Effectiveness of COVID-19 vaccine (Covaxin) against breakthrough SARS-CoV-2 infection in India

India approved COVID-19 vaccine called Covaxin, developed by the Indian Council of Medical Research and Bharat Biotech Ltd. The primary objective of the study was to estimate the effectiveness of Covaxin in preventing breakthrough SARS-CoV-2 infection in healthcare workers (HCWs). A test-negative matched case-control study was conducted among HCWs of tertiary care hospital in Eastern India. Any HCW who tested positive for COVID-19 using RT-PCR during April and May 2021 was taken as the case. The HCWs who tested negative for COVID-19 by RT-PCR were considered as controls after matching with the date of testing and profession of the cases. Vaccination data were collected from the institution's vaccine database and recall. In case of discrepancy, it was confirmed from the CoWIN portal (cowin.gov.in). The sample size was 670 participants (335 pairs). Conditional logistic regression models were used to calculate the adjusted odds ratio for breakthrough SARS-CoV-2 infection. Vaccine effectiveness was calculated using the following formula: VE = (1-aOR) × 100%. Sensitivity analysis was done for effectiveness of Covaxin, excluding Covishield vaccination. The mean age of participants was 29.1 years (SD = 7.1), and the majority were males (55.2%). Among the study participants, 60% were completely vaccinated, 18.51% were partially vaccinated, and 21.49% were unvaccinated. After adjusting for age, gender, type of household and past history of COVID-19 disease in conditional logistic models, the vaccine effectiveness was 22% (aOR 0.78, 95% CI: 0.52-1.17; p = .233). Sensitivity analysis with Covaxin showed an effectiveness of 29% (aOR 0.71, 95% CI: 0.47-1.08; p = .114) for preventing breakthrough SARS-CoV-2 infection.

Association mapping for protein, total soluble sugars, starch, amylose and chlorophyll content in rice

BACKGROUND

Protein, starch, amylose and total soluble sugars are basic metabolites of seed that influence the eating, cooking and nutritional qualities of rice. Chlorophyll is responsible for the absorption and utilization of the light energy influencing photosynthetic efficiency in rice plant. Mapping of these traits are very important for detection of more number of robust markers for improvement of these traits through molecular breeding approaches.

RESULTS

A representative panel population was developed by including 120 germplasm lines from the initial shortlisted 274 lines for mapping of the six biochemical traits using 136 microsatellite markers through association mapping. A wide genetic variation was detected for the traits, total protein, starch, amylose, total soluble sugars, chlorophyll a, and chlorophyll b content in the population. Specific allele frequency, gene diversity, informative markers and other diversity parameters obtained from the population indicated the effectiveness of utilization of the population and markers for mapping of these traits. The fixation indices values estimated from the population indicated the existence of linkage disequilibrium for the six traits. The population genetic structure at K = 3 showed correspondence with majority of the members in each group for the six traits. The reported QTL, qProt1, qPC6.2, and qPC8.2 for protein content; qTSS8.1 for total soluble sugar; qAC1.2 for amylose content; qCH2 and qSLCHH for chlorophyll a (Chl. a) while qChl5D for chlorophyll b (Chl. b) were validated in this population. The QTL controlling total protein content qPC1.2; qTSS7.1, qTSS8.2 and qTSS12.1 for total soluble sugars; qSC2.1, qSC2.2, qSC6.1 and qSC11.1 for starch content; qAC11.1, qAC11.2 and qAC11.3 for amylose content; qChla8.1 for Chl. a content and qChlb7.1 and qChlb8.1 for Chl. b identified by both Generalized Linear Model and Mixed Linear Model were detected as novel QTL. The chromosomal regions on chromosome 8 at 234 cM for grain protein content and total soluble sugars and at 363 cM for Chl. a and Chl. b along with the position at 48 cM on chromosome 11 for starch and amylose content are genetic hot spots for these traits.

CONCLUSION

The validated, co-localized and the novel QTL detected in this study will be useful for improvement of protein, starch, amylose, total soluble sugars and chlorophyll content in rice.

