Evaluation of carbon dioxide elevation on phenolic compounds and antioxidant activity of red onion (Allium cepa L.) during postharvest storage

Carbon dioxide (CO₂) is considered one of the eco-related key factors that negatively affect global climatic change. Also, CO₂ can play an important role in the postharvest quality of the agri-products. In this study, the impact of CO₂ on the quality of postharvest onions that were stored at 23 °C for 8 weeks was investigated. The weight loss, phenolic, flavonoid, flavanol, anthocyanin, antioxidant activity, and soluble sugar were analyzed during the study period. The results showed that 20% CO₂ treatment was significantly (P > 0.05) more effective than 15% CO₂ and control in inhibiting weight loss. Additionally, 20% CO₂ treatment significantly retained higher antioxidant enzyme activities such as CAT, APX, and SOD than 15% CO₂ and control. During storage, 20% CO₂ treatment significantly (P < 0.05) improved glucose, fructose, and sucrose levels by more than 15% CO₂ exposure and control groups. Besides the chlorogenic acid, kaempferol and quercetin were significantly (P < 0.05) higher in the 20% CO₂ than in the 15% CO₂ after 2 weeks of storage. In conclusion, this study's novelty comes from the broad prospects of using CO₂ for maximizing the stored onion phytochemical functionality that is usually affected by the room temperature long storage. This will help in the onion shelf-life extension by considering the quality-related attributes.

Early Impact of Cardiopulmonary Bypass on Renal Function after Valve Replacement Surgery

Renal dysfunction following cardiopulmonary bypass is well recognized. The pathophysiology of renal injury is multifactorial and culmination of the interplay of several pathophysiological mechanism. Cardiac surgery requiring cardiopulmonary bypass (CPB) is being carried out on an extended patient population of different age groups and undergoing complex surgical procedure, and thus it places them at an increased risk of renal impairment. Valve replacement surgery is a major and complex surgical procedure requiring CPB. This study was therefore designed to observe the impact of CPB and short term outcome on patients with reduced estimated Glomerular Filtration Rate (eGFR) (60-89ml/min/1.73m²) after valve replacement surgery. This cross-sectional study was conducted in the Department of Cardiac Surgery, National Institute of Cardio Vascular Diseases (NICVD) during the period of January 2015 to August 2016. After fulfillment of enrollment criteria 100 patients were studied for the purpose of the study and they were grouped in two, patients with normal eGFR (≥90ml/min/1.73m²) in Group A and patients with reduced eGFR (60-89ml/min/1.73m²) in Group B. A total of 100 patients, 50 in each group were studied for renal function alteration after valve replacement surgery under cardiopulmonary bypass. The incidence of Acute Kidney Injury (AKI) was higher in Group B. Chi-square test was done and p value was 0.011 which is statistically significant. Postoperative blood loss (ml/hr) (p=0.038), duration of Intensive Care Unit (ICU) stay (in hours) (p=0.009), postoperative hospital stay (days) (p=0.014) was significantly higher and postoperative Urine Output (ml/hr) (p=0.001) was significantly lower in patients with reduced eGFR (60-89ml/min/1.73m²) in Group B. Deterioration of renal function is more in patient with eGFR (60-89ml/min/1.73m²) after valve replacement surgery under cardiopulmonary bypass in comparison with patients with eGFR (≥90ml/min/1.73m²).

Chemical aspects of polyphenol-protein interactions and their antibacterial activity

The hunt for novel antibiotics has become a global public health imperative due to the rise in multidrug-resistant microorganisms, untreatable infection cases, overuse, and inefficacy of modern antibiotics. Polyphenols are getting much attention in research due to their multiple biological effects; their use as antimicrobial agents is attributed to their activity and that microbes have a hard time developing resistance to these natural compounds. Polyphenols are secondary metabolites produced in higher plants. They are known to possess various functional properties in the human body. Polyphenols also exhibit antibacterial activities against foodborne pathogens. Their antibacterial mechanism is based on inhibiting bacterial biofilm formation or inactivating enzymes. This review focused on polyphenol-protein interactions and the creation of this complex as a possible antibacterial agent. Also, different phenolic interactions on bacterial proteins, efflux pump, cell membrane, bacterial adhesion, toxins, and other bacterial proteins will be explored; these interactions can work in a synergic combination with antibiotics or act alone to assure bacterial inhibition. Additionally, our review will focus on polyphenol-protein interaction as a possible strategy to eradicate bacteria because polyphenols have shown a robust enzyme-inhibitory characteristic and a high tendency to complex with proteins, a response that neutralizes any bactericidal potential.

Understanding the role of power and its relationship to the implementation of the polio eradication initiative in india

Background

Power is exercised everywhere in global health, although its presence may be more apparent in some instances than others. Studying power is thus a core concern of researchers and practitioners working in health policy and systems research (HPSR), an interdisciplinary, problem-driven field focused on understanding and strengthening multilevel systems and policies. This paper aims to conduct a power analysis as mobilized by the actors involved in implementation of the polio program. It will also reflect how different power categories are exerted by actors and embedded in strategies to combat program implementation challenges while planning and executing the Global Polio Eradication Initiative.

Methods

We collected quantitative and qualitative data from stakeholders who were part of the Polio universe as a part of Synthesis and Translation of Research and Innovations from the Polio Eradication Project. Key informants were main actors of the polio eradication program, both at the national and sub-national levels. Research tools were designed to explore the challenges, strategies and unintended consequences in implementing the polio eradication program in India. We utilized Moon's expanded typology of power in global governance to analyze the implementation of the polio eradication programme in India.

Results

We collected 517 survey responses and conducted 25 key informant interviews. Understanding power is increasingly recognized as an essential parameter to understand global governance and health. Stakeholders involved during polio program implementation have exerted different kinds of power from structural to discursive, moral power wielded by religious leaders to institutional power, expert power used by professional doctors to commoners like female vaccinators, and network power exercised by community influencers. Hidden power was also demonstrated by powerless actors like children bringing mothers to polio booths.

