Sialic acid blockade in dendritic cells enhances CD8+ T cell responses by facilitating high-avidity interactions

Sialic acids are negatively charged carbohydrates that cap the glycans of glycoproteins and glycolipids. Sialic acids are involved in various biological processes including cell-cell adhesion and immune recognition. In dendritic cells (DCs), the major antigen-presenting cells of the immune system, sialic acids emerge as important regulators of maturation and interaction with other lymphocytes including T cells. Many aspects of how sialic acids regulate DC functions are not well understood and tools and model systems to address these are limited. Here, we have established cultures of murine bone marrow-derived DCs (BMDCs) that lack sialic acid expression using a sialic acid-blocking mimetic Ac53FaxNeu5Ac. Ac53FaxNeu5Ac treatment potentiated BMDC activation via toll-like receptor (TLR) stimulation without affecting differentiation and viability. Sialic acid blockade further increased the capacity of BMDCs to induce antigen-specific CD8+ T cell proliferation. Transcriptome-wide gene expression analysis revealed that sialic acid mimetic treatment of BMDCs induces differential expression of genes involved in T cell activation, cell-adhesion, and cell-cell interactions. Subsequent cell clustering assays and single cell avidity measurements demonstrated that BMDCs with reduced sialylation form higher avidity interactions with CD8+ T cells. This increased avidity was detectable in the absence of antigens, but was especially pronounced in antigen-dependent interactions. Together, our data show that sialic acid blockade in BMDCs ameliorates maturation and enhances both cognate T cell receptor-MHC-dependent and independent T cell interactions that allow for more robust CD8+ T cell responses.

Yogic Neti-Kriya Using Povidone Iodine: Can it have a Preventive Role Against SARS-CoV-2 Infection Gateway?

During this COVID-19 pandemic, except steroid, none of the therapeutic measures have showed any evidence of efficacy. Traditionally jala-neti using lukewarm salted water remains a yogic way of maintaining upper airway hygiene. Saline irrigation decreases the concentration of inflammatory mediators (e.g. histamine, leukotriene etc.) in nasal secretions, reduces the severity and frequency of sinusitis, reduce need of antibiotic therapy and restores competency of nasal mucosa. Jala-neti is an integral part of six cleansing techniques of yogic kriyas practised in India since thousands of years. Jala-neti can clean the upper airways, prevents colonization of infectious agents, removes foreign bodies, prevents stasis of mucous and subsequently enhances the drainage of paranasal sinuses and maintain health. Regular practice of Jala neti improves nasal symptoms and overall health status of patients with sinusitis. Jala-neti sample can even be used for COVID-19 diagnosis. Povidone iodine (PVP-I) has been utilized as a time tested antimicrobial agent with broad spectrum coverage against wide range of bacteria and viruses. Anti-SARS-CoV-2 action of PVP-I was seen at a concentration as low as 0.45%. PVP-I is generally well tolerated upto 5%, however nasal ciliotoxicity is reported at this concentration, however, this toxicity is not reported with lower concentrations(1.25% and 0.5%). So, theoretically, by using neti-kriya with povidone iodine (0.5–1%) as irrigation solution can combine and enhance the protection against COVID-19 and this can be an important armor in the fight against COVID-19. However, this hypothesis needs to be validated in real life clinical trial scenario before implementing.

Rhino-orbital-cerebral-mucormycosis in COVID-19: A systematic review

Since the onset of COVID-19 pandemic, parallel opportunistic infections have also been emerging as another disease spectrum. Among all these opportunistic infection, mucormycosis has become a matter of concern with its rapid increase of cases with rapid spread as compared to pre-COVID-19 era. Cases have been reported in post-COVID-19-related immune suppression along with the presence of comorbidity which adds on the deadly outcome. There is no systematic review addressing the issue of COVID-19-associated mucormycosis. This is the first systematic review of published studies of mucormycosis associated with COVID-19. The aim was to analyze the real scenario of the disease statement including all the published studies from first November 2019 to 30th June to analyze the contemporary epidemiology, clinical manifestations, risk factor, prognosis, and treatment outcome of COVID-19 associated rhino-orbito-cerebral-mucormycosis. A comprehensive literature search was done in following databases, namely, PubMed, Google Scholar, Scopus, and EMBASE using keywords mucormycosis, rhino orbital cerebral mucormycosis, COVID-19, and SARS-CoV-2 (from November 01, 2019 to June 30, 2021). Our study shows that, while corticosteroids have proved to be lifesaving in severe to critical COVID-19 patients, its indiscriminate use has come with its price of rhino-orbito-cerebral mucormycosis epidemic, especially in India especially in patients with preexisting diabetes mellitus with higher mortality. Corticosteroid use should be monitored and all COVID-19 patients should be closely evaluated/monitored for sequelae of immunosuppression following treatment.

An open label randomized comparative study on axillary vis a vis supraclavicular approaches for brachial plexus block in forearm surgery

Aims and Objectives: Regional anesthesia like brachial plexus blocks are increasingly practiced now a day’s avoiding the complications of general anesthesia for upper limb surgery. Among the many techniques axillary and supraclavicular approaches are common though both have its merits and demerits. This study was planned to compare these two techniques in terms of onset, completion time of sensory and motor blockade, its duration and overall success during upper limb surgeries. Materials and Methods: After obtaining institutional ethics committee approval and written informed consent, 100 patients of American Society of Anesthesiologists grade I or II scheduled for forearm and hand surgeries were included in the study and were randomly allocated into two groups. 30ml of the 0.5% bupivacaine was injected either by supraclavicular or axillary route by a single trained experienced anesthetist. The onset and completion time of sensory and motor blockade, its duration and overall success were noted and the collected data was statistically analyzed.Results: The patients (n=100) predominantly female (56%) with comparable demographic profile found to have equal efficacy in onset of sensory block, extent of motor blockade, duration of block (analgesia) in both the group. However considering overall effectiveness of the techniques including their failure rates, axillary approach appeared to be more acceptable and a better technique (p<0.05).Conclusion: Axillary approach could be a safer choice among regional block for the conduct of upper limb surgery.Asian Journal of Medical Sciences Vol.8(1) 2017 71-76

