High prevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antibodies among unvaccinated children of Chandigarh, Northwest India, in a household-based paediatric serosurvey post-second wave of pandemic (June to July 2021)

OBJECTIVE

Current national severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination policy covers children aged >12 years. Unvaccinated, uninfected children remain susceptible to SARS-CoV-2 and play a role in community transmission, as paediatric infection is mostly mild or asymptomatic. To estimate the proportion of susceptible children in a community for public health measures, there is a need to assess the extent of natural infection.

STUDY DESIGN

We performed a cross-sectional household serosurvey of SARS-CoV-2 antibodies in unvaccinated children aged between 6 and 18 years after the second COVID-19 wave.

METHODS

Anti-SARS-CoV-2 immunoglobin G (IgG) testing in serum was done using chemiluminescence immunoassay. We used a logistic regression model to investigate predicted factors of seropositivity.

RESULTS

We observed a high prevalence (weighted average: 68.3%) of anti-SARS-CoV-2 IgG in 2700 enrolled children. Logistic regression for predictors of IgG seropositivity showed lower odds in households with completely vaccinated adults (adjusted odds ratio [OR]: 0.43, 95% confidence interval [CI]: 0.26-0.71, P = 0.0011) compared with households with unvaccinated adults. Other factors for low seropositivity included frontline workers as family members (adjusted OR: 0.69, 95% CI: 0.52-0.91, P = 0.0091) and non-crowded households (adjusted OR: 0.74, 95% CI: 0.61-0.89, P = 0.0019).

CONCLUSION

A high SARS-CoV-2 IgG prevalence in unvaccinated children was indicative of previous exposure to potentially infected contacts. This implies in-person academic activities for children can be continued during future community transmission. Comparatively lower seropositivity in children of completely vaccinated households or frontline workers suggests decreased transmission due to vaccination-induced immunity of family members. Vaccination will still be required in these children to maintain protective IgG levels, particularly in low seroprevalence groups.

Beta glucan as an immune stimulant in tumor microenvironment - Insight into lessons and promises from past decade

Cancer is characterized by a perturbed immune landscape. Inside tumor microenvironment, immune system is reprogrammed to facilitate tumor growth and survival rather than eliminating it. This immune evasive mechanism needs to be reversed to normal for effective anticancer therapeutic strategy. Immunotherapy has emerged as a novel strategy for redeployment of immune cells against cancer. However, they suffer in their efficacy, response rate and side effects. This necessitated us to turn toward natural repertoires which can act as a substitute to conventional immunotherapeutics. Beta glucan, a polysaccharide derived from mushroom, serves the role of immunomodulator inside tumor microenvironment. It acts as pathogen associated molecular pattern and bind to various pattern recognition receptors expressed on surface of immune cells thereby facilitating their activation and crosstalk. This result in resurgence of suppressed immune surveillance in the tumor milieu. In this review, we highlight in brief the advances and limitation of cancer immunotherapy. Alongside, we have discussed the detailed mechanistic principle and recent advances underlying restoration of immune functionality by beta glucan.

Computational-sampling-moiré-based on-machine alignment for freeform optics

The manufacturing and characterization of freeform optical surfaces are influenced by their high sensitivity to misalignments. In this work, the computational sampling moiré technique combined with phase extraction is developed for the precise alignment of freeform optics during fabrication and in metrology applications. This novel, to the best of our knowledge, technique achieves near-interferometry-level precision in a simple and compact configuration. This robust technology can be applied to industrial manufacturing platforms (such as diamond turning machines, lithography, and other micro-nano-machining techniques) as well as their metrology equipment. In a demonstration of computational data processing and precision alignment using this method, iterative manufacturing of freeform optical surfaces with a final-form accuracy of about 180 nm was accomplished.

Prognostic significance of soft tissue deposits in head and neck squamous cell carcinoma: a systematic review and meta-analysis

Soft tissue deposits, also known as tumour deposits (TDs), have not been studied well in head and neck squamous cell carcinoma (HNSCC) and are not included in any of the staging systems or treatment guidelines. The aim of this systematic review was to determine the prevalence and prognostic implications of TDs in patients with HNSCC. This systematic review of the literature was conducted following the PRISMA guidelines. The PubMed, Embase, and Scopus electronic databases were searched for relevant studies, from inception to August 2022. Although 14 studies qualified for inclusion, only eight were finally included in the review due to the considerable overlap of patients in several studies. Data from 7127 patients were analysed. The pooled prevalence of TDs was 21% (95% confidence interval (CI) 9-33%). The presence of TDs was adversely associated with overall survival and disease-free survival, with hazard ratios of 2.08 (95% CI 1.60-2.70) and 2.56 (95% CI 1.97-3.32), respectively. TDs are detected in a significant number of patients with HNSCC and adversely affect survival. Longitudinal prospective studies are needed to evaluate the prognostic implications of TDs in HNSCC for their potential role in cancer staging and adjuvant treatment planning.

1167. Changing spectrum of aetiology of Acute Fever with Jaundice (Tropical Jaundice) in Adults presenting to Emergency Care--- A study from a Tertiary Care Hospital in North India

Background

The spectrum of infections causing the above acute onset fever with jaundice has changed over the last few years from the conventional hepatotropic viruses to new emerging infections.

Methods

250 adult patients ≥ 14 years of age) with acute fever (body temperature > 101ᵒF of 14 days or less in duration) without any localized source of infection on initial clinical evaluation accompanied with jaundice (hyperbilirubinemia ≥ 1.5 mg/dl or elevation of ALT or AST ≥ three times upper limit) were enrolled.All these patients with fever and jaundice were evaluated on the basis of a standard proforma and were evaluated for malaria (peripheral smears/rapid diagnostic kits), scrub typhus( PCR /IgM ELISA), leptospirosis(IgM ELISA), enteric fever by blood cultures and dengue by dengue (NS1 antigen test and IgM ELISA), Hepatitis(IgM ELISA of EBV/HSV, IgM ELISA of HAV/HEV and HBsAg with IgM HBc ELISA if HBsAg positive)