Clinico-Epidemiological Characteristics of Healthcare Workers with SARS-CoV-2 Infection during the First and Second Waves in a Teaching Hospital from Eastern India: A Comparative Analysis

In this retrospective observational study, we have performed a comparative analysis of the demographic, clinical and epidemiological characteristics of the HCWs affected with SARS-CoV-2 infection during first two waves in India. The overall prevalence of SARS-CoV-2 infection among HCWs was found to be 15.24% (14.20-16.33) and 23.38% (22.14-25.65) during first and second waves respectively. The second wave showed an adjusted odds ratio of 0.04(0.02-0.07) and 2.09(1.49-2.93) for hospitalization and being symptomatic, respectively. We detected significantly higher level of C-reactive protein (CRP) among admitted HCWs during the second wave (5.10 -14.60 mg/dl) as compared to the first wave (2.00 - 2.80 mg/dl). Our study found the relative risk of SARS-CoV-2 reinfection among HCWs during the second wave to be 0.68 [0.57-0.82, p < 0.001)]. Although, the prevalence of SARS CoV-2 infection and risk of being symptomatic was higher during second wave, the risk of hospitalization was less when compared with the first wave.

Genome-wide analysis and characterization of heat shock transcription factors (Hsfs) in common bean (Phaseolus vulgaris L.)

Heat shock transcription factors (Hsfs) play an essential role as transcriptional regulatory proteins against heat stress by controlling the expression of heat-responsive genes. Common bean is a highly thermosensitive crop, and, therefore, its genome sequence information is segregated, characterized here in terms of heat shock transcription factors and its evolutionary significance. In this study, a complete comprehensive set of 29 non-redundant full-length Hsf genes were identified and characterized from Phaseolus vulgaris L. (PvHsf) genome sequence. Detailed gene information such as chromosomal localization, domain position, motif organization, and exon-intron identification were analyzed. All the 29 PvHsf genes were mapped on 8 out of 11 chromosomes, indicating the gene duplication occurred in the common bean genome. Motif analysis and exon-intron structure were conserved in each group, which showed that the cytoplasmic proteins highly influence the conserved structure of PvHsfs and heat-induced response. The HSF genes were grouped into three classes, i.e., A to C and 14 groups, based on structural features and phylogenetic relationships. Only one pair of paralog sequences suggests that it may be derived from the duplication event during evolution. A comparative genomics study indicated the influence of whole-genome duplication and purifying selection on the common bean genome during development. In silico expression analysis showed the active role of class A and B family during abiotic stress conditions and higher expression in floral organs. The qRT-PCR analysis revealed PvHSFA8 as the master regulator and PvHSFB1A and PvHSFB2A induction during heat exposure in French beans.

Understanding Community Participation in Rural Health Care: A Participatory Learning and Action Approach

Community participation is one of the founding pillars of primary health care. However, due to various reasons, we are yet to achieve complete integration of this component into the health system functioning in India. The objective of our study was to do a formative assessment of community participation in a rural healthcare setting by adopting participatory learning action (PLA). technique. The study participants included frontline health workers and members from local governing institutions of rural areas. The study design is qualitative in nature with a participatory approach. A number of three PLA techniques have been used as a part of this study to recognize available resources for community participation, address its barriers and facilitators, and finally devise a time-line-based action plan. Based on the this, a conceptual framework for community participation pertaining to the rural healthcare system has been developed. This study highlights the importance of understanding the psychosocial aspects of community participation among various stakeholders involved in rural health care. Lessons learned from this PLA study will be helpful in the integration of community-based participatory approach within grassroot level healthcare planning and service delivery.

Hospital-Based Contact Tracing of Patients With COVID-19 and Health Care Workers During the COVID-19 Pandemic in Eastern India: Cross-sectional Study

Background

The contact tracing and subsequent quarantining of health care workers (HCWs) are essential to minimizing the further transmission of SARS-CoV-2 infection and mitigating the shortage of HCWs during the COVID-19 pandemic situation.

Objective

This study aimed to assess the yield of contact tracing for COVID-19 cases and the risk stratification of HCWs who are exposed to these cases.

Methods

This was an analysis of routine data that were collected for the contact tracing of COVID-19 cases at the All India Institute of Medical Sciences, Bhubaneswar, in Odisha, India. Data from March 19 to August 31, 2020, were considered for this study. COVID-19 cases were admitted patients, outpatients, or HCWs in the hospital. HCWs who were exposed to COVID-19 cases were categorized, per the risk stratification guidelines, as high-risk contacts or low-risk contacts