Conclusion

Power is not a finite resource, and it can be used, shared, or created by stakeholders and networks in multiple ways. Those people who seem to be powerless possess invisible power that can influence decision making. Moreover, these power categories are not mutually exclusive and may be deeply interconnected with each other; one type of power can be transformed into another. Power and relations play an important role in influencing the decision-making of the community and individuals. Mid-range theories of core implementation science like PARIHAS and CFIR can also add an important variable of power in their construct necessary for implementation success of any health program.

30 years of polio campaigns in Ethiopia, India and Nigeria: the impacts of campaign design on vaccine hesitancy and health worker motivation

Introduction

The debate over the impact of vertical programmes, including mass vaccination, on health systems is long-standing and often polarised. Studies have assessed the effects of a given vertical health programme on a health system separately from the goals of the vertical programme itself. Further, these health system effects are often categorised as either positive or negative. Yet health systems are in fact complex, dynamic and tightly linked. Relationships between elements of the system determine programme and system-level outcomes over time.

Methods

We constructed a causal loop diagram of the interactions between mass polio vaccination campaigns and government health systems in Ethiopia, India and Nigeria, working inductively from two qualitative datasets. The first dataset was 175 interviews conducted with policymakers, officials and frontline staff in these countries in 2011–2012. The second was 101 interviews conducted with similar groups in 2019, focusing on lessons learnt from polio eradication.

Results

Pursuing high coverage in polio campaigns, without considering the dynamic impacts of campaigns on health systems, cost campaign coverage gains over time in weaker health systems with many campaigns. Over time, the systems effects of frequent campaigns, delivered through parallel structures, led to a loss of frontline worker motivation, and an increase in vaccine hesitancy in recipient populations. Co-delivery of interventions helped to mitigate these negative effects. In stronger health systems with fewer campaigns, these issues did not arise.

Conclusion

It benefits vertical programmes to reduce the construction of parallel systems and pursue co-delivery of interventions where possible, and to consider the workflow of frontline staff. Ultimately, for health campaign designs to be effective, they must make sense for those delivering and receiving campaign interventions, and must take into account the complex, adaptive nature of the health systems in which they operate. 

Broadband negative group velocity dispersion in all-dielectric metamaterial and its role in supercontinuum generation

All-dielectric metamaterials conforming to an optical reflectionless potential (ORP) offer broadband, omni-directional suppression of reflection. Though they are predicted to possess broadband negative group velocity dispersion (GVD), ultrashort pulse propagation through such materials has not been studied so far, to the best of our knowledge. In this work, we demonstrate negative GVD and group delay dispersion over broadband covering visible to near-infrared wavelengths. We investigate the role of ORP in supercontinuum generation (SC), which is observed to be polarization independent. The negative GVD in ORPs is interesting for pulse compression, phase compensation, dispersion engineering, and controlled SC generation.

Long-term outcomes in perianal fistulizing Crohn's disease in a resource-limited setting: A cohort analysis

BACKGROUND

Perianal fistula is one of the most challenging complications of Crohn's disease (CD). We aimed to describe treatment response with surgical and medical therapies, and long-term complications.

METHODS

We retrospectively analyzed records of patients with perianal fistulizing CD who were prospectively followed from January 2005 to December 2018.

RESULTS

Among 807 patients, 81 (10%) had perianal fistula and 65 were included in the final analysis. The mean age of presentation was 27.4 ± 10.3 years, and 78.5% were males with a median duration of follow-up of 45 (IQR, 24-66) months. 75.4% (n = 49) had complex fistulae. 55.4% (n = 36) of patients received multiple courses (> 5 courses) of antibiotics. Complete response rates with immunomodulators, fistula surgery, biologicals, and diversion were 25%, 42.8%, 39.5%, and 45.4%, respectively. The relapse rate was highest after fistula surgery (52.6%). 44.6% of patients received medical (immunomodulators-21 and biologicals-8) whereas 46.1% received surgery as the first-line therapy. The absence of perianal abscess was associated with complete fistula closure. One patient developed malignancy and 4 (6.1%) died at the end of follow-up. Among the patients (n = 28) who received biologicals, TB reactivation occurred in one patient (3.5%).

CONCLUSION

Medical therapy should be offered as first-line therapy, and immunomodulators can be considered when patients cannot afford biologicals. Surgery offers temporary improvement and is associated with high relapse rates. Absence of perianal abscess predicts long-term complete fistula closure.

Synthesis and translation of research and innovations from polio eradication (STRIPE): initial findings from a global mixed methods study

BACKGROUND

Lessons from polio eradication efforts and the Global Polio Eradication Initiative (GPEI) are useful for improving health service delivery and outcomes globally. The Synthesis and Translation of Research and Innovations from Polio Eradication (STRIPE) is a multi-phase project which aims to map, package and disseminate knowledge from polio eradication initiatives as academic and training programs. This paper discusses initial findings from the knowledge mapping around polio eradication activities across a multi-country context.

METHODS

The knowledge mapping phase (January 2018 - December 2019) encompassed four research activities (scoping review, survey, key informant interviews (KIIs), health system analyses). This paper utilized a sequential mixed method design combining data from the survey and KIIs. The survey included individuals involved in polio eradication between 1988 and 2019, and described the contexts, implementation strategies, intended and unintended outcomes of polio eradication activities across levels. KIIs were conducted among a nested sample in seven countries (Afghanistan, Bangladesh, the Democratic Republic of Congo, Ethiopia, India, Indonesia, Nigeria) and at the global level to further explore these domains.

RESULTS

The survey generated 3955 unique responses, mainly sub-national actors representing experience in over 74 countries; 194 KIIs were conducted. External factors including social, political, and economic factors were the most frequently cited barriers to eradication, followed by the process of implementing activities, including program execution, planning, monitoring, and stakeholder engagement. Key informants described common strategies for addressing these barriers, e.g. generating political will, engaging communities, capacity-building in planning and measurement, and adapting delivery strategies. The polio program positively affected health systems by investing in system structures and governance, however, long-term effects have been mixed as some countries have struggled to institutionalize program assets.

CONCLUSION

Understanding the implementing context is critical for identifying threats and opportunities to global health programs. Common implementation strategies emerged across countries; however, these strategies were only effective where organizational and individual capacity were sufficient, and where strategies were appropriately tailored to the sociopolitical context. To maximize gains, readiness assessments at different levels should predate future global health programs and initiatives should consider system integration earlier to ensure program institutionalization and minimize system distortions.

