Mice were treated with vehicle or DIM (250 mg kg, subcutaneous injection) on days -1 pre-irradiation through +14 post-irradiation. DIM induced a significant improvement in survival by day 150 post-irradiation. Fibrosis-related gene expression and metabolomics were examined using lung tissue from days 15, 45, 60, 90, and 120 post-irradiation. Our qRT-PCR experiments showed that DIM treatment reduced radiation-induced late expression of collagen Iα and the cell cycle checkpoint proteins p21/waf1 (CDKN1A) and p16ink (CDKN2A). Metabolomic studies of lung tissue demonstrated a significant dampening of radiation-induced changes following DIM treatment. Metabolites associated with pro-inflammatory responses and increased oxidative stress, such as fatty acids, were suppressed by DIM treatment compared to irradiated samples. Together these data suggest that DIM reduces radiation-induced sequelae in the lung.

Translation, cross-cultural adaptation, and measurement properties of the Nepali version of the central sensitization inventory (CSI)

BACKGROUND

Central sensitization is thought to be an important contributing factor in many chronic pain disorders. The Central Sensitization Inventory (CSI) is a patient-reported measure frequently used to assess symptoms related to central sensitization. The aims of the study were to translate and cross-culturally adapt the CSI into Nepali (CSI-NP) and assess its measurement properties.

METHODS

The CSI was translated into Nepali using recommended guidelines. The CSI-NP was then administered on 100 Nepalese adults with sub-acute and chronic musculoskeletal pain with additional demographic and pain-related questions. The CSI-Nepali was administered again about 2 weeks later. Four measurement properties of the CSI-NP were evaluated: (1) internal consistency using Cronbach's alpha, (2) test-retest reliability using intraclass correlation coefficient (ICC2,1), (3) measurement errors, and (4) construct validity testing five a priori hypotheses. Confirmation of construct validity was determined if a minimum of 75% of the hypotheses were met.

RESULTS

The CSI was successfully translated into Nepali. Internal consistency and test-retest reliability were both excellent (Cronbach's alpha = 0.91, and ICC = 0.98). The standard error of measurement was 0.31 and the smallest detectable change was 0.86. Four out of five (80%) a priori hypotheses were met, confirming the construct validity: the CSI-NP correlated strongly with the Pain Catastrophizing Scale total scores (r = 0.50); moderately with the total number of pain descriptors (r = 0.35); weakly with the Numerical Rating Scale (r = 0.25); and women had significantly higher CSI scores than men. However, the CSI scores did not correlate significantly with the total duration of pain, as hypothesized (r = 0.10).

CONCLUSIONS

The Nepali translation of the CSI demonstrated excellent reliability and construct validity in adults with musculoskeletal pain. It is now available to Nepali health care providers to help assess central sensitization-related signs and symptoms in individuals with musculoskeletal pain in research or clinical practice to advance the understanding of central sensitization in Nepalese samples.

A nucleotide-dependent oligomerization of the Escherichia coli replication initiator DnaA requires residue His136 for remodeling of the chromosomal origin

Escherichia coli replication initiator protein DnaA binds ATP with high affinity but the amount of ATP required to initiate replication greatly exceeds the amount required for binding. Previously, we showed that ATP-DnaA, not ADP-DnaA, undergoes a conformational change at the higher nucleotide concentration, which allows DnaA oligomerization at the replication origin but the association state remains unclear. Here, we used Small Angle X-ray Scattering (SAXS) to investigate oligomerization of DnaA in solution. Whereas ADP-DnaA was predominantly monomeric, AMP–PNP–DnaA (a non-hydrolysable ATP-analog bound-DnaA) was oligomeric, primarily dimeric. Functional studies using DnaA mutants revealed that DnaA(H136Q) is defective in initiating replication in vivo. The mutant retains high-affinity ATP binding, but was defective in producing replication-competent initiation complexes. Docking of ATP on a structure of E. coli DnaA, modeled upon the crystallographic structure of Aquifex aeolicus DnaA, predicts a hydrogen bond between ATP and imidazole ring of His136, which is disrupted when Gln is present at position 136. SAXS performed on AMP–PNP–DnaA (H136Q) indicates that the protein has lost its ability to form oligomers. These results show the importance of high ATP in DnaA oligomerization and its dependence on the His136 residue.