Results

During contact tracing, 3411 HCWs were identified as those who were exposed to 360 COVID-19 cases. Of these 360 cases, 269 (74.7%) were either admitted patients or outpatients, and 91 (25.3%) were HCWs. After the risk stratification of the 3411 HCWs, 890 (26.1%) were categorized as high-risk contacts, and 2521 (73.9%) were categorized as low-risk contacts. The COVID-19 test positivity rates of high-risk contacts and low-risk contacts were 3.8% (34/890) and 1.9% (48/2521), respectively. The average number of high-risk contacts was significantly higher when the COVID-19 case was an admitted patient (number of contacts: mean 6.6) rather than when the COVID-19 case was an HCW (number of contacts: mean 4.0) or outpatient (number of contacts: mean 0.2; P=.009). Similarly, the average number of high-risk contacts was higher when the COVID-19 case was admitted in a non–COVID-19 area (number of contacts: mean 15.8) rather than when such cases were admitted in a COVID-19 area (number of contacts: mean 0.27; P<.001). There was a significant decline in the mean number of high-risk contacts over the study period (P=.003).

Conclusions

Contact tracing and risk stratification were effective and helped to reduce the number of HCWs requiring quarantine. There was also a decline in the number of high-risk contacts during the study period. This indicates the role of the implementation of hospital-based, COVID-19–related infection control strategies. The contact tracing and risk stratification approaches that were designed in this study can also be implemented in other health care settings.

Experience from a COVID-19 screening centre of a tertiary care institution: A retrospective hospital-based study

BACKGROUND

The COVID-19 pandemic continues to be a significant public health concern across the whole world, including India. In the absence of any specific treatment or vaccine against COVID-19, the role of efficient testing and reporting has been uncontested so far as the number of cases is rising daily. In order to strengthen the screening activities and to prevent nosocomial infection, facility-based screening centres have been designed and operated at various levels of healthcare, including tertiary care institutions.

METHODS

The present study has been planned with an objective to understand the patient profile and evaluate the functioning of COVID-19 screening OPD (CS-OPD) at a tertiary care hospital. In this hospital-based retrospective study, data from individuals visiting the COVID-19 screening OPD during the period from 17th March 2020 to 31st July 2020 were collected. We documented and analysed relevant demographic, epidemiological and clinical characteristics of the patients.

RESULTS

A total of 10,735 patients visited the COVID-19 screening OPD during the defined study period of which 3652 individuals were tested. The majority of the patients, i.e., 65.67% (7050) were male and in the 15-59 years age group (84.68%). The most common symptoms among patients visiting CS-OPD was cough (9.86%). Of the total, 17.17% (1843) of patients reported to the CS-OPD with a contact history of COVID-19-positive patient. On the other hand, 13.49% (1448) of patients were with either domestic or international travel history. The overall testing rate and positivity rate for CS-OPD during this period were found to be 34.02% and 7.94%, respectively.

CONCLUSION

The clinical, demographic and epidemiological characteristics of patients visiting CS-OPD varied across the study period depending upon the containment and testing strategy. The CS-OPD played a crucial role in preventing nosocomial infection and maintaining non-COVID care at the tertiary care hospital.

Fear and anxiety among COVID-19 Screening Clinic Beneficiaries of a tertiary care hospital of Eastern India

India is one among the most affected countries in the COVID-19 pandemic. The increasing number of cases in India and the fear of COVID-19 infection is causing fear and anxiety. Fear and anxiety related to COVID-19 the community dwellers are less studied. This study was conducted to assess the fear and anxiety related to COVID-19 among the people seeking COVID-19 screening test. The cross-sectional study was conducted on a sample of 398 participants aged 18 years and above who attended the screening clinic of a tertiary care hospital of eastern India. Participants were assessed using Coronavirus Anxiety Scale (CAS) and Fear of COVID-19 scale which are validated screening scales. Result showed that 20.4 % of the participants were having anxiety due to COVID-19. The mean fear score was 17.87 ± 4.48. Females, Middle aged, housewives, less educated, symptomatic, co-morbid and people under institutional quarantine were having more fear. People with COVID-19 related anxiety faced more fear. These findings suggest the need for screening anxiety in COVID-19 screening clinics. People with high levels of COVID related anxiety and fear are at risk for developing psychiatric disorders hence need targeted approach to address their mental health.

