Assessment of chlorinated pesticide exposure to white-rumped vulture Gyps bengalensis in India

Populations of the critically endangered white-rumped vulture (WRV) Gyps bengalensis have declined drastically due to the use of diclofenac for veterinary purposes in Indian subcontinent. Thirty-two dead WRVs collected from three states, namely Gujarat, Assam and Tamil Nadu in India between 2011 and 2014 were investigated to understand the role of diclofenac in the death, and the results were published. Furthermore, since organochlorine pesticides have been linked to long-term impact on populations in many species of birds across the globe, available tissues of 21 WRVs were tested also for six organochlorine pesticides (DDT, HCH, endosulfan, heptachlor, dieldrin and dicofol) and chlorpyrifos. All vultures were found to have had one or more detectable levels of pesticides in their tissues except one. Similarly, all the pesticides included in the study were detected in at least one of the vultures analysed. DDT (95.2%) was the most frequently detected pesticide followed by HCH (90.5%), and DDT (73.6%) contributed the most to the total pesticide load. Total pesticide load ranged between below detection limit (BDL) and 8753.4 ng/g. High levels of total pesticide load recorded in gut contents showed recent exposure to these legacy pesticides even long after their ban. However, it is perceived that studied pesticides' exposure to birds and their presence in the environment is in decreasing trend in India. Although, varying levels of pesticides were detected, all of which were below the levels reported to be toxic, and also reported earlier in the same species in India. Recorded levels may not create a problem to vultures unlike diclofenac; nevertheless, as continued exposure to the pesticides studied may lead to sub lethal effects in birds, it is prudent to monitor these pesticides along with new generation pesticides and NSAIDs in the critically endangered white-rumped vulture in India, towards its conservation.

Thermal, dielectric, mechanical and structural behavior of 2-amino 4-methylpyridinium 4-nitrophenolate 4-nitrophenol bulk single crystal

Applications in both science and industry have received increased attention as a result of bulk single crystals with particular orientations. However, due to the instability of organic crystals at high temperatures and stress, there is an interest in growing good-quality bulk single crystals with stable thermal and mechanical properties. Here, the 2-amino 4-methylpyridinium 4-nitrophenolate 4-nitrophenol (2A4MPPP) crystal was prepared employing a single-wall ampoule and the vertical Bridgman technique. Structure and functional groups were determined by XRD, NMR, and FTIR studies. More importantly, detailed thermal and kinetic properties such as activation energy, frequency factor, rate constant, and Avrami exponent are discussed. The mechanical stability and dielectric studies are also demonstrated for the title compound. According to the single crystal XRD investigation, 2A4MPPP is a member of the orthorhombic crystal system with the Pna21 space group. Through the TGA and DTA analyses, it was confirmed that the compound starts to melt at 98 °C and complete melting occurs at 103.3 °C. The dielectric experiments reveal the crystal's poor dielectric constant and high-frequency dielectric loss. Vickers microhardness investigations show that grown 2A4MPPP belongs to the soft materials group. As a result of these findings, the 2A4MPPP crystal should be well suited for usage in thermomechanical, microelectronic, optical communications, and nonlinear optical applications.

Effect of alternate nostril breathing exercises on cardiorespiratory function- a systematic review

Introduction- Alternate nostril breathing has positively affected the cardio-respiratory system. This review aimed to compile information on the effects of alternate nostril breathing on cardiorespiratory function. Method– Databases such as PubMed, Medline, Scopus, Cochrane, and Google Scholar were systematically searched to review current evidence of randomized control trials (RCT) on alternate nostril breathing over the past two decades. Out of 89 articles, six were chosen for the final data extraction based on the inclusion and exclusion criteria. Results- All of the final included studies demonstrated a significant improvement in respiratory endurance and functioning and a high heart rate variability (HRV) that mostly has a parasympathetic effect. Conclusion- Alternate nostril breathing shows promising results in reducing stress, improving cardiovascular and respiratory function, and reducing complications of pulmonary problems in the future.

Spatial-temporal lipidomics profile of acute myocardial injury

Background

Lipidome disturbance has long been recognized to occur after myocardial infarction (MI). Accumulation of excessive fatty acids induces production of reactive oxygen species and consequently deteriorates cardiac injury in MI. However, the spatial and temporal lipid profile in the heart following ischemic injury remains unknown.

Purpose

We aim to uncover the temporal-spatial lipidome profile of the heart following ischemia reperfusion (I/R) injury and identify circulating lipids released from injured myocardium that are potentially useful for diagnosis of ischemic heart disease.

Methods

C57/BL6 mice were subjected to 30 min myocardial ischemia followed by removal of the ligature to establish reperfusion injury. Porcine I/R injury was induced by 105 min myocardial ischemia followed by reperfusion. Human plasma was obtained from 143 post-MI patients. Myocardial lipid profiles were generated by matrix-assisted laser desorption/ionization (MALDI) mass spectrometry imaging (MALDI-MSI) in different regions (infarct, remote and peri-infarct) at different time points. Moreover, the lipids in the heart and plasma were analysed by LC-MS/MS.