Socioeconomic factors, psychological factors, and function in adults with chronic musculoskeletal pain from rural Nepal

Background

Both socioeconomic and psychological factors have been shown to predict patient function in samples of individuals with chronic pain in Western countries. However, little is known about their role as predictors of function in individuals with chronic pain from developing countries.

Purpose

The purpose of this study was to examine the associations between measures of socioeconomic factors (income, education) and psychological factors (catastrophizing and resilience) and measures of function in a sample of individuals with chronic pain from rural Nepal. In addition, we sought to evaluate the moderating effects of socioeconomic factors on the associations between the psychological variables and function.

Methods

We interviewed 143 adults with chronic musculoskeletal pain from rural areas of Nepal to assess income, education level, pain intensity, catastrophizing, resilience, physical function, and depression. We performed two regression analyses to evaluate the direct and unique effects of the socioeconomic and psychological variables and pain intensity as predictors of patient function, as well as the moderating influence of income, education level, and pain intensity on the associations between the psychological variables and function.

Results

Education and income both predicted physical function, but only income predicted depression. In addition, pain catastrophizing, but not resilience, evidenced a direct and significant independent association with depression. Neither catastrophizing nor resilience made independent and significant direct contributions to the prediction of physical function. The association between resilience and physical function was moderated by pain intensity and income, and income (but not education or pain intensity) moderated the associations between both 1) resilience and depression and 2) catastrophizing and depression.

Conclusion

The results suggest the possibility that cultural differences may influence the role that psychosocial factors play in chronic pain adjustment. These findings have important implications regarding how psychosocial pain interventions should be adapted by individuals in developing countries.

An essential Staphylococcus aureus cell division protein directly regulates FtsZ dynamics

Binary fission has been well studied in rod-shaped bacteria, but the mechanisms underlying cell division in spherical bacteria are poorly understood. Rod-shaped bacteria harbor regulatory proteins that place and remodel the division machinery during cytokinesis. In the spherical human pathogen Staphylococcus aureus, we found that the essential protein GpsB localizes to mid-cell during cell division and co-constricts with the division machinery. Depletion of GpsB arrested cell division and led to cell lysis, whereas overproduction of GpsB inhibited cell division and led to the formation of enlarged cells. We report that S. aureus GpsB, unlike other Firmicutes GpsB orthologs, directly interacts with the core divisome component FtsZ. GpsB bundles and organizes FtsZ filaments and also stimulates the GTPase activity of FtsZ. We propose that GpsB orchestrates the initial stabilization of the Z-ring at the onset of cell division and participates in the subsequent remodeling of the divisome during cytokinesis.

A bacterium called Staphylococcus aureus causes many infections in humans, especially in hospital patients with weakened immune systems. These infections are generally treated with drugs known as antibiotics that interact with specific proteins in the bacteria to kill the cells, or stop them from growing. However, some S. aureus infections are resistant to the antibiotics currently available so there is a need to develop new drugs that target different bacterial proteins.

Bacteria multiply by dividing to make identical copies of themselves. When a bacterium is preparing to divide, filaments made of a protein called FtsZ form a ring at the site where the cell will split. Many other proteins are involved in controlling how and when a cell divides. For example, several species of bacteria harbor a dispensable cell division protein called GpsB. In at least one organism, it helps to maintain the proper shape of the cell during cell division. In S. aureus, though, GpsB is essential for cells to survive and could therefore be a potential target for new antibiotics. However, its role in S. aureus has not been studied.

