Evaluating the efficacy and safety of nivolumab and ipilimumab combination therapy compared to nivolumab monotherapy in advanced cancers (excluding melanoma): a systemic review and meta-analysis

BACKGROUND

Nivolumab (Nivo) and ipilimumab (Ipi) have revolutionized cancer treatment by targeting different pathways. Their combination shows promising results in various cancers, including melanoma, but not all studies have demonstrated significant benefits. A meta-analysis was performed to assess the effectiveness and safety of Nivo-Ipi compared to Nivo alone in advanced cancer types (excluding melanoma).

METHODS

Following PRISMA guidelines, we conducted a meta-analysis up to September 30, 2023, searching databases for randomized controlled trials (RCTs). We focused on advanced solid malignancies (excluding melanoma) with specific Nivo and Ipi dosing. Primary outcomes were overall survival (OS), progression-free survival (PFS), grades 3-4 adverse events (AEs), and treatment-related discontinuations. Secondary outcomes included specific adverse events. Statistical analysis in Review Manager included hazard ratio (HR) and risk ratio (RR), assessing heterogeneity (Higgins I2).

RESULTS

Nine RCTs, involving 2152 patients covering various malignancies, were analyzed. The Nivo plus Ipi group exhibited a median OS of 12.3 months and a median PFS of 3.73 months, compared to monotherapy with 11.67 months and 3.98 months, respectively. OS showed no significant difference between Nivo and Ipi combination and Nivo alone (HR = 0.97, 95% CI: 0.88 to 1.08, p = 0.61). PFS had a slight improvement with combination therapy (HR = 0.91, 95% CI: 0.82 to 1.00, p = 0.04). Treatment-related cumulative grades 3-4 adverse events were higher with Nivo and Ipi (RR = 1.52, 95% CI: 1.30 to 1.78, p < 0.00001), as were treatment-related discontinuations (RR = 1.99, 95% CI: 1.46 to 2.70, p < 0.0001). Hepatotoxicity (RR = 2.42, 95% CI: 1.39 to 4.24, p = 0.002), GI toxicity (RR = 2.84, 95% CI: 1.44 to 5.59, p = 0.002), pneumonitis (RR = 2.29, 95% CI: 1.24 to 2.23, p = 0.008), dermatitis (RR = 2.96, 95% CI: 1.08 to 8.14, p = 0.04), and endocrine dysfunction (RR = 6.22, 95% CI: 2.31 to 16.71, p = 0.0003) were more frequent with Nivo and Ipi.

CONCLUSIONS

Combining nivolumab and ipilimumab did not significantly improve overall survival compared to nivolumab alone in advanced cancers (except melanoma). However, it did show slightly better PFS at the cost of increased toxicity, particularly grades 3-4 adverse events. Specific AEs occurred more frequently in the combination group. Further trials are needed to fully assess this combination in treating advanced cancers.

Oleuropein activates autophagy to circumvent anti-plasmodial defense

Antimalarial drug resistance and unavailability of effective vaccine warrant for newer drugs and drug targets. Hence, anti-inflammatory activity of phyto-compound (oleuropein; OLP) was determined in antigen (LPS)-stimulated human THP-1 macrophages (macrophage model of inflammation; MMI). Reduction in the inflammation was controlled by the PI3K-Akt1 signaling to establish the "immune-homeostasis." Also, OLP treatment influenced the cell death/autophagy axis leading to the modulated inflammation for extended cell survival. The findings with MII prompted us to detect the antimalarial activity of OLP in the wild type (3D7), D10-expressing GFP-Atg18 parasite, and chloroquine-resistant (Dd2) parasite. OLP did not show the parasite inhibition in the routine in vitro culture of P. falciparum whereas OLP increased the antimalarial activity of artesunate. The molecular docking of autophagy-related proteins, investigations with MMI, and parasite inhibition assays indicated that the host activated the autophagy to survive OLP pressure. The challenge model of P. berghei infection showed to induce autophagy for circumventing anti-plasmodial defenses.

Improving Single-Stage Object Detectors for Nighttime Pedestrian Detection

Improving the reliability of nighttime pedestrian detection is a crucial challenge towards the design of robust autonomous systems. Not surprisingly, most pedestrian fatalities occur in low-illumination settings, thus emphasizing the need for new algorithmic advances. This work presents a novel pedestrian detection approach that makes a number of crucial modifications to the state-of-the-art YOLOV5-PANet architecture, in order to improve the reliability of features extracted from nighttime images. More specifically, the proposed architecture systematically incorporates powerful shuffle attention mechanisms and a transformer module to improve the feature learning pipeline. Instead of advocating the use of other sensing modalities that are better suited for nighttime detection, our approach relies only on conventional RGB cameras and is hence broadly applicable. Our empirical studies with nighttime pedestrian detection benchmarks show that with only minimal increase in model complexity, our approach provides significant improvements in detection efficacy over existing solutions. Finally, we explore the impact of post-hoc network pruning on the speed-accuracy trade-off of our approach and demonstrate that it is well suited for reduced memory/compute requirements.

Full blood count values in adolescents and its comparison by gender and ethnicity in Seremban district, Malaysia

BACKGROUND

Adolescence is when an individual undergoes development and growth. Many studies suggest variations in the number and size of blood cells during this period in various individuals. The full blood count (FBC) is often the starting point of medical investigations, which help diagnose a wide range of illnesses, infections, and diseases. This study aimed to report the mean FBC values and compare them by gender and ethnicity, using blood results from the thalassemia screening programme in Seremban District, Malaysia.