Significant Left Main Coronary Artery Disease Does Not Incur Any Additional Risk to the Short Term Outcome of Off Pump Coronary Artery Bypass Grafting Surgery

Coronary artery disease is the most common form of heart disease and single most important cause of premature death in developed countries. Off pump coronary artery bypass grafting surgery has recently became widespread internationally and has produced good clinical outcome even in left main coronary artery disease following off pump coronary artery bypass grafting surgery. A prospective observational study was conducted in the department of Cardiac Surgery, National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh from January 2015 to September 2016 after fulfillment of enrollment criteria, 428 patients were studied for the purpose of the study and they were grouped in two, significant left main coronary artery disease in group A and non left main coronary artery disease requiring surgery in group B. Comparison of risk factors between groups demonstrates that diabetes mellitus and smoking habit between two groups were almost identical. 69.2% of patient with significant left main coronary artery group were hypertensive and 25.2% were dyslipidaemic in comparison to non left main coronary artery disease group which were 50.9% and 6.5% respectively. Requirement of per operative inotropic support was significantly higher in left main coronary artery group. 33.6% of patient of left main coronary artery group required per operative inotropic support whereas non left main coronary artery group require 24.8%. Postoperative inotropic support, mechanical ventilation time, ICU stay, hospital stay and complication were similar in both these groups. So, we can say that off pump coronary artery bypass grafting surgery for significant left main coronary artery disease is as safe as non left main coronary artery disease.

Silver nanoparticles (AgNPs) induced impairment of in vitro pollen performance of Peltophorum pterocarpum (DC.) K. Heyne

Increasing use of silver nanoparticles (AgNPs) in myriad applications including electronics, medicines and agriculture has led to serious concerns regarding its release to plant ecosystems. Over the years, numerous studies have demonstrated the toxic impact of AgNPs in a variety of cell and tissue systems involved in vegetative growth across a wide range of plant species. However, assessing their impact on haploid phase of plant life cycle was restricted only to a study with Kiwifruit. In this study, in vitro pollen performance of Peltophorum pterocarpum at two endpoints i.e., germination and tube growth was assessed to evaluate the impact of nanoparticulate or ionic form of silver. Increasing concentrations of AgNO₃/AgNPs significantly reduced the pollen germination and retarded the tube growth. The EC 50 values indicated a more potent toxic effect of AgNPs than AgNO₃ on pollen germination as well as tube growth. Impairment of pollen performance was more pronounced at the stage of emergence of pollen tube. Extensive alterations in the muri and lumen of exine as revealed through SEM analysis and subsequent blockage of germpore might disrupt the emergence of pollen tube. The dynamics of pollen tube growth was analyzed with polynomial models of different degrees. A high degree of polynomial, the quintic model was able to approximate the real data points with highest coefficient of determination and smallest RMSE, compared to other models. An oscillating pattern of tube growth was portrayed with the passage of time in all the treatments that fits well with the established mechanistic oscillatory model of tube growth. It appears that exposure to AgNO₃/AgNPs inhibited pollen germination and retarded tube growth without affecting the oscillatory behavior of tip-growth.

Phytostimulatory effect of silver nanoparticles (AgNPs) on rice seedling growth: An insight from antioxidative enzyme activities and gene expression patterns

The knowledge on the mode of action, biocompatibility and ecological tolerance of silver nanoparticles (AgNPs) is gradually accumulating over the years with contradictory findings. Most of the studies indicated the toxic impact of AgNPs on plant growth and development, where induction of oxidative stress was considered to be one of the causal factors. The present study demonstrates the phytostimulatory effect of bio-synthesized silver nanoparticles (AgNPs) during seed germination and seedling growth of rice (Oryza sativa L., cv. Swarna) under in vitro condition. All the tested concentrations of AgNPs (10, 20, 40 ppm) promote both the shoot and root growth which was evident from the increased length and biomass of the seedlings. Exposure to AgNPs also significantly increased the chlorophyll a and carotenoid contents. The content and the pattern of distribution of phenolic metabolites among the different treatments are indicative of non-toxic impact of AgNP mimicking mild or no stress to the seedlings. Growth stimulation of rice seedlings by AgNPs was further supported by a low level of reactive oxygen species (ROS) concomitant with decreased amount of lipid peroxidation and H₂O₂ content, compared to control. In order to unravel the stimulatory impact of AgNPs on rice seedling growth, the present study also describes the AgNPs induced changes in antioxidative enzyme activity and related gene expression levels. Elevated levels of catalase (CAT), ascorbate peroxidase (APX) and glutathione reductase (GR) activities were recorded in all the AgNPs treated seedlings with improved growth. The activity of superoxide dismutase (SOD) was not significantly altered at low concentration of AgNPs. It appears that enzymes of ascorbate cycle, APX and GR are more active in ensuring protection against oxidative damage than SOD. There was significant up-regulation of CAT and APX gene expressions in seedlings exposed to AgNPs, whereas the expression level of CuZnSOD gene was decreased gradually with an increase in the concentration of AgNPs. The antioxidant enzyme activities and gene expression patterns coupled with the levels of H₂O₂ and lipid peroxidation indicates that the efficiency of redox reactions was increased in the presence of AgNPs and that accelerates the seedling growth.

A bibliometric analysis of the published road traffic injuries research in India, post-1990

BACKGROUND

Globally, road traffic injuries are the leading cause of death among those aged 15-29 years. However, road traffic injury research has not received adequate attention from the scientific community in low- and middle-income countries, including India. The present study aims to provide a bibliometric overview of research assessing road traffic injuries in India.

METHODS

We used Scopus to extract relevant research in road traffic injuries published from 1991 to 2017. This study presented the key bibliometric indicators such as trends of annual publications and citations, top 10 authors, journals, institutions and highly cited articles, citation analysis of articles, co-occurrence of keywords, etc. Analysis was performed using Scopus, Microsoft Excel, and VOS-viewer.