Eswara et al. have now used genetic and biochemical approaches to study the S. aureus form of the GpsB protein. The experiments show that GpsB moves to the middle of S. aureus cells just before they begin to divide and binds directly to FtsZ. This helps to secure the position of FtsZ across the middle of the cell and activates the protein so that the cell can begin to divide into two. In cells that produce too much GpsB, the FtsZ proteins become active too early, leading to the cells growing larger and larger until they burst.

The findings of Eswara et al. reveal that GpsB plays a different role in S. aureus cells than in some other species of bacteria. Further studies into such differences could help researchers to develop new antibiotics, as well as improving our understanding of why bacteria are so diverse.

Captopril mitigates splenomegaly and myelofibrosis in the Gata1low murine model of myelofibrosis

Allogeneic stem cell transplantation is currently the only curative therapy for primary myelofibrosis (MF), while the JAK2 inhibitor, ruxolitinib. Has been approved only for palliation. Other therapies are desperately needed to reverse life-threatening MF. However, the cell(s) and cytokine(s) that promote MF remain unclear. Several reports have demonstrated that captopril, an inhibitor of angiotensin-converting enzyme that blocks the production of angiotensin II (Ang II), mitigates fibrosis in heart, lung, skin and kidney. Here, we show that captopril can mitigate the development of MF in the Gata1low mouse model of primary MF. Gata1low mice were treated with 79 mg/kg/d captopril in the drinking water from 10 to 12 months of age. At 13 months of age, bone marrows were examined for fibrosis, megakaryocytosis and collagen expression; spleens were examined for megakaryocytosis, splenomegaly and collagen expression. Treatment of Gata1low mice with captopril in the drinking water was associated with normalization of the bone marrow cellularity; reduced reticulin fibres, splenomegaly and megakaryocytosis; and decreased collagen expression. Our findings suggest that treating with the ACE inhibitors captopril has a significant benefit in overcoming pathological changes associated with MF.

Physiological and biochemical characterization of NERICA-L-44: a novel source of heat tolerance at the vegetative and reproductive stages in rice

The predicted increase in the frequency and magnitude of extreme heat spikes under future climate can reduce rice yields significantly. Rice sensitivity to high temperatures during the reproductive stage is well documented while the same during the vegetative stage is more speculative. Hence, to identify and characterize novel heat-tolerant donors for both the vegetative and reproductive stages, 71 rice accessions, including approximately 75% New Rice for Africa (NERICAs), were phenotyped across field experiments during summer seasons in Delhi, India, and in a controlled environment study at International Rice Research Institute, Philippines. NERICA-L-44 (NL-44) recorded high seedling survival (52%) and superior growth and greater reproductive success exposed to 42.2°C (sd ± 2.3) under field conditions. NL-44 and the heat-tolerant check N22 consistently displayed lower membrane damage and higher antioxidant enzymes activity across leaves and spikelets. NL-44 recorded 50-60% spikelet fertility, while N22 recorded 67-79% under controlled environment temperature of 38°C (sd±1.17), although both had about 87% fertility under extremely hot field conditions. N22 and NL-44, exposed to heat stress (38°C), had similar pollen germination percent and number of pollen tubes reaching the ovary. NL-44 maintained low hydrogen peroxide production and non-photochemical quenching (NPQ) with high photosynthesis while N22 avoided photosystem II damage through high NPQ under high-temperature stress. NL-44 with its reproductive stage resilience to extreme heat stress, better antioxidant scavenging ability in both vegetative tissue and spikelets and superior yield and grain quality is identified as a novel donor for increasing heat tolerance at both the vegetative and reproductive stages in rice.