MATERIALS AND METHODS

This cross-sectional study used secondary data from the thalassemia screening programme on Form 4 students aged 15-16 years from January 2018 to October 2018 by the Seremban District Health Office, Malaysia. These students participated in the thalassemia screening programme in which their blood samples were taken for FBC analysis. The data were extracted for this study.

RESULTS

There were statistically significant gender-based differences for total white blood cell (WBC) count, neutrophils, lymphocytes, mixed WBC, and platelets. It was also observed that ethnic-specific differences were statistically significant for RBC count, platelets, platelet distribution width and mean platelet volume.

CONCLUSION

This study was able to report the mean FBC values among Malaysian adolescents with respect to their gender and ethnicity, of which there is a lack of published data.

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

BACKGROUND

Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications.

METHODS

We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC).

FINDINGS

In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]).

INTERPRETATION

In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required.

FUNDING

British Journal of Surgery Society.

Nitrogen-doped carbon quantum dots conjugated isoreticular metal-organic framework-3 particles based luminescent probe for selective sensing of trinitrotoluene explosive

Amine group-containing isoreticular metal-organic framework (IRMOF-3) particles are utilized for the first time as a trinitrotoluene (TNT) sensing material. IRMOF-3 particles are synthesized using zinc nitrate as a metal precursor and 2-amino-1,4-benzenedicarboxylic acid as a linker. The nitrogen-doped carbon quantum dots (NCQDs) are synthesized from citric acid and ethylenediamine as carbon and nitrogen precursor, respectively. The NCQDs are conjugated with IRMOF-3 particles as IRMOF-3/NCQDs. The TEM micrograph revealed the average size of IRMOF-3 particles to be 363.66 nm. The photoluminescence emission intensity of IRMOF-3 particles at λ_em 430 nm is highly increased in the presence of NCQDs (λ_ex 330 nm). Both the as-synthesized IRMOF-3 and IRMOF-3/NCQD particles are explored for TNT detection to compare the effect of NCQDs on the IRMOF-3 particle surface. Lower limit of detection (7.5 × 10^-8 M) and higher Stern-Volmer constant (4.46 × 10⁶ M^-1) are achieved by IRMOF-3/NCQD particles. The association constant also increased from 5.3 × 10⁴ to 2.78 × 10⁶ M^-1 after the conjugation of IRMOF-3 particles with NCQDs. Moreover, enhanced selectivity for TNT over trinitrophenol is achieved using the IRMOF-3/NCQD particles. Graphical Abstract.

Enhanced magnetic and room temperature intrinsic magnetodielectric effect in Mn modified Ba2Mg2Fe12O22 Y-type hexaferrite

We have reported a systematic investigation on structural, magnetic, magnetodielectric and magnetoimpedance characteristics of Y-type Ba₂Mg₂(Fe_1-x Mn _x )₁₂O₂₂ (0  ⩽  x  ⩽  0.12) hexaferrite synthesized by solid-state reaction route. Rietveld refinement of x-ray diffraction pattern confirms the phase purity of all the samples with rhombohedral crystal structure. The Mn dopant modulates not only superexchange angle near to the boundary of magnetic blocks but also magnetic transition temperature. Temperature-dependent magnetization data suggests that due to Mn doping at Fe sites, ferrimagnetic to proper screw transition temperature (T _II) increases from 190 K to 208 K, while there is a decrease in proper screw to longitudinal conical spin transition temperature (T _I) from 35 K to 25 K. We observe remarkable decrease in the magnetic field from 20 kOe to 12 kOe to produce intermediate spin ordering from ferrimagnetic ordering which can be understood because of modification of superexchange angle due to Mn doping. The value of loss tangent decreases with increasing doping concentration at 300K, i.e. ~60% and 180% in BMFM4 (x  =  0.04) and BMFM8 (x  =  0.08) respectively as compared to BMF, suggesting the evolution of intrinsic feature in the doped samples. Magnetodielectric (MD) effect shows that in the low-frequency regime, the robust MD effect is because of Maxwell-Wagner interfacial polarization, whereas in the high-frequency regime intrinsic effect dominates. Further, magnetoimpedance measurement confirms the presence of substantial intrinsic MD% (~6%) at 1.3 T applied field at 300 K for 4% Mn-doped sample. Finally, the nature and strength of magnetoelectric coupling in BMFM4 and BMFM8 samples at 300 K is found to be biquadratic (P ² M ²) and maximum strength of coupling is 3.09  ×  10^-4 emu² g^-2 and 2.34  ×  10^-4 emu² g^-2, respectively.

Epizootiological observations on canine microfilaremia in Gujarat state, India

Aim

The present investigation was conducted to study the prevalence of microfilaremia in dogs in Gujarat.

Materials and Methods

A total of 418 adult dogs aged between 2 and 14 years with signs of weakness and non-specified complaints, presented at TVCC, Deesa (North Gujarat), Nandini Veterinary Hospital, Surat (South Gujarat), and Private Clinics, Ahmedabad (Central Gujarat), were included in the present investigation for studying the prevalence of microfilaremia from July 2016 to May 2017.