Results

62.5 % were males and 37.5 % were females. The mean duration of fever before the presentation was 8.1 ± 2.58 days. 10 patients (4%) died, while 133 patients (96%) improved with treatment. Scrub typhus 57 (22.8%), Hepatitis E 33 (13.2%), malaria 9 (3.6%), dengue fever, enteric fever, hepatitis A and leptospirosis in 26 (10.4%), 6 (2.4%), 6 (2.4%) patients and 4 (1.6%) patient respectively were the prominent aetiology a patient presenting with fever and jaundice. Probable sepsis (Fulfilling SIRS criteria with a negative culture) accounted for 40(16%) patients. In 69(27.6%) cases no diagnosis could be made on serological testing Conjunctival suffusion (OR=23.17), respiratory crepitations (OR=5.17), thrombocytopenia (OR=1.14), normal INR (OR=0.29) were significant predictors of a diagnosis of scrub typhus in patients with fever and jaundice. Severe anaemia (Hb< 8), Hypoalbuminemia, severe thrombocytopenia (Platelet count < 50,000) and a near-normal INR at admission were predictors of a malarial vs a viral aetiology of Tropical jaundice. Co-infection with scrub typhus and malaria was seen in 6 patients (vivax-5 and falciparum-1) and viral hepatitis A & E was observed in 10 patients.

Conclusion

Neglected Tropical diseases like Scrub typhus infection is emerging as common aetiology of acute onset tropical jaundice in adults presenting to emergency services.

Disclosures

All Authors: No reported disclosures.

Prevalence of Asymptomatic Bacteriuria and Antimicrobial Resistance Profile among Pregnant Females in a Tertiary Care Hospital

Background and Objectives:

Urinary tract infection (UTI) is the most common clinical finding during pregnancy, and if it is asymptomatic bacteriuria (ASB), it can progress to pyelonephritis, leading to further complications. The present study aims to know the prevalence of ASB in pregnant females and the antimicrobial resistance pattern in our hospital setup.

Materials and Methods:

A total of 552 urine samples were collected from pregnant females (with no symptoms of UTI) both attending outpatient department and admitted in the wards of obstetrics and gynecology department. Urine culture was performed on blood agar, MacConkey agar, and UTI chromogenic agar. Antibiotic sensitivity test was done using Kirby-Bauer disc diffusion method, and the results were interpreted.

Results:

The prevalence rate of ASB in pregnant females was 17.4%. It was common in the age group of 25–33 years (60.4%). The infection rate was higher in the second trimester (43.7%) compared to the third (29.2%) and first (27.1%) trimester. Multiparity (60.4%) was a common finding in ASB during pregnancy. There was a significant finding of previous history of UTI (22.9%) and anemia (58.3%) associated with ASB in pregnant females. Escherichia coli (39.2%) was the most common microorganism isolated followed by Staphylococcus aureus (34.3%), Enterococcus faecalis (14.7%), Klebsiella (4.9%), coagulase-negative Staphylococcus spp. (2.9%), and Citrobacter and Acinetobacter (1.9%). Most sensitive drugs to be given in ASB during pregnancy were nitrofurantoin and fosfomycin.

Conclusion:

It was emphasized that urine culture should be done in early antenatal visit as routine screening to identify ASB in pregnant females as it can prevent fetal and maternal complications.

Therapeutic applications of mushrooms and their biomolecules along with a glimpse of in silico approach in neurodegenerative diseases

Neurodegenerative diseases (NDs) represent a common neurological pathology that determines a progressive deterioration of the brain or the nervous system. For treating NDs, comprehensive and alternative medicines have attracted scientific researchers' attention recently. Edible mushrooms are essential for preventing several age-based neuronal dysfunctions such as Parkinson's and Alzheimer's diseases. Mushroom such as Grifola frondosa, Lignosus rhinocerotis, Hericium erinaceus, may improve cognitive functions. It has also been reported that edible mushrooms (basidiocarps/mycelia extracts or isolated bioactive compounds) may reduce beta-amyloid-induced neurotoxicity. Medicinal mushrooms are being used for novel and natural compounds that help modulate immune responses and possess anti-cancer, anti-microbial, and anti-oxidant properties. Compounds such as polyphenols, terpenoids, alkaloids, sesquiterpenes, polysaccharides, and metal chelating agents are validated in different ND treatments. This review aims to assess mushrooms' role and their biomolecules utilization for treating different kinds of NDs. The action mechanisms, presented here, including reducing oxidative stress, neuroinflammation, and modulation of acetylcholinesterase activity, protecting neurons or stimulation, and regulating neurotrophins synthesis. We also provide background about neurodegenerative diseases and in-silico techniques of the drug research. High costs associated with experiments and current ethical law imply efficient alternatives with limited cost value. In silico approaches provide an alternative method with low cost that has been successfully implemented to cure ND disorders in recent days. We also describe the applications of computational procedures such as molecular docking, virtual high-throughput screening, molecular dynamic (MD) simulation, quantum-mechanical methods for drug design. They were reported against various targets in NDs.

Boiling histotripsy and in-situ CD40 stimulation improve the checkpoint blockade therapy of poorly immunogenic tumors

Background: Advanced stage cancers with a suppressive tumor microenvironment (TME) are often refractory to immune checkpoint inhibitor (ICI) therapy. Recent studies have shown that focused ultrasound (FUS) TME-modulation can synergize ICI therapy, but enhancing survival outcomes in poorly immunogenic tumors remains challenging. Here, we investigated the role of focused ultrasound based boiling histotripsy (HT) and in-situ anti-CD40 agonist antibody (αCD40) combinatorial therapy in enhancing therapeutic efficacy against ICI refractory murine melanoma. Methods: Unilateral and bilateral large (~330-400 mm3) poorly immunogenic B16F10 melanoma tumors were established in the flank regions of mice. Tumors were exposed to single local HT followed by an in-situ administration of αCD40 (HT+ αCD40: HT40). Inflammatory signatures post treatment were assessed using pan-cancer immune profiling and flow cytometry. The ability of HT40 ± ICI to enhance local and systemic effects was determined by immunological characterization of the harvested tissues, and by tumor growth delay of local and distant untreated tumors 4-6 weeks post treatment. Results: Immune profiling revealed that HT40 upregulated a variety of inflammatory markers in the tumors. Immunologically, HT40 treated tumors showed an increased population of granzyme B+ expressing functional CD8+ T cells (~4-fold) as well as an increased M1 to M2 macrophage ratio (~2-3-fold) and CD8+ T: regulatory T cell ratio (~5-fold) compared to the untreated control. Systemically, the proliferation rates of the melanoma-specific memory T cell population were significantly enhanced by HT40 treatment. Finally, the combination of HT40 and ICI therapy (anti-CTLA-4 and anti-PD-L1) caused superior inhibition of distant untreated tumors, and prolonged survival rates compared to the control. Conclusions: Data suggest that HT40 reprograms immunologically cold tumors and sensitizes them to ICI therapy. This approach may be clinically useful for treating advanced stage melanoma cancers.