Rational Hyperoxia in the Perioperative Period: a Safe and Effective Tool in the Reduction of SSI

Oxygen supplemented at a concentration higher than 40-50 % for at least 2 h perioperatively is expected to reduce surgical site infections (SSI). Although supplementation of 80 % of oxygen perioperatively has shown to reduce SSI in various studies, this concentration is known to be associated with airway complications. This study was taken up to assess the efficacy of 60 %, i.e. <80 and >50 %, inspired oxygen supplemented perioperatively in reducing SSI. One hundred and eighty-eight patients who underwent elective class I and II surgeries were studied. Patients were divided equally into two groups and subgroups and matched for age, sex, type of surgeries, etc. The control group received 30 % and the study group received 60 % oxygen supplementation perioperatively for 2 h. Wounds were observed for the development of SSI. 8/94 patients in the study group and 13/94 patients in the control group developed SSI (p < 0.01). The results indicate a relative risk of 1.62, risk difference of 0.0531 and attributable risk of 38.42 %. Hence, it may be concluded that perioperative oxygen supplementation at 60 % concentration reduces SSI.

Nickel, its adverse health effects & oxidative stress

Nickel-induced toxicity and carcinogenicity, with an emphasis on the generation and role of reactive oxygen species is reviewed. Nickel is a known haematotoxic, immunotoxic, neurotoxic, genotoxic, reproductive toxic, pulmonary toxic, nephrotoxic , hepatotoxic and carcinogenic agent. This article presents a selective review on nickel and effect of its acute, subchronic and chronic doses on certain metabolically active tissues in human as well as animals. Nickel exposure causes formation of free radicals in various tissues in both human and animals which lead to various modifications to DNA bases, enhanced lipid peroxidation, and altered calcium and sulphydryl homeostasis. The primary route for nickel toxicity is depletion of glutathione and bonding to sulphydryl groups of proteins. Nickel homeostasis, nickel-induced activation of signaling pathways and the protective role of enzymatic and non-enzymatic antioxidants against nickel toxicity and carcinogenicity are also discussed.

Characteristics of patients admitted with stroke

Population based study on stroke morbidity and mortality is lacking in our country. We described the clinical pattern of patients with stroke admitted in Neuromedicine Unit, Chittagong Medical College Hospital, Bangladesh. One hundred and six consecutive patients were included in the study. Clinical diagnosis of stroke, initial assessment, and assessment of outcome of stroke were performed by the neurologists. On admission blood glucose, and creatinine level was estimated, and an electrocardiogram was recorded. Fasting lipid level estimation and CT-scan of brain were performed for patients who could afford the cost. The mean age of the patients was 60.0 +/-13.7 years and the highest occurrence of stroke was found in the age group of 61 - 70 years. The proportions of rural, semiurban and urban patients were 46.2%, 27.4% and 26.4% respectively. A large portion of the patients were found illiterate (47.2%), and only one patient had postgraduate education. The average per capita income was found 1159 +/-762 taka per month. About one-fourth of the patients had diabetes (21.7%). Hypertension, ischemic heart disease and dyslipidemia were found in 59.4%, 18.9% and 11.3% respectively. The cause of hospitalization was altered consciousness (58.5%), right hemiplegia (32.1%), and left hemiplegia (31.1%) either alone or in combination. The mean duration of hospital stay was 5.25 +/-2.19 days. Fifty percent partially and 35% satisfactorily recovered, and 7 (6.6%) patients expired. Patients from lower socioeconomic group were admitted in the hospital. A considerable number of stroke patients had hypertension and diabetes.

Opportunities not taken: Successes and shortcomings in the Institute of Medicine's report on organ donation

The Institute of Medicine's recent report, Organ Donation: Opportunities for Action, studies the current problems facing organ donation in the USA, making suggestions for quality improvement and analyzing various proposals of incentivized donation and presumed consent (PC). Although the report deals with the donation of several solid organs, this mini review examines the findings from the perspective of kidney transplantation. The committee's recommendations to move from circulatory to neurologic criteria for cadaveric donation and to increase opportunities for donor decision making are prudent. We agree with the committee's arguments against providing incentives for donation because of the inherent distributional inequalities and imperfect information; the intrinsic difficulties in establishing market equilibrium for such heterogeneous and perishable goods; the implied commoditization of the human body; and the inadequate data regarding the long-term risks of living donation. However, we question the committee's firm opposition to PC, especially given recent data from 22 European countries showing a 25-30% increase in organ supply attributable to a PC policy. If this simple change in the default position on donation has the potential to increase organ supply, decrease the need for living donation, reduce the burden on grieving families, maintain familial authority over the deceased, and respect patient autonomy, at least a pilot program of PC seems warranted.

Gastric intestinal metaplasia as detected by a monoclonal antibody is highly associated with gastric adenocarcinoma

BACKGROUND

Some forms of gastric intestinal metaplasia (GIM) may be precancerous but the cellular phenotype that predisposes to gastric carcinogenesis is not well characterised. Mucin staining, as a means of differentiating GIM, is difficult. A monoclonal antibody, mAb Das-1 (initially called 7E(12)H(12)), whose staining is phenotypically specific to colon epithelium, was used to investigate this issue.