Results

A total of 418 dogs were screened, of which 33 were found positive for circulating microfilariae with the prevalence rate of 7.89% in the population. Among microfilaremic dogs, the finding of microfilariae of Dipetalonema (Acanthocheilonema) reconditum was more common (23 cases; 69.69%) than Dirofilaria immitis (10 cases; 30.30%) making their prevalence in the population of 418 dogs as 5.50% and 2.39%, respectively. Breed-wise distribution of microfilaremic dogs revealed that 12 (36.36%), 8 (24.24%), 5 (15.15%), 4 (12.12%), 2 (6.06%), 1 (3.03%), and 1 (3.03%) cases were observed in Pomeranian, non-descript, German Shepherd, Labrador, Great Dane, Lhasa Apso, and Pug dogs, respectively. Of 10 cases of D. immitis, 5, 2, 2, and 1 were observed in Pomeranian, Labrador, non-descript, and Great Dane dogs, respectively. Cases of Dipetalonema reconditum were highest in Pomeranian (7), followed by non-descript (6), German Shepherd (5), Labrador (2), Great Dane (1), Lhasa Apso (1), and Pug (1). Age-wise distribution recorded significantly (p≤0.01) higher number of cases in adult dogs (4-14 years) for D. immitis (30.30%) and D. reconditum (39.39%). Sex-wise distribution of microfilaremic dogs showed that male (22/33, 66.66%) was more predisposed to microfilaremia rather than females (11/33, 33.34%). It is apparent from the study that the number of dogs with microfilaremia due to D. reconditum was significantly (p≤0.01) higher than that of D. immitis.

Conclusion

The present study revealed that microfilaremia due to D. immitis and D. reconditum is prevalent in the state of Gujarat. The infection with D. immitis was associated with severe lung and cardiac pathological manifestations.

Maternal intake of milk and milk proteins is positively associated with birth weight: A prospective observational cohort study

BACKGROUND

A striking number of low birth weight (LBW) Indian babies are born annually. Previous studies have confirmed the positive association between milk intake and birth weight. However, the relations between protein and vitamin B₁₂ from milk and birth weight have not been systematically explored.

AIMS

We examined the relations between birth weight and maternal intake of milk, protein from milk and vitamin B₁₂ from milk.

METHODS

This prospective, observational cohort study was conducted in an urban South Indian hospital. The dietary intakes of milk and milk products were assessed using validated food frequency questionnaire and at delivery birth outcomes were measured. The relations between milk products, milk protein, and vitamin B₁₂ from milk with birth weight and gestational weight gain were assessed in 2036 births with first trimester dietary and delivery data.

RESULTS

Median consumption of milk products in the first trimester was 310 g·day^-1 and average birth weight was 2876 g. Birth weight was positively associated with intake of milk products and of % protein from milk products (%milk protein) in the first trimester [β = 86.8, 95% confidence interval (CI): 29.1, 144.6; β = 63.1, 95% CI: 10.8, 115.5; P < 0.001 for both]. Intake of milk products and of %milk protein in the third trimester was positively associated with gestational weight gain (GWG) between the second and third trimester (One-way ANOVA, P < 0.001 and = 0.001, respectively). Neither birth weight nor GWG were associated with %vitamin B₁₂ from milk products.

CONCLUSIONS

These findings indicate that intake of milk products in the first trimester and especially, protein from milk products is positively associated with birth weight in this South Asian Indian population.

Ethylenediamine mediated luminescence enhancement of pollutant derivatized carbon quantum dots for intracellular trinitrotoluene detection: soot to shine

Vehicle-generated toxic pollutants are composed of gaseous smoke and particulate byproducts accumulated as a black substance at its exhaust. This particulate matter (soot) is utilized for the green synthesis of highly stable, non-toxic, environment friendly, carbon quantum dots (CQD). The CQDs are synthesized via the simple hydrothermal route in the absence (C1) and presence (C2) of oxidants. The as-synthesized CQDs are amine functionalized using ethylenediamine. The amine functionalized CQDs (C1N and C2N) are explored for trinitrotoluene detection. From transmission electron microscopy, the average size of C1 and C2 was found to be about 4.2 nm and 5.6 nm respectively. The incorporation of amine groups lead to an increase in quantum yields from 5.63% to 12.7% for C1 and from 3.25% to 8.48% for C2 QDs. A limit of detection (LOD) of 13 ppb was displayed by C1N while the LODs of 11 ppb and 4.97 ppb were delivered by C2N at λ_ex 370 nm and λ_ex 420 nm respectively. The Stern–Volmer constant for C1N is 2.02 × 10⁶ M⁻¹ while for C2N at λ_ex 370 nm and λ_ex 420 nm is 0.38 × 10⁶ M⁻¹ and 0.48 × 10⁶ M⁻¹ respectively. Furthermore, C1N presents high selectivity for TNT compared to C2N. Owing to their higher luminescence, C1N particles are successfully demonstrated for their applicability in intracellular TNT detection.

Vehicle-generated toxic pollutants are composed of gaseous smoke and particulate byproducts accumulated as a black substance at its exhaust.

Abstract P2-08-07: Anti-proliferative and anti-inflammatory estrogen receptor agents for treatment of endocrine-resistant breast cancer

This abstract was not presented at the symposium.

Structural and functional insights into the stationary-phase survival protein SurE, an important virulence factor of Brucella abortus

The stationary-phase survival protein SurE from Brucella abortus (BaSurE) is a metal-dependent phosphatase that is essential for the survival of this bacterium in the stationary phase of its life cycle. Here, BaSurE has been biochemically characterized and its crystal structure has been determined to a resolution of 1.9 Å. BaSurE was found to be a robust enzyme, showing activity over wide ranges of temperature and pH and with various phosphoester substrates. The active biomolecule is a tetramer and each monomer was found to consist of two domains: an N-terminal domain, which forms an approximate α + β fold, and a C-terminal domain that belongs to the α/β class. The active site lies at the junction of these two domains and was identified by the presence of conserved negatively charged residues and a bound Mg(2+) ion. Comparisons of BaSurE with its homologues have revealed both common features and differences in this class of enzymes. The number and arrangement of some of the equivalent secondary structures, which are seen to differ between BaSurE and its homologues, are responsible for a difference in the size of the active-site area and the overall oligomeric state of this enzyme in other organisms. As it is absent in mammals, it has the potential to be a drug target.