Coinfection of H1N1 Influenza and Scrub Typhus-A Review

The H1N1 influenza infection usually coincides with the typical scrub typhus season in North India. This leads to diagnostic difficulties due to their similar and non-specific symptoms. We describe three patients with confirmed co-infection of pandemic (H1N1) influenza and scrub typhus who had presented with acute respiratory distress syndrome. A systematic review of database yielded one case of scrub typhus and H1N1 influenza co-infection reported from South Korea. Co-infection of influenza with tropical infections may not be uncommon in endemic countries and hence a high index of suspicion on the part of physicians coupled with appropriate investigations are needed. The true burden of co-infections needs to be evaluated during outbreaks of influenza in a systematic manner.

In-situ vaccination using focused ultrasound heating and anti-CD-40 agonistic antibody enhances T-cell mediated local and abscopal effects in murine melanoma

The success of melanoma immunotherapy is dependent on the presence of activated and functional T-cells in tumors. The objective of this study was to investigate the impact of local-focused ultrasound (FUS) heating (∼42-45 °C) and in-situ anti-CD-40 agonistic antibody in enhancing T-cell function for melanoma immunotherapy. We compared the following groups of mice with bilateral flank B16 F10 melanoma: (1) Control, (2) FUS, (3) CD-40, and (4) CD-40 + FUS (FUS40). FUS heating was applied for ∼15 min in right flank tumor, and intratumoral injections of CD-40 were performed sequentially within 4 h. A total of 3 FUS and 4 anti-CD-40 treatments were administered unilaterally 3 days apart. Mice were sacrificed 30 days post-inoculation, and the treated tumor and spleen tissues were profiled for T-cell function and macrophage polarization. Compared to all other groups, histology and flow cytometry showed that FUS40 increased the population of tumor-specific CD-4+ and CD-8+ T cells rich in Granzyme B+, interleukin-2 (IL-2) and IFN-γ production and poor in PD-1 expression. In addition, FUS40 promoted the infiltration of tumor-suppressing M1 phenotype macrophages in the treated mice. The resultant immune-enhancing effects of FUS40 suppressed B16 melanoma growth at the treated site by 2-3-folds compared to control, FUS, and CD-40, and also achieved significant abscopal effects in untreated tumors relative to CD40 alone. Additionally, the local FUS40 prevented adverse liver toxicities in the treated mice. Our study suggests that combined FUS and CD-40 can enhance T-cell and macrophage functions to aid effective melanoma immunotherapy.

Novel calreticulin-nanoparticle in combination with focused ultrasound induces immunogenic cell death in melanoma to enhance antitumor immunity

Rationale: Some studies have shown that the local activation of immunogenic cell death (ICD) by upregulating calreticulin (CRT) expression in solid tumors can improve antitumor effects. Although a promising approach, a key current challenge in ICD tumor therapy is the absence of a clinically translatable method for reproducibly inducing the CRT expression. Herein, we report a novel calreticulin-nanoparticle (CRT-NP) that enhances ICD and synergizes with focused ultrasound (FUS) to achieve local and systemic antitumor effects. Methods: Full-length clone DNA of calreticulin was encapsulated in NPs made from DOTAP and cholesterol. Three CRT-NP intratumoral injections of 20 µg each were given 2 days apart, and FUS heating (42-45°C, ~15min) was applied sequentially 24h after each injection to induce ICD. To investigate ICD specific immune effect, the splenocytes of mice vaccinated with CRT-NP (± FUS) treated B16F10 cells were evaluated ex-vivo for TRP-2 antigen specific immunity. Additionally, the long-term protection was evaluated by re-challenging with the melanoma cells in the flank regions of tumor bearing mice. Results: CRT-NP plus FUS (CFUS) upregulated CRT expression, expanded the population of melanoma TRP-2 specific functional CD4+ and CD8+ T cells and tumor-suppressing M1 phenotype, and increased PD-1 and PD-L1 marker expression in the T cells. Therapeutically, CFUS suppressed B16 melanoma growth by >85% vs. that seen in untreated controls, and >~50% vs. CRT-NP or FUS alone, and prevented tumor growth in distal untreated sites. Conclusions: CRT-NP amplifies the FUS and ICD therapeutic outcomes against melanoma, suggesting that the proposed combinatorial methodology may be clinically translatable.

Well-differentiated Squamous Cell Carcinoma Arising in Syringocystadenoma Papilliferum

Syringocystadenoma papilliferum (SCAP) is a hamartoma of apocrine sweat gland origin, occurring predominantly in children, in the head and neck region. SCAP can arise or coexist with both benign and malignant tumors. We report herein an extremely rare case of squamous cell carcinoma (SCC) arising in SCAP growth located in unusual supragluteal region in an elderly Indian male. A wide surgical excision of the growth was performed which upon histopathological examination revealed the confirmatory diagnosis. SCC arising in SCAP is unusual, and only two histologically confirmed cases have been previously reported in the literature. This case report emphasizes about extremely rare malignant transformation of SCAP, which should be kept in mind while evaluating a suspicious skin lesion.

