Transcriptomic Downregulation of APOE, Polymorphic Variations of APOE, Diet, Social Isolation, and Co-morbidities as Contributing Factors to Alzheimer's Disease: a Case-Control Study of Kashmiri Population

Alzheimer's disease (AD) is the most common form of dementia, generally affecting elderly people in the age group of above 60-65 years. Amyloid deposition has been found to be a possible cause and a characteristic feature of Alzheimer's disease. Mutations, variant genotypes, or downregulation that reduce amyloid clearance or accelerate amyloid accumulation can lead to Alzheimer's disease. This study involved clinically confirmed AD patients, age matched controls of similar ethnicity, and patients who had no history of cancer or any other chronic disease. DNA and RNA extractions of samples were done as per Saguna et al. [45] and TRIzol method, respectively. Frequencies of variant genotypes were observed using the RFLP technique, whereas, for expression analysis, qPCR was performed. The association between diet, smoking status, family history, and co-morbidities was calculated using statistical tools. Expression analysis showed downregulation in more than 65% of AD cases. Hypertension and diabetes also had a significant association with AD. Allelic isoforms ε2:ε2 and ε2:ε3 tend to be less frequent among AD cases compared to controls (2.85% vs 26.15% and 11.42% vs 21.43%, respectively). Among individuals (AD cases) with ε2:ε3 and ε2:ε4, 37.5% of the patients were having severe dementia and 62.5% were having mild to moderate dementia, whereas, among individuals with ε3:ε4 and ε4:ε4, 57% were having severe dementia and 43% were having mild to moderate dementia. Besides this, all early-onset Alzheimer's patients were found to have at least one ε4 allele. The percentage of individuals with family history (cases vs controls) was 34.17% vs 3.75%, without family history 64.55% vs 95%. On comparing AD cases against controls for smoking status, the results observed are the following: chain smokers, 12.65% vs 18.75%; moderate smokers, 16.45% vs 6.25%; ex-smokers, 36.70% vs 22.50%; non-smokers, 34.17% vs 52.50%. On comparing dietary habits in AD cases against controls, the results were as follows: individuals with generally fatty diet 26.58% vs 11.25%, with mixed diet 36.70% vs 78.75%, with generally vegetarian diet 34.17% vs 10.00%, data not available 2.53% among AD cases. Family history, dietary habits, genetics, and socioeconomic status are strongly associated with the development of Alzheimer disease. Although family history or genetic makeup cannot be changed, eating habits can be changed quite easily. We simply need to go from a high-fat diet to one that is lower in fat. Regarding socioeconomic status, which includes stress of both kinds, including economic stress, stress brought on by the loss of loved ones through death or separation, and co-morbidities (hypertension and diabetes), all are manageable and even modifiable through counseling, positive behavior, and physical activity like exercise, walking, cycling, and playing games.

Seroprevalence of Rickettsial disease: A population-based survey from kashmir valley, North India

Background

Limited studies have been done regarding the prevalence of Rickettsial diseases in India and as far as UT of Jammu and Kashmir is concerned, only a few hospital-based studies are available.

Objectives

The present study was therefore planned to find the seroprevalence of Rickettsial diseases in Kashmir Valley.

Materials and Methods

A multistage sampling procedure was used for the collection of samples from 10 districts of Kashmir Valley and a total of 1740 samples were collected. In addition, 802 healthy blood donors were included to establish baseline titers for Weil-Felix (WF) Test.

Results

Of 1734 subjects, 73 were positive by the WF test. The overall seroprevalence of Rickettsial diseases was 4.1% with the highest prevalence of scrub typhus (2.30%) followed by the spotted fever group (1.5%) and typhus group (0.40%). Maximum seropositive subjects were from district Kulgam (6.97%) followed by Pulwama (5.92%), Shopian (5.79%), Anantnag (5.47%), Ganderbal (5.00%), Kupwara (4.72%), Baramulla (4.62%), Srinagar (2.63%), Bandipora (2.41%), and Budgam (0.54%), respectively. Seropositivity was higher in females and subjects who had contact with ticks and mites like those involved in the collection of firewood and grass or had contact with uncut grass or shrub. The seropositivity was also significantly higher in those working in paddy fields and those living near the forest (P < 0.05).