METHODS

Using mAb Das-1, by a sensitive immunoperoxidase assay, we examined histologically confirmed GIM specimens from two countries, the USA and Japan. A total of 150 patients comprised three groups: group A, GIM (fields away from the cancer area) from patients with gastric carcinoma (n=60); group B, GIM with chronic gastritis (without gastric carcinoma) (n=72); and group C, chronic gastritis without GIM (n=18).

RESULTS

Fifty six of 60 (93%) patients with GIM (both goblet and non-goblet metaplastic cells) from group A reacted intensely with mAb Das-1. Cancer areas from the same 56 patients also reacted. In contrast, 25/72 (35%) samples of GIM from patients in group B reacted with mAb Das-1 (group A v B, p<0.0001). None of the samples from group C reacted with the mAb.

CONCLUSIONS

Reactivity of mAb Das-1 is clinically useful to simplify and differentiate the phenotypes of GIM. The colonic phenotype of GIM, as identified by mAb Das-1, is strongly associated with gastric carcinoma.

Pattern of dermatological diseases in Gauhati Medical College and Hospital Guwahati

A study on 42198 new cases who have attended the Dermatology department of Gawahati Medical College and Hospital, Guwahati, Assam was carried out for a period of 3 years (1998, 1999 and 2000) Eczema (23.10%), pyoderma (14.29%), fungal infection(14.24%) and psoriasis (5.77%) were the major skin diseases in this part of our country. The incidence of S.T.D. and leprosy has been recorded as 2.63% and 2.26% respectively.

The influence of ascorbic acid on nickel-induced hepatic lipid peroxidation in rats

We studied the effect of oral ascorbic acid treatment on nickel sulfate-induced lipid peroxidation in the liver of Wistar strain male albino rats. Lipid peroxide and glutathione levels and the activities of the antioxidant enzymes superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) were estimated in liver. Nickel sulfate administration significantly increased the level of lipid peroxides and decreased glutathione, SOD, CAT, and GSH-Px activities in liver. The simultaneous administration of ascorbic acid with nickel sulfate resulted in a remarkable improvement of lipid peroxide, glutathione, SOD, CAT, and GSH-Px status in liver in comparison with rats treated with nickel alone. Nickel sulfate has an adverse effect on hepatic lipid peroxidation in animals, but simultaneous treatment with ascorbic acid offers a relative protection against nickel-induced hepatotoxicity.

Physical fitness: a longitudinal study among Muslim children of Bijapur (Karnataka)

Aerobic capacity or maximum oxygen uptake capacity (VO2 max) has been widely considered to be reliable and valid measure of cardio respiratory fitness. Persons possessing higher values and have the capacity to yield larger amounts of energy, are capable of performing better in athletic and other field activities. Seventy school going children from the Muslim community of Bijapur (Karnataka) aged 12-16 years (means +/- SEM = 14.33 +/- 0.94), volunteered for this study. Their height (cm) and weight (kg) were measured as physical anthropometry and Body mass index (BMI) was calculated (kg/m2). VO2max (ml.kg-1.min-1) was determined by applying the step test study of Margaria et al. The Physical fitness index (PFI) of the subjects were assessed by Harvard Step Test. The physiological endurance measured as VO2max (ml.kg-1.min-1) was found to be 34.31 +/- 2.44 S.E.M, which is lower in comparison to their Caucasian counterparts but nearly similar when compared with their Indian counterparts. The present study reveals that VO2max significantly correlates with BMI and PFI score. The present study also reveals that 27.2%, 20.07%, 15.77%, 14.37% and 22.87% of the subjects are in excellent, very good, good, average and poor classifications of fitness level respectively.

Large capillary haemangioma arising from the nasal columella--a case report

A 39-year-old male presented with a mass arising from the nasal columella for last 8 months. The mass was lobulated, dark red in colour, firm in consistency and approximately 3 cm in diameter. It was attached to the columella of the nose by a narrow stalk. The mass was excised completely under general anaesthesia and histopathological examination suggested it to be a case of capillary haemangioma.

Effect of nickel on testicular nucleic acid concentrations of rats on protein restriction

The nucleic acids (DNA and RNA) and total protein concentration in testes were estimated in male Wistar strain rats treated intraperitorally with nickel sulfate (2.0 mg/100 g body weight) on alternate days for 10 dosages. In both normal (18% casein) and protein-restricted (5% casein) experimental animals, the nucleic acids and total protein concentration were found to decrease significantly compared to the corresponding controls. Sperm count and sperm motility were also reduced in both experimental groups of animals. The results indicate that nickel influences the expression of genetic information by reducing testicular nucleic acids and protein concentration in both dietary experimental groups.

ROLE OF ASCORBIC ACID ON TRANSAMINASE ACTIVITIES IN SOME METABOLICALLY ACTIVE TISSUES OF ASPIRIN TREATED RATS

Aspartate amino transferase (GOT) and alanine amino transferase (GPT) activities were studied in plasma, liver and kidney of aspirin treated and ascorbic acid supplemented groups for a period of seven days. GOT and GPT activities were increased in plasma but decreased significantly in liver and kidney in aspirin treated animals. Ascorbic acid supplemented groups showed no significant change of GOT and GPT in plasma and liver. In case of kidney, GOT activity remained unchange but GPT activity showed significant change in ascorbic acid supplemented group. The results clearly indicate that aspirin is a potent hepatotoxic and nephrotoxic drug but supplementation of ascorbic acid in High doses to rats fed aspirin can restore enzyme activities to the normal level.