Results

We observed a drastic alteration in the lipidome with distinct spatial-temporal features in the injured heart by both MALDI-MSI and LC-MS/MS. In the infarct heart tissue, as revealed by LC-MS/MS, we observed an elevation of glycerolipids that peaked at 3 hours after I/R, and a sustained elevation of phospholipids and sphingolipids up to 3 days. Similar alternations in lipid profile was observed but much weaker in the remote and peri-infarct heart tissue compared to the infarct tissue. Among those lipids, PC 32:0 detected by MALDI-MSI highly overlapped CD68 staining at a single-cell level, showing a strong correlation of PC 32:0 with macrophage infiltration in mouse hearts (R2=0.93, p<0.0001). A similar increase of PC 32:0 in the infarct area was also observed in porcine hearts following I/R injury. Surprisingly, plasma levels of PC 32:0 in the mice decreased after I/R injury. In humans, plasma levels of PC 32:0 in post-MI patients were lower than that in healthy individuals (p=0.03). Further analysis demonstrated that plasma levels of PC 32:0 determined within 72 hours after percutaneous coronary intervention were negatively correlated with the 6-month post-MI cardiac ejection fraction in patients (R2=0.08, p<0.001).

Conclusions

A temporal-spatial lipidome profile was established in heart injury by synergizing LC-MS/MS and mass spectrometry imaging. PC 32:0 levels are positively correlated with myocardial macrophage infiltration but negatively correlated with cardiac function in cardiac I/R injury. Our findings indicate that PC 32:0 is a potential biomarker for cardiac injury and the inflammatory status in the injured heart.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Singapore Ministry of Health's National Medical Research Council

Nimesulide poisoning in white-rumped vulture Gyps bengalensis in Gujarat, India

Population of white-rumped vulture has not recovered in India to a desired level even after diclofenac was banned in 2006. During 2019, there were two known separate incidents of white-rumped vulture mortality involving four white-rumped vultures in Gujarat. After post-mortem examinations, tissues of all four vultures were received for toxicological investigation at the National Centre for Avian Ecotoxicology, SACON. Tissues were screened for a set of toxic pesticides, and none of them was at detectable level. Subsequently, the tissues were analysed for thirteen NSAIDs and paracetamol. Of all the drugs tested, only nimesulide was detected in all the tissues (17-1395 ng/g) indicative of exposure. Visceral gout was also observed in all the four vultures during post-mortem. Residues of nimesulide in tissues with symptoms of gout indicated that the vultures died due to nimesulide poisoning. Although, other than diclofenac, many NSAIDs are suspected to be toxic to white-rumped vultures, only nimesulide is reported in the recent past with clear symptom of gout in wild dead white-rumped vultures similar to diclofenac. Since, nimesulide appears to act similar to diclofenac in exerting toxic effects, if veterinary use of nimesulide continues, white-rumped vulture are bound to suffer. Hence, it is recommended that nimesulide should be banned by the government to conserve white-rumped vulture in the Indian subcontinent. Further, an effective system is recommended to be put in place to collect the tissues of dead vultures for toxicological investigations and eventual conservation of the critically endangered species.

Variation in Polycyclic Aromatic Hydrocarbon Contamination Between Native and Introduced Species of Fishes of Pallikaranai Wetland, Chennai, Tamil Nadu, India

The impacts of invasive fish species on recipient communities are mostly considered a threat to the biodiversity of freshwater systems. A characteristic of introduced species turning invasive is their higher tolerance to environmental stressors. To understand if non-native fishes in Pallikaranai wetland, Tamil Nadu, India, are more tolerant to anthropogenic pressures in the Wetland, we assessed the variation in Polycyclic Aromatic Hydrocarbon contamination between introduced and native fish species. Mean levels of Naphthalene, fluorene, phenanthrene, anthracene, pyrene, and total PAH in samples of introduced species were higher than native species, while High Molecular weight PAH and carcinogenic PAH4 were higher in native fish species. The data was also analysed to assess if co-variates (organs, seasons, and sex) affected PAH accumulation patterns in non-native species. It was observed that only organs, sex, and year contributed significantly.

Scleredema adultorum of Buschke associated with hypothyroidism and liver cirrhosis

Scleredema adultorum of Buschke is a rare disorder of the connective tissue, involving the skin. Here, we present a 61-year-old male, who is a known case of compensated liver cirrhosis with a past history of being treated for autoimmune thyrotoxicosis, who presented with complaints of alopecia, skin tightening, dry skin, pruritus, and woody indurated plaques on the skin of the upper back, shoulder, and arms. Skin biopsy of the arm revealed the characteristic features of scleredema. He was extensively evaluated for known literature-cited causes of scleredema, and the work up revealed a negative result. He was also found to be hypothyroid on presentation. Hence, we present a case of scleredema occurring in a patient with hypothyroidism and chronic liver disease, which to our knowledge is being described for the first time in literature.

FRI0010 GM-CSFR PATHWAY IS IMPLICATED IN PATHOGENIC INFLAMMATORY MECHANISMS IN GIANT CELL ARTERITIS

Background:

Giant Cell Arteritis (GCA) is characterized by inflammation of large and medium arteries. Classic symptoms include headaches, malaise and, in severe cases, blindness and aortic aneurysms. Corticosteroids (CS) are the first line of treatment. Relapsing disease patients undergo multiple courses of CS therapy increasing their CS exposure and toxicity. A significant unmet need for disease-modifying CS-sparing therapy remains in GCA as the efficacy of current treatment options, including tocilizumab have limitations.