Correlation of Foot Bimalleolar Angle and Ultrasonography in Assessing the Severity of Club Foot in Neonates Treated by the Ponseti Method

Introduction: Correlation of Pirani score and foot bimalleolar (FBM) angle has been used in few studies but correlation of FBM angle with ultrasonography has never been evaluated so they are being correlated in assessing the severity of clubfoot in neonates treated by Ponseti method. Material and Methods: Thirty-two feet with congenital talipes equinovarus (CTEV) deformity in neonates were prospectively treated by the Ponseti method. FBM angle and ultrasound parameters were measured three times i.e. at the time of initial presentation, at four weeks of treatment and at completion of treatment. The feet were divided according to the Pirani score in groups: one (0-2.0), two (2.5-4) and three (4.5-6). Correlation between FBM angle and ultrasound parameters were evaluated using Pearson correlation/regression. Results: Correlation between FBM angle and ultrasound parameters were statistically significant (p-value < 0.05). Conclusion: Ultrasound has the potential to accurately depict the pathoanatomy in clubfoot. FBM angle and ultrasound are objective methods to assess the severity of clubfoot. FBM angle and ultrasonography correlated in severity of deformity and correction achieved along the course of treatment.

Long-term operation of electro-biocatalytic reactor for carbon dioxide transformation into organic molecules

Electro-biocatalytic reactor was operated using selectively enriched mixed culture biofilm for about 320 days with CO₂/bicarbonate as C-source. Biocathode consumed higher current (-16.2 ± 0.3 A/m²) for bicarbonate transformation yielding high product synthesis (0.74 g/l/day) compared to CO₂ (-9.5 ± 2.8 A/m²; 0.41 g/l/day). Product slate includes butanol and butyric acid when CO₂ gets transformed but propionic acid replaced both when bicarbonate gets transformed. Based on electroanalysis, the electron transfer might be H₂ mediated along with direct transfer under bicarbonate turnover conditions, while it was restricted to direct under CO₂. Efficiency and stability of biofilm was tested by removing the planktonic cells, and also confirmed in terms of Coulombic (85-97%) and carbon conversion efficiencies (42-48%) along with production rate (1.2-1.7 kg/m² electrode) using bicarbonate as substrate. Selective enrichment of microbes and their growth as biofilm along with soluble CO₂ have helped in efficient transformation of CO₂ up to C4 organic molecules.

Heavy metal pollution due to coal washery effluent and its decontamination using a macrofungus, Pleurotus ostreatus

Release of the effluent generated during washing of coal became a major problem for coal industries due to presence of many toxic metals and other pollutants. These effluents are the main source of pollution in rivers and other water bodies. Therefore in this study, we tried to analyse the toxicity of coal washery effluent (CWE) collected from one of the washery plant situated in Dhanbad, India. CWE was found to be very toxic containing large amount of suspended particles and many heavy metals above than their permissible limits. Mycoremediation of CWE was also performed to decontaminate heavy metals from the CWE using a macrofungi Pleurotus ostreatus. Efficiency of Pleurotus for remediation of heavy metals was found to be highest in the 50% diluted effluent (57.2% Mn, 82.6% Zn, 98.0% Ni, 99.9% Cu, 99.3% Co, 99.1% Cr, 89.2% Fe and 35.6% Pb) followed by 25% diluted effluent (33.0% Mn, 55.1% Zn, 97.8% Ni, 99.7% Cu, 97% Co, 84.4% Cr, 87.1% Fe and 73.4% Pb) and raw effluent (23.3% Mn, 73.1% Zn, 78.7% Ni, 87.5% Cu, 59.3% Co, 64.6% Cr, 34.6% Fe and 11.3% Pb) respectively. Increased activity of antioxidant enzymes, lipid peroxidation, concentration of metallothionein proteins and changes in peaks of FTIR spectra were also observed in fungal mycelia grown on the CWE containing media due to accumulation of different metals. Overall this study suggests that Pleurotus can be used as promising option for removal of heavy metals from the effluent released from washery plants and dilution of effluent could increase the efficiency of remediation.

Outcome of bone marrow instillation at fracture site in intracapsular fracture of femoral neck treated by head preserving surgery

PURPOSE

The aim of present study is to evaluate the outcome of bone marrow instillation at the fracture site in fracture of intracapsular neck femur treated by head preserving surgery.

METHODS

This study included 32 patients of age group 18-50 years with closed fracture of intracapsular neck femur. Patients were randomized into two groups as per the plan generated via www.randomization.com. The two groups were Group A (control), in which the fracture of intracapsular neck femur was treated by closed reduction and cannulated cancellous screw fixation, and Group B (intervention), in which additional percutaneous autologous bone marrow aspirate instillation at fracture site was done along with cannulated cancellous screw fixation. Postoperatively the union at fracture site and avascular necrosis of the femoral head were assessed on serial plain radiographs at final follow-up. Functional outcome was evaluated by Harris hip score.

RESULTS

The average follow-up was 19.6 months. Twelve patients in each group had union and 4 patients had signs of nonunion. One patient from each group had avascular necrosis of the femoral head. The average Harris hip score at final follow-up in Group A was 80.50 and in Group B was 75.73, which was found to be not significant.

CONCLUSION

There is no significant role of adding on bone marrow aspirate instillation at the fracture site in cases of fresh fracture of intracapsular neck femur treated by head preserving surgery in terms of accelerating the bone healing and reducing the incidence of femoral head necrosis.

Analysis of silver binding nucleolar organizer regions in exfoliative cytology smears of potentially malignant and malignant oral lesions

Nucleolar organizer regions are nucleolar components that contain proteins that are stained selectively by silver methods; they can be identified as black dots throughout the nucleolus and are known as silver binding nucleolar organizer regions (AgNOR). The number of AgNOR is related to the cell cycle and the proliferative activity of the cells. We investigated AgNOR using exfoliative cytology smears of potentially malignant oral lesions. Eighty individuals were divided into four equal groups: healthy controls, oral leukoplakia, oral submucous fibrosis and oral squamous cell carcinoma. The mean number of AgNOR in each study group gradually increased from control to oral leukoplakia to oral submucous fibrosis to oral squamous cell carcinoma. The proliferative index was increased in the oral premalignant and malignant patients compared to normal subjects. The mean AgNOR size gradually increased from control to oral leukoplakia to oral submucous fibrosis to oral squamous cell carcinoma. Spherical shaped AgNOR were most common in controls, whereas large, clustered and kidney shapes were most common in oral squamous cell carcinoma. Multiparameter analysis of AgNOR in oral exfoliative smears is a simple, sensitive and cost-effective method for differentiating premalignant from malignant lesions and can be used in conjunction with routine cytomorphological evaluation.