The Effect of Constituent Metal Ions on the Electrokinetics of Chalcopyrite

Chalcopyrite in contact with water is thermodynamically unstable in the presence of oxygen. Oxidation of chalcopyrite may take place due to various factors, e.g., geological environment, mining/comminution, and storage. In this work oxidation of chalcopyrite has been investigated through interfacial electrokinetics. The characteristics of samples obtained from different geological locations as well as the effects of ageing and laboratory oxidation have been delineated. Variation of the solid-liquid ratio was found to have a significant effect on the zeta-potential characteristics of chalcopyrite. The role of constituent metal ions, namely copper and iron, has been studied in the absence and presence of externally added metal ions. The results indicated that the ratio of Cu/Fe on the surface of oxidized chalcopyrite determines the Stern layer potential and under appropriate solution chemistry conditions influences charge reversals. The mineral surfaces, thus, could be either copper-rich or iron-rich as reflected by a shift in pHiep(s). The observed charge reversals have been explained on the basis of a model proposed by James and Healy. Copyright 1997 Academic Press. Copyright 1997Academic Press

Alteration of testicular biochemistry during protein restriction in nickel treated rats

Nickel sulfate (2.0 mg/100 g.b.wt) dissolved in double-distilled water was administered (i.p.) on alternate days for ten doses to normal protein-fed and protein-restricted Wister strain albino rats (b.wt. 160 +/- 5 g). Two groups were used: one with normal protein diet, whereas the other with protein-restricted diet served as control. Twenty-four hours after the last treatment, the animals were sacrificed by decapitation. Tissues such as the testes, seminal vesicles, epididymis (Cauda and Caput) and prostate were dissected out, wiped clean, and stored at -20 degrees C until analysis. Lactate dehydrogenase (LDH) activities, glutamate oxaloacetate transaminase (GOT) activities, glycogen content, cholesterol content, and total protein content of the testes were estimated. Nickel sulfate administration significantly decreased the body weight of both normal protein-fed and protein-restricted groups of animals; the organ weights were also decreased. Significant decrease of LDH activity was observed, but GOT activity was not altered significantly. Testicular glycogen and cholesterol increased significantly in both experimental groups, but total protein content decreased. Nickel sulfate seems to have an adverse effect on the male reproductive system in both groups of animals fed with normal protein (18% casein) diet and protein restricted (5% casein) diet.

Efficacy of methotrexate in rheumatoid arthritis

Rheumatoid arthritis is a common inflammatory articular disorder in Bangladesh. Methotrexate has proved to be an effective and relatively safe disease modifying drug for this disease. A quasiexperimental trial of the efficacy of methotrexate in rheumatoid arthritis was carried out in the Rheumatology Clinic, Institute of Postgraduate Medicine & Research, Dhaka during the period between July 1992 and September 1993. Thirty eight patients fulfilling the revised ARA criteria were given methotrexate in a total weekly dose of 7.5 to 15 mg. They were followed up at weekly intervals for one month and then monthly for a total duration of six months. Twenty three subjects eventually completed the trial. The trial showed significant differences in the disease activity indices at the end of six months. The decline of activity was noted at the end of one month. As a whole the response was complete in 4(17%), marked in 14(61%), moderate in 4(17%) and nil in 1(4%). Adverse effects occurred in 27 subjects. They were mild and transient in 22. Methotrexate appeared to be an acceptable DMARD for our rheumatoid arthritis population.

Influence of ascorbic acid on acid and alkaline phosphatase activities in some metabolically active tissues of aspirin treated rats

ACP and ALP activities in plasma were increased in aspirin treated groups for a period of seven days. Ascorbic acid supplemented groups showed no significant change in plasma ACP activity, but a significant change in ALP activity was found. ACP and ALP activities in liver and kidney were decreased significantly in aspirin treated animals. ACP activities in liver and kidney in ascorbic acid supplemented groups showed no significant changes. No significant alteration of ALP activity in liver was found in ascorbic acid supplemented group but a significant changes was observed in kidney. Supplementation of ascorbic acid in high doses to rats fed aspirin can restore enzyme activities almost to the normal level.

Improved heterodyne mixing efficiency and signal-to-noise ratio with an array of hexagonal detectors

An array of hexagonal pixel geometries is considered and its improvement in the mixing efficiency as well as the signal-to-noise ratio is compared with an equal-area array of square pixel detectors. We also consider the phase-front misalignment between the signal and the local oscillator wave fronts for both pixel geometries.

Place of transvaginal sonography in the evaluation of reproductive endocrinology

A high frequency vaginal probe with improved resolution offers a remarkable sharp clear image of pelvic organs. This is possible because of its closed proximity with target organ and non-intervention by gut or omentum. Study of ovarian follicular dynamics (folliculometry), identification of proliferative, secretory and decidual changes of endometrium (endometrial dating) in different phases of menstrual cycle and imaging of mucus secretion in the cervical canal (cervical mucus study) in the pre-ovulatory phase is possible by transvaginal probe. It is non-invasive, acceptable to patients, and thus can be repeated any number of times. A close serial monitoring offers immense wealth of information about the anatomical as well as reproductive endocrinal status of the patient. Ovulation can be predicted in advance. The case of dysovulation can be identified in first cycle of study; corrective therapy can be started in another two or three cycles, aiming at achieving perfect folliculogenesis. Once well tuned synchronised cycle is restored, the pregnancy outcome is remarkable. Thus transvaginal sonography offers one of the best reproductive endocrinology evaluation in the hand of a modern gynaecological sonologist and infertility specialist.