Response to Errors in Crystal structure of HINT from Helicobacter pylori

A response is published to a Letter to the Editor by Maize [(2016), Acta Cryst. F72, 336-337].

Phytoremediation potential of some halophytic species for soil salinity

Phytoremediation potential of six halophytic species i.e. Suaeda nudiflora, Suaeda fruticosa, Portulaca oleracea, Atriplex lentiformis, Parkinsonia aculeata and Xanthium strumarium was assessed under screen house conditions. Plants were raised at 8.0, 12.0, 16.0, and 20.0 dSm(-1) of chloride-dominated salinity. The control plants were irrigated with canal water. Sampling was done at vegetative stage (60-75 DAS). About 95 percent seed germination occurred up to 12 dSm(-1) and thereafter declined slightly. Mean plant height and dry weight plant(-1) were significantly decreased from 48.71 to 32.44 cm and from 1.73 to 0.61g plant(-1) respectively upon salinization. Na(+)/K(+) ratio (0.87 to 2.72), Na(+)/ Ca(2+) + Mg(2+) (0.48 to 1.54) and Cl(-)/SO4(2-) (0.94 to 5.04) ratio showed increasing trend. Salinity susceptibility index was found minimum in Suaeda fruticosa (0.72) and maximum in Parkinsonia aculeata (1.17). Total ionic content also declined and magnitude of decline varied from 8.51 to 18.91% at 8 dSm(-1) and 1.85 to 7.12% at 20 dSm(-1) of salinity. On the basis of phytoremediation potential Suaeda fruticosa (1170.02 mg plant(-1)), Atriplex lentiformis (777.87 mg plant(-1)) were the best salt hyperaccumulator plants whereas Xanthium strumarium (349.61 mg plant(-1)) and Parkinsonia aculeata (310.59 mg plant(-1)) were the least hyperaccumulator plants.

Crystal structure of HINT from Helicobacter pylori

Proteins belonging to the histidine triad (HIT) superfamily bind nucleotides and use the histidine triad motif to carry out dinucleotidyl hydrolase, nucleotidyltransferase and phosphoramidite hydrolase activities. Five different branches of this superfamily are known to exist. Defects in these proteins in humans are linked to many diseases such as ataxia, diseases of RNA metabolism and cell-cycle regulation, and various types of cancer. The histidine triad nucleotide protein (HINT) is nearly identical to proteins that have been classified as protein kinase C-interacting proteins (PKCIs), which also have the ability to bind and inhibit protein kinase C. The structure of HINT, which exists as a homodimer, is highly conserved from humans to bacteria and shares homology with the product of fragile histidine triad protein (FHit), a tumour suppressor gene of this superfamily. Here, the structure of HINT from Helicobacter pylori (HpHINT) in complex with AMP is reported at a resolution of 3 Å. The final model has R and Rfree values of 26 and 28%, respectively, with good electron density. Structural comparison with previously reported homologues and phylogenetic analysis shows H. pylori HINT to be the smallest among them, and suggests that it branched out separately during the course of evolution. Overall, this structure has contributed to a better understanding of this protein across the animal kingdom.

Body composition of term healthy Indian newborns

BACKGROUND/OBJECTIVES

Previous anthropometry-based studies have suggested that in Indian newborns fat mass is conserved at the expense of lean tissue. This study was undertaken to assess the body composition of Indian newborns and to evaluate its relation with parents' anthropometry, birth weight and early postnatal weight gain.

SUBJECTS/METHODS

Body composition of healthy term singleton newborns was assessed by the deuterium dilution method in the second week of life. Anthropometry was carried out at birth and on the day of study.

RESULTS

Data from 127 babies were analyzed. Birth weight was 2969±383 g. Body composition was assessed at a mean age of 12.7±3.1 days. Fat and fat-free mass were 354±246 and 2764±402 g, respectively, and fat mass percentage (FM%) was 11.3±7.3%. Birth weight and fat-free mass were higher among boys, but no gender difference was noted in FM%. Birth weight was positively correlated with fat as well as fat-free mass but not FM%. FM% showed positive correlation with gain in weight from birth to the day of assessment.

CONCLUSIONS

This is the first study from India to report body composition in newborns using deuterium dilution. FM% was comparable to that reported for Western populations for babies of similar age. Our results suggest that the percentage of fat and fat-free mass is relatively constant over the range of birth weights included in this study, and greater weight gain during early postnatal period results in greater increase in FM%.

New Hydroxylated Cationic Gemini Surfactants as Effective Corrosion Inhibitors for Mild Steel in Hydrochloric Acid Medium

Inhibitory action of hydroxylated cationic gemini surfactants on corrosion of mild steel [MS] in 1 M hydrochloric acid medium is studied by gravimetric, electrochemical polarization and electrochemical impedance spectroscopic (EIS) techniques. The results obtained reveal that these compounds are very efficient inhibitors. The inhibitory action of surfactants increases with the concentration and chain length. Concentration as low as 10−5 M of 16–4–16 MEA could show 99% inhibition whereas 12–4–12 MEA showed 93% inhibition at 10−4 M concentration. The inhibition efficiency versus concentration curves show an S-shape plot indicating adsorption of surfactants on metal surface as a three steps process. From Arrhenius plots corrosion rate of MS was observed to decrease at any given temperature with inhibitor concentration due to the increase in the degree of surface coverage. In contrast, at constant inhibitor concentration, the corrosion rate increases with temperature. EIS measurements show increase in the charge transfer resistance with the inhibitor concentration.