Synthesis of drug conjugated magnetic nanocomposite with enhanced hypoglycemic effects

In the present study, a magnetic nanocomposite (magnetite Fe₃O₄ and hematite Fe₂O₃) has been successfully synthesized by the sol-gel method and coated with polyvinyl alcohol (PVA) followed by conjugation of anti-diabetic drug metformin. Detailed structural and microstructural characterization of the nanocomposite (NP) and drug conjugated nanocomposite (NP-DC) are analyzed by the Rietveld refinement of respective XRD patterns, FTIR analysis, UV-Vis spectroscopy, SEM and TEM results. SEM and TEM image analyses reveal the spherical morphology and average size of NP, PVA coated nanoparticles (NP-PVA) and NP-DC samples, indicating a suitable size to be a nanocarrier. The biocompatibility of NP and NP-DC was carried out in NIH/3T3 and J774A. 1 cells. The enhanced activity of the drug, when conjugated with nanocomposite, is confirmed after the treatment of both the pure drug and NP-DC sample on the 18 h fasted normoglycemic and hyperglycemic mice. The blood glucose level of the mice is effectively decreased with the same concentration of the pure drug and NP-DC sample. It proves the increased activity of the NP-DC sample, as only 5 wt% drug is present that shows the same efficiency as the pure drug. This study suggests excellent biocompatibility and cytocompatibility of NP and NP-DC besides the critical property as a hypoglycemic agent. It is the first time approach of conjugating metformin with a magnetic nanocomposite for a significant increment of its hypoglycemic activity, which is very important to reduce the side effect of metformin for its prolonged use.

Empowering primary healthcare institutions against COVID-19 pandemic: A health system-based approach

Primary health care institutions (PHCIs) are an essential foundation for the national response to COVID-19 disease in India. With the soaring number of confirmed cases, the health system is currently under unprecedented stress. In this scenario, there is a pressing need for empowering PHCIs in COVID-19 preparedness and response. The World Health Organization's (WHO) "Health system building block" approach is a classic model, which can work as a road map for the national health system in the process of empowering PHCIs against COVID-19 as well as other upcoming global and regional public health emergencies.

Association mapping reveals multiple QTLs for grain protein content in rice useful for biofortification

Rice is the staple food for majority of the global population. But, rice grain has low protein content (PC). Mapping of QTLs controlling grain PC is essential for enhancement of the trait through breeding programs. A shortlisted panel population for grain protein content was studied for genetic diversity, population structure and association mapping for grain PC. Phenotyping results showed a wide variation for grain PC. The panel population showed a moderate level of genetic diversity estimated through 98 molecular markers. AMOVA and structure analysis indicated linkage disequilibrium for grain PC and deviation of Hardy-Weinberg's expectation. The analysis showed 15% of the variation among populations and 73% among individuals in the panel population. STRUCTURE analysis categorized the panel population into three subpopulations. The analysis also revealed a common primary ancestor for each subpopulation with few admix individuals. Marker-trait association using 98 molecular markers detected 7 strongly associated QTLs for grain PC by both MLM and GLM analysis. Three novel QTLs qPC3.1, qPC5.1 and qPC9.1 were detected for controlling the grain PC. Four reported QTLs viz., qPC3, QPC8, qPC6.1 and qPC12.1 were validated for use in breeding programs. Reported QTLs, qPC6, qPC6.1 and qPC6.2 may be same QTL controlling PC in rice. A very close marker RM407 near to protein controlling QTL, qProt8 and qPC8, was detected. The study provided clue for simultaneous improvement of PC with high grain yield in rice. The strongly associated markers with grain PC, namely qPC3, qPC3.1, qPC5.1, qPC6.1, qPC8, qPC9.1 and qPC12.1, will be useful for their pyramiding for developing protein rich high yielding rice.

Early seedling vigour, an imperative trait for direct-seeded rice: an overview on physio-morphological parameters and molecular markers

Rapid uniform germination and accumulation of biomass during initial phase of seedling establishment is an essential phenotypic trait considered as early seedling vigour for direct seeded situation in rice irrespective of environment. Enhanced role of carbohydrate, amylase, growth hormones, antioxidant enzymes and ascorbic acid brings changes in vigour and phenotype of seedling. Early establishment and demanding life form dominate the surroundings. Crop plant that has better growth overdrives the weed plant and suppresses its growth. Seedling early vigour is the characteristic of seed quality and describes the rapid, uniform germination and the establishment of strong seedlings in any environmental condition. The phenotype of modern rice varieties has been changed into adaptable for transplanted rice with thirst toward water and selection pressure for semi-dwarf architecture resulting in reduced early vigour. Decreasing freshwater availability and rising labour cost drives the search for a suitable alternative management system to enhance grain yield productivity for the burgeoning world population. In view of these issues, much attention has been focused on dry direct-seeded rice, because it demands low input. A rice cultivar with a strong seedling vigour trait is desirable in case of direct seeding. However, seedling vigour has not been selected in crop improvement programmes in conventional breeding due to its complex nature and quantitative inheritance. Molecular markers have been proven effective in increasing selection efficiency, particularly for quantitative traits that are simply inherited. Marker-assisted selection approach has facilitated efficient and precise transfer of genes/QTL(s) into many crop species and suggests a speedy and efficient technique over conventional breeding and selection methods. In this review, we present the findings and investigations in the field of seedling vigour in rice that includes the nature of inheritance of physio-morphological and biochemical traits and QTLs to assist plant breeders who work for direct-seeded rice.