Efficacy of ciprofloxacin in enteric fever: comparison of treatment duration in sensitive and multidrug-resistant Salmonella

The efficacy of two regimens of ciprofloxacin was compared in a randomized study conducted on 69 patients with enteric fever, 52.2% of whom had infection with multidrug-resistant (MDR) strains of Salmonella typhi or S. paratyphi. Patients were randomly assigned to two regimens (10 days versus 14 days) of ciprofloxacin (500 mg twice a day). The mean +/- SD time required for defervescence was similar for both regimens (4.2 +/- 1.9 days in the 10-day group and 4.9 +/- 2.6 days in the 14-day group). A 100% cure was observed in each treatment group and no serious side effects were observed. Relapse occurred in two patients (14-day regimen). Only one patient (14-day regimen) had growth of S. typhi in stool culture at the time of the first follow-up three days after completion of therapy. Follow-up studies on available patients on two, six, and 12 months after completion of therapy revealed that all patients had negative stool cultures for S. typhi and S. paratyphi. This study indicates that ciprofloxacin may be recommended as an initial therapy for enteric fever for adult men and nonpregnant and nonlactating women in areas where MDR strains of S. typhi and S. paratyphi are prevalent, and that 500 mg twice a day of the drug given for 10 days is as effective as 14 days at the same dosage.

Role of transvaginal sonography in pelvic scan for female reproductive system

Three hundred twenty-nine cases of early pregnancy and 116 pelvic pathology studied by transabdominal sonography were compared with 81 cases of early pregnancy and 88 cases of pelvic pathology subjected to transvaginal sonography. A high frequency vaginal probe, because of its close proximity with the target organ, produces remarkably sharp image. An accurate diagnosis is possible in great majority of cases within a short time. Vaginal sonography is done with an empty bladder. A close serial monitoring of ovarian follicles, endometrium and cervical mucus with transvaginal sonography offers an immense wealth of information about the structural and reproductive endocrinal status of the patient. Ovulation can be predicted in advance. Imaging of female reproductive system by transvaginal sonography is indispensable for any modern gynaecological care and for infertility assessment in particular.

Study of the impact of epidemiological factors on intelligence of rural children of 3 to 6 years age group belonging to low socio-economic status

There are many factors which affect intelligence as well as physical growth of children, although genetic factor plays a prime role but social, environmental and psychological factors influence significantly the physical growth and intelligence of the child and the same can be improved through intervention. Community based studies are therefore useful to understand effect of these factors for future planning. The present study was therefore undertaken in Burdwan district of West Bengal with the objectives of studying level of intelligence of children of 3 to 6 years age group and impact of the factors related to the level of intelligence of these children. 72 children of 3 to 6 years age group were studied, of which 2/3 were either normal or having Grade-I undernutrition and the rest were either Grade-II or Grade-III. A significant positive association was found between DST IQ score (Bharat Raj) and the nutritional grade. Non-formal education also was found to have significant bearing on the IQ level. No significant relationship was however found between DST IQ score and the religion indicating culture independence of the scoring system.

Measuring the interactions of the determinants of health

Considering environmental sanitation and health care services as most important determinants of health, this study was undertaken to know their impacts in an urban slum area of Calcutta. The families were studied in-depth and detail in relation to their health status in the form of morbidities and utilisation of preventive and promotive services. The health service impact was mainly assessed through comparative study between these who availed the services and to these who did not. Similarly, environmental sanitation services impact on health was measured through comparing the slum group with those who lived in Pucca houses. The criteria of priority decision on determinants was attempted through analysis of cost of these services and comparing their beneficial effects on health.

(Dr. P. C. Sen Award on rural health practice). Infant and early childhood mortality in some rural ICDS blocks of west Bengal

This one year prospective study was carried out to determine the CBR, CDR and different underfive mortality rates in some selected rural ICDS blocks of West Bengal and also to find out the common causes of infant and childhood mortality in these areas. It was revealed that most of the above mentioned indicators in ICDS blocks were considerably lower than that of National figures, but more or less similar to those of rural Bengal as recorded in routine Govt. reports. Compared to the picture of rural West Bengal, both still birth & perinatal mortality rates were found higher in all ICDS blocks. The causes of mortality trends among under fives' were found similar to that of rural India pattern i.e. prematurity, acute respiratory infections and diarrhoea being the leaders. Neonates, who contributed the largest share of infant mortality died mainly due to prematurity. So, observations like high perinatal mortality & still birth rates, huge proportion of neonatal death during infancy, same IMR but low 5MR, and death of neonates due to prematurity etc. claim the necessity of improving maternal component of ICDS services, their nutritional care in particular.

Disability pattern amongst leprosy cases in an urban area (Calcutta)

In a retrospective study of 1,264 leprosy cases, registered during 1987-1992, 282 were found to have disabilities giving a disability rate (DR) 22.31% and 150 of them were also found to have deformities, giving a deformity rate 11.9%. Mean disability index (DI) was found to be 1.17. Disability rate (DR) significantly increased with age and the highest rate was 52.75% in lepromatous (L) cases, followed by 27.51% in borderline (N?L) and only 4.53% in nonlepromatous (N) cases. L cases had the highest deformity rate (22.25%) and N cases had the lowest DR (2.23%). DI was highest (1.46) in L, and lowest (0.52) in N cases. Males had significantly higher DR (27.2%) compared to females (13.0%). Deformity in hands (42.55%) was more common than in feet (22.70%). Increasing trend of DI was noticed with increasing duration of disease in L and N?L types. The number of nerves involved was high (4.72) in L cases compared to other types. DI was highest (1.25) in patients engaged in occupations involving hard work.