Polygalacturonase-inhibiting proteins--leucine-rich repeat proteins in plant defence

Plant polygalacturonase-inhibiting proteins (PGIPs) belong to the leucine-rich repeat (LRR) family and are known to prevent pathogen invasion by inhibiting the plant cell wall degrading enzyme, polygalacturonase. Our study reveals that these multigene-encoded defence proteins found in flowering plants only exhibit identical domain architecture with 10 tandemly-arranged LRRs. This implies that variations of PGIP inhibitory properties are not associated with the number of the repeats but with subtle changes in the sequence content of the repeats. The first and eighth repeat contain more mutations compared to the strict conservation of the plant-specific LRRs or any repeat at other positions. Each of these repeats forms a separate cluster in the phylogenetic tree, both within and across plant families, thus suggesting uniqueness with respect to their position. A study of the genes encoding PGIPs, shows the existence of two categories (i) single exon and hence no intron; and (ii) two exons with an intron in between. Analyses of the intron phase and correlation of the exon-intron structure with the compact structural modules in PGIPs support insertion of introns in the pre-existing single exon genes and thus the intron late model. Lack of conservation of phase across families and formation of individual clusters for each family in the phylogenetic tree drawn with the intron sequences illustrate the event of insertion that took place separately in each of these families.

Antibacterial potential assessment of jasmine essential oil against e. Coli

The antibacterial activity of Jasmine (Jasminum sambac L.) flower hydro steam distilled essential oil, synthetic blends and six major individual components was assessed against Escherichia coli (MTCC-443) strain. The activity was bactericidal. Minimum inhibitory concentration was determined by tube dilution technique, and the Minimum inhibitory concentration ranged between 1.9-31.25 μl/ml. Phenolcoefficient of the oil, synthetic blends and components varied between 0.6-1.7. The activity of the chemicals was possibly due to the inhibition of cell membrane synthesis.

Acclimatory response to hydrogen peroxide and glutathione under salt-boron stress through their impact on mineral nutrition and antioxidant defense system in pigeonpea (Cajanus cajan L.)

Investigations were carried out on a salt tolerant (Manak, H77-216) and a comparatively salt sensitive (ICPL 88039) genotypes of pigeonpea (Cajanus cajan L. Millsp.) under NaCl, B and NaCl + B stress to examine the acclimatory response to H2O2, glutathione and H2O2 + glutathione through their effect on mineral nutrition, morpho-physiological parameters and antioxidant defense system. Both B and NaCl alone and their combinations had deleterious effect on dry biomass of plumule, enhanced relative stress injury (RSI), lipid peroxidation with concomitant increase in Na, Cl and B contents. However it did not bear any correlation with osmotic potential of plumule and K contents. Antioxidative enzymes like superoxide dismutase (SOD), catalase (CAT), ascorbate peroxidase (APX), peroxidase (POX) and glutathione reductase (GR) also decreased with salt, B and salt + B treatments. However contents of H2O2 enhanced and that of ascorbate declined under aforementioned treatments. These injurious effects are partially alleviated by exogenous application of H2O2; glutathione (GSH) and H2O2 + GSH treatments. The role of H2O2 and GSH in the present study is suggestive of triggering multifunctional signal transduction in plant defense mechanisms to prevent cellular oxidation, membrane injury, lipid peroxidation and protein enzyme inactivation.

Extrapolated Biogeography-Based Optimization (eBBO) for Global Numerical Optimization and Microstrip Patch Antenna Design

Biogeography-Based Optimization (BBO) uses the idea of probabilistically sharing features between solutions based on the solutions’ fitness values. Therefore, its exploitation ability is good but it lacks in exploration ability. In this paper, the authors extend the original BBO and propose a hybrid version combined with ePSO (particle swarm optimization with extrapolation technique), namely eBBO, for unconstrained global numerical optimization problems in the continuous domain. eBBO combines the exploitation ability of BBO with the exploration ability of ePSO effectively, which can generate global optimum solutions. To validate the performance of eBBO, experiments have been conducted on 23 standard benchmark problems with a range of dimensions and diverse complexities and compared with original BBO and other versions of BBO in terms of the quality of the final solution and the convergence rate. Influence of population size and scalability study is also considered and results are compared with statistical paired t-test. Experimental analysis indicates that the proposed approach is effective and efficient and improves the exploration ability of BBO.

First- and second-line drug resistance patterns among previously treated tuberculosis patients in India

Culture and drug susceptibility testing results of 2816 tuberculosis (TB) patients from across India who had failed repeated treatments from 2001 to 2004 were retrospectively analysed at the Tuberculosis Research Centre, Chennai. Of 1498 (53%) identified as having multidrug-resistant TB (MDR-TB), 671 (44.8%) were resistant to > or =1 second-line drugs (SLDs): 490 (32.7%) to ethionamide, 245 (16.4%) to ofloxacin and 169 (11.3%) to kanamycin; 69 (4.6%) were extensively drug-resistant TB (XDR-TB). Although from a highly select and non-representative patient group, such high SLD resistance levels, including XDR-TB, among MDR-TB patients is of concern. The prevention of MDR/XDR-TB through quality DOTS services, however, remains the priority. In addition, rapid scale-up of quality programmatic management under the RNTCP is needed, with more control and rational use of SLDs outside the programme.