Preferential enhancement of laser-driven carbon ion acceleration from optimized nanostructured surfaces

High-intensity ultrashort laser pulses focused on metal targets readily generate hot dense plasmas which accelerate ions efficiently and can pave way to compact table-top accelerators. Laser-driven ion acceleration studies predominantly focus on protons, which experience the maximum acceleration owing to their highest charge-to-mass ratio. The possibility of tailoring such schemes for the preferential acceleration of a particular ion species is very much desired but has hardly been explored. Here, we present an experimental demonstration of how the nanostructuring of a copper target can be optimized for enhanced carbon ion acceleration over protons or Cu-ions. Specifically, a thin (≈0.25 μm) layer of 25–30 nm diameter Cu nanoparticles, sputter-deposited on a polished Cu-substrate, enhances the carbon ion energy by about 10-fold at a laser intensity of 1.2×10¹⁸  W/cm². However, particles smaller than 20 nm have an adverse effect on the ion acceleration. Particle-in-cell simulations provide definite pointers regarding the size of nanoparticles necessary for maximizing the ion acceleration. The inherent contrast of the laser pulse is found to play an important role in the species selective ion acceleration.

Chromosome segregation in Vibrio cholerae

The study of chromosome segregation is currently one of the most exciting research frontiers in cell biology. In this review, we discuss our current knowledge of the chromosome segregation process in Vibrio cholerae, based primarily on findings from fluorescence microscopy experiments. This bacterium is of special interest because of its eukaryotic feature of having a divided genome, a feature shared with 10% of known bacteria. We also discuss how the segregation mechanisms of V. cholerae compare with those in other bacteria, and highlight some of the remaining questions regarding the process of bacterial chromosome segregation.

Photoionization of clusters in intense few-cycle near infrared femtosecond pulses

In this article we present a perspective on the current state of the art in the photoionization of atomic clusters in few-cycle near-infrared laser pulses.

Anomalous ion charge distribution from cluster nanoplasmas

In nearly all the intense laser experiments with nanoclusters, the key observation has been that immense ionization drives highly charged ions to highest energies while low charge ions, if any, have lower kinetic energies. We show experimental measurements that are contrary to this established notion. The active role of outer-ionized electrons in a multicluster interaction is shown to effectively reduce high charge ions to low charge states with no loss of momentum. The role of Rydberg excited clusters, intrinsic in dense cluster ensembles, is identified and a quantitative analysis is shown to comprehensively explain the anomalous charge distribution and ion energies observed in experiments.

Dopant-induced ignition of helium nanodroplets in intense few-cycle laser pulses

We demonstrate ultrafast resonant energy absorption of rare-gas doped He nanodroplets from intense few-cycle (~10 fs) laser pulses. We find that less than 10 dopant atoms "ignite" the droplet to generate a nonspherical electronic nanoplasma resulting ultimately in complete ionization and disintegration of all atoms, although the pristine He droplet is transparent for the laser intensities applied. Our calculations at those intensities reveal that the minimal pulse length required for ignition is about 9 fs.

Neoadjuvant and adjuvant therapy with imatinib for locally advanced gastrointestinal stromal tumors in eastern Indian patients

BACKGROUND

Imatinib mesylate is able to at least modify the course of gastrointestinal stromal tumours (GISTs). Neoadjuvant use for locally advanced lesions is evolving as a new treatment paradigm in this hitherto universally fatal disease.

METHODS AND RESULTS

The study patients with locally advanced GIST received neoadjuvant and adjuvant imatinib mesylate. Response was noted as per the RECIST protocol and overall progression free survival was reported. Of 19 patients (mean age 38.5 years, range 26 yrs to 64 yrs) studied, 13 achieved partial response (PR) and 6 a stationary disease (SD) on preoperative imatinib. Histopathological evaluation and grading of responses revealed only moderate and low grade pathological response after imatinib. R0 resection was possible in 13/19 and R1 in 6/19. Imatinib was well tolerated and adverse reactions were minimal. Post operative complications of surgery were not out of the ordinary for a surgical series featuring extensive abdominal surgery.

CONCLUSION

Preoperative imatinib in locally advanced GIST seems to be a reasonable option for locally advanced GIST patients and enough downstaging to allow a resection with microscopically negative margins can be expected in a fairly good proportion of patients.