Prevalence of high-risk human papilloma virus types and cervical smear abnormalities in female sex workers in Chandigarh, India

PURPOSE

Cervical cancer is the most common cancer among women in developing nations. Nearly 90% of the cases have been linked to the presence of high-risk human papillomavirus (hrHPV) types 16 and 18. The risk of cervical cancer may be high in female sex workers (FSWs) due to multiple sexual partners. This study aimed to determine the prevalence of cytological abnormalities and hrHPV types 16 and 18 in FSWs in Chandigarh, North India using the liquid-based cytology (LBC) approach.

MATERIALS AND METHODS

The cervical brush samples were collected from 120 FSW and 98 age-matched healthy controls (HCs). These were subjected to pap smear using conventional method, LBC and the detection of hrHPV types 16 and 18 was carried out using polymerase chain reaction.

RESULTS

The LBC samples showed better cytological details and also reduced the number of unsatisfactory smears from 11% in Pap to 1.5% in the LBC. A significantly higher number of inflammatory smears were reported in FSWs (51.7% vs. 34.7%, P = 0.01). The hrHPV types 16/18 were detected in 33/120 (27.5%) FSW versus 23/98 (23.5%) HCs. The risk of acquiring hrHPV was higher in FSWs, who had age at first sex ≤25 years, higher income and the habit of smoking.

CONCLUSION

The high prevalence of hrHPV among FSWs and HCs suggests the need for the implementation of effective National Screening Programme for early detection of hrHPV types to decrease the burden of cervical cancer, especially in high-risk population.

Perturbations and 3R in carbon management

Perturbations in various carbon pools like biological, geological, oceanic, and missing carbon sink affect its global data, which are generally neglected or ignored in routine calculations. These natural and anthropogenic events need to be considered before projecting a sustainable carbon management plan. These plans have both general and experimental aspects. General plans should focus on (a) minimizing emission; (b) maximizing environmentally sound reuse, reduce, and recycling; (c) effective treatment; and (d) converting carbon into valuable products with atom economy. Experimental carbon management plans involving various biological and chemical techniques with limitation in terms of research level and economic feasibility. Chemical options have benefits of higher productivity and wider product range, but it suffers from its higher-energy requirements and environmental unfriendliness. In contrast to this, biological options are more selective and less energy intensive, but their productivity is very low. Hence, there is a requirement of hybrid process where the benefits of both the options, i.e., biological and chemical, can be reaped. In view of above, the proposed review targets to highlight the various perturbations in the global carbon cycle and their effects; study the currently practiced options of carbon management, specifically in light of 3R principle; and propose various new hybrid methods by compatible combinations of chemical and biological processes to develop better and safer carbon management. These methods are hypothetical so they may require further research and validations but may provide a comprehensive base for developing such management methods.

Quantitative evaluation of apical extrusion of intracanal bacteria using rotary ProTaper, K3XF, twisted and hand K-file system: An ex vivo study

AIMS

The aim of this study was to evaluate the number of intracanal bacteria extruded apically during root canal preparation using rotary ProTaper, K3XF, twisted, and hand K-file system.

SUBJECTS AND METHODS

Seventy extracted single-rooted human mandibular premolar teeth were used. Access cavities were prepared and the teeth were mounted in glass vials. Root canals were then contaminated with a pure culture of Enterococcus faecalis (ATCC 29212) and incubated at 37°C for 24 h. The contaminated roots were divided into four experimental groups of 15 teeth each and one control group of 10 teeth. Group 1: ProTaper; Group 2: K3XF; Group 3: Twisted file; Group 4: Hand K-file; Group 5: Control group. Bacteria extruded from the apical foramen during instrumentation were collected into vials. The microbiological samples were incubated in culture media for 24 h. Colonies of bacteria were counted and the results were given as number of colony-forming units (CFU)/ml.

STATISTICAL ANALYSIS USED

The obtained data were analyzed using the Kruskal-Wallis one-way analysis of variance and Mann-Whitney U-tests.

RESULTS

There was a significant difference between the rotary and hand instrumentation system related to the apically extruded intracanal bacteria.

CONCLUSIONS

Both the rotary and hand instrumentation systems extruded intracanal bacteria through the apical foramen. K3XF file system showed least bacterial extrusion amongst all instrumentation groups.

Malunion in displaced intracapsular fracture of femoral neck: A rare case

Intracapsular fracture of femoral neck is treated by anatomical reduction (preferably closed) and cannulated cancellous lag screw fixation. Malunion of these fractures have been described in the coronal plane (coxa valga or coxa vara). We reported a case of young adult patient with displaced intracapsular fracture of femoral neck that had malunited in sagittal plane with callus formation with excellent functional outcome. The radiographs revealed intracapsular fracture of femoral neck right side (Garden type 4 and Pauwel type 3). The patient was operated and closed reduction and internal fixation with three cannulated cancellous screws was performed. The postoperative radiograph revealed a loss of reduction in the lateral view. Due to this technical error, the patient was counselled for revision fixation for which he refused. At 9 months we observed union of the fracture in the displaced position by callus formation. Harris hip score at 2 years was 96 that indicate excellent functional outcome and the radiographs did not reveal any evidence of avascular necrosis of femoral head. We advised revision surgery to our patient as he had increased chances of implant failure and nonunion. However he refused the revision surgery and was continued with the suboptimal reduction. However, the fracture united and that too with callus formation, which is not a described phenomenon in neck of femur fracture.

Electro-biocatalytic treatment of petroleum refinery wastewater using microbial fuel cell (MFC) in continuous mode operation

Refinery wastewater (RW) treatment in microbial fuel cell (MFC) was studied in batch mode operation followed by continuous mode operation with 8h and 16h hydraulic retention time (HRT). The MFC performance was evaluated in terms of power density, organics removal, specific contaminants (oil & grease, phenol and sulfide) removal and energy conversion efficiency with respect to operation mode. Higher power density of 225±1.4mW/m² was observed during continuous mode operation with 16h HRT along with a substrate degradation of 84.4±0.8% including the 95±0.6 of oil content. The columbic efficiency during this operation was about 2±0.8% and the projected power yield was 340±20kWh/kg COD_R/day. Batch mode operation also showed good substrate degradation (81±1.8%) but took longer HRT which resulted in significantly low substrate degradation rate (0.036±0.002kgCOD_R/m³-day) over continuous mode operation (1.05±0.01kgCOD_R/m³-day). Overall, current study depicted the possibility of utilizing RW as substrate in MFC for power generation along with its treatment.