RESULTS

A total of 242 articles were retrieved with an h-index of 18, excluding self-citations. A steadfast growth of publications was documented in last decade, especially after the year 2010. The h-index of the top 10 authors, institutions, journals and highly cited articles did not surpass single digits. A network visualisation map showed that 'traffic accident', 'male', 'adolescent' and 'child' were the most commonly encountered key terms. The prominent authors were Gururaj G, Dandona R, and Hyder AA, whereas the top journals were the Indian Journal of Forensic Medicine and Toxicology, Medico Legal Update, and the International Journal of Applied Engineering Research and top institutions were the All India Institute of Medical Sciences, New Delhi, the Indian Institute of Technology, Delhi, and the Administrative Staff College of India.

CONCLUSION

In India, road traffic injuries research is inadequate in quantity and quality, warranting greater attention from researchers and policy planners to address the burden of road traffic injuries.

Machine vision based evaluation of impact of light emitting diodes (LEDs) on shoot regeneration and the effect of spectral quality on phenolic content and antioxidant capacity in Swertia chirata

The present study demonstrates the influence of LED irradiance of various wavelengths on shoot regeneration, biomass accumulation, photosynthetic pigment contents, and antioxidant potentials of Swertia chirata - a critically endangered medicinal plant. Mixed treatment of blue (BL) and red LEDs (RL) in equal proportion (1:1) significantly improved the shoot regeneration response. A machine vision system was developed to assess the shoot regeneration potential under different lighting treatments. Regenerated shoots exposed under BL:RL (1:1) exhibited higher biomass accumulation and canopy development compared to other lighting treatments. Improved canopy growth was evident from the increase in the area, major axis, minor axis, convex area, equivalent diameter and perimeter of regenerated shoot clusters. A higher correlation of dry weight (DW) was noted with the image feature, weighted density (WD) than the fresh weight (FW) in all the LED treated cultures. The significant correlation between DW and WD implies that the image feature WD can be adopted as a non-invasive approach for measuring biomass accumulation as well as detecting hyperhydricity. The developed machine vision approach provides a new direction in the evaluation of shoot organogenesis that displayed features including both shoot multiplication and canopy development. Chlorophyll and carotenoid contents of the regenerated shoots were found to be higher under BL:RL (1:1) than the other treatments. Supplementation of RL led to a reduction in the pigment contents. Spectral quality of lights also significantly influenced the accumulation of total phenolics, flavonoids and flavonols. Cultures exposed under BL exhibited the maximum accumulation of polyphenols. A similar effect of spectral quality was observed with the antioxidant capacity and reducing power potential of leaf extract. The findings demonstrate the ability of LEDs in inducing shoot regeneration as well as accumulation of phenolic antioxidants and suggest that the proportion of blue and red LEDs is an important factor in achieving the optimum response.

Low-dose toxicity of biogenic silver nanoparticles fabricated by Swertia chirata on root tips and flower buds of Allium cepa

Chemically synthesized silver nanoparticles (chem-AgNPs) have been assessed extensively to show adverse effects on plant cells but the role of biologically synthesized nanoparticles (bio-AgNPs) at lower concentrations and their toxicological impact on plant cells have not been sufficiently studied. In this study, bio-AgNPs were prepared using aqueous leaf extracts of Swertia chirata. This AgNPs showed absorption peak at 440nm of the visible spectrum. TEM analysis revealed that the average size of AgNPs were 20nm and mainly spherical in shape. AFM topographic images depicted the three dimensional aspects of AgNPs. XRD analysis confirmed the crystalline nature. FTIR spectrum of the AgNPs revealed the possible biomolecules involved in bioreduction and efficient stabilization of the particles. Low-dose of bio-AgNPs concentrations (5, 10 and 20μgml^-1) were used for toxicity studies on Allium cepa. The studies revealed that various chromosomal aberrations were induced in both mitotic and meiotic cells of Allium cepa even at lower concentrations of bio-AgNPs. Abnormalities in post meiotic products were also observed. Both mitotic and meiotic indexes decreased with increasing concentrations of bio-AgNPs in the treated cells. These findings implied that low dose bio-AgNPs can induce significant clastogenic effects on both meristematic and reproductive plant cells.

Alteration in steroid hormone and Her-2/neu receptor status following neoadjuvant chemotherapy in locally advanced breast cancer: Experience at a tertiary care centre in India

CONTEXT

Use of neoadjuvant chemotherapy (NACT) in locally advanced breast cancer (LABC) enables tumor reduction and conservative surgery. It is proposed in some studies that there may be an alteration in the hormonal receptor (HR) status and human epidermal growth factor receptor 2 (Her-2)/neu immune-expression following NACT.

AIMS

To study the status of estrogen receptor (ER), progesterone receptor (PR), and Her-2/neu receptor before and after NACT in LABC.

MATERIALS AND METHODS

HR and Her-2/neu status were evaluated by immunohistochemistry on 100 core needle biopsy of primary tumors and surgical specimens after receiving NACT (NACT group); fifty patients without NACT served as non-NACT group, and discordance was compared between the two groups.

RESULTS

In the NACT group, discordance of 17%, 13%, and 11% was noted in ER, PR, and Her-2/neu status, while in non-NACT group, discordance seen in ER, PR, and Her-2/neu was 8%, 8%, and 4%, respectively.

CONCLUSIONS

There was a significant alteration in ER and Her-2/neu status from the core biopsy to the treated resected tumor in the study group. As these changes may impact treatment, HR and Her-2/neu expression reanalysis in final surgical specimens is recommended.

Assessing the impact of a program for late surgical intervention in early-blind children

OBJECTIVE

Many blind children in the developing world are unable to obtain timely treatment due to lack of financial and medical resources. Can public health programs that identify and treat such children several years after the onset of blindness enhance their quality of life? The notion that visual development is subject to an early 'critical period' argues against this possibility. However, there are inadequate empirical data from humans on this issue. To address this need, we examined the quality of life of children living in India and who were treated for early-onset blindness (before one year of age), due to cataracts or corneal opacities.

STUDY DESIGN

Survey study.

METHODS

As part of an ongoing scientific effort named Project Prakash, we screened over 40,000 children in rural northern India to identify those suffering from early-onset blindness. They were provided eye surgeries in a tertiary care ophthalmic center in New Delhi. We subsequently surveyed 64 Prakash children, ranging in age from 5 to 22 years and obtained their responses on a multi-dimensional quality of life questionnaire.