Pattern of Breast Cancer in a Tertiary Care Center

INTRODUCTION: Breast Cancer is the second commonest cause of cancer death in women. Almost all women survive breast cancer if it is detected before it starts to spread. The aim of the study is to analyze the demographical profile, stage of presentation, histological type, and treatment modalities of breast cancer in a tertiary care setting. METHODS: Total 1141 cases of breast cancer had been followed retrospectively from 1999 to 2006 A.D. in a tertiary care center and their patterns were analyzed. RESULTS: The mean age of presentation of breast cancer was 47.30 +/- 11.57 years in female and 59.03 +/- 14.63 in male, 31 (2.1%) cases of breast cancer were male. There were 123 (10.78%) stage I, 281 (24.62%) stage II, 466 (40.84%) stage III, and 271 (23.75%) stage IV patients. Infiltrating ductal carcinoma was the commonest variety 610 (53.5%). Chemotherapy was the mainstay for treatment of breast cancer 341 (29.9%) followed by surgery 287 (25.2%). CONCLUSIONS: Breast cancer trend is rising with more in late and advanced stages, mostly due to lack of awareness. Infiltrating ductal carcinoma is the commonest variety. Chemotherapy is the most commonly used modality of treatment. Male breast cancer present late and is not so uncommon. Keywords: breast cancer; chemotherapy; infiltrating ductal carcinoma; staging. 

Pattern of breast cancer in a tertiary care center

INTRODUCTION

Breast Cancer is the second commonest cause of cancer death in women. Almost all women survive breast cancer if it is detected before it starts to spread. The aim of the study is to analyze the demographical profile, stage of presentation, histological type, and treatment modalities of breast cancer in a tertiary care setting.

METHODS

Total 1141 cases of breast cancer had been followed retrospectively from 1999 to 2006 A.D. in a tertiary care center and their patterns were analyzed.

RESULTS

The mean age of presentation of breast cancer was 47.30 +/- 11.57 years in female and 59.03 +/- 14.63 in male, 31 (2.1%) cases of breast cancer were male. There were 123 (10.78%) stage I, 281 (24.62%) stage II, 466 (40.84%) stage III, and 271 (23.75%) stage IV patients. Infiltrating ductal carcinoma was the commonest variety 610 (53.5%). Chemotherapy was the mainstay for treatment of breast cancer 341 (29.9%) followed by surgery 287 (25.2%).

CONCLUSIONS

Breast cancer trend is rising with more in late and advanced stages, mostly due to lack of awareness. Infiltrating ductal carcinoma is the commonest variety. Chemotherapy is the most commonly used modality of treatment. Male breast cancer present late and is not so uncommon.

A scenario of cervical carcinoma in a cancer hospital

INTRODUCTION

Cervical carcinoma is an important women's health problem throughout the world. There are very few published data on this disease in Nepal. We wanted to study the pattern of cervical carcinoma based on hospital data.

METHODS

A 10 years retrospective study of scenario of cervical carcinoma was conducted. The data have been analyzed according to age, occurrence of other cancers, histological type, religion, risk factors and district wise.

RESULTS

The number of cervical carcinoma showed a rising pattern over the 10 year period. The median age of the patients was 45 years and maximum frequency (33%) of cases were found in the age group 40 to 49 years. Squamous cell carcinoma comprised 40% of cases, Adenocarcinoma 4% and 1.1% cases were of mixed variety. 92% of cases were Hindu by religion. 43% of patients were smoker in our study, 5% had positive family history. Chitwan with 7.35% had the maximum number of cases followed by Rupandehi with 6.40% and Nawalparasi with 5.41%.

CONCLUSIONS

The cancer pattern revealed by the present study provides valuable leads to cervical cancer epidemiology in Nepal. Routine cytological screening of the population for cervical cancer is highly necessary for its early detection and treatment.