We have previously reported elevated expression of granulocyte-macrophage colony stimulating factor (GM-CSF) pathway transcriptomic signature in GCA vessels. GM-CSF may contribute to underlying disease mechanisms by regulating inflammatory macrophages, dendritic cells (DCs) and T helper (TH1/TH17) cells which are involved in GCA pathogenesis. GM-CSF produced by T cells1can promote polarization of inflammatory macrophages2and recruitment and differentiation of monocytes into inflammatory DCs2that can in turn recruit T cells and stimulate TH1/TH17 differentiation creating a feedback loop. GM-CSF may also exert direct effects on angiogenesis3and vessel wall remodeling4.

Objectives:

To demonstrate the contributing role of GM-CSF pathway to inflammation in GCA arteries.

Methods:

Immunostaining was used to examine expression of GM-CSF and GM-CSF-Rα proteins in temporal artery biopsies (TABs) from GCA and controls (patients with suspected but not confirmed GCA and a negative TAB). Costaining with cell markers such as CD31, CD3, and CD68 allowed visualization of cells expressing GM-CSF and GM-CSF-Rα. Expression of GM-CSF pathway molecules such as phospho-JAK2 and PU.1 proteins was detected by immunohistochemical staining of GCA and control TABs.Ex vivocultured GCA arteries treated (10 each) with mavrilimumab (anti-GM-CSF-Rα) or placebo for 5 days were assayed for gene expression by qPCR, and culture supernatants were analyzed by ELISA.

Results:

Endothelial cells and macrophages were the main cell types expressing GM-CSF and GM-CSF-Rα. Increased expression of phospho-JAK2 (activated signaling molecule) and nuclear-localized PU.1 (transcription factor) in GCA TABs compared to controls indicated the presence of active GM-CSF signaling pathway in GCA.

Inhibition of PU.1 mRNA expression inex vivocultures of GCA arteries treated with mavrilimumab indicated blockade of GM-CSFR signaling pathway. Mavrilimumab induced decrease in mRNA expression of key cell type markers including DC and macrophage activation markers CD83 and HLA-DRA, monocyte markers CD14 and CD16, T cell marker CD3ε, and B cell marker CD20 in these GCA artery cultures. Expression of inflammatory TH1/TH17 factors IFNγ (mRNA), TNFα, CXCL10 (IFNγ-stimulated chemokine) and IL-6 (mRNA and protein) was also inhibited by mavrilimumab in GCA artery cultures.

Conclusion:

Increased GM-CSF, GM-CSF-Rα, and downstream pathway-associated protein levels in GCA biopsies were consistent with previously-observed increased transcriptome signature. Expression of genes associated with inflammatory cells was suppressed by mavrilimumab in cultured GCA arteries. These data implicate the GM-CSF pathway in GCA pathophysiology and increase confidence in rationale for targeting the GM-CSF pathway in GCA.

References:

[1]GM-CSF and T-cell responses: what we do and don’t know. Shiet al., Cell Res 2006

[2]GM-CSF-Dependent Inflammatory Pathways. Hamilton, Front Immunol 2019

[3]GM-CSF increases tumor growth and angiogenesis. Zhenget al., Tumour Biol 2017

[4]GM-CSF deficiency affects vascular elastin production and integrity of elastic lamellae. Weissen-Plenzet al., J Vasc Res 2008

Disclosure of Interests:

Maria C. Cid Grant/research support from: Kiniksa Pharmaceuticals, Consultant of: Janssen, Abbvie, Roche, GSK, Speakers bureau: Vifor, Sujatha Muralidharan Shareholder of: Kiniksa, Employee of: Kiniksa, Marc Corbera-Bellalta: None declared, Georgina Espigol-Frigole Consultant of: Roche and Janssen, Javier Marco Hernandez: None declared, Amanda Denuc: None declared, Roberto Rios-Garces: None declared, Nekane Terrades-Garcia: None declared, John F. Paolini Shareholder of: Kiniksa, Employee of: Kiniksa, Annalisa D’Andrea Shareholder of: Kiniksa, Employee of: Kiniksa

Six-year study on peripheral venous catheter-associated BSI rates in 262 ICUs in eight countries of South-East Asia: International Nosocomial Infection Control Consortium findings

BACKGROUND

Short-term peripheral venous catheter-associated bloodstream infection rates have not been systematically studied in Asian countries, and data on peripheral venous catheter-associated bloodstream infections incidence by number of short-term peripheral venous catheter days are not available.

METHODS

Prospective, surveillance study on peripheral venous catheter-associated bloodstream infections conducted from 1 September 2013 to 31 May 2019 in 262 intensive care units, members of the International Nosocomial Infection Control Consortium, from 78 hospitals in 32 cities of 8 countries in the South-East Asia Region: China, India, Malaysia, Mongolia, Nepal, Philippines, Thailand, and Vietnam. For this research, we applied definition and criteria of the CDC NHSN, methodology of the INICC, and software named INICC Surveillance Online System.

RESULTS

We followed 83,295 intensive care unit patients for 369,371 bed-days and 376,492 peripheral venous catheter-days. We identified 999 peripheral venous catheter-associated bloodstream infections, amounting to a rate of 2.65/1000 peripheral venous catheter-days. Mortality in patients with peripheral venous catheter but without peripheral venous catheter-associated bloodstream infections was 4.53% and 12.21% in patients with peripheral venous catheter-associated bloodstream infections. The mean length of stay in patients with peripheral venous catheter but without peripheral venous catheter-associated bloodstream infections was 4.40 days and 7.11 days in patients with peripheral venous catheter and peripheral venous catheter-associated bloodstream infections. The microorganism profile showed 67.1% were Gram-negative bacteria: Escherichia coli (22.9%), Klebsiella spp (10.7%), Pseudomonas aeruginosa (5.3%), Enterobacter spp. (4.5%), and others (23.7%). The predominant Gram-positive bacteria were Staphylococcus aureus (11.4%).

