An Investigation on the Coinfection of Measles and HSV-1 in Hospitalized Acute Encephalitis Syndrome Patients in Eastern India

Acute encephalitis syndrome (AES) is a clinical condition that occurs due to infectious and noninfectious agents- however, viruses are considered to be the dominant pathogen. agents- however, viruses are considered to be the dominant pathogen. In this study, suspected AES cases were enrolled and tested for viral etiology through serology and polymerase chain reaction (PCR)/reverse transcriptase PCR from August 2012-July 2013. During this period, 820 cases were investigated and 96 cases were diagnosed to have a viral etiology whereas 20 patients had IgM antibodies for measles in serum and HSV-1 DNA in cerebrospinal fluid. All 20 of the patients were children below 14 years of age. The median hospital stay was 15 days (IQR: 14.2-17 days) and median GCS score was 7(IQR: 6-8) and were significantly different with patients with co-infections when comapred with patients having HSV-1 infection only. It may be suspected that the measles infection may have a role in the pathogenesis and thus an impact on the prognosis of the AES when present with HSV-1.

Epidemiological and clinical profile of Influenza A(H1N1) pdm09 in Odisha, eastern India

Epidemic of flu is highly contagious and it spreads through air. In 2009 H1N1 influenza virus emerged after reassortment of North American TRIG and Eurasia Avian like virus of swine and started epidemic in Mexico. The first cases were reported from Hyderabad city on 16th May 2009 in India that spread rapidly within a short span of time. During this period large population of Odisha situated at the eastern side of India was also affected and incidences of H1N1 cases were recorded through state Government surveillance system. In this study real time RT-PCR based diagnosis was conducted for the throat swabs collected from suspected H1N1 cases in Odisha during 2009–2017. A total of 2872 throat swabs were received from 23 different Government and private hospitals and 21.1% positivity was confirmed. The disease affected mostly 46–60 years age group, males (50.6%) being more affected. The clinical features had shown that fever with cough (89.6%) was the most common symptom followed by shortness of breath (72.7%). Post monsoon was the peak season in which most of the cases were reported. Neurological signs, pregnancy, diabetes and hypertension were found to be risk factors for H1N1. The case fatality rate (CFR) was 15%.

Short implants and platelet-rich fibrin for transcrestal sinus floor elevation: a prospective multicenter clinical study

INTRODUCTION

Inadequacy of residual bone height due to sinus pneumatization and alveolar bone remodeling could jeopardize the option for implant supported rehabilitation in posterior atrophied maxillae.

AIM

The aim of this prospective, multi-centric clinical study is to investigate and assess the survival rate of short implants in single posterior maxillae atrophied sites with adjacent natural teeth, when augmented with leukocyte and platelet-rich fibrin (L-PRF) alone using a minimally invasive trans-crestal approach.

MATERIALS AND METHODS

Seventy-four short implants were installed in 53 patients with residual bone height (RBH) <4mm using piezoelectric ultrasonic guided sinus elevation by transcrestal approach. Six perforations of the sinus membrane occurred (11.3% perforation rate), out of which five were managed by using just L-PRF as grafting material. Postoperatively, the implants were clinically evaluated for survival rate. The cumulative implant survival rate was 93.3% at the end of first year of follow-up. Considering 2 dropouts by the end of 2nd year follow-up, and no further implant loss, the cumulative survival rate remained 93.3% up to 5 years follow-up period.

DISCUSSION

The use of L-PRF plug as grafting and careful preparation of osteotomy site with piezoelectric ultrasonic device could allow for simultaneous crestal sinus floor elevation and short implant installation in posterior atrophied maxillae with RBH <4mm, extending the indications for implant rehabilitation.

Prospective association between late evening food consumption and risk of prediabetes and diabetes: the Whitehall II cohort study

AIMS

We examined whether late evening food consumption was prospectively associated with the risk of developing prediabetes or diabetes in a large observational study of individuals with normoglycaemia.