In vitro biosynthesis of GbOse4Cer (globoside) and GM2 ganglioside by the (1-->3) and (1-->4)-N-acetyl beta-D-galactosaminyltransferases from embryonic chicken brain. Solubilization, purification, and characterization of the transferases

(1-->4)-N-Acetyl-beta-D-galactosaminyltransferase (GalNAcT-1) and (1-->3)-N-acetyl-beta-D-galactosaminyltransferase (GalNAcT-2), which are involved in the in vitro biosynthesis of GM2 and GbOse4Cer glycosphingolipids, respectively, have been solubilized and separated by differential detergent extraction from a membrane preparation of 19-day-old embryonic chicken brain. The separated GalNAcT-1 activity had a pH optima of 7.8-8.0, and the separated GalNAcT-2 activity a single pH optimum of 7.2. Furthermore, the partially purified GalNAcT-2 preparation catalyzed the transfer of N-acetylgalactosamine from UDP-D-[3H]GalNAc to only GbOse3Cer and nLcOse5Cer. Both GalNAcT-1 and GalNAcT-2 activities were purified to approximately 316- and 428-fold, respectively, by use of UDP-hexanolamine-Sepharose 4B affinity-column chromatography. However, the partially purified GalNAcT-1 preparation appeared to be active only with GM3, lactosylceramide, and lactotriaosylceramide. The proposed linkage of the N-acetylgalactosamine unit incorporated into GM3 is beta-D-GalpNAc-(1-->4)-GM3 from the isolation of [3H]threitol after hydrolysis of the desialylated, lead tetraacetate-treated, enzymic product, beta-D-GalpNAc-(1-->4)-beta-D-[6-3H]Galp-(1-->4)-beta-D-Glcp-(1-->1)-Cer . In addition, beta-D-GalpNAc-(1-->3)-GbOse3Cer was produced, as shown by the identification of 2,4,6-tri-O-methyl-galactose after permethylation and hydrolysis of the GalNAcT-2 enzymic product, GalpNAc-[6-3H]Galp--->Gal-->Glc-->Cer.

Study of the characteristics and causes of relapse amongst leprosy cases in an urban area (Calcutta)

In this retrospective study of the 3737 cases of leprosy released from treatment and followed-up during 1975 to 1990, 63 had relapsed giving an overall relapse rate of 1.69%. The relapse rate was significantly higher in the immunologically unstable N?L (Borderline) cases (2.9%). It was also higher in those who had dapsone monotherapy (1.92%) compared to those who had multidrug therapy (1.01%). The relapse rate was higher in the 10 to 29 years age group and among those who became pregnant suggesting puberty and pregnancy could be risk factors. Males had a significantly higher relapse rate (2.1%) than females (1.1%). 45.2% of relapses in N (Non-lepromatous) cases occurred within 24 months and 71.4% within 36 months of stopping treatment. In those having monotherapy, 57.1% of relapses occurred within 24 months and 76.8% within 36 months. Regularity in treatment did not seem to have much influence on relapse rates.

Biosynthesis in vitro of GlcA beta 1-3nLcOse4Cer by a novel glucuronyltransferase (GlcAT-1) from embryonic chicken brain

A novel glucuronyltransferase (GlcAT-1) has been detected in embryonic chicken brains. This enzyme catalyzes the biosynthesis in vitro of glucuronic acid containing glycolipids starting from neolactotetraosylceramide (nLcOse4Cer) and neolactohexaosylceramide (nLcOse6Cer). The activity is present primarily in the Golgi-rich membrane fraction and can be extracted (60%) from the membrane using a neutral detergent, Nonidet P-40, at pH 7.0. The detergent-solubilized GlcAT-1 is stable (70%) at -20 degrees C for at least 4 months. Both membrane-bound GlcAT-1 and solubilized GlcAT-1 show similar pH optima, 6.5-7.0, in HEPES buffer. The Km values were 15 and 200 microM with UDP-[14C] GlcA and nLcOse4Cer, respectively, when the detergent-solubilized supernatant fraction was used as enzyme source. The purified 14C radioactive product that comigrated with chemically characterized GlcA beta 1-3nLcOse4Cer (GlcA-nLc4) also yielded a positive immunostain with monoclonal antibody (human IgM-RI). The anomeric linkage was established as beta-linked GlcA to the terminal galactose of the substrate, as evidenced by 90-99% cleavage of the terminal [14C] GlcA by purified Helix pomatia and limpet glucuronidases. Permethylation studies of the radioactive product obtained from [6-3H]Gal beta 1-4LcOse3Cer and non-radioactive UDP-GlcA showed the presence of 2,4,6-tri-O-methylgalactose in the hydrolyzed enzymatic product. These studies established the structure of the biosynthesized product from nLcOse4Cer as GlcA beta 1-3Gal beta 1-4 GlcNAc beta 1-3Gal beta 1-4Glc-ceramide.

Biosynthesis in vitro of core lacto-series glycosphingolipids by N-acetyl-D-glucosaminyltransferases from human colon carcinoma cells, Colo 205

Two N-acetyl-D-glucosaminyltransferases have been detected in human colon carcinoma Colo 205 cells. These enzymes catalyze the biosynthesis in vitro of the core-glycolipid of Type 1 and Type 2 lacto-series antigens and of the polylactosamine-containing longer chain antigenic structures, respectively. The first enzyme, GlcNAcT-1, which catalyzes the formation of lactotriosylceramide [LcOse3Cer, beta-D-GlcpNAc-(1----3)-LcOse2Cer, the core for all lacto-series Type 1 and Type 2 chains] from lactosylceramide [beta-D-Galp-(1----4)-D-Glcp-Cer, LcOse2Cer] and UDP-GlcNAc shows optimum activity in the presence of nonionic detergent Triton CF-54. The other enzyme, GlcNAcT-2, which catalyzes the biosynthesis in vitro of iLcOse5Cer [beta-D-GlcpNAc-(1----3)-nLcOse4Cer, the core for polylactosamine-containing antigens] from nLcOse4Cer [beta-D-Galp-(1----4)-LcOse3Cer] and UDP-GlcNAc, is optimally active with the zwitterionic detergent, Zwittergent 3-14, when membrane-bound. Both of these activities, however, can be extracted from the membrane by use of a nonionic detergent. Triton X-114, with nearly the same efficiency. These two transferases showed different pH optima, different cation and anion effects, and differential heat-inactivation patterns at 55 degrees. Permethylation studies of the radioactive products isolated from both of the enzyme-catalyzed reactions using respective 3H-substrates and nonradioactive UDP-GlcNAc showed the presence of 2,4,6-tri-O-methylgalactose in the hydrolyzed products. This indicated the presence of a (1----3)-linked beta-D-GlcpNAc group at the nonreducing end in both cases. The linkage of the beta-D-GlcpNAc group to the subterminal D-Gal residue in the two products was confirmed by an almost 90% cleavage of the terminal [3H]GlcNAc group by purified clam and papaya beta-D-hexosaminidases.