CONCLUSIONS

Infection prevention programs must be implemented to reduce the incidence of peripheral venous catheter-associated bloodstream infections.

Organochlorine Pesticide Residues Among Colonial Nesting Birds in Tamil Nadu, India: A Maiden Assessment from Their Breeding Grounds

Use of pesticides continues to be indiscriminate, and birds are one of the worst affected non-targeted organisms. Information on the ill effects of pesticides on birds far from desired in India. Despite the presence of a wide variety and number of birds, there is exceedingly little data on organochlorine pesticide (OCP) residues in colonial nesting birds in sanctuaries of India. A total of 76 individuals belonging to 14 species of birds found dead between March 2008 and March 2010 were analyzed for pesticide residues in various tissues. Of all the OCPs analyzed, concentration of HCH was found to be the highest. Magnitude of contamination varied widely among species. Accumulation pattern of OCPs in colonial nesting birds was in the order ∑HCH > ∑endosulfan > ∑DDT > heptachlor epoxide > dieldrin. Pesticides, namely p,p-DDE and β-HCH contributed most towards the total OCPs. Concentrations of DDT and its metabolites, HCH and isomers, dieldrin, and heptachlor epoxide were lower than the concentrations reported for various species of birds elsewhere in India. Although the sanctuaries presently studied have official boundaries, physical demarcations are missing and there are no proper earthen dykes particularly in Vedanthangal and Koonthankulam Bird Sanctuaries. During monsoon, runoff not only floods the Sanctuaries but also the cultivated areas nearby. Run off brings in residues of pesticides and fertilizers from the agricultural lands into the sanctuaries. Although OCP results in this study were below threshold limits, it may be noted that the long duration exposure even to low levels of pesticides could create a significant impact at population level. Hence, earthen dykes need to be built to avoid agricultural runoff entering the Sanctuary and also help to hold sufficient amount of water for breeding birds.

International Nosocomial Infection Control Consortium (INICC) report, data summary of 45 countries for 2012-2017: Device-associated module

BACKGROUND

We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2012 to December 2017 in 523 intensive care units (ICUs) in 45 countries from Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific.

METHODS

During the 6-year study period, prospective data from 532,483 ICU patients hospitalized in 242 hospitals, for an aggregate of 2,197,304 patient days, were collected through the INICC Surveillance Online System (ISOS). The Centers for Disease Control and Prevention-National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI) were applied.

RESULTS

Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the medical-surgical ICUs, the pooled central line-associated bloodstream infection rate was higher (5.05 vs 0.8 per 1,000 central line-days); the ventilator-associated pneumonia rate was also higher (14.1 vs 0.9 per 1,000 ventilator-days,), as well as the rate of catheter-associated urinary tract infection (5.1 vs 1.7 per 1,000 catheter-days). From blood cultures samples, frequencies of resistance, such as of Pseudomonas aeruginosa to piperacillin-tazobactam (33.0% vs 18.3%), were also higher.

CONCLUSIONS

Despite a significant trend toward the reduction in INICC ICUs, DA-HAI rates are still much higher compared with CDC-NHSN's ICUs representing the developed world. It is INICC's main goal to provide basic and cost-effective resources, through the INICC Surveillance Online System to tackle the burden of DA-HAIs effectively.

Cross-country transport and isolation and identification of Streptococcus pneumoniae by use of alternate sources of blood supplemented media among laboratories in India

Background

The isolation of S. pneumoniae (Sp) depends on specimen integrity / transport, media and expertise. The non-availability of sheep blood agar poses a challenge in identification of colonial morphology and identification in India.

Methods

Laboratories processed swabs containing either pure Sp or Sp in mixed cultures with a second (confounding) bacterium shipped across the country in cold conditions. Duplicate set of swabs was shipped back to the central laboratory to assess the impact of shipping on culture viability. The identical swab was cultured on sheep, human blood and one additional agar plate used in the laboratory.

Results

46/60(77%) of cultures containing only Sp were correctly identified. In specimens where Sp was present in mixed culture, the proportion of isolates in which Sp was correctly identified varied, with most variability attributed to the particular confounding organism rather than the media. There was no discernible impact of temperature-controlled (4-6°C) transport on the isolation of Sp from culture swabs.

Conclusions

The study clearly elucidates the ability of laboratories for isolation of S. pneumoniae on human blood agar in resource limited settings. The results highlight the difficulties inherent in correctly identifying pathogens in mixed cultures in needs improvement using standardized tests across the study centers. The study also reaffirms the ability to transport biological specimens over long geographical distances without loss.

Follow-up and management of valvular heart disease patients with prosthetic valve: a clinical practice guideline for Indian scenario

PURPOSE

Valvular heart disease (VHD) patients after prosthetic valve implantation are at risk of thromboembolic events. Follow-up care of patients with prosthetic valve has a paramount role in reducing the morbidity and mortality. Currently, in India, there is quintessential need to stream line the follow-up care of prosthetic valve patients. This mandates the development of a consensus guideline for the antithrombotic therapy in VHD patients post prosthetic valve implantation.