Bio-electro catalytic treatment of petroleum produced water: Influence of cathode potential upliftment

Treatment of petroleum produced water (PPW) was studied using bioelectrochemical system (BES) under uplifted cathode potential. The treatment efficiency in terms of COD and hydrocarbon removal was observed at 91.25% and 76.60% respectively, along with the reduction in TDS during BES operation under 400mV of cathode potential. There was also a reduction in concentration of sulfates, however, it was not significant at, since oxidative conditions are being maintained at anode. Improved oxidation of PPW at anode also resulted in good power output (-20.47mA) and also depicted improved fuel cell behaviour. The electrochemical analysis in terms of cyclic/linear sweep voltammetry also showed well correlation with the observed treatment efficiencies. The microbial dynamics of the BES after loading real field wastewater showed the dominance of species that are reported to be effective for petroleum crude oil degradation.

Prevalence of parasitic infection in captive wild animals in Bir Moti Bagh mini zoo (Deer Park), Patiala, Punjab

Aim:

The study was conducted to know the prevalence of gastrointestinal parasites of captive wild animals at Bir Moti Bagh Mini Zoo (Deer Park), Patiala, Punjab.

Materials and Methods:

A total of 31 fecal samples from eight species of captive animals including Civet cat (Viverra zibetha), Porcupine (Hystrix indica), Nilgai (Boselaphus tragocamelus), Spotted deer (Axis axis), Black buck (Antelope cervicapra), Sambar deer (Cervus unicolor), Hog deer (Axis porcinus), and Barking deer (Muntiacus muntjak) were screened using classical parasitological techniques including sedimentation and floatation technique.

Results:

Out of 31 fecal samples examined, 20 were positive for parasitic ova/oocysts of different species indicating an overall prevalence of 68.0%. The six different types of parasites observed in the study included strongyle (67%), Strongyloides spp. (14%), coccidia (38%), Trichuris spp. (19%), ascarid (10%), and Capillaria spp. (10%). Strongyles were the most common parasites observed (67%) followed by coccidia (38%). Mixed helminth and protozoan infection were observed in 48% of animals. No cestode or trematodes were detected during the study.

Conclusion:

The high prevalence of gastrointestinal parasites without overt clinical signs of disease or mortality as observed in this study is suggestive of subclinical infection. The findings will help in formulating the appropriate deworming protocol for parasitic control in these captive animals.

Antibody response to Toxoplasma gondii in saliva samples from human immunodeficiency virus-infected patients

Toxoplasma gondii is an important opportunistic infection among human immunodeficiency virus (HIV)-infected patients as it causes fatal encephalitis. In the present study, antibody response to T. gondii is assessed in saliva samples from 100 HIV-seropositive patients and 25 HIV-negative healthy controls by indirect enzyme-linked immunosorbent assay (ELISA). Sensitivity and specificity for detection of IgG and IgM in saliva is calculated using a positive antibody response in serum samples (from an earlier study) as the gold standard. IgG and IgM antibodies were found in 20% and 25% patients, respectively. One control subject showed the presence of IgM antibody. Sensitivity for IgG and IgM antibodies was 64% and 81.25%, respectively, while specificity was 94.67% and 85.71%, respectively. This study indicates that saliva samples can be used as an alternative to serum samples to detect anti-toxoplasma antibodies, particularly IgM, for the diagnosis of toxoplasma encephalitis in HIV/acquired immune deficiency syndrome patients.

Socio-demographic, Epidemiological and Environmental Determinants of Acute Gastroenteritis in Western India

INTRODUCTION

An outbreak of acute gastroenteritis had occurred in Rajpara village of Bhavnagar district. The objective of this study was to find out the socio-demographic, epidemiological and environmental determinants of this outbreak.

METHODS

A case-control study was conducted in Rajpara village among 238 cases of acute gastroenteritis and an equal number of controls in January 2015. Multiple logistic regression was used for identifying the variables independently predicting acute gastroenteritis.

RESULTS

Upper socio-economic status, occupation requiring travel outside village, source of drinking water from well of 'new' Rajpara village, change in taste of water, use of chlorine tablets, travel outside village in last week, another family member affected with acute gastroenteritis, using common utensil for hand washing, hand washing before eating, ate food from outside in last week, having sanitary latrine at house, waste disposal in a common dump (instead of at house), waste accumulation around house and flies inside house were significantly associated with occurrence of acute gastroenteritis. On multiple logistic regression, change in taste of water (P<0.001), waste disposal in a common dump (P=0.012), another family member been affected (P<0.001), waste accumulation around house (P<0.001), higher socio-economic status (P=0.002) and eating outside food (P=0.011) made a significant contribution to prediction.

CONCLUSIONS

Socio-demographic factors (higher socio-economic status), epidemiological correlates (change in taste of water, another family member been affected with acute gastroenteritis and eating outside food) and environmental determinants (waste disposal in a common dump and waste accumulation around house) significantly determines the occurrence of cases of acute gastroenteritis.

Controversies in Orthopaedic Trauma- Management of Fractures of Shaft of Femur in Children Between 6 and 12 Years of Age

The management of femoral shaft fractures in children is largely directed by the age and built of the child. There is wide consensus on the non operative treatment of children less than six years of age. Operative treatment is recommended for children more than 12 years of age, only the surgical options vary. The age group of 6-12 years remains a controversial area with multiple studies advocating different lines of treatment.We studied the literature on treatment of femoral shaft fractures in 6 to 12 year age group over the past 25 years through PubMed search and found 79 studies dealing with management of paediatric shaft femur fractures in this age group. Studies dealing with other age groups, animal studies and languages other than English were excluded. The treatment modalities included early or immediate hip spica, traction alone, external fixator, plating (open/minimally invasive), intramedullary nailing- rigid/flexible and intramedullary Kirschner wire. The short listed articles were studied for rate and time of union, complications such as non-union and malunion, leg length discrepancy, infection, implant impingement, refracture and cost analysis.Operative treatment is usually the preferred treatment option in this age group, as it decreases hospitalization time, decreases morbidity and allows early return of child to school. Flexible intramedullary nailing is recommended for length stable fractures. Submuscular bridge plating (minimally invasive) is reserved for comminuted fractures. External fixator is reserved for open fractures and initial stabilization of femoral shaft fractures in polytrauma pediatric patients. Intramedullary K wire is a viable option in resource contrained centres where specialized implants and instrumentation is not available.Kathmandu University Medical Journal Vol.12(1) 2014: 77-84