Effect of a fatty acid moiety of phospholipid and ceramide on purified GalT-3 (UDP-Gal:GM2 beta 1-3 galactosyltransferase) activity from embryonic chicken brain

Galactosyltransferase, GalT-3 (UDP-Gal:GM2 beta 1-3 galactosyltransferase) has been characterized and solubilized from 19-day-old embryonic chicken brain, and purified to over 2000-fold using mixed-modal chromatography on a omega-aminohexyl Sepharose column and affinity chromatography on a UDP-hexanolamine Sepharose column. The activity of purified GalT-3 was modulated by phospholipids in vitro with stimulation observed specifically with dipalmitoyl phosphatidylethanolamine (PE). All natural phospholipids tested (PE, PC and PI) inhibited GalT-3 activity. Enzyme activity was affected by the structure of the phospholipid vesicle. It was stabilized by the hexagonal (dipalmitoyl PE) structure and inhibited by the bilayer (dielaidoyl PE) structure. The long-chain fatty acid moiety of the glycosphingolipid substrate, GM2, was found to be necessary for optimum enzyme activity. In the absence of fatty acid, the modified substrates, lyso-GM2 and acetyl-GM2, had a 10-fold increased Km and a 4-8 fold decreased Vmax compared to the normal substrate. We postulate that GalT-3 belongs to a group of glycosyltransferases having recognition for both the carbohydrate as well as the hydrophobic domains (HY-CARS) of their substrates and that the fatty acid moiety of either the substrate (GM2) or a heterotropic effector (phospholipid) plays an important role in regulating the activity of this enzyme.

Characterization of solubilized GlcAT-1 (UDP-GlcA: nLcOse4Cer beta 1-3 glucuronyltransferase) activity from embryonic chicken brain and its inhibition by D-erythro-sphingosine

Glycolipid glucuronyltransferase activity (GlcAT-1) has been solubilized and characterized from 19-day-old embryonic chicken brain Golgi-rich membranes. The enzyme catalyzes the biosynthesis in vitro of GlcA beta 1-3nLcOse4Cer glycolipid using neolactetraosylceramide (nLcOse4Cer, Gal beta 1-4GlcNAc beta 1-3Gal beta-1-4Glc-Cer) as the substrate. The membrane-bound enzyme shows optimum activity in the presence of neutral detergents such as Triton CF-54, Triton DF-12, and Nonidet P-40. Approximately 60% of the enzyme activity can be solubilized from the Golgi membrane by Nonidet P-40. The solubilized GlcAT-1 activity is inhibited by different salts such as NaCl, NaBr, NaI, and NaOAc, but not by sodium fluoride (up to 0.4 M concentration). Desialyzed alpha 1 acid glycoprotein (SA alpha 1AGP) can be used as a substrate for glucuronyltransferase. Competition studies between glycolipid (nLcOse4Cer) and glycoprotein SA alpha 1AGP) substrates show a mixed type of inhibition. Phospholipids, in particular phosphatidylglycerol, stimulate solubilized GlcAT-1 activity, while D-erythro-sphingosine, a metabolite of glycosphingolipids, is inhibitory (50% inhibition at 0.8 mM D-erythro-sph). These results demonstrate that both phospholipid as well as sphingosine might be involved in modulating glucuronyltransferase activity.

Carbohydrate and hydrophobic-carbohydrate recognition sites (CARS and HY-CARS) in solubilized glycosyltransferases

Six different glycosyltransferases that are active with glycosphingolipid substrates have been purified from Golgi-membranes after solubilization with detergents. It appears that GalT-4(UDP-Gal:GlcNAc-R1 beta 1-4GalT), GalNAcT-2(UDP-Gal:Gal alpha-R2 beta 1-3GalNAcT) and FucT-2(GDP-Fuc:Gal beta GlcNAc-R3 alpha 1-2FucT) are specific for oligosaccharides bound to ceramide or to a protein moiety. These are called CARS (carbohydrate recognition sites) glycosyltransferases (GLTs). On the other hand, GalT-3(UDP-Gal:GM2 beta 1-3GalT), GalNAcT-1(UDP-GalNAc:GM3 beta 1-4GalNAcT) and FucT-3 (GDP-Fuc:LM1 alpha 1-3FucT) recognize both hydrophobic moieties (fatty acid of ceramide) as well as the oligosaccharide chains of the substrates. These GLTs are called HY-CARS (hydrophobic and carbohydrate recognition sites). D-Erythro-sphingosine (100-500 microM) modulates the in vitro activities of these GLTs. Modulation depends on the binding of D-sphingosine to a protein backbone, perhaps on more than one site and beyond transmembrane hydrophobic domains. Control of GLTs by free D-sphingosine was suggested with the concomitant discovery of ceramide glycanase in rabbit mammary tissues. The role of free sphingosine as an in vivo homotropic modulator of glycosyltransferases is becoming apparent.