METHODS

A national level panel was constituted comprising 13 leading cardio care experts in India who thoroughly reviewed the up to date literature, formulated the recommendations, and developed the consensus document. Later on, extensive discussions were held on this draft and the recommendations in 8 regional meetings involving 79 additional experts from the cardio care in India, to arrive at a consensus. The final consensus document is developed relying on the available evidence and/or majority consensus from all the meetings.

RESULTS

The panel recommended vitamin K antagonist (VKA) therapy with individualized target international normalized ratio (INR) in VHD patients after prosthetic valve implantation. The panel opined that management of prosthetic valve complications should be personalized on the basis of type of complications. In addition, the panel recommends to distinguish individuals with various co-morbidities and attend them appropriately.

CONCLUSIONS

Anticoagulant therapy with VKA seems to be an effective option post prosthetic valve implantation in VHD patients. However, the role for non-VKA oral therapy in prosthetic valve patients and the safety and efficacy of novel oral anticoagulants in patients with bioprosthetic valve need to be studied extensively.

Cutaneous Bacteriological Profile in Patients with Pemphigus

BACKGROUND

Pemphigus is an autoimmune blistering disease. The common cause of death in pemphigus is septicemia which is usually secondary to cutaneous bacterial infection.

AIM

The aim was to study the cutaneous bacteriological profile in patients with pemphigus.

MATERIALS AND METHODS

Pus for culture and sensitivity was collected from clinically infected lesions of pemphigus patients in the Department of Dermatology, St. John's Medical College Hospital, Bengaluru, from June 2013 to June 2014.

RESULTS

Of the 49 patients included in the study, 44 were suffering from pemphigus vulgaris, 4 from pemphigus foliaceus and one had pemphigus vegetans. There were 31 male and 18 female patients. The mean age of the group was 35.51 year. Mean Autoimmune Bullous Disorder Intensity Score was 17.36. About 32.7% were diabetic. About 40.81% showed the growth of Staphylococcus aureus, 12.24% of Pseudomonas aeruginosa, 6.12% of Proteus mirabilis, 4.08% of β-hemolytic streptococci and nonfermenting Gram-negative bacilli, and 2.04% of Proteus vulgaris, Staphylococcus saprophyticus, Enterococcus species, and Klebsiella species. S. aureus showed 100% sensitivity to antibiotics - tetracycline, amikacin, chloramphenicol, and netilmicin; 90% resistance was found for penicillin and 55% resistance was found for ciprofloxacin and erythromycin. Methicillin-resistant S. aureus was 30%. P. aeruginosa showed 100% sensitivity to ciprofloxacin, amikacin, gentamicin, piperacillin, piperacillin + tazobactam, and netilmicin.

CONCLUSION

S. aureus was the most common organism showing sensitivity to tetracycline, amikacin, chloramphenicol, and netilmicin and resistance to penicillin, ciprofloxacin, and erythromycin.

Incidences of mortality of Indian peafowl Pavo cristatus due to pesticide poisoning in India and accumulation pattern of chlorinated pesticides in tissues of the same species collected from Ahmedabad and Coimbatore

Incidences of mortality of Indian peafowl Pavo cristatus, the national bird (Schedule I Indian Wild Life Protection Act 1972), are rampant in India. Between January 2011 and March 2017, around 550 peafowl in 35 incidences were reported dead across the country. Due to the non-availability of fresh carcases, poisoning could not be confirmed. Birds which died due to kite string injuries in Ahmedabad (15) and accidents in Coimbatore (5) were tested for residues of chlorinated pesticides, namely hexachlorocyclohexane (HCH), dichloro-diphenyl-trichloroethane (DDT), endosulfan, heptachlor, dicofol, dieldrin and cholipyrifos. The liver, kidney and muscle were the tissues considered to document pesticide load. Total load ranged from BDL to 388.2 ng/g. DDT (95%) and HCH (80%) were detected more frequently. DDT (40%) and endosulfan (26%) contributed maximum to the total pesticide load followed by HCH (21%). Pesticide accumulation pattern among the organs was in the order of liver (123.9 ng/g) > kidney (91.9 ng/g) > muscle (19.5 ng/g) with significant difference (p < 0.05). Peafowl from Ahmedabad had significantly (p < 0.05) higher level of total pesticide (149.0 ng/g) than birds from Coimbatore (47.8 ng/g). Although varying levels of chlorinated pesticide were detected, they were below reported toxic limits. Nevertheless, persistence of chlorinated pesticides and poisoning due to modern pesticides across the entire distribution range of Peafowl in India is a cause for concern.

Residues of Diclofenac in Tissues of Vultures in India: A Post-ban Scenario

Populations of three resident Gyps species (Indian white-backed vulture Gyps bengalensis, Indian vulture Gyps indicus, and Slender-billed vulture Gyps tenuirostris) in India have decreased by more than 90% since mid 1990s, and they continue to decline. Experimental studies showed the mortality of vultures to be due to renal failure caused by diclofenac, a nonsteroidal anti-inflammatory drug. India, Pakistan, and Nepal banned the veterinary usage of diclofenac in 2006 to prevent further decline in vulture population. This study was performed to know the current status of the impact of diclofenac on vultures in India. Between 2011 and 2014, 44 vultures comprising two species, namely Indian white-backed vulture (32) and Himalayan griffon Gyps himalayensis (12) were collected dead from Gujarat, Assam, and Tamil Nadu on an opportunistic basis. Kidney and liver tissues and gut content were analysed for diclofenac. Of the 32 dead white-backed vultures analysed, 68.75% of them had diclofenac ranging from 62.28 to 272.20 ng/g. Fourteen white-backed vultures had diclofenac in kidney in toxic range (70-908 ng/g). Of 12 Himalayan griffon studied, 75% of them had diclofenac in the range of 139.69 to 411.73 ng/g. Himalayan griffon had significantly higher levels of diclofenac in tissues than Indian white-backed vultures. It is possible that 14 of 29 white-backed vultures and 9 of 12 Himalayan griffon included in this study died due to diclofenac poisoning. Studies have indicated that diclofenac can continue to kill vultures even after its ban in India for veterinary use.