Investigation of an outbreak of infectious pustular balanoposthitis in cattle breeding bulls at a frozen semen bank

Infectious pustular balanoposthitis (IPB) is one of the reproductive disorders caused by bovine herpesvirus 1 (BoHV1) that can be transmitted through artificial insemination. A herd of 63 breeding bulls at a frozen semen bank in Odisha state in India experienced a suspected outbreak of IPB, with 11 bulls showing clinical signs of the infection. Clinical signs were noticed in two bulls initially and a few days after in the other nine animals. Serum samples from 53 bulls were examined for anti-BoHV1 antibodies using a virus neutralisation test (VNT) and a competitive enzyme-linked immunosorbent assay (cELISA); the remaining ten bulls were not included in the study because it was difficult to restrain them at that time. Paired serum samples were collected 21 days apart from ten clinically affected bulls (the eleventh clinically affected bull was not included in the study for the reason stated above). In the neutralisation test, the paired serum samples showed a two- to fourfold increase in anti-BoHV1 antibody titre; in the cELISA, the paired samples were also found positive for anti-BoHV1 antibodies. Serum samples from 43 in-contact bulls were collected about day 22 after the first observation of clinical infection in the herd. Among these serum samples, a total of 30 were found positive for anti-BoHV1 antibodies in the VNT and a total of 30 were found positive in cELISA. Ten samples were positive in one test but not the other and 25 tested positive in both tests. In all, 35 serum samples from in-contact bulls tested positive in either one or both of the two types of test. An overall agreement of 76.74% was found in detection of anti-BoHV1 antibodies in the two tests. Sensitivity was higher than specificity in detection of anti-BoHV1 antibodies in the serum samples. The glycoprotein C region of the genomic DNA of BoHV1 was amplified from semen samples by polymerase chain reaction. The findings from the outbreak indicate that continuous monitoring of breeding bulls at frozen semen banks is warranted to avoid the risks associated with artificial insemination.

Unusual calcified foreign body in ureter

DOI: http://dx.doi.org/10.3126/jcmsn.v8i3.8688 Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-3, 47-50

Public health impact of plastics: An overview

Plastic, one of the most preferred materials in today's industrial world is posing serious threat to environment and consumer's health in many direct and indirect ways. Exposure to harmful chemicals during manufacturing, leaching in the stored food items while using plastic packages or chewing of plastic teethers and toys by children are linked with severe adverse health outcomes such as cancers, birth defects, impaired immunity, endocrine disruption, developmental and reproductive effects etc. Promotion of plastics substitutes and safe disposal of plastic waste requires urgent and definitive action to take care of this potential health hazard in future.

A lethal chest injury following rhinoceros attack– a case report

Injuries following wild animal encounters continue to be a major public health problem. Majority of such injuries are minor, however, many injuries remain undocumented. Many victim die, primarily in third-world countries, before receiving adequate medical care. Penetrating injuries to the chest following the attack by the wild animals, though rare, present a challenging problem. Though a great number of papers have been published regarding the injuries following encounter with animals, least are the lethal injuries occuring in the thoracic region and the survival out of these grave injury is very minimum. We herein present the least possible surviving case with lethal penetrating injury of the chest and left lung following the goring by the rhinoceros. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-1, 52-55 DOI: http://dx.doi.org/10.3126/jcmsn.v8i1.6827

A community based study of health related quality of life of the elderly in urban India