A study of the impact of health education inparted to school children on their knowledge, attitude and practice in regard to personal hygiene

Education concerning prevailing health problems and the method of preventing and controlling them was considered to be one of the first eight essential activities in primary health care. Hence this study was attempted to assess the impact of health education on the knowledge, attitude and practices of school children aged 10-14 years in two secondary schools situated in Burdwan District of West Bengal. For this purpose health education was imparted by a team consisting of Medical Officer and Paramedical staff. Education was given on personnel hygiene. The entire education programme was arranged in such a way that the course could be completed in six months time. The knowledge, attitude and practice status of the students was assessed before imparting training, twice during the training period at an interval of three months and finally after 9 months from the start of training. The evaluation was done with the help of scoring. The results indicated that the health knowledge of the student significantly improved after education. Attitude of the students towards personal hygiene also improved significantly after education. The practice of personal hygiene improved significantly as well. The present study also revealed that the improvement in health practice was not commensurating with the improvement of knowledge and attitude after education.

Solubilized glycosyltransferases and biosynthesis in vitro of glycolipids

The assembly of most of the ceramide-linked glycolipids (GSLs) in eukaryotic cells occurs in Golgi bodies. At least 18 different glycolipid:glycosyltransferases (GSL:GLTs) have been characterized, 10 of which have been solubilized. These GLTs can be classified into 2 distinct groups: 1) GLTs dedicated to either Dol-P-P-sugar(s) or ceramide-linked sugar(s); and 2) GLTs with dual loyalties (i.e., they compete with glycolipid- and glycoprotein-bound oligosaccharides). Studies with solubilized and purified GalNAcT-1 and GalNAcT-2 from embryonic chicken brains prove that GalNAcT-1 (UDP-GalNAc:GM3 beta 1-4GalNAcT) is specific for GSL, whereas GalNAcT-2 (UDP-GalNAc:Gb3 beta 1-3GalNAcT) can transfer to an oligosaccharide containing the alpha-linked terminal galactose. Similarly, GalT-3 (UDP-Gal:GM2 beta 1-3GalT) is more specific for ganglio-oligosaccharide and GalT-4 (UDP-Gal:Lc3 beta 1-4GalT) can transfer galactose to N-acetylglucosamine linked to p-nitrophenol, glycolipid or glycoprotein. Both GalT-3 and GalT-4 have been separated and purified from embryonic chicken brains. Studies with solubilized SAT-4 and SAT-3, from bovine spleen and embryonic chicken brains, respectively, suggest the existence of 2 different gene-expressed alpha 2-3SATs. The newly discovered FucT-3 (GDP-Fuc:NeuGc-iLc6-alpha 1-3FucT) from human colon carcinoma (Colo-205) has also been solubilized and separated from other GSL:GLTs. Using a new activity gel-Western blot combined technique, the molecular mass of this FucT-3 was determined to be 105 kDa.

Biosynthesis in vitro of a globoside containing a 2-acetamido-2-deoxy-beta-D-galactopyranosyl group (1----3)-linked and Forssman glycolipid by two N-acetylgalactosaminyltransferases from chemically transformed guinea pig cells

Two N-acetylgalactosaminyltransferase activities (GalNAcT-2 and GalNAcT-3) have been characterized in chemically transformed, cultured guinea-pig cell lines (104C1 and 106B). Line 104C1 is a benz[a]pyrene-transformed tumorigenic variant, whereas line 106B is a 7,12-dimethylbenz[a]anthracene-transformed nontumorigenic variant obtained from fetal guinea-pig cells at 43 days of gestation. The GalNAcT-2 (UDP-GalNAc:GbOse3Cer beta-N-acetylgalactosaminyltransferase) isolated from both 104C1 and 106B cells catalyzed the transfer of Gal-NAc from UDP-GalNAc to the 3H-labeled terminal galactose group of Gb3 [( 6-3H]Gal alpha 1----4Gal beta 1----4Glc----Cer). The 3H-labeled globoside was purified and then subjected to exhaustive methylation. After acetolysis, the partially methylated sugars were separated by two-dimensional, thin-layer chromatography. 3H-Label was detected in two major areas, 2,4,6-tri-O-Me-Gal (40%) and 2,3,4,6-tetra-O-Me-Gal (46%). In a separate experiment, 80% of the GalNAc was released when labeled GbOse4Cer [( 3H]GalNAc----Gal alpha 1----4Gal beta 1----4Glc----Cer) was treated with purified clam beta-hexosaminidase. The present results establish the formation of a beta-D-GalpNAc-(1----3) linkage in the terminal region of the biosynthesized globoside. GalNAcT-3 activity (UDP-GalNAc:GbOse4Cer alpha-GalNAc-transferase), which catalyzes the transfer of GalNAc from UDP-[14C]- or -[3H]GalNAc to GbOse4Cer (GalNAc beta 1----3Gal alpha 1----4Gal beta 1----4Glc----Cer), was three times higher in 106B cells than in 104C1 cells. The isolated, purified radioactive product formed an immunoprecipitin line against rabbit anti-Forssman antibody.

A rapid preparative method for isolation of neutral and acidic glycosphingolipids by radial thin-layer chromatography

An efficient method to separate neutral and acidic glycosphingolipids (GSLs) from their mixtures within a short period (45-60 min) and with low consumption of solvents (chloroform-methanol-water, 60/35/8 (v/v/v); 250-500 ml) has been developed. This method utilizes a centrifugal thin-layer chromatograph (Chromatotron) and the GSL mixtures (30-400 mg) are applied to glass plates coated with a 1-mm layer of silica gel 60 PF-254. The method (radial thin-layer chromatography) is rapid and simple and the recovery of glycosphingolipids is high (70-80%).