Anticoagulation Management in Patients with Valve Replacement

BACKGROUND

Prosthetic valve implantation requires postoperative prophylactic anticoagulation to preclude thrombotic events. The aim of this review is to assess the role of anticoagulation therapy in the management of valve replacement patients.

METHODOLOGY

Literature from PubMed, Embase, Medline and Google Scholar were searched using the terms "valvular heart disease", "anticoagulant", "mechanical heart valve", "bioprosthesis", "bridging", "Vitamin K antagonist (VKA)", and "acenocoumarol". A committee comprising leading cardiothoracic surgeons from India was convened to review the literature and suggest key practice points.

RESULTS

Prosthetic valve implantation requires postoperative prophylactic anticoagulation to preclude thrombotic events. A paramount risk of thromboembolic events is observed during the first three months after surgery for both mechanical and bioprosthetic devices. The VKA therapy with individualized target international normalized ratio (INR) is recommended in patients after prosthetic valve replacement. Therapies for the management of prosthetic valve complications should be based on the type of complications. Special care is mandated in distinguished individuals and those with various co-morbidities.

CONCLUSION

In patients with prosthetic valve replacement, anticoagulant therapy with VKA seems to be an effective option. The role for non-VKA oral anticoagulants in the setting of prosthetic valve replacement has yet to be established. Furthermore, whether the novel oral anticoagulants are safe and efficacious in patients after placement of a bioprosthetic valve remains unanswered.

Correction: The biology of environmental stress: molecular biomarkers in Sydney rock oysters (Saccostrea glomerata)

Correction for 'The biology of environmental stress: molecular biomarkers in Sydney rock oysters (Saccostrea glomerata)' by D. A. Raftos et al., Environ. Sci.: Processes Impacts, 2016, 18, 1129-1139.

The biology of environmental stress: molecular biomarkers in Sydney rock oysters (Saccostrea glomerata)

This review describes our recent work on environmental stress in Sydney rock oysters, focusing on the identification of molecular biomarkers for ecotoxicological analysis. We begin by describing the environmental pressures facing coastal estuaries in Australia, with particular reference to Sydney Harbour. After providing that context, we summarise our transcriptional and proteomic analyses of Sydney rock oysters responding to chemical contamination and other forms of environmental stress. This work has shown that the intracellular processes of oysters are highly responsive to environmental threats. Our data agree with the broader literature, which suggests that there is a highly conserved intracellular stress response in oysters involving a limited number of biological processes. We conclude that many effective molecular markers for environmental biomonitoring are likely to lie within these biological pathways.

Oxygen evolution catalytic behaviour of Ni doped Mn3O4 in alkaline medium

In this study, the electrocatalytic behavior of Mn₃O₄ was enhanced by non-precious metal doping.

Different mechanisms for Arabidopsis thaliana hybrid necrosis cases inferred from temperature responses

Temperature is a major determinant of plant growth, development and success. Understanding how plants respond to temperature is particularly relevant in a warming climate. Plant immune responses are often suppressed above species-specific critical temperatures. This is also true for intraspecific hybrids of Arabidopsis thaliana that express hybrid necrosis due to inappropriate activation of the immune system caused by epistatic interactions between alleles from different genomes. The relationship between temperature and defence is unclear, largely due to a lack of studies that assess immune activation over a wide range of temperatures. To test whether the temperature-based suppression of ectopic immune activation in hybrids exhibits a linear or non-linear relationship, we characterised the molecular and morphological phenotypes of two different necrotic A. thaliana hybrids over a range of ecologically relevant temperatures. We found both linear and non-linear responses for expression of immunity markers and for morphological defects depending on the underlying genetic cause. This suggests that the influence of temperature on the trade-off between immunity and growth depends on the specific defence components involved.

Crystal structure of bis[4-(dimethylamino)pyridinium] bis(2-nitrobenzoate) trihydrate

The title salt, 2C7H11N2+·2C7H4NO4−·3H2O, crystallized with two anions and two cations in the asymmetric unit, together with three water molecules. Both 4-dimethylaminopyridinium cations are protonated at their pyridine N atoms with the plane of the N(CH3)2hetero atoms inclined to the pyridine ring by 4.5 (2) and 1.4 (2)°. In the 2-nitrobenzoate anions, the carboxyl and nitro groups are inclined to their respective benzene rings by 77.1 (3) and 20.0 (3)°, and 75.8 (2) and 20.9 (3)°. In the crystal, the anions are linkedviaO—H...O hydrogen bonds involving the water molecules, forming chains along [100]. The cations are linked to these chains by N—H...O hydrogen bonds. The chains are linkedviaC—H...O hydrogen bonds and C—H...π and π–π interactions [inter-centroid distances range from 3.617 (1) to 3.851 (1) Å], forming a three-dimensional structure.