The increasing population of elderly and emergence of chronic diseases, which adversely affects their quality of life, have implications in form of rising burden on the health systems in developing countries like India. A study was conducted to know the common morbidities and their effect on the health related quality of life (HRQOL) of the elderly. A community based cross-sectional study was conducted and 200 subjects, selected by cluster sampling from central Delhi, India, were studied from April 2005-February 2006. A pretested, semi-structured questionnaire along with short form-36 (SF-36) survey was used for data collection. The data was analysed using Chi-square and Student's 't' test on SPSS 12 statistical software. There were 89 males and 111 females, majority (64.5%) between 60 and 69 years of the age, were included in the study; 68.0% men and 37.8% of the women were married at the time of the study. Mean number of morbidities was 2.25 and 71.5% subjects had at least one disability/impairment. Around 2.5% subjects reported their health being poor and, another 50% of worsening of their health in last one year. HRQOL score for people with and without chronic morbidity/disability was 51.8 and 73.5 respectively with mean being at 56.7 (p < 0.05). Most commonly affected HRQOL domains were role physical, physical functioning and general health. Scores decreased as the age increased with females having less mean scores than males (p < 0.05). The quality of life of elderly in urban India is severely affected by the disabilities, impairments and chronic morbidities. There is an immediate need for specific preventive and rehabilitative measures targeted on elderly to maintain their quality of life in this population in Delhi.

Persistent left fifth aortic arch with pentalogy of Fallot

Congenital double-lumen aortic arch resulting from persistence of the fifth aortic arterial arch (PFAA) is a rare congenital anomaly. It appears as a vascular structure running inferior and parallel to the "real" aortic arch from the innominate artery to the left subclavian artery. We report a case of persistent fifth aortic arch (systemic-to-systemic arterial connection) with pentalogy of Fallot in a patient who underwent successful intracardiac repair with a transannular patch with very proximal aortic cannulation for cardiopulmonary bypass (CPB).

Physicians and communities knowledge and awareness about new vaccines in immunization program: a study to derive lesson for increasing uptake

BACKGROUND

The knowledge, attitude of physicians about any interventions has effect on the practices while the perceptions about such intervention by caregivers have impact on the acceptance in community.

OBJECTIVES

This study was conducted to assess the knowledge and attitude of physicians and perception of the caregivers about new vaccines, and to identify the solutions to address the knowledge gap, if any.

MATERIALS AND METHODS

A cross sectional study was conducted a major city of India from Sept 2006-Jan 2007. 107 physicians and 298 caregivers were interviewed using a pre-tested semi structured interview schedule. The data so collected was analyzed using chi square test and proportions. P value of less than 0.05 was considered statistically significant.

RESULTS

It was found that only 3/5th physicians were aware that typhoid vaccination was part of the immunisation program. The knowledge about all the aspects of typhoid was poor amongst physicians in comparison of other vaccine (Hepatitis B) in the immunisation program. Physicians at private health facilities had poor knowledge than those working at government health facilities. However, majority of the physicians had positive attitude towards typhoid vaccination. All the caregivers had heard about typhoid disease and 39.8% about the vaccine also. Almost 80% of them were ready to pay for typhoid vaccination.

CONCLUSIONS

The study underlines the need for special efforts to increase the awareness about typhoid vaccination amongst these groups to increase the uptake of the vaccine.

Comparison of propofol based anaesthesia to conventional inhalational general anaesthesia for spine surgery

BACKGROUND

Often conventional Inhalational agents are used for maintenance of anaesthesia in spine surgery. This study was undertaken to compare propofol with isoflurane anaesthesia with regard to haemodynamic stability, early emergence, postoperative nausea and vomiting (PONV) and early assessment of neurological functions. PATIENTS #ENTITYSTARTX00026;

METHODS

Eighty ASA grade I &II adult patients were randomly allocated into two groups. Patients in study group received inj propofol for induction as well as for maintenance along with N(2)O+O(2) and the control group patients received inj thiopentone for induction and N(2)O+O(2)+isoflurane for maintenance. BIS monitoring was used for titrating the anaesthetic dose adjustments in all patients. All patients received fentanyl boluses for intraoperative analgesia and atracurium as muscle relaxant. Statistical data containing haemodynamic parameters, PONV, emergence time, dose of drug consumed & quality of surgical field were recorded and compared using student t' test and Chi square test.

RESULTS

The haemodynamic stability was coparable in both the groups. The quality of surgical field were better in study group. Though there was no significant difference in the recovery profile (8.3% Vs 9.02%) between both the groups, the postoperative nausea and vomiting was less in propofol group than isoflurane group (25%Vs60%). The anaesthesia cost was nearly double for propofol than isoflurane anaesthesia.

CONCLUSION

Haemodynamic stability was comparable in both the groups. There was no significant difference in the recovery time between intravenous and inhalational group. Patients in propofol group were clear headed at awakening and were better oriented to place than inhalational group.

