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Gallbladder agenesis is a rare congenital entity. The incidence is around 1 per 6500 live births. Around 50-70% patients are asymptomatic and the rest are symptomatic with symptoms mimicking biliary colic. Right upper quadrant ultrasound (US) is usually