Electrochemical removal of sulfate from petroleum produced water

Petroleum produced water (PPW) is a waste-stream that entails huge cost on the petroleum industry. Along with other suspended and dissolved solids, it contains sulfate, which is a major hurdle for its alternative use intended toward enhanced oil recovery. This study proposes a two-step process for sulfate removal from PPW. A synthetic PPW was designed for the study using response surface methodology. During the first step, sulfate present in PPW was reduced to sulfide by anaerobic fermentation with 80% efficiency. In the second step, more than 70% of the accumulated sulfide was electrochemically oxidized. This integrated approach successfully removed sulfate from the synthetic wastewater indicating its applicability in the treatment of PPW and its subsequent applications in other oil field operations.

Importance of algae as a potential source of biofuel

Algae have a great potential source of biofuels and also have unique importance to reduce gaseous emissions, greenhouse gases, climatic changes, global warming receding of glaciers, rising sea levels and loss of biodiversity. The microalgae, like Scenedesmus obliquus, Neochloris oleabundans, Nannochloropsis sp., Chlorella emersonii, and Dunaliella tertiolecta have high oil content. Among the known algae, Scenedesmus obliquus is one of the most potential sources for biodiesel as it has adequate fatty acid (linolenic acid) and other polyunsaturated fatty acids. Bio&mdash;ethanol is already in the market of United States of America and Europe as an additive in gasoline. Bio&mdash;hydrogen is the cleanest biofuel and extensive efforts are going on to bring it to market at economical price. This review highlights recent development and progress in the field of algae as a potential source of biofuel.

Production of ligninolytic enzymes by white rot fungi on lignocellulosic wastes using novel pretreatments

Production of extracellular ligninolytic enzymes (laccase and polyphenol oxidase) secreted by three species of white rot fungi (Pleurotus florida, P. flabellatus and P. sajor&mdash;caju) under in vivo condition was studied on two lignocellulosic substrates i.e., paddy straw and wheat straw. These lignocellulosic substrates were treated with neem (Azadirachta indica) oil and ashoka (Saraca indica) leaves extract. Between the two lignocellulosic substrates, paddy straw pretreated with neem oil supported maximum activity of laccase and polyphenol oxidase (PPO). The activities of both the enzymes were low on the 5th day of cultivation which increased on the 10th day and reached at peak on the 15th day. Thereafter, there was continuous decrease in the enzymatic activity. Among the three species, P. flabellatus (P3) showed maximum ligninolytic enzymatic activity followed by P. florida (P2)and P. sajor&mdash;caju (P1).

Biodegradation of wheat straw by Pleurotus ostreatus

Wheat straw pretreated with chemicals as well as hot water was subjected to degradation by edible mushroom Pleurotus ostreatus. Lignin, cellulose and hemicelluloses component of both chemically as well as hot water treated wheat straw was degraded by the fungus and in turn the edible and nutritious fruiting body of the mushroom was produced. Biodegradation of wheat straw in terms of loss of lignin, cellulose and hemicellulose showed positive correlation with cellulases, xylanase, laccase and polyphenol oxidase (PPO) activity of the fungus. During vegetative growth of the fungus, lignin degradation was faster and during fructification, lignin degradation was slower than cellulose and hemicellulose. The carbon content of the wheat straw decreased while, nitrogen content increased during degradation of the waste. Hot water treated wheat straw supported better production of enzymatic activity and degraded more efficiently than chemically sterilized substrate. The cumulative yield and biological efficiency (BE) of the mushroom was maximum on the hot water treated substrate. Degradation of the hot water treated wheat straw was better and faster than chemically treated substrate.

Direct red decolorization and ligninolytic enzymes production by improved strains of Pleurotus using basidiospore derived monokaryons

In the present investigation the efficiency of three species of Pleurotus and their improved dikaryons (heterokaryons) was assessed for decolorization of direct red and production of lignin peroxidase (LiP), manganese peroxidase (MnP) and laccase enzymes. All the species of Pleurotus i.e. P. flabellatus, P. ostreatus, and P. citrinopileatus decolorized the dye Direct Red well. However, Pfo 6X9 and Poc 9X6 decolorized the dye more effectively than three species of Pleurotus. The improved dikaryons also showed higher ligninolytic activity than the parental species. Poc 9X6 showed higher LiP (76.27U), MnP (623.24U) and laccase activity (594.80U). In the present work different pH, age and concentration of inoculum and effect of surfactant i.e. sodium dodecyl sulphate (SDS) and Tween&mdash;80 were analyzed in order to determine the optimum ones to decolorize maximum concentration of dye. 5 ml of 10 days old culture on pH 5.5 and 0.1% Tween&mdash;80 supported maximum decolorization of direct red dye.

Bioremediation of vegetable and agrowastes by Pleurotus ostreatus: a novel strategy to produce edible mushroom with enhanced yield and nutrition

Pleurotus ostreatus was grown on paddy straw as well as other vegetable and agricultural wastes i.e. pea pod shell, cauliflower leaves, radish leaves and brassica straw in various combinations with paddy straw. The mushroom did not grow on the vegetable wastes separately. The cumulative yield and biological efficiency of the edible oyster mushroom P. ostreatus grown on substrate containing paddy straw in various combinations with different vegetable wastes i.e. 20% and 30 % vegetable wastes mixed with 80% and 70% (w/w) of paddy straw was found to be better, when compared with yield and biological efficiency obtained on paddy straw (100%) alone. The protein content and six essential amino acid contents (Leu, Ile, Val, Thr, Met, Phe) showed a significant increase and total sugar and reducing sugar contents showed decrease in the mushroom fruit bodies grown at different combinations of vegetable wastes with paddy straw as compared to paddy straw alone. However, there was not any significant change in moisture content of mushroom cultivated on different groups of wastes. Hence, results of this investigation suggest that the vegetable wastes which are generally left to rot in situ in many cities and villages causing outbreak of diseases can be bioremediated by edible mushroom P. ostreatus. The added advantage is that we get edible mushroom fruit body with improved nutrition.