Survival of enteric bacteria and coliphage MS2 in pure human urine

AIMS

The survival of Escherichia coli, Salmonella enterica serovar Typhimurium, Enterococcus faecalis and coliphage MS2 was studied in stored, fresh and diluted (1 : 1) human urine at 15 and 30 degrees C.

METHODS AND RESULTS

Survival rate was studied by the plate count method. All the organisms showed rapid inactivation in stored urine, but they survived better in diluted and fresh urine. The high pH level and temperature were the major factors found to influence the survival of the micro-organisms with the survival rate being higher at 15 degrees C than at 30 degrees C.

CONCLUSIONS

The destruction of all micro-organisms in stored urine required <1 week at 30 degrees C. Thus, the storage of urine is a useful way to reduce the risk of contamination while using urine as a fertilizer.

SIGNIFICANCE AND IMPACT OF THE STUDY

The urine fertilization is aimed for the developing countries and the high temperatures in these countries may hasten the destruction of micro-organisms in urine. On the contrary, a higher survival rate of these organisms in fresh and diluted urine is a public health concern because the dilution of urine with water is likely to happen during flushing.

Socio-demographic profile of 15-24 years old male narcotic substance users in a resettlement colony of Delhi

A community based cross-sectional study was conducted during April 2004-March 2005 in an urban resettlement colony in East Delhi to study the narcotic substance use and the socio-demographic characteristics of users. 208 male narcotic substance users aged 15-24 years were studied. 59.1% of the narcotic substance users were between 21-24 years of age. 78.8% were using ganja and 39.9% each heroin & bhang. 37% were abusers; 36% were dependent users. 58.7% were single at the time of interview. 48% were either illiterate or just literate; 64% belonged to middle socio-economic status. 68% had initiated narcotic substance use out of curiosity.

Screening for psychosocial development among infants in an urban slum of Delhi

OBJECTIVE

Psychosocial developmental screening of the infants in an urban slum of Delhi and studying the factors influencing the development.

METHODS

In this cross-sectional study 202 infants and their mothers were included. Psychosocial Development Screening Test developed by Indian Council of Medical Research was used to asses the development status of infants, and the mothers were interviewed for socio-demographic details

RESULTS

Infants who achieved milestones in time were 92.5% for personal skills, 91.8% for hearing language and concept development and 90.6% for gross motor milestones, respectively. These percentages were lower for Vision and fine motor (88.6) and social skills (81.4). Sex of the infant and socioeconomic status of their families significantly influences the few domains of development. Other factors like age of the infant, literacy of their mothers were not significantly influencing the development of infants.

CONCLUSION

The objective evaluation and screening for psychosocial development of infants living tin urban slums is necessary for early detection and intervention.

Can Southeast Asia eradicate yaws by 2010? Some lessons from the Yaws Eradication Programme of India

Yaws has traditionally been known as a skin disease that affects people living in hilly, remote and inaccessible areas. Despite the availability of successful treatment and yaws control programmes worldwide since 1948, yaws is endemic in a number of countries, probably because it is not considered a priority disease for eradication. The presence of a disease that can be eradicated in a community can be taken as a sign of 'backwardness' and an indicator of inappropriate public health efforts. Yaws is endemic in 3 countries of the Southeast Asia (SEA) Region of WHO-indonesia, India and Timor-Leste. The WHO SEA Regional Office has set a target for yaws eradication from the region by year 2010. Yaws eradication is at various stages in these countries. India has reported no cases for the past 3 years and has declared elimination. In the other 2 countries yaws eradication programmes are in their infancy and achieving the WHO regional goal appears impossible. However, if lessons are learnt from the Yaws Eradication Programme in India and an externally funded, technically supported, vertical programme is started immediately in Indonesia and Timor-Leste, the target would not be difficult to accomplish.

Prospects of eradicating poliomyelitis by 2007: compulsory vaccination may be a strategy

The polio eradication has reached at a critical juncture. The progress was good until year 2000, and since then no major success has been achieved. The year 2006 can easily be termed as 'nightmare period' as there was sudden increase of polio cases in the affected countries this year. The threats of re-emergence and importation continued. The apprehensions became stronger, while the target elusive. This situation requires an immediate decisive action, by the international health community, to eradicate polio at the earliest possible. This article draws some lessons from polio eradication program in last two decades, along with analyzing the concept, feasibility and applicability of compulsory vaccination for achieving the goal of polio eradication by the end of the year 2007.