Effects of Sodium Nitroprusside Activity of Acid and Alkaline Invertases and Alkaline Phosphatase in Lemongrass (Cymbopogon flexuosus Steud) Wats

We investigated effects of sodium nitroprusside (SNP) on sucrose metabolizing enzymes, acid, and alkaline invertase and alkaline phosphatase in lemongrass (Cymbopogon flexuosus Steud) Wats varieties i.e. Krishna, Cauveri, Nima and Cheerharit. Fifteen day old lemongrass tillers were treated with SNP (1 and 2 mM) under sunlight for four hours. Our results clearly indicated that SNP (2 mM) substantially decreased the amount of proteins in all varieties studied, with maximum values of 40% and 33% in Nima and Krishna, respectively. SNP (1 mM) significantly increased the amount of proteins 43% and 31% in Krishna and Cauveri, respectively. SNP (2 mM) rapidly and severely reduced the activity of acid and alkaline invertases in all varieties, except Krishna and Cauveri. However, the effect of SNP was more pronounced on acid invertase causing at 2 mM an inhibition of 37%, 35% and 28% in Cheerharit, Nima and Cauveri, respectively, whereas it showed relatively less inhibition in alkaline invertase activity 27%, 24% and 21%, respectively, in Nima, Krishna and Cheerharit. Alkaline phosphatase activity was only considerably decreased following SNP (2 mM) treatment in all lemongrass varieties studied with the exception of Nima, where a sharp decrease of 50% was observed. SNP (1 mM) also demonstrated similar effects on acid and alkaline invertases and alkaline phosphatase. These results clearly suggest that SNP affects acid and alkaline phosphatase activity and, therefore, has a role in sucrose metabolism in lemongrass. Alterations in alkaline phosphatase activity upon SNP treatment have several consequences.

Association of GSTM1, GSTT1, and GSTM3 gene polymorphisms and susceptibility to cervical cancer in a North Indian population

OBJECTIVE

The objective of the study was to evaluate the influence of genetic polymorphisms of GSTM1, GSTT1, and GSTM3 on the susceptibility of cervical cancer.

STUDY DESIGN

Blood samples from 150 women with biopsy-confirmed cervical cancer and 168 healthy controls were analyzed by multiplex polymerase chain reaction (PCR) to detect the presence or absence of GSTM1 and GSTT1. Insertion/deletion polymorphism in intron 6 of GSTM3 was determined by PCR.

RESULTS

The frequencies of homozygous GSTM1 null and GSTT1 null genotypes were found to be significantly higher in cancer patients as compared with healthy controls (P = .009, odds ratio [OR] 1.52, 95% confidence interval [CI], 1.1 to 2.0 and P = .0004, OR 2.4, 95% CI: 1.4 to 4.0, respectively). The AB genotype of GSTM3 also conferred higher risk of cancer (P = .053, OR 1.64, 95% CI, 1.0 to 2.6). However, no significant association of at-risk genotypes was observed with any stages of cervical cancer. Interactions among GSTM1 null, GSTT1 null, and AB genotype of GSTM3 resulted in additive predictive risks of cervical cancer. In case-only analysis, carriers of the AA genotype of GSTM3 among tobacco users were at elevated risk of cervical cancer (P = .024, OR 2.1, 95% CI, 1.0 to 4.1) as compared with AB and BB genotypes.

CONCLUSION

GSTM1 null, GSTT1 null, and GSTM3*AB genotypes may confer higher susceptibility to cervical cancer and cancer risk because at-risk genotypes are additive. Tobacco usage by carriers of GSTM3*AA has enhanced the risk of cervical cancer as compared with nonusers.

Care centre visits to married people living with HIV: an indicator for measuring AIDS-related stigma & discrimination

We tested whether observation of the presence and relationship of attendants (i.e. those that accompany upon admission) and visitors to a sample of 230 (128 male, 102 female) married HIV-positive people in an HIV care centre provides an indicator of caregiving, AIDS-related stigma and discrimination. Sensitivity to gender, location (urban vs. rural), age (<35 yrs vs. >35) and source of infection (spouse vs. non-spouse) were factors considered to modulate AIDS-related stigma and assess discrimination. HIV-positive people were accompanied by their spouse (53%), mother (14%), father (7%), with only 7% attending alone. Immediate family most commonly accompanied on admission (80%), but visitors were mainly from the 'extended' family (32%) with many receiving no visitors (48%). Females (11%) were more likely than males to attend alone (11% vs. 4%; p<0.05). No effect of location, age or infector was obtained. Females were more likely to be visited by their mother (14% vs. 6%; p<0.01) and non-immediate family (39% vs. 27%; p<0.05) than males were. In contrast, fathers (0% vs. 6%; p <0.05) and spouses were less likely (3% vs. 10%; p<0.05) to visit females than males. No effect of location or age upon visitation was obtained. Non-spouse infected persons were less likely than spouse-infected to be visited by their spouse (3% vs. 10%; p<0.05) but more likely to receive 'extended' family visitation (43% vs. 24%; p<0.01). Spouse-infected persons had a higher rate of no visitors than persons not infected by their spouse (54% vs. 40%; p<0.05). Observation of the presence and relationship of attendants and visitors to HIV-positive people has potential as an indicator of caregiving AIDS-related stigma and discrimination. The measure appears particularly sensitive to the gender of the HIV-positive person. Such a measure may aid healthcare professionals to focus resources such as relational counselling upon the family and close friends of people experiencing AIDS-related stigma and discrimination, with the aim of improving the provision of care within the community.