International Nosocomial Infection Control Consortium (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module

We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line-associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN.

Technology: an aid to clinical judgement

Complete removal of renal cell tumor with thrombus which extends above the diaphragm often necessitates use of cardiopulmonary bypass. Transesophageal echocardiography (TEE) can play an important role in delineating the extent of tumor growth. We describe a patient with renal cell carcinoma with thrombosis invading into the right ventricle and its complete removal with the aid of TEE.

Organochlorine pesticide residues in eggs and tissues of house sparrow, Passer domesticus, from Tamil Nadu, India

This study provides information on the current status of contamination by organochlorine pesticides (OCPs) in eggs and tissues of House Sparrow, Passer domesticus, in Tamil Nadu, India. The mean concentration of total hexachlorocyclohexane (∑HCH) and total dichloro-diphenyl-trichloroethane (∑DDT) in eggs ranged from 0.01 to 1.81 μg/g and 0.02 to 1.29 μg/g, respectively. Concentration of 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (p,p'-DDE) ranged from below detectable limit (BDL) to 0.64 μg/g, representing more than 60% of the ∑DDTs. About 28% of samples had p,p'-DDE levels above the critical concentration associated with reproductive impairment. However, the mean concentrations of cyclodiene insecticides were less than 0.5 μg/g. Although OCPs levels detected in tissues are not indicative of toxicity, continuous monitoring is recommended.

Metal contamination in select species of birds in Nilgiris district, Tamil Nadu, India

Variation in metal contamination in six species of birds, namely the Cormorant (Phalacrocorax carbo), Cattle Egret (Bubulcus ibis), Little Egret (Egretta garzetta), Pond Heron (Ardeola grayii), Common Myna (Acridotheres tristis) and Jungle Babbler (Turdoides striatus) in Nilgiris district, Tamil Nadu, India. The accumulation of heavy metals differed among the species studied. On an average, Little Egret accumulated high concentrations of copper (53.31 ± 23.19 ppm) followed by Cattle Egret (16.27 ± 9.83 ppm) in liver. Of all the species, Jungle Babbler recorded the maximum concentrations (20.59 ± 9.07 ppm) in muscle. The Pond Heron recorded the maximum concentration (35.38 ± 11.14 ppm) in brain. On an average the maximum level was in the kidney of Common Myna (7.76 ± 1.80 ppm).

A Validated RP-HPLC Method for Simultaneous Estimation of Nebivolol and Hydrochlorothiazide in Tablets

A simple, selective, rapid, precise and economical reverse phase high pressure liquid chromatographic method has been developed for the simultaneous estimation of nebivolol and hydrochlorthiazide from pharmaceutical formulation. Phenomenex Gemini C₁₈ (25 cm×4.6 mm i.d., 5 μ) column with a mobile phase consisting of acetonitrile: 50mM ammonium acetate (adjusted to pH 3.5 using orthophosphoric acid) (70:30 v/v) at a flow rate of 1.0 ml/min was used. Detection was carried out at 254 nm. Probenecid was used as an internal standard. The retention times of probenecid, nebivolol and hydrochlorthiazide were 13.05, 3.32 and 4.25 min, respectively. The developed method was validated in terms of accuracy, precision, linearity, limit of detection, limit of quantitation and solution stability. The proposed method can be used for the estimation of these drugs in combined dosage forms.

Distribution of persistent organochlorine chemical residues in blood plasma of three species of vultures from India

The presence of persistent organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) were determined in blood plasma of white-backed vulture Gyps bengalensis, Egyptian vulture Neophron percnopterus, and griffon vulture Gyps fulvus collected from Ahmedabad, India. All the samples had varying levels of organochlorine pesticides and PCBs. Statistically significant (P<0.05) differences among species were detected for beta-hexachlorocyclohexane (β-HCH), ∑HCH, and dichloro-diphenyl-trichloroethane (DDT). The mean concentration of ∑HCH, ∑DDT, and ∑PCBs among plasma ranged from 43.7 to 136, 8.8 to 64.8, and 226 to 585 ng/ml, respectively. Among the various OCPs analyzed, 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (p,p'-DDE) was detected most frequently. The concentrations of cyclodiene insecticides detected were lower than the other organochlorine residues. The levels of pesticides measured in plasma samples of three species of vulture were comparable to the results documented for a number of avian species and were lower than those reported to have deleterious effects on survival or reproduction of birds. Although no threat is posed by any of the organochlorine pesticides detected, continuous monitoring of breeding colonies is recommended. This study is also the first account of a comprehensive analysis of toxicants present in blood plasma of vulture species in India. The values reported in this study can serve as guidelines for future research in general as well as control values during the analysis of samples obtained from birds in the event of suspected organochlorine poisoning.

Organochlorine pesticide residues in inland wetland fishes of Karnataka, India and their implications on human dietary intake

As part of a larger study assessing contamination status of inland wetlands of India, we evaluated the organochlorine pesticide (OCP) residues in fishes collected from different inland wetlands in Karnataka, India and their suitability for human consumption. Among the OCPs tested, isomers of hexachlorocyclohexane (HCH) were the most frequently detected with β- and γ-HCH as the main pollutants. Average concentration of ∑HCH and ∑DDT ranged from 2.1 to 51.7 μg/kg and below detection level to 12.3 μg/kg respectively. Other organochlorine pesticides such as heptachlor epoxide, dieldrin and endosulphan were found at lower levels. Among various fish species tested, the higher pesticide burden was recorded in Anguilla bicolor bicolour (77.9 μg/kg) and the lower was in Heteropneustes fossilis (2.1 μg/kg). OCPs detected in the present study were well below the tolerance limits recommended for fishes. The calculated daily dietary intake of OCPs in all the species examined was lower than the maximum acceptable dietary intake (ADI) limits prescribed for human consumption. However, continuous monitoring is recommended to facilitate the early identification of risks.