Emergence of chikungunya virus in Indian subcontinent after 32 years: A review

An outbreak of chikungunya virus is currently ongoing in many countries in Indian Ocean since January 2005. The current outbreak appears to be the most severe and one of the biggest outbreaks caused by this virus. India, where this virus was last reported in 1973, is also amongst affected countries. Chikungunya virus has affected millions of the people in Africa and Southeast Asia, since it was first reported in 1952 in Tanzania. Even then, natural history of this disease is not fully understood. The intra-outbreak studies, point towards recent changes in the viral genome facilitating the rapid spread and enhanced pathogenecity. The available published scientific literature on chikungunya virus was searched to understand the natural history of this disease, reasons for the current outbreak and the causes behind re-emergence of the virus in India. The paucity of the scientific information on various epidemiological aspects of chikungunya virus threatens off an epidemic as control of spread of virus might be difficult in the absence of appropriate knowledge. There is an immediate need of the research on chikungunya virus, for an effective vaccine besides strengthening the existing diagnostic laboratory facilities. The current outbreak can also be taken as a lesson for establishment of a system for continuous surveillance of diseases, considered disappeared from the countries. The re-emergence and epidemics are unpredictable phenomena but the impact of such events can be ameliorated by appropriate knowledge and by being in the right state of preparedness.

Avian flu and possible human pandemic

Avian flu is affecting the poultry animals world over since first outbreak in 1997 in Hong Kong and has resulted in 92 human deaths and culling of more than 150 million poultry animals in Asia and Europe. The loss to the economy has also been enormous. 13 new countries, including India, reported occurrence of the disease in poultry animals in February 2006 only, to the World Health Organisation. This rapid rate of spread of virus along with notoriety of the virus for frequent genetic re-assortment, which might enable H5N1 to infect human beings, threatens of possible influenza pandemic since the last pandemic in 1968. The human influenza caused by this subtype of the virus (H5N1) has high case fatality of 54% and majority of affected humans are between the age of 5 to 23 years. Lack of effective vaccine, poor knowledge about treatment, and with scarcity of public health measures in developing countries are major causes of concern. The real threat of impending pandemic can be avoided only if we act immediately on the basis of currently available source of information and apply scientific knowledge rationally for containment and prevention of bird flu and treat human cases promptly.

Primary signet-ring cell carcinoma mimicking segmental Crohn's colitis

Primary signet-ring cell carcinoma of the colon is a rare entity with a dismal prognosis, mainly due to a delay in diagnosis. Here, we present a case of a 30-year-old Filipino woman who presented with symptoms mimicking inflammatory bowel disease. A barium enema and colonoscopy demonstrated a stricture in the rectosigmoid region. A biopsy revealed granulomatous changes indicative of inflammatory bowel disease. Despite initial improvement of her symptoms on total parenteral nutrition and steroids, the patient relapsed several weeks later with recurrent left lower quadrant pain. A subsequent biopsy revealed poorly differentiated signet-ring cell carcinoma of the colon. She was treated surgically with a left hemi-colectomy and primary repair. A high degree of suspicion is necessary to correctly diagnose these, often young, patients with primary signet-ring cell carcinoma early and have a positive impact on survival. The literature on primary signet-ring cell carcinoma is reviewed.

Effect of sewage water on the growth and yield parameters of wheat and blackgram with different fertilizer levels

Impact of biologically treated domestic sewage water was studied on the growth and yield attributing characters of wheat and blackgram under different fertilizer levels in the field condition. There was no significant difference on the yield and yield attributing characters of wheat. However, yield attributing characters like number of tillers/plant, panicle length (cm), number of grains/panicle and 1,000 grain weight showed increasing trend to the tune of 13.29, 1.59. 5.49 and 3.79 per cent respectively over the tubewell irrigated crop. Yield was also increased to the tune of 3.63 per cent when the crop was irrigated with sewage water. Interactions between irrigation and fertilizer levels were also insignificant. However, sewage water with N60P45K45 responded better on tillering, panicle length, number of grains/panicle and yield of wheat. In case of blackgram, treated sewage water had no significant effect on the grwoth and yield attributing characters, rather sewage water had some negative effect on these parameters. Interactions between irrigation and fertilizer levels were insignificant. But tubewell irrigation with N10P10K10 was more responsive on growth parameters. When the crop was grown with tubewell irrigation and without fertilizer, yield attributing characters were more positively responded.