METHODS

Participants were 2642 men and women with normoglycaemia (HbA_1c < 39 mmol/mol; < 5.7%) from the Whitehall II study. Time of last eating episode (TLEE) before the examination day was assessed at baseline. We studied the associations of TLEE with 5-year changes in HbA_1c and risk of developing prediabetes or diabetes (HbA_1c ≥ 39 mmol/mol; ≥ 5.7%). Potential heterogeneity in the association between TLEE and prediabetes or diabetes was examined using recursive partitioning modelling for time-to-event outcomes.

RESULTS

There was a tendency of an overall association of TLEE with change in HbA_1c but with little effect size [β per 1-h increase in TLEE = 0.2 mmol/mol, 95% CI -0.0 to 0.3 (0.01%, -0.00 to 0.03); P = 0.055] and no association with the risk of developing prediabetes/diabetes (risk ratio per 1-h increase in TLEE = 1.03, 95% CI 0.94 to 1.13; P = 0.511). According to the recursive partitioning modelling, women with HbA_1c ≤ 36 mmol/mol and TLEE after 21:00 had a 1.51 times (95% CI 1.16 to 1.93) higher 5-year risk of developing prediabetes or diabetes than those having their TLEE between 16:00 and 21:00 (35.4% vs. 23.5%; P = 0.003).

CONCLUSIONS

There was no overall association of TLEE with the development of prediabetes or diabetes in the Whitehall II population. However, explorative analyses suggested that eating late in the evening was associated with increased risk of developing prediabetes/diabetes among women with good glycaemic control. Whether restricting late evening food consumption is effective and feasible for the prevention of Type 2 diabetes needs testing in randomized controlled trials.

Molecular and phylogenetic analysis of the dengue strains circulating in Odisha, India

Dengue has emerged as a major public health challenge in terms of both changing clinical pattern and epidemiological features. The state of Odisha reported first dengue epidemic in the year 2010 and this continued each year in epidemic form during post monsoon period gradually becoming an endemic phenomenon. Present study depicts the changing epidemiological and clinical pattern of dengue with reference to its serotypes and genotypes. The study included 5320 suspected dengue cases from different health facilities of the state during 2010-2017. Dengue NS1 antigen and IgM antibody was done through ELISA. Serotyping was done through RTPCR by amplifying a part of core-pre-membrane gene (CprM) followed by sequencing and phylogenetic analysis. Dengue IgM antibody in 17.7% cases and NS1 antigen in 53.20% cases was detected. Dengue serotype 2 (DEN-2) was the only serotype detected in 2010 and 2011 where as all four serotypes 1, 2, 3, 4 were detected in 2012-2017, DEN-2 being dominant but in 2017 DEN-3 was found to be dominant. Phylogenetic analysis revealed genotype IV of DEN-2 and genotype III of DEN-1 and DEN-3 circulating in this region. In 6 cases involvement of DEN-2 in clinically evident encephalitis cases is an important observation in this region and needs public health attention. High prevalence of dengue was observed without any previous reported outbreaks in the state with increased number of cases from 2010 to 2012 affecting both urban and rural areas. High incidence in 2012 was due to co-circulation of more than one serotype which continued in the following years. Severity in some cases was associated with mixed infection but in most cases it was mild indicating the endemic nature of the virus in most parts of Odisha.

Abstract 5069: Breast cancer prevention by triterpenoids from allspice

Breast cancer ranks second as a lethal cancer in women. Although survival following initial diagnosis is ~ 100% in first five years, cancer progression and mortality is imminent in subsequent years. The slow progression to the lethal form of breast cancer has prompted development of multiple avenues to delay the progression, metastasis and mortality using potent prevention strategies, including the use of nutraceuticals. Oleanolic acid (OA) and ursolic acid (UA) are two triterpenoids found in edible plant parts-fruits and seeds with potent cancer preventive, and selective cytotoxic activities against multiple cancers including breast cancer. We conducted cytotoxic assays of the combination of OA and UA. We found the combination has enhanced efficacy as compared to OA or UA alone. The combination of OA and UA and UA alone caused cell death by increased autophagy but not apoptosis in both MCF7 and MB231 human breast cancer cells. Further analysis revealed increased autopagosomes and autophagic flux, inhibition of either process reduced cytotoxicity, indicating cytotoxic autophagy is the primary mechanism of their action. Therefore, a combination of OA and UA with conventional therapies could enhance their therapeutic efficacy while limiting systemic toxicities of existing therapies.