Diclofenac residues in blood plasma and tissues of vultures collected from Ahmedabad, India

The study reports residues of diclofenac, a non-steroidal anti inflammatory drug, in tissues of 11 White-backed Vulture, Gyps bengalensis collected between 2005 and 2007 and blood plasma of 12 White-backed Vulture, four Egyptian Vulture, Neophron percnopterus and two Griffon Vulture, Gyps fulvus collected during 2005. Samples were analysed using High Performance Liquid Chromatograhy (HPLC) equipped with UV detector. One of the White-backed Vultures collected during 2005 had substantial urate deposits on its viscera and diclofenac was detected in its liver (1.42 ppm wet weight) and kidney (1.18 ppm wet weight), which is suggestive of diclofenac exposure and intoxication. Although uric acid crystals were not observed in the remaining birds received during 2005, the residues of diclofenac detected were at levels higher than the toxic limits (0.25-1 ppm). No residues were detected in any of the tissues of birds collected during 2006 and 2007 (6 birds). About 89% (16 of 18) of plasma samples collected during 2005 had diclofenac residues (White-backed vulture: BDL to 0.17 ppm; Egyptian vulture: BDL to 0.09 ppm; Griffon vulture: 0.07-0.14 ppm). However, plasma diclofenac concentrations were less than the concentrations reported to be toxic. Although use of diclofenac for treating cattle has been banned in India, regular monitoring is recommended to assess the effectiveness of the ban on the drug in support of the conservation of these species.

Levels of organochlorine pesticide residues in blood plasma of various species of birds from India

Concentrations of organochlorine pesticides (OCPs) were measured in blood plasma of 13 species of birds collected from Ahmedabad, India. Among the various OCPs determined, HCHs and its isomers had higher contribution to the total OCPs. Concentration of summation operatorHCHs varied from 11.4 ng/mL in White ibis Threskiornis melanocephalus to 286 ng/mL in Sarus Crane Grus antigone, while summation operatorDDT ranged between 19 ng/mL in Black Ibis Pseudibis papillosa and 147 ng/mL in Painted Stork Mycteria leucocephala. p,p'-DDE was accounted for more than 50% of total DDT in many of the samples analysed. However, a p,p'-DDT to p,p'-DDE ratio higher than one obtained for many species of birds indicates the recent use of DDT in this study region. The concentrations of cyclodiene insecticides, heptachlor epoxide, dieldrin and total endosulfan ranged from 15.8 to 296.2 ng/mL, below detectable level to 15 and 41.1-153.2 ng/mL, respectively. The pattern of total OCP load generally occurred in the following order: granivores < insectivores < omnivores < piscivores < carnivores. Although, the organochlorine residues detected in blood plasma of birds are not indicative of toxicity, the presence of residues in birds over the years (2005-2007) indicates continued exposure to organochlorine compounds. However, continuous monitoring is recommended to facilitate the early identification of risks to the survival of a species.

Comparative evaluation of two cold staining methods with the Ziehl-Neelsen method for the diagnosis of tuberculosis

In developing countries pulmonary tuberculosis is usually diagnosed by detecting acid-fast bacilli (AFB) in sputum using a Ziehl-Neelsen (Z-N) staining method. However, in the field the traditional method of staining is difficult to carry out. This study evaluates the efficiency of two cold staining methods, namely Gabbet's and a modified two reagent cold staining method compared with the Z-N taken as the gold standard. Triplicate smears were prepared from 267 sputum samples and stained by the Z-N, Gabbet's, and a modified cold staining method, the smears were positive for AFB in 21 (7.87%), 18 (6.74%) and 19 (7.12%), respectively. The sensitivities for the Gabbet's and modified cold stain were 85.7% and 90.5%, respectively. The positive agreement between the Z-N and Gabbet's (92.3%) and Z-N and modified cold stain (95%) were good. The modified cold staining method was less time consuming and easier to perform in the field.

Persistent organochlorine pesticide residues in tissues and eggs of white-backed vulture, Gyps bengalensis from different locations in India

Organochlorine pesticide residues were determined in tissues of five Indian white-backed vultures and two of their eggs collected from different locations in India. All the samples had varying levels of residues. p,p'-DDE ranged between 0.002 microg/g in muscle of vulture from Mudumali and 7.30 microg/g in liver of vulture from Delhi. Relatively higher levels of p,p'-DDT and its metabolites were documented in the bird from Delhi than other places. Dieldrin was 0.003 and 0.015 microg/g while p,p'-DDE was 2.46 and 3.26 microg/g in egg one and two respectively. Dieldrin appeared to be lower than the threshold level of 0.5 microg/g. p,p'-DDE exceeded the levels reported to have created toxic effects in eggs of other wild birds. Although varying levels of DDT, HCH, dieldrin, heptachlor epoxide and endosulfan residues were detected in the vulture tissues, they do not appear to be responsible for the present status of population in India.