A Scenario of Cervical Carcinoma in a Cancer Hospital

Introduction: Cervical carcinoma is an important women’s health problem throughout the world.There are very few published data on this disease in Nepal. We wanted to study the pattern ofcervical carcinoma based on hospital data.Methods: A 10 years retrospective study of scenario of cervical carcinoma was conducted. The datahave been analyzed according to age, occurrence of other cancers, histological type, religion, riskfactors and district wise.Results: The number of cervical carcinoma showed a rising pattern over the 10 year period. Themedian age of the patients was 45 years and maximum frequency (33%) of cases were found in theage group 40 to 49 years. Squamous cell carcinoma comprised 40% of cases, Adenocarcinoma 4% and1.1% cases were of mixed variety. 92% of cases were Hindu by religion. 43% of patients were smokerin our study, 5% had positive family history. Chitwan with 7.35% had the maximum number of casesfollowed by Rupandehi with 6.40% and Nawalparasi with 5.41%.Conclusions: The cancer pattern revealed by the present study provides valuable leads to cervicalcancer epidemiology in Nepal. Routine cytological screening of the population for cervical cancer ishighly necessary for its early detection and treatment.Key Words: Cervical carcinoma, hospital based study, Nepal, pattern

Energy pooling in multiple ionization and Coulomb explosion of clusters by nanosecond-long, megawatt laser pulses

We report the results of experiments that establish the possibility of bringing about multiple ionization and Coulomb explosion of molecular clusters with nanosecond laser pulses at intensities as small as 10(9) W cm(-2). We demonstrate several new facets of the laser-cluster interaction in the low-intensity, long-pulse domain: (i) The choice of laser wavelength for a given cluster species is very crucial. (ii) Excited electronic states play a very important role in the ionization dynamics. (iii) When field ionization is insignificant and ponderomotive energies are very small, it is energy pooling rather than inverse bremsstrahlung that determines how clusters absorb energy from the optical field.

Therapeutic efficacy of antimalarial drugs along the eastern Indo-Nepal border: a cross-border collaborative study

This collaborative cross-border study was performed to determine the therapeutic efficacy of antimalarial drugs used by the National Programmes for falciparum malaria along the eastern Indo-Nepal border where there is unregulated population movement across the border. The study was conducted at sites in Jhapa District, Nepal and Darjeeling District, India. The study was conducted from August 2003 to February 2004, following the WHO 28 day treatment protocol. The efficacy of chloroquine was tested in India among 91 subjects and of sulfadoxine-pyrimethamine in Nepal among 107 subjects with laboratory-confirmed Plasmodium falciparum malaria. Of the 102 subjects who completed the study in Nepal, there were 21 (20.6%) treatment failures comprising 7 (6.9%) early treatment failures (ETF) and 14 (14.7%) late treatment failures (LTF) (5 late clinical failures [LCF] and 9 late parasitological failures [LPF]). Of the 89 subjects who completed the study in India, there were 46 (51.7%) treatment failures comprising 7 (7.9%) ETFs and 39 (43.8%) LTFs (13 LCFs and 26 LPFs). Based on WHO guidelines both countries need to review their drug policy urgently and make appropriate changes, taking into account aspects of cross-border collaboration in the control of drug-resistant malaria.

Evaluation of safety and efficacy of a gold containing Ayurvedic drug

Gold containing Ayurvedic preparation, Swarna Vasant Malti, was given to 20 male persons in a dose of 100 mg twice a day for 40 days under supervision of Ayurvedic physicians. The total cumulative intake of 160 mg of gold at the rate of 4 mg per day in this form did not have any toxic effect on human body as evidenced by clinical examination, unaltered body weight, absence of urinary pathology and by 30 sensitive biochemical and enzymatic tests. The gold from this Ayurvedic preparation was found in plasma and erythrocytes, excreted partly in urine and was present in semen. Gold binding to albumin and hemoglobin slightly increased their electrophoretic mobility towards anode. This gold preparation seemed to increase sperm motility and prostatic activity.