Diagnosis of bacterial vaginosis in a rural setup: comparison of clinical algorithm, smear scoring and culture by semiquantitative technique

This study was undertaken to estimate the prevalence of bacterial vaginosis (BV) and other sexually transmitted infections (STIs) in a rural set up and compare the smear scoring system to that of culture by semiquantitative technique. A total of 505 married women, who were in sexually active age group of 15-44 years, were selected from three different villages. High vaginal swabs, endocervical swabs, vaginal discharge and blood were collected and processed in the laboratory. Overall prevalence of 29% reproductive tract infection was detected. Endogenous infection was commonly observed (27.92%), and very low prevalence of STIs (Trichomonas 1.18%, Syphilis 0%, Gonorrhea 0%) was detected. Diagnosis of BV was possible in 104 (20.5%) women by smear alone and 88 (17.42%) women by semiquantitative culture.

In vitro demonstration of the hemolytic, cytotoxic activities and induction of apoptosis in Orientia tsutsugamushi infected L929 mouse fibroblast cells

Using cultured mouse fibroblast L929 cells, this study demonstrated the hemolytic and cytotoxic activities and induction of apoptosis in cells infected with Orientia tsutsugamushi. Low levels of hemolytic activity were detected using heavily infected cells. No hemolysin or cytotoxin were detected in the infected culture fluid regardless of the pathogenicity of the O. tsutsugamushi strains in mice. Using propidium iodide uptake assay, acridine orange/ethidium bromide staining and terminal deoxynucleotide transferase-mediated dUTP-digoxigenin nick-end labeling assay, apoptosis was observed in L929 cells infected with Karp and Gilliam strains.

Isolation and PCR detection of rickettsiae from clinical and rodent samples in Malaysia

Isolation of rickettsiae from patients' blood samples and organ samples of wild rodents from areas with high seroprevalence of rickettsial infections was attempted using cell culture assay and animal passages. L929 mouse fibroblast cells grown in 24 well tissue culture plate were inoculated with buffy coat of febrile patients and examined for the growth of rickettsiae by Giemsa, Gimenez staining and direct immunofluorescence assay. No rickettsiae were isolated from 48 patients' blood samples. No symptomatic infections were noted in mice or guinea pigs infected with 50 organ samples of wild rodents. There was no rickettsial DNA amplified from these samples using various PCR detection systems for Orientia tsutsugamushi, typhus and spotted fever group rickettsiae.

Expression of recombinant proteins of Orientia tsutsugamushi and their applications in the serodiagnosis of scrub typhus

In this study, recombinant proteins that encompassed the AD I-AD III regions of 56 kDa immunodominant gene of 2 Orientia tsutsugamushi (OT) serotypes; Gilliam and TA763 were expressed in Escherichia coli. Both recombinant proteins exhibited serologic cross-reactivity with the rabbit antisera against various OT serotypes, as evaluated by enzyme-linked immunosorbent assay (ELISA), but not against other rickettsial species, including Rickettsia typhi, R. prowazekii and TT118 SFG rickettsiae. The feasibility of using the recombinant proteins as a diagnostic reagent was further evaluated by ELISA using sera from blood donors and scrub typhus patients. The results suggested a higher affinity of the antihuman IgM than IgG with both recombinant proteins. The IgM ELISA findings were agreeable with the results of indirect immunoperoxidase (IIP) assay especially with sera of high antibody (1:1600). However, more than one antigen are probably needed for development of an effective assay for serodiagnosis of scrub typhus in endemic areas.

Antigenic types of Orientia tsutsugamushi in Malaysia

The seroprevalence of various Orientia tsutsugamushi (OT) strains among Malaysian patients with suspected scrub typhus infections was determined using an indirect immunoperoxidase (IIP) assay. IgG against a single OT strain were detected in six sera (3 Karp, 1 Gilliam and 2 TC586), whereas IgM antibodies against a single OT strain (Gilliam) were noted in 3 sera (Gilliam). IgG reactive to all OT strains were present in 33 (47.1%) of the 70 sera and IgM reactive to all OT strains were present in 22 (78.6%) of the 28 sera. The fact that most sera were reactive to multiple OT strains suggests that group-specific antigens are involved in scrub typhus infections, whereas very few were due to strain-specific epitopes present on these strains. Peak IgG and IgM titers were noted more frequently against Gilliam, Karp, and TA763 strains: this suggests that these strains may be the commonest infecting strains among Malaysian patients. Two predominant OT polypeptides consistently reacted with patients' sera were the 70 kDa and 56 kDa proteins.

Virulence of Malaysian isolates of Orientia tsutsugamushi in mice

The pathogenicity of Malaysian isolates of Orientia tsutsugamushi was investigated by a mouse virulence assay. The isolates could be differentiated as low (4 isolates), moderately (3 isolates) and highly virulent (2 isolates) based on the different responses in infected mice. No direct correlation between severity of human scrub typhus infections and virulence of the O. tsutsugamushi in mice was observed. Mice infected with virulent strains of O. tsutsugamushi showed splenomegaly, ascitis accumulation and enlargement of kidneys and livers whereas avirulent O. tsutsugamushi strains were asymptomatic and exhibited ruffled fur for a short period after infection. There was low antibody response in mice infected with isolates of low pathogenicity as compared with those of highly virulent isolates. Upon dissection of the infected mice, enlargement of mouse organs such as spleen, kidney and liver was noted. Presence of rickettsemia in mice was confirmed by the growth of O. tsutsugamushi in the L929 cells when inoculated with blood from infected mice. O. tsutsugamushi was also cultured from the peritoneal exudates of the infected mice. However, DNA of O. tsutsugamushi was only detected in the peritoneal exudates (by PCR) and blood (by cell culture) and not from other tissue samples.