Conclusion

The results of the present study confirm the existence of Rickettsial diseases in this region. This data would promote awareness of rickettsioses among local physicians and will also serve as a baseline to detect changing prevalence in the future.

Coliform pollution mapping in major watersheds along Jhelum River Basin of Kashmir Himalaya

Coliform pollution for the last three decades in major river systems of the world has resulted in far ranging impacts on water quality. In this context, the present study aimed to assess the levels of indicator bacteria like total Coliform (TC), fecal Coliform (FC) and fecal Streptococcus (FS) in major watersheds of Kashmir valley. Sampling was carried out for a period of 2 years (summer 2017 to spring 2019) along several upstream, midstream and downstream reaches of Jhelum River Basin (JRB), while analysis was carried out by multiple tube fermentation technique involving Most Probable Number (MPN). Major highlights of the results revealed high levels of TC, FC and FS among downstream sites with pronounced seasonal variations between summer and winter. TC was highest at all the reaches and during all the seasons followed by FC and FS. Non-metric multidimensional scaling (NMDS) revealed more variation in Coliform count among reaches as compared to seasons. Mantle test revealed that environmental factors like observable environmental pressure (OEP) (r: 0.235, p < 0.0001), DO (r: 0.2815, p < 0.0001) and temperature (r: 0.04419, p = 0.0104) had prominent effect on Coliform distribution as compared to geographical factors. The study thus highlights the prevalence of Coliform bacteria along JRB resulting from fecal sources. Due to growing urbanization and lack of adequate sewage treatment facilities, there is an increase in the levels of Coliform bacteria along downstream reaches especially those residing within lower Jhelum and Dara watershed, which could jeopardize water quality and public health.

RET/PTC Gene Rearrangements in Thyroid Carcinogenesis: Assessment and Clinico-Pathological Correlations

Rearranged during transfection (RET) is a proto oncogene implicated in thyroid carcinogenesis of papillary type (PTC). The RET proto-oncogene in PTC is constitutively activated by fusion of its tyrosine kinase domain with the 5 ´region of another gene thereby generating chimeric products collectively named RET/PTCs. RET/PTC1 and RET/PTC3 are best characterized among all RET/PTC rearrangements. Kashmir valley has witnessed an alarming increase in thyroid cancer incidence in young women. Therefore, we investigated the occurrence of RET/PTC 1 & 3 rearrangements by semi quantitative and qPCR in thyroid cancer patients (n = 48) of Kashmiri population and interrelated results with various clinicopathological characteristics. We observed that all the RET/PTC rearrangements were confined to PTC cases (10/40). Presence of RET/PTC rearrangement significantly correlated with gender, elevated TSH levels and lymph node metastasis. Overall, our study advocates that RET/PTC3 rearrangement is a frequent event in the carcinogenesis of thyroid gland in Kashmiri population although a study with a larger sample size is needed to get a clear scenario.

Prevalence of ovine cystic echinococcosis in Kashmir Valley, North India

A total of 1455 local and non-local (originating from other Indian states), slaughtered or spontaneously dead, sheep in various areas of Kashmir Valley were investigated for the presence of cystic echinococcosis over a period of one year. The overall prevalence was 7.97% with higher prevalence in local (14.3%) than in non-local sheep (6.06%). The prevalence of infection, total number of cysts recovered and mean intensity of infection were higher in lungs as 66.2%, 506 & 5.1% respectively, followed by liver (28.5%, 169, 3.9%) and spleen (5.3%, 9, 1.13%). Either single (71.55%) or multiple (28.45%) organ involvements were observed. 66.6% of cysts were of small size, 19.29% medium, 7.01% large and 7.01% calcified. The fertility of cysts was noted to be 65.7% whereas 34.2% were infertile which included 27.1% sterile and 7.01% calcified cysts. The viability percentage of protoscolices from all the fertile cysts was 74.2%. The number of cysts recovered was higher in sheep with body condition score- emaciated, thin and average, and lower in, fat and obesed. The study showed that the local sheep were more vulnerable to contract cystic echinococcosis than non-local sheep which is further aggravated by poor body condition.