A high prevalence of antibodies to hepatitis C virus among commercial plasma donors from Western India

A very high prevalence of anti-hepatic C virus (anti-HCV) antibodies (63/73, 86.3%) was noted among commercial plasma donors of an organization manufacturing blood products, studied in 1989. Retrospective serological analysis of these donors revealed continued high prevalence of anti-HCV, i.e. 35/40 (87.5%) in 1988, 28/31 (90.3%) in 1987 and 86/94 (91.4%) in 1986. HCV RNA detection by polymerase chain reaction (PCR) demonstrated 15/33 (45.45%) plasma donors to be positive in 1989. Interestingly, 3/24 (12.5%) serum samples collected from employees of the organization were also anti-HCV positive. All three anti-HCV positive employees were directly associated with plasmapheresis. Of the three anti-HCV positive employees one had been anti-HCV positive since 1985, but the other two employees were negative during 1985-1987 and then became positive in 1987 and remained positive in 1989. One of these two employees was also a plasma donor. Commercial blood donors from a local blood bank had anti-HCV prevalence of 13% which was significantly lower (P < 0.001) when compared with plasma donors of the organization and significantly higher than volunteer blood donors (< 0.25%, P < 0.01).

Contribution of HEV and HCV in causing fulminant non-A, non-B hepatitis in western India

During 1990, 38 patients with fulminant non-A, non-B hepatitis (NANB) died in Government Medical College Hospital, Aurangabad. Serum samples from these patients were tested for antibodies to hepatitis C virus (anti-HCV) and IgM antibodies to hepatitis E virus (IgM-anti-HEV). All samples were also subjected to polymerase chain reaction (PCR) for the detection of HBV DNA, HCV RNA and HEV RNA. None of the patients had circulating anti-HCV antibodies; three had HCV RNA. Based on anti-HEV-IgM positivity 14 patients (37%) could be diagnosed as suffering from hepatitis E. None was positive for HEV RNA. In the absence of serological markers, HBV DNA was present in three cases. None of the HBV DNA positive patients had anti-delta antibodies. Dual infections (HBV with HEV, and HBV with HCV) were seen in two cases. The aetiology of half of the NANB cases could not be assigned to the known hepatitis viruses using current techniques.

Prevalence of anti-HCV antibodies in western India

Nearly 2000 serum samples collected from different risk groups from Pune and Bombay metropolitan areas were tested for antibodies to hepatitis C virus (anti-HCV) by Recombinant Immunoblot Assay-3 (RIBA-3). Patients undergoing haemodialysis showed 24.5 per cent seropositivity whereas 5.7 and 5.3 per cent of multiply transfused patients (>2 units) and chronic liver disease patients respectively were anti-HCV positive. Leprosy patients had almost 0.7 per cent seropositivity. In other risk groups the positivity rate was nil. In normal population only one out of 830 persons had anti-HCV antibodies. It is therefore apparent that the prevalence of hepatitis C virus (HCV) in western India is not high. However, special care needs to be taken for dialysis patients. As none of the 430 pregnant women and 86 children below the age of 5 yr were anti-HCV positive, vertical mode of HCV transmission seems to be negligible.

Aetiology of acute sporadic non-A, non-B viral hepatitis in India

Non-A, non-B (NANB) hepatitis viruses are now classified as hepatitis E (enterically transmitted) and hepatitis C (parenterally transmitted). India experiences a large number of epidemics of the enteric disease every year. In addition, about 70% of the sporadic cases among adults are also due to NANB hepatitis. With the availability of an immunoblot assay for the detection of anti-HEV-IgM and the polymerase chain reaction (PCR) for the detection of HCV-RNA, serum samples from epidemic and sporadic NANB patients were screened for these markers. We found that a large number of cases from the epidemics were HEV, though a few remained undiagnosed, while of the sporadic cases only a few could be diagnosed as HCV or HEV; a large proportion remained undiagnosed.