Typhoid fever in Kuala Lumpur and a comparative evaluation of two commercial diagnostic kits for the detection of antibodies to Salmonella typhi

The aim of this study was to compare two commercial kits, theTyphidot and the PanBio ELISA with the present Widal test. Demographic data for all serodiagnosed cases for the years 1991-1998 were collected. From this data, 144 were selected as samples for comparative evaluation of the commercial kits. Fifty sera were culture positive for Salmonella typhi, 50 were culture negative but clinically diagnosed as typhoid fever and Widal positive and 44 were serodiagnosed as enteric of which 21 were culture positive for other Salmonella species, 20 were serodiagnosed for other febrile illnesses and three sera culture positive for other species of enterobacteriaceae. The specificity, sensitivity and efficiency of the tests were calculated with the positive culture for S. typhi as the gold standard. Sensitivity, specificity and efficiency of test for Typhidot and Typhidot M kits were 98%, 76.6% and 84.0% and PanBio ELISA were 78%, 80% and 79.9%. The two commercial kits evaluated were found to be less time consuming and easier to perform than Widal. The Typhidot M seems to be a practical alternative in the field and in small hospitals with lesser facilities.

Serological evidence of hantavirus infections in Malaysia

Hantaviruses are primarily rodent-borne and transmission is by inhalation of virus-contaminated aerosols of rodent excreta, especially urine and saliva. The genus Hantavirus, family Bunyaviridae, comprises at least 14 serotypes and the symptoms of clinical illness range from mild fever to severe hemorrhagic manifestations with renal complications. Many countries in Southeast Asia are unaware of the importance of hantavirus infections and give them low priority. Malaysia, like other countries in the region, has conducted very few studies on the epidemiology of hantaviruses - and even these were conducted in the 1980s. Using a more extensive range of hantavirus antigens, we conducted a seroprevalence study of rodents and humans and found further evidence of hantavirus infections. Moreover, the data from the antibody profiles strongly suggest the presence of different hantaviruses at the study sites.

Comparison of safety and immunogenicity of a Vi polysaccharide typhoid vaccine with a whole-cell killed vaccine in Malaysian Air Force recruits

OBJECTIVE

To carry out a comparative study of the safety and immunogenicity of Vi polysaccharide vaccine against whole-cell killed (WCK) typhoid vaccine.

METHODS

The study was carried out on young adult recruits (aged 18-25 years) of the Malaysian Air Force. A total of 125 subjects received the Vi polysaccharide vaccine and 114 received the WCK vaccine.

FINDINGS

The Vi vaccine was significantly less reactogenic than the WCK vaccine with regard to systemic and local reactions. Following administration of the Vi vaccine, seroconversion rates (defined as the percentage of subjects with a 4-fold rise of baseline antibody level) of 75.5% and 67% were observed at 2 weeks and 6 weeks, respectively, after immunization, compared with 25% and 31.3% among recipients of the WCK vaccine. Of the 110 Vi vaccinees with serological data, 21 (19%) had high, seroprotective, pre-immunization levels of anti-Vi antibodies (> or = 1 microgram/ml). The majority of subjects in this group came from a region in Malaysia which is known to have high typhoid endemicity. Interestingly, these antibody levels were boosted considerably following administration of vaccine at a level that was 5-fold higher than in subjects with low pre-immunization levels. In contrast, the seroconversion rates in those receiving the Vi vaccine were higher in subjects with low pre-immunization levels of anti-Vi antibodies (76-84%), compared to those with protective levels of > or = 1 microgram/ml prior to immunization (48-57%).

CONCLUSIONS

The study reaffirms the safety and efficacy of the Vi polysaccharide vaccine and identifies a hitherto unrecognized advantage in its use, i.e. it is a potent immunogen that boosted considerably the protective antibody levels among a significant number of immunologically sensitized individuals living in typhoid-endemic regions.

Leptospirosis in Kuala Lumpur and the comparative evaluation of two rapid commercial diagnostic kits against the MAT test for the detection of antibodies to leptospira interrogans

The aim of the study was to look into the epidemiology of serodiagnosed cases of leptospirosis at the University Hospital and compare two commercial ELISA Assays to the Microscopic Agglutination Test (MAT). Demographic data for all serodiagnosed cases for the years 1991-1997 were collected. From this data, 104 sera (n = 104) were selected as samples for comparative evaluation of the commercial ELISAs (INDX Dip-S-Ticks and PanBio ELISA) to the MAT test. Thirty two (n = 32) negative control sera were selected from serodiagnosed cases of other differential diagnosis of leptospira infection. The MAT test is a standard test that detects agglutination antibodies to leptospira biflexa, while the INDX Dip-S-Ticks is an ELISA dot test assaying for total anti-leptospira antibodies. The PanBio ELISA is a colorometric assay in test well strips to detect anti-leptospira IgM. The sensitivity, specificity, and efficiency of tests were calculated at a MAT cut-off value of 1:320. Demographic data showed that leptospirosis peaks during March-May and Aug-Nov coinciding with the inter-monsoon period with more men being infected than women and more adults than children. The sensitivity, specificity, and efficiency of test for the INDX Dip-S-Ticks were 83.3%, 93.8% and 87.5% while the values for the PanBio ELISA were 54.2%, 96.9% and 71.3%. The suboptimal PanBio result could be related to the blocking effect of high IgG titres or could be related to the diagnostic MAT cut-off values used in this study. The data hence reflects a pattern of transmission that is related to "wet" occupational risk factors. The commercial assays evaluated, are easier to perform but interpretation of results should be based on level of endemicity. The INDX Dip-S-Ticks allows this flexibility and is a practical alternative to the MAT test.