Predominance of Central Asian and European families among Mycobacterium tuberculosis isolates in Kashmir Valley, India

BACKGROUND

As there are no data available regarding the strains of Mycobacterium tuberculosis circulating in Kashmir Valley, India, the current study aimed at describing the genetic diversity of M. tuberculosis strains in this region, by spoligotyping and 12-locus-based MIRU-VNTR typing (Mycobacterial Interspersed Repetitive Unit-Variable Number Tandem Repeat).

METHODS

Sputa from 207 smear positive cases with newly diagnosed pulmonary tuberculosis were subjected to culture for M. tuberculosis. Eighty-five isolates confirmed as M. tuberculosis were subjected to drug susceptibility testing and molecular typing by spoligotyping and MIRU-VNTRs.

RESULTS

Drug susceptibility results of 72 isolates revealed 76.3% as fully sensitive while 5.5% as multidrug resistant (MDR). Spoligotyping of 85 isolates detected 42 spoligotypes with 50 isolates (58.8%) clustered into seven spoligotypes. SIT26/CAS1_Del was the major spoligotype (23, 27%) followed by SIT127/H4 (12, 14.1%); CAS lineage (37.6%) was predominant, followed by Haarlem (25.8%) and ill-defined T clade (23.5%). MIRU-VNTR analysis displayed 82 MIRU patterns from 85 strains, including 3 small clusters and 79 unique. MIRU 26 was found to be the most discriminatory locus.

CONCLUSIONS

Kashmir Valley has CAS as the predominant lineage of M. tuberculosis similar to the rest of the Indian sub-continent, while it is peculiar in having Euro American lineages such as Haarlem and ill-defined T clade.

Bacterial biota of Nigeen Lake waters (Kashmir Valley)

One of the greatest apprehensions of water consumers all over the world with respect to the quality of drinking water is its contamination with pathogenic microorganisms. This research work determined the potential bacterial contaminants of the waters of Nigeen Lake, a subsidiary of Dal Lake and is regarded as a separate lake in Kashmir. The study was carried out from May 2014 to November 2014 excluding August and September at four different sites. During the study the bacterial flora showed variation in relation to the conditions prevailing at different sites. The highest viable count of bacteria was observed at Site:2 (surrounded by residential hamlets) followed by Site:1 (inlet) and Site:4 (centre) followed by Site:3 (outlet). Based on the examination of morphological features of bacterial colonies on nutrient agar plates after 48 h of incubation period, 40 different strains were isolated. The isolates were identified with the help of Gram's staining and DNA sequencing, 55% of the strains were Gram negative and 45% of the strains were Gram positive. With the help of 16S rRNA sequencing, out of the 40 isolates of bacteria, 7 strains were different at the genetic level. The bacteria which were identified with the help of DNA sequencing are Pseudomonas synxantha, Delftia acidovorans, Bacillus pumilus, Bacillus licheniformis, Macrococcus caseolyticus, Azotobacter vinelandii, and Stenotrophomonas maltophiria.

Intestinal helminth infections among children of district Shopian of Kashmir Valley, India

Intestinal helminth infections are amongst the most common infections worldwide. Studies in other districts of Kashmir Valley revealed a high prevalence of intestinal helminth infections among the children. The objectives of the current study were to determine the prevalence of intestinal helminth infections among children of Shopian district and to identify associated socio-demographic and environmental actors, behavioral habits and also related complaints. Stool samples were collected from 352 children and a questionnaire was filled for each case. The samples were processed using both simple smear and zinc sulphate concentration methods, and then microscopically examined for intestinal helminths. Of the 352 children surveyed, 75.28 % had 1, or more, helminth parasites. Prevalence of Ascaris lumbricoides was highest (71.8 %), followed by Trichuris trichiura (26.4 %), Enterobius vermicularis (13.9 %) and Taenia saginata (5.3 %). Conditions most frequently associated with infection included the age group, water source, boiled or unboiled water, defecation site, personal hygiene, and the extent of maternal education. The study shows a relatively high prevalence of intestinal helminths and suggests an imperative for the implementation of control measures.