Citation Format: Jie Gao, Kenza Mamouni, Georgios Kallifatidis, Siva Panda, Muthusamy Thangaraju, Bal L. Lokeshwar. Breast cancer prevention by triterpenoids from allspice [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 5069.

Predictive accuracy of Demirjian's, Modified Demirjian's and India specific dental age estimation methods in Odisha (Eastern Indian) population

This study is aimed at finding the predictive accuracy of Demirjian's (D), modified Demirjian's (MD) and India specific age estimation methods (AA) Indian specific age estimation methods in 522 healthy children of Odisha population among 3-18 years. Correlations between chronological age (CA) and derived age (DA) by above mentioned methods were evaluated by Wilcoxon signed rank test and Pearson's correlation analysis. Analysis of mean absolute error concluded that D and MD predicted the CA with fair accuracy, whereas, AA had lower accuracy in Odisha children. Odisha specific polynomial regression formula, derived in this study is showing a strong correlation with CA (r=0.84). Comparison of mean absolute error of D, MD, AA and Odisha specific method indicated a better predictive accuracy of Odisha specific method.

An Arcak-type state estimation design for time-delayed static neural networks with leakage term based on unified criteria

The issue of unified dissipativity-based Arcak-type state estimator design for delayed static neural networks (SNNs) with leakage term and noise distraction was considered here. An Arcak-type state observer, which is compact than the usually used Luenberger-type state estimator, is selected to implement the subject of a unified dissipativity performance of SNNs. This paper primarily concentrates on the issue of Arcak-type state estimator of delayed SNNs involving leakage delay. The first attempt is made to tackle the Arcak-type state estimator of SNNs with time delay in leakage term in this paper based on the unified criteria, by constructing a novel Lyapunov functional together with newly improved integral inequalities. As a result, a novel unified state estimation criterion is launched in the form of linear matrix inequalities (LMIs) and put forward to justify the dynamics of error system is extended dissipative with the influence of leakage term and estimator gain matrices K¯₁ and K¯₂. Finally, an interesting simulation study is ultimately explored to show the performance of the established unified dissipativity-based theoretical results, in which, comparison results are also made together with recent works as a special case.

Efficient Synthesis of Pyrazinoic Acid Hybrid Conjugates

Benzotriazole-activated pyrazinoic acid was utilized as a versatile building block for the efficient and convenient synthesis of novel hybrid conjugates of pyrazinoic acid with secondary amines via amino acid linkers in high yields.

Thermal conductivity, thermal diffusivity, and volumetric heat capacity of silicone elastomer nanocomposites

Silicone elastomer (SiR) nanocomposites were prepared using multiwalled carbon nanotubes (MWCNT) and nano-graphite (NG). The morphology of the SiR nanocomposites has been studied using scanning electron microscopy and high-resolution transmission electron microscopy techniques. Detailed analysis of the morphology reveals a uniform distribution of the MWCNT and NG filler particles in the silicone matrix. On increasing the filler loading, a continuous network structure is formed and aggregation takes place. The effect of the MWCNT and NG loadings on the thermal properties of the silicone elastomer has been investigated. The thermal properties of the SiR nanocomposites were measured by a thermal properties analyzer based on the transient hot-wire method. Studies also suggest that incorporation of nanoparticles improves the thermal conductivity of SiR nanocomposites. The thermal conductivity of SiR nanocomposites increased from 0.200 W/(m K) to 0.440 W/(m K) and to 0.310 W/(m K) for 6 wt% MWCNT and NG loadings, respectively. Because of the positive temperature coefficient and the conductive nature of the nanoparticles, the thermal conductivity of the material increased on increasing the temperature. The thermal diffusivity and the volumetric heat capacity of the SiR nanocomposites were measured. The thermal diffusivity of the SiR nanocomposites increased from 0.1194 mm2/s to 0.3209 mm2/s and to 0.2050 mm2/s for 6 wt% MWCNT and NG loadings, respectively. This indicates that the temperature response becomes faster with MWCNT and NG loadings. The volumetric heat capacity of the silicone elastomer nanocomposites decreased from 1.80 MJ/(m3K) to 1.34 MJ/(m3K) and to 1.40 MJ/(m3K) for 6 wt% MWCNT and NG loadings, respectively. Thus, MWCNT particles are more effective in increasing the thermal conductivity and diffusivity of the SiR nanocomposites, when compared to NG fillers at any loading.