RESULTS

Nearly all of the subjects indicated that their quality of life had improved after treatment. Children reported marked enhancement in their mobility, independence, and safety, and also in social integration. Surprisingly, we found no significant correlations between quality of life metrics and factors such as age at treatment, gender, time since treatment, and pre-surgery and post-surgery acuity.

CONCLUSIONS

A key question for public health policy makers is whether a program of surgical intervention for older blind children is likely to be beneficial, or if the resources are better spent on rehabilitation via vocational training and assistive devices. The marked improvements in quality of life we find in our data strongly argue for the provision of surgical care regardless of a child's age.

A population-based screening program for early detection of common cancers among women in India - methodology and interim results

BACKGROUND

Cancers of the uterine cervix, breast, and oral cavity accounted for 134,420, 115,251, and 24,375 cases, respectively, and were responsible for 52.8% of the total cancers among women in India in 2008.

AIM

The major objectives were to create awareness regarding common cancers among women, to detect pre-cancers of the uterine cervix and oral cavity, and early cancers of the breast, uterine cervix, and oral cavity, by conducting screening with simple, low-cost technology, within the community, and to facilitate confirmation of diagnosis among the screen positives and treatment and follow-up among the diagnosed cases.

SETTINGS AND METHODS

This is a community-based screening program for early detection of breast, uterine cervix, and oral cancers, being implemented among the socioeconomically disadvantaged women in Mumbai, India. The process involves selection of clusters, household surveys, health education, and screening the eligible women for breast, uterine cervix, and oral cancers, by primary healthcare workers, at a temporarily set-up clinic within the community. The program is planned to cover a 125,000 disadvantaged population in five years.

RESULTS

Twenty-one thousand and fifteen people, with 4009 eligible women, have been covered to date. The compliance for screening for breast, cervix, and oral cavity has been 85, 70, and 88% and the screen positivity rates are 3.9, 14.9, and 3.9%, respectively. Twenty-seven oral pre-cancers, 25 cervix pre-cancers, one invasive cancer of the breast, two of the cervix, and one oral cavity cancer have been diagnosed among the screened women and all of them have complied with the treatment.

CONCLUSIONS

The program is raising awareness about the common cancers and harms of tobacco among the disadvantaged women population in Mumbai. It is also helping in detecting pre-cancers and cancers among asymptomatic women and is assisting them in receiving treatment.

Are sanitation interventions a threat to drinking water supplies in rural India? An application of tryptophan-like fluorescence

Open defecation is practised by over 600 million people in India and there is a strong political drive to eliminate this through the provision of on-site sanitation in rural areas. However, there are concerns that the subsequent leaching of excreta from subsurface storage could be adversely impacting underlying groundwater resources upon which rural populations are almost completely dependent for domestic water supply. We investigated this link in four villages undergoing sanitary interventions in Bihar State, India. A total of 150 supplies were sampled for thermotolerant (faecal) coliforms (TTC) and tryptophan-like fluorescence (TLF): an emerging real-time indicator of faecal contamination. Sanitary risk inspections were also performed at all sites, including whether a supply was located within 10 m of a toilet, the recommended minimum separation. Overall, 18% of water supplies contained TTCs, 91% of which were located within 10 m of a toilet, 58% had TLF above detection limit, and sanitary risk scores were high. Statistical analysis demonstrated TLF was an effective indicator of TTC presence-absence, with a possibility of TTCs only where TLF exceeded 0.4 μg/L dissolved tryptophan. Analysis also indicated proximity to a toilet was the only significant sanitary risk factor predicting TTC presence-absence and the most significant predictor of TLF. Faecal contamination was considered a result of individual water supply vulnerability rather than indicative of widespread leaching into the aquifer. Therefore, increasing faecal contamination of groundwater-derived potable supplies is inevitable across the country as uptake of on-site sanitation intensifies. Communities need to be aware of this link and implement suitable decentralised low-cost treatment of water prior to consumption and improve the construction and protection of new supplies.

Impact of 'gutkha and pan masala ban' in the state of Maharashtra on users and vendors

BACKGROUND

Gutkha and pan masala contain harmful and carcinogenic chemicals. Hence, Maharashtra Government banned their manufacture, storage, distribution and sale on 19 th July 2012 for a year.

OBJECTIVES

The objective of this study is to determine the impact of the ban on gutkha and pan masala on its users and vendors.

MATERIALS AND METHODS

A cross- sectional study was conducted among gutkha and/or pan masala users and tobacco vendors in the selected area of Mumbai city, 4-6 months after the implementation of the ban. The parameters studied included knowledge regarding the ban, usage or discontinuation of use of the banned products, product availability, withdrawal symptoms among quitters, etc.,

RESULTS

A total of 68 users and five tobacco vendors were enrolled in this study. Although all users were aware about the ban on gutkha, very few knew about the ban on pan masala. Only 5.9% of users knew that currently the ban had been declared for only 1 year. Electronic media was the main source of information regarding the ban as reported by 45.6% users. All users and vendors were in favor of the ban. After the ban, 23.53% gutkha users quit their habit while 55.88% reduced their gutkha consumption. Non-availability of gutkha was the most important reason stated by the gutkha users for quitting or reducing the consumption. In spite of the ban, gutkha is still available in the market, but at an increased cost or in a different form.

CONCLUSION

Nearly 23.53% of gutkha users have quit their habit post-ban despite its availability through illegal sources.

Primary Sjögren's Syndrome Presenting as Flaccid Quadriparesis

Primary Sjögren's syndrome is an autoimmune disease presenting classically as keratoconjunctivitis sicca. Renal involvement in Sjögrens's syndrome is less common, and the initial presentation with renal complications without any sicca symptoms is extremely rare. The renal involvement may present with symptoms arising from interstitial nephritis, mainly distal renal tubular acidosis.

Community-based tobacco cessation program among women in Mumbai, India

BACKGROUND

Globally tobacco epidemic kills nearly six million people annually. Consumption of tobacco products is on the rise in low- and middle-income countries. Tobacco is addictive; hence, tobacco users need support in quitting.

AIMS

Providing tobacco cessation services to women in community enabling them to quit tobacco, identifying factors associated with quitting and documenting the processes involved to establish a replicable "model tobacco cessation program."