Production of cellulolytic enzymes by Pleurotus species on lignocellulosic wastes using novel pretreatments

In the present investigation three species of Pleurotus i.e. P. sajor&mdash;caju (P1), P. florida (P2) and P. flabellatus (P3) along with two lignocellulosic substrates namely paddy straw and wheat straw were selected for evaluation of production of extracellular cellulolytic enzymes. During the cultivation of three species of Pleurotus under in vivo condition, the two lignocellulosic substrates were treated with plants extracts (aqueous extracts of ashoka leaves (A) and neem oil (B)), hot water (H) and chemicals (C).Among all treatments, neem oil treated substrates supported better enzyme production followed by aqueous extract of ashoka leaves, hot water and chemical treatment. Between the two substrates paddy straw supported better enzyme production than wheat straw. P. flabellatus showed maximum activity of exoglucanase, endoglucanase and &#946;&mdash;glucosidase followed by P. florida and P. sajor&mdash;caju.

Predictors of success for electronic health record implementation in small physician practices

BACKGROUND

The federal government is promoting adoption of electronic health records (EHRs) through financial incentives for EHR use and implementation support provided by regional extension centers. Small practices have been slow to adopt EHRs.

OBJECTIVES

Our objective was to measure time to EHR implementation and identify factors associated with successful implementation in small practices receiving financial incentives and implementation support. This study is unique in exploiting quantitative implementation time data collected prospectively as part of routine project management.

METHODS

This mixed-methods study includes interviews of key informants and a cohort study of 544 practices that had worked with the Primary Care Information Project (PCIP), a publicly funded organization that since 2007 has subsidized EHRs and provided implementation support similar to that supplied by the new regional extension centers. Data from a project management database were used for a cohort study to assess time to implementation and predictors of implementation success.

RESULTS

Four hundred and thirty practices (79%) implemented EHRs within the analysis period, with a median project time of 24.7 weeks (95% CI: 23.3 - 26.4). Factors associated with implementation success were: fewer providers, practice sites, and patients; fewer Medicaid and uninsured patients; having previous experience with scheduling software; enrolling in 2010 rather than earlier; and selecting an integrated EHR plus practice management product rather than two products. Interviews identified positive attitude toward EHRs, resources, and centralized leadership as additional practice-level predictors of success.

CONCLUSIONS

A local initiative similar to current federal programs successfully implemented EHRs in primary care practices by offsetting software costs and providing implementation assistance. Nevertheless, implementation success was affected by practice size and other characteristics, suggesting that the federal programs can reduce barriers to EHR implementation but may not eliminate them.

Biodegradation of sugarcane bagasse by Pleurotus citrinopileatus

The chemically as well as hot water treated agrowaste sugarcane bagasse was subjected to degradation by Pleurotus citrinopileatus. The fungus degraded lignin, cellulose, hemicellulose, and carbon content of both chemically as well as hot water treated waste and produced in turn the edible and nutritious fruiting body. Biodegradation of the waste in terms of loss of lignin, cellulose and hemicellulose showed positive correlation with cellulases, xylanase, laccase and polyphenol oxidase (PPO) activity of the fungus. During mycelial growth of the fungus, lignin degradation was faster and during fructification, lignin degradation was slower than cellulose and hemicellulose. The carbon content of the sugarcane bagasse decreased while, nitrogen content increased during degradation of the waste. Hot water treated substrate supported better production of enzymatic activity and degraded more efficiently than chemically sterilized substrate. The total yield and biological efficiency of the mushroom was maximum on the hot water treated substrates. Degradation of the hot water treated sugarcane bagasse was better and faster than chemically treated substrates.

Biodegradation of vegetable and agrowastes by Pleurotus sapidus: a novel strategy to produce mushroom with enhanced yield and nutrition

Edible oyster mushroom Pleurotus sapidus was cultivated, on pea pod shell, cauliflower leaves, radish leaves, brassica straw in various combinations of paddy straw. The mushroom failed to grow on these vegetable wastes separately. However, it grew very well on these vegetable wastes when mixed with various combinations of paddy straw as substrate. Total yield and biological efficiency of the mushroom cultivated on substrate containing 20% and 30% vegetable wastes mixed with 70% and 80% (w/w) of paddy straw was found to be better, when compared with yield and efficiency obtained with paddy straw alone (100%). The protein content in the fruit bodies was found to be higher in the mushroom grown on paddy straw mixed with vegetable wastes than that obtained with paddy straw alone. Similarly, six amino acids (Leu, Ile, Val, Thr, Met and Phe) showed a significant increase when the mushroom was grown on a mixed substrate containing both vegetable wastes and paddy straw. On the contrary, the total sugar and reducing sugar content declined in the mushroom grown on the mixture of paddy straw and other wastes, when compared with the results obtained with paddy straw alone.

Inhibition of P. falciparum PFATP6 by curcumin and its derivatives: a bioinformatic study

Curcumin, a yellow spice has been shown to have many pathological uses including cancer and malaria. Recent experimental data have shown the inhibitory effect of curcumin and its two derivatives on the growth of Plasmodium falciparum in cell culture at low micromolar concentrations. Previous studies have suggested that Ca(2+)—ATPase (PfATP6) of P. falciparum is the target of many antimalarial drugs. However, the mechanism of inhibition of Ca(2+)—ATPase (PfATP6) is not known. In addition, it is not clear which specific isomeric form of curcumin is the most potent inhibitor of P. falciparum. Here we address this issue using bioinformatics tools. We generated a molecular model of Ca(2+)—ATPase (PfATP6) of P. falciparum and carried out molecular docking of all curcumin analogues of Zinc database of compounds (zinc.docking.org). Two molecular docking programs Glide and FlexX were used to determine binding feasibility of 351 analogues of curcumin. The comparison of docking parameters showed, more than 20 analogues are better ligands of PfATP6 than curcumin itself. . The binding of curcumin and its analogues to PFATP6 is mediated by both hydrophobic and polar interactions. Our results suggest that curcumin analogues are promising lead compounds for the development of antimalarial drugs.