Issues around childhood disclosure of HIV status - findings from a qualitative study in West Bengal, India

INTRODUCTION

Informing the children living with HIV (CLH) about their disease (disclosure) is important from the perspective of disease treatment and overall psychosocial development. There are no published studies that qualitatively explored HIV disclosure-related issues among CLH in India. Our aim was to provide insights into the perceptions of informal caregivers of CLH regarding childhood disclosure.

METHODS

Children were defined as those aged <16 years. In-depth interviews were conducted with 34 primary caregivers of CLH aged 8 to 15 years old who were residing in West Bengal, India. The participants were recruited with the help of a community-based organization that provides need-based services to people living with HIV.

RESULTS

We obtained caregivers' perspectives on the motivators and barriers of childhood disclosure. Health benefits such as medication adherence emerged as an important motivator, while distress caused by disclosure and potential for stigma were identified as barriers. Health care providers were the preferred disclosers for most caregivers, followed by the caregivers themselves. Some caregivers wanted their child to learn about his/her HIV status by him/herself. There was no consensus among the caregivers about the ideal age for disclosure. Many preferred to wait until the child attained maturity or was of marriageable age.

DISCUSSION

Disclosure of HIV status to children is an emotional issue, both for the caregiver and the child. Like most low-or middle-income countries, no standardized, age-appropriate disclosure guidelines exist in India. Our findings advocate adoption of a multi-faceted approach, including increased availability of social and familial support, for childhood HIV disclosure.

Glycemic Status in Organophosphorus Poisoning

BACKGROUND

Organophosphorus(OP) poisoning, in addition to its cholinergic manifestations shows metabolic derangements leading to hyperglycemia. Apart from inhibiting acetylcholinesterase it also induces oxidative stress to exhibit this manifestation. The present study aims to assess the glycemic status of OP poisoned patients and its association with various factors in OP poisoning like oxidative stress and dose of atropine.

METHODS

This is a prospective study which recruited 102 patients above 18 years of age with history of OP poisoning. They were categorized into 3 grades-mild, moderate and severe based on the Peradeniya Organophosphorus Poisining Scale. The routine biochemical parameters along with serum malondialdehyde (MDA) and cholinesterase were estimated in the study group.

RESULTS

Hyperglycemia and glycosuria were observed, with majority cases of hyperglycemia (57%) noticed in the severe group. There was a rise in the random plasma glucose (RPG), serum malondialdehyde (MDA), total dose of atropine across the groups along with a fall in the serum cholinesterase with increase in severity of poisoning. The fall in plasma glucose at the time of discharge was significant in all three groups when compared to the admission random plasma glucose(RPG) level. This transient hyperglycemia exhibited a significant positive association with serum MDA and dose of atropine administered during treatment (p<0.05).

CONCLUSIONS

Glycemic status in OP poisoning may play a role in identifying the severity of poisoning at the time of admission.

Review of cesarean section on maternal request in a tertiary care institute; scenario in developing country

Mother requesting of caesarean reflects a belief among society that elective caesarean safer than vaginal delivery in term of fetus and mother. Although the study data neglecting the facts other skewed part in this issue is consideration of resources, as in developing countries, where maternal mortality is still high due to lack of adequate resources. Mother coming to obstetrician with mother's request should individualize in every case considering mother's argument, society and evidence base guideline.