SETTINGS AND DESIGN

This is a community based tobacco cessation program of one year duration conducted among women in a low socioeconomic area of Mumbai, India.

SUBJECTS AND METHODS

It involved three interventions conducted at three months interval, comprised of health education, games and counseling sessions and a post intervention follow-up.

STATISTICAL ANALYSIS

Uni and multivariate analysis was performed to find out association of various factors with quitting tobacco.

RESULTS

The average compliance in three intervention rounds was 95.2%. The mean age at initiation of tobacco was 17.3 years. Tobacco use among family members and in the community was primary reasons for initiation and addiction to tobacco was an important factor for continuation, whereas health education and counseling seemed to be largely responsible for quitting. The quit rate at the end of the programme was 33.5%. Multivariate logistic regression analysis found that women in higher age groups and women consuming tobacco at multiple locations are less likely to quit tobacco.

CONCLUSIONS

Changing cultural norms associated with smokeless tobacco, strict implementation of antitobacco laws in the community and work places and providing cessation support are important measures in preventing initiation and continuation of tobacco use among women in India.

Cavity-controlled spectral singularity

We study theoretically a parity-time (PT)-symmetric, saturable, balanced gain-loss system in a ring-cavity configuration. The saturable gain and loss are modeled by a two-level medium with or without population inversion. We show that the specifics of the spectral singularity can be fully controlled by the cavity and the atomic detuning parameters. The theory is based on the mean-field approximation, as in the standard theory of optical bistability. Further, in the linear regime we demonstrate the regularization of the singularity in detuned systems, while larger input power levels are shown to be adequate to limit the infinite growth in absence of detunings.

Mushroom tyrosinase inhibition activity of Aloe vera L. gel from different germplasms

In this study, lyophilized and methanolic extracts of aloe gel from different germplasms were evaluated for their potential to inhibit mushroom tyrosinase activity. The results showed potent inhibitory effect of Aloe vera gel extracts on L-dihydroxyphenylalanine (L-DOPA) oxidation catalyzed by tyrosinase in a dose-dependent manner. Significant differences in % inhibition of tyrosinase among the extraction methods and the germplasms were observed. The relative performance of the germplasms was evaluated with the help of posthoc multicomparison test. The methanolic extract was more effective than the lyophilized crude gel in all the germplasms. The inhibitory effect of the lyophilized gel and methanolic extract tested from five germplasms followed the order: RM > TN > S24 > OR > RJN. The germplasm RM showed the highest tyrosinase inhibition, and the maximum % inhibition noted was 26.04% and 41.18%, respectively for the lyophilized and methanolic extracts at 6 mg · mL(-1) concentration. Lineweaver-Burk plots of the different concentrations of L-DOPA in the absence and presence of lyophilized gel extract showed competitive inhibition of mushroom tyrosinase in all the germplasms. This study suggests that the germplasm RM could potentially be used for the isolation and identification of the effective tyrosinase inhibitory component, and ascertains the critical role of selecting the best source of germplasm for natural product isolation and characterization.

Giant Goos-Hänchen shift in scattering: the role of interfering localized plasmon modes

The longitudinal and transverse beam shifts, namely, the Goos-Hänchen (GH) and the Spin-Hall (SH) shifts are usually observed at planar interfaces. It has recently been shown that the transverse SH shift may also arise due to scattering of plane waves. Here, we show that analogous in-plane (longitudinal) shifts also exist in the scattering of plane waves from micro/nano systems. We study both the GH and the SH shifts in plasmonic metal nanoparticles/nanostructures and dielectric micro-particles employing a unified framework that utilizes the transverse components of the Poynting vector of the scattered wave. The results demonstrate that the interference of neighboring resonance modes in plasmonic nanostructures (e.g., electric dipolar and quadrupolar modes in metal spheres) leads to great enhancement of the GH shift in scattering from such systems. We also unravel interesting correlations between these shifts with the polarimetry parameters, diattenuation and retardance.

Optical reflectionless potentials for broadband, omnidirectional antireflection

Reflectionless potentials (RPs) represent a class of potentials that offer total transmission in the context of one dimensional scattering. An optical realization of RP can exhibit a truly broadband omni-directional antireflection. We report our experimental observations confirming the reflectionless behavior. Stratified media conforming to RP's are designed and fabricated using Al(2)O(3) and TiO(2) heterolayers. They showed < 0.5% reflection over the broad wavelength range of 350 nm to 2500 nm for angles of incidence 0 - 50 degrees. These RPs can be designed on substrates and are thus interesting for optical instrumentation as broadband, omni-directional antireflection coatings.

Gap solitons with null-scattering

In this Letter, we study the excitation of gap solitons under the conditions of coherent perfect absorption. Our system consists of a symmetric periodic structure with alternating Kerr nonlinear and linear layers illuminated from both ends. We show near-total transfer of incident light energy into the gap solitons resulting in null scattering. We also report on the nonlinear super-scattering states. Both the exact and the approximate results, which show good agreement based on nonlinear characteristic matrix methods, are presented.

Use of local anesthesia in transrectal ultrasound guided prostatic biopsy

Transrectal ultrasound (TRUS) guided biopsy of the prostate is the gold standard for detecting prostate cancer. Intraprostatic administration of local anesthesia significantly decreases pain during prostatic biopsy. Transrectal ultrasound guided intraprostatic lidocaine administration along with intrarectally lidocaine gel is a new local anesthesia technique for prostatic biopsy. It was a randomized prospective, comparative, interventional type of the study. A total of 60 patients of age over 55 years included in the study among them 30 patients with transrectal lidocaine gel was in Group I and 30 patients with intraprostatic lidocaine injection with intra rectal gel were in Group II. The mean age was almost identically distributed between the two groups (p=0.668). About 47% of patients in Group I exhibited hard prostate on digital rectal examination (DRE), 33.3% single nodule and 20% multinodule compared to 33.3% of patients in Group II had hard prostate, 26.7% single nodule and 40% multinodule (p=0.236). The mean serum prostate specific antigen (PSA) was significantly higher in Group II than that in Group I (36.7±9.2 vs. 7.5±5.8ng/ml; p=0.007). The mean pain intensity during biopsy was almost two times higher in Group I than in Group II (p<0.001). The present study concludes that the intraprostatic lidocaine injection along with intra rectal lidocaine gel is less painful method and can be considered in all patients undergoing transrectal ultrasound guided prostate biopsy.