Clinical study of cutaneous leishmaniasis in the Kashmir Valley

BACKGROUND

Cutaneous leishmaniasis (CL) is an infectious disease of tropical and semitropical areas of the world. The cold and harsh winter conditions of the Kashmir Valley do not favor the survival and growth of the Leishmania parasite or its vector, the sand fly, and the disease was until now practically unheard of in the Kashmir Valley.

AIMS

There has been a recent rise in the number of cases of CL in the Kashmir Valley. Against this background, the present study was taken up to describe the epidemiology, clinical features, and management outcomes of CL in the Kashmir Valley, where it represents a new phenomenon.

MATERIALS AND METHODS

Patients with direct smear-confirmed CL were evaluated. For each patient, we noted age, gender, geographical origin, stays in endemic areas, clinical aspects, number, site and size of lesions, treatment, and outcome. All the infected patients were treated with sodium stibogluconate. The dose, route of administration, adverse effects, and the clinical response in each patient was noted down.

RESULTS

Eighteen patients, 11 males (61.12%) and 7 females (38.88%) were studied. The age of the patients ranged from 3 to 60 years (mean age 29.8). The majority of our patients (16, 88.9%) belonged to two hilly areas, Uri and Karnah. Duration of the disease ranged from a minimum of 1 month to a maximum of 18 months (mean duration 4.6 months). Lesions in most of our patients (16, 88.9%) were located on the face including the lip and nose. The size of lesions varied from 4 to about 50 mm (average 2-3 cm). Most of our patients (13, 73.3%) had only a single lesion and a few (5, 26.7%) had two or three lesions. The clinical type of lesion in most of our patients (16, 88.9%) was noduloulcerative, only two (11.1%) had nodular (nonulcerative) lesions. Sixteen patients; all with facial lesions were treated with intravenous sodium stibogluconate. A complete response was seen in 14 (87%), without any major adverse effect. Two adult patients with extrafacial lesions were treated with four doses of weekly intralesional injections of sodium stibogluconate. A complete response was seen in both, without any major adverse effect.

CONCLUSION

The emergence of CL in this nonendemic area is of great epidemiological importance. Because no parasite isolation and characterization was carried out, further epidemiological studies and taxonomic differentiation of the species are required.

Population analysis of the genera buildup on some commercially important vegetable crops grown in Kashmir Valley

In order to list the genera buildup on Brassica oleracea (Cauliflower), Capsicum frustscens (Chillies), Spinacia oleracea (Spinach) and Phaseolus vulgaris (Farash bean) a general survey was carried in the summer season of 2013. On examining the soil samples as well as root samples of Cauliflower Boleodorus, Psilenchus, Helicotylenchus, Merlinius, Aglenchus and Filenchus were encountered with their absolute density of 18, 31, 34.5, 35, 35 and 31.5 %. On Chillies, Tylenchus, Helicotylenchus, Psilenchus, Pratylenchus and Hirschmaniella with their absolute frequency of 86, 96.6, 100, 100 and 96.6 % respectively were collected. Among these five genera recorded on Chillies the Relative prominence value of 16 % is lowest for Psilenchus and 26.7 % for Helicotylenchus. Merlinius, Psilenchus, Aglenchus, and Boleodorus were encountered on examining the soil and root samples of Spinach during the period of study. Boleodorus was met with the highest percentage of frequency of 90 % as well as highest proportion of absolute density of 37 % and lowest value of 24 % in case of Merlinius and Psilenchus. Soil samples as well as root samples of Farash bean, Aglenchus, Tylenchus, Hirschmaniella, Helicotylenchus and Psilenchus were encountered with their absolute density of 27, 19.5, 33, 33 and 35.4 %. The absolute frequency of 100 % was found in Tylenchus with the lowest frequency of 70 % in Helicotylenchus. Among the genera recorded on Farash bean relative prominence value happened to be highest in Hirschmaniella with the value as 23.6 % and lowest on Tylenchus with the value of 14.2 %.