Follicular dendritic cell sarcoma with paraneoplatic pemphigus: Rare case and a brief review of literature

Paraneoplastic pemphigus (PNP) is often a fatal autoimmune bullous disease characterized by severe stomatitis, polymorphous skin eruptions, and underlying neoplasms. We describe a patient with PNP associated with follicular dendritic cell sarcoma (FDCS), a rare neoplasm originating from follicular dendritic cells, which are non-lymphoid, non-phagocytic accessory cells of the lymphoid system and play an integral role in regulation of the germinal center reaction and present antigens to B-cells. The presence of rich vascularity around the tumor and few hyalanized vascular follicles found in histopathological examination gives the clue that the tumor might have developed from Castleman's disease (CD). As for the mechanisms by which CD induces PNP, it has been proposed that autoantibodies secreted from the Castleman's tumor play pivotal role. This hypothesis seems to be supported by the present case, in which CD may have triggered both the FDCS and the PNP.

Two-photon quantum interference in plasmonics: theory and applications

We report perfect two-photon quantum interference with near-unity visibility in a resonant tunneling plasmonic structure in folded Kretschmann geometry. This is despite absorption-induced loss of unitarity in plasmonic systems. The effect is traced to perfect destructive interference between the squares of amplitude reflection and transmission coefficients. We further highlight yet another remarkable potential of coincidence measurements as a probe with better resolution as compared to standard spectroscopic techniques. The finer features show up in both angle resolved and frequency resolved studies.

Light-controlled perfect absorption of light

We study coherent perfect absorption (CPA) of light in a Kerr nonlinear metal-dielectric composite medium, illuminated from the opposite ends. Elementary symmetry considerations reveal that equality of the incident light intensities is a prerequisite to ensure CPA in both linear and nonlinear systems for specific system parameters. We also derive the sufficient conditions for having CPA. We further show that, while CPA in a linear system is insensitive to the incident power level, in a nonlinear system CPA can be achieved only for discrete intensities with interesting hysteretic responses. Our unified formulation of CPA and waveguiding identifies them as opposite scattering phenomena. We further investigate light-induced CPA in on-resonant and off-resonant systems.

Nonlinearity induced critical coupling

We study a critically coupled system [Opt. Lett. 32, 1483 (2007)] with a Kerr nonlinear spacer layer. Nonlinearity is shown to inhibit null scattering in a critically coupled system at low powers. However, a system detuned from critical coupling can exhibit near-complete suppression of scattering by means of nonlinearity-induced changes in refractive index. Our studies reveal clearly an important aspect of critical coupling as a delicate balance in both the amplitude and the phase relations, while a nonlinear resonance in dispersive bistability concerns only the phase.

Strong coupling of in-plane propagating plasmon modes and its control

We show anti-crossings due to strong in-plane coupling of grating excited propagating plasmon modes in dielectric-metal-dielectric structure with 2D dielectric pattern on top. Grating coupled propagating plasmon modes along with their complete dispersion in the measurement range and all different sample orientations are calculated first. Further a coupled mode theory is presented for the specific geometry presented here. Experimentally measured anti-crossing widths are compared with those calculated by coupled mode theory. It is shown that the coupling strength of the plasmon modes and thus the anti-crossing width can be controlled by the orientation of the sample.

Enhancing spin-orbit interaction of light by plasmonic nanostructures

The spin orbit interactions (SOI) of light mediated by single scattering from plasmon resonant metal nanoparticles (nanorods and nanospheres) are investigated using Jones and Mueller matrix polarimetry formalism. The effect of neighboring resonances in plasmonic nanostructures (e.g., orthogonal electric dipolar modes in rods or electric dipolar and quadrupolar modes in spheres) on the individual SOI effects are analyzed and interpreted via the Mueller matrix-derived polarimetry characteristics, namely, diattenuation d and retardance δ. The results clearly reveal that each of these can be controllably tuned and enhanced by exploiting the interference of neighboring modes.

Nonfamilial cherubism

Cherubism is a non neoplastic progressive heredity disease affecting the jaw bones. It is a benign disease with a characteristic symmetrical involvement of the maxilla and mandible. It usually affects children before 5 years of age, with painless progressive swelling of the cheeks, frequently associated with dental malformations. Here, we are presenting a case report of a 12-year-old boy suffering from cherubism.

Coherent perfect absorption mediated anomalous reflection and refraction

We show bending of light on the same side of the normal in a free-standing corrugated metal film under bidirectional illumination. Coherent perfect absorption (CPA) is exploited to suppress the specular zeroth order leading to effective back-bending of light into the "-1" order, while the "+1" order is resonant with the surface mode. The effect is shown to be phase sensitive, yielding CPA and superscattering in the same geometry.

Controllable coherent perfect absorption in a composite film

We exploit the versatility provided by metal-dielectric composites to demonstrate controllable coherent perfect absorption (CPA) or anti-lasing in a slab of heterogeneous medium. The slab is illuminated by coherent light from both sides, at the same angle of incidence and the conditions required for CPA are investigated as a function of the different system parameters. Our calculations clearly elucidate the role of absorption as a necessary prerequisite for CPA. We further demonstrate the controllability of the CPA frequency to the extent of having the same at two distinct frequencies even in presence of dispersion, rendering the realization of anti-lasers more flexible.

Study of cellular immune response against Hepatitis E virus (HEV)

Hepatitis E virus infection (HEV) is a major cause of acute viral hepatitis in the developing world. The immunopathology of HEV infections has not yet been elucidated. The virus is noncytopathic, and therefore, liver injury may be attributed to immune-mediated damage by cytotoxic T cells and natural killer cells. Therefore, we studied the nature of immune cells involved in HEV-induced liver damage using immunohistochemistry in liver biopsies taken from patients with HEV-induced acute liver failure and demonstrated a significant infiltration of activated CD8(+) T cells containing granzymes. These findings suggest the possible involvement of cytotoxic T cells in disease pathogenesis during HEV infection.

DNA triplex-mediated inhibition of MET leads to cell death and tumor regression in hepatoma

Mesenchymal epithelial transition factor (MET) is one of the critical cell signaling molecules whose aberrant expression is reported in several human cancers. The aim of the study is to investigate the antigene and antiproliferative effect of short triplex forming oligonucleotides, TFO-1 (part of the positive regulatory element) and TFO-2 (away from the transcription start site) on MET expression. HepG2 cells transfected only with TFO-1 (but not with TFO-2 and non-specific TFO) significantly decreased MET levels, which is accompanied by decrease in antiapoptotic proteins and increase in pro-apoptotic proteins. Phosphoproteome-array analysis of 46 intracellular kinases revealed hypophosphorylation of about 15 kinases including ERK, AKT, Src and MEK, suggesting the growth inhibitory effect of TFO-1. Further, the efficacy of TFO-1 was tested on diethylnitrosamine-induced liver tumors in wistar rats. T2-weighted magnetic resonance imaging showed decrease in liver tumor volume up to 90% after treatment with TFO-1. Decreased MET expression and elevated apoptotic activity further indicate that TFO-1 targeted to c-met leads to cell death and tumor regression in hepatoma. Formation of stable DNA triplex between TFO-1 and targeted gene sequence was confirmed by circular dichroic spectroscopy and gel retardation assay. Therefore, it can be concluded that DNA triplex-based therapeutic approaches hold promise in the treatment of malignancies associated with MET overexpression.

Loss of heterozygosity on chromosome 11p15.5 and relapse in hepatoblastomas

BACKGROUND

IGF2 is a tumor suppressor gene at locus 11p15. Many hepatoblastomas have loss of heterozygosity (LOH) at this locus. Earlier studies have not demonstrated any association between LOH and prognosis. Aim of the study was to evaluate the prognostic significance of LOH at 11p15.5 in hepatoblastomas.

METHODS

DNA was isolated from normal liver and tumor tissue in 20 patients with hepatoblastoma. PCR was performed and cases were classified as LOH present, absent or non-informative. Patients' follow-up data was analyzed using Fischer's exact test and Kaplan-Meier survival analysis for relapse-free survival (RFS) in relation to LOH. Ethical clearance was obtained from the institutional ethics board.

RESULTS

All cases were informative for at least one microsatellite marker used. 4 of the 20 cases (20%) had LOH at 11p15.5. One patient died in the immediate postoperative period. 5 of 19 patients relapsed (26%). Of 4 patients who had LOH, 3 (75%) relapsed, the time to relapse being 7, 7 and 9 months, respectively. Of the 15 cases without LOH, 2 (13.3%) relapsed. 4 patients had mixed epithelial and mesenchymal histology; 3 of them had LOH. The 2 groups with and without LOH were well matched. The RFS for patients with LOH (n=4) was 13% (mean survival time [MST]: 8.7 months; 95CI 6.7-10.7), while the RFS for cases without LOH (n=15) was 75% (MST: 100.7 months; 95CI 74.5-126.8).

CONCLUSION

Mixed epithelial and mesenchymal histology is more frequently associated with LOH on chromosome 11p15.5 than pure epithelial histology. LOH on chromosome 11p15.5 is associated with a significantly increased incidence of relapse and a significantly shorter relapse-free survival in patients with hepatoblastoma. The risk of relapse is higher and the RFS lower both in standard-risk and high-risk patients with hepatoblastoma if they demonstrate the presence of LOH at 11p15.5.

Matrix supported liquid culture and machine vision analysis of regenerated shoots of gladiolus

Enhancement of efficiency and efficacy of plant regeneration are primary goals of micropropagation. An efficient method with rapid and improved shoot regeneration of gladiolus based upon matrix supported liquid culture technique has been demonstrated. This technique in addition ensured the quality of the regenerated shoots by effectively alleviating the phenomenon of hyperhydricity. Efficacy in plant regeneration can be brought about by the ability to sort and objectively select plants or group of plants with a desired feature. A reliable, noninvasive, machine vision-neural network based sorting method for clustering photometric variants of regenerated shoots of gladiolus has also been described.

Prognostic significance of location of the primary tumor in operable breast cancers

BACKGROUND

The prognostic significance of the primary tumor site in breast cancers is not established with only a few studies having evaluated the issue.

MATERIALS AND METHODS

The relevance of a primary tumor site with respect to systemic disease relapse was evaluated in 187 patients with breast cancer treated with primary surgery and adjuvant chemotherapy, in whom the location of primary tumor was classifiable in any one of the three sites, namely: outer, periareolar, and inner, quadrants. Data was obtained from prospectively maintained records of breast cancer patients treated at a single surgical unit in a tertiary care center.

RESULTS

The three groups were comparable with regard to demographic, pathological tumor, and treatment characteristics. In the multivariate analysis, patients with inner and periareolar quadrant tumors had a higher hazard for systemic disease relapse, (2.53, 95% CI: 1.18-5.42; P = 0.02, and 2.73, 95% CI: 1.04-7.14; P = 0.04, respectively) as compared to outer quadrant tumors. The projected five-year survival estimates in Kaplan Meier were 87%, 61%, and 69%, respectively, for outer, periareolar, and inner quadrant. On further substratification the difference was particularly noted in high risk inner quadrant tumors: age 45, premenopausal patients, tumor size> 2 cms, positive nodes and intermediate or high grade histology, as also in patients treated with breast conservation and CMF, Cyclophosphamide, Methorexate, 5 Fluorouracil chemotherapy.

CONCLUSION

The location of the primary tumor influences survival in breast cancer with inferior outcome for tumors in inner and periareolar quadrants, especially in high risk groups and those treated with conservative approaches. The role of aggressive therapies merits investigation in these patients.

Case report. Schwannoma of both intrahepatic and extrahepatic bile ducts: a rare case

Schwannoma of the biliary tree is extremely uncommon, with only a few cases having been reported so far. They commonly present with obstructive jaundice. Although involvement of the extrahepatic duct is common, occurrence in the intrahepatic ducts has not been reported. We report a case of combined intrahepatic and extrahepatic schwannoma in a 46-year-old man presenting with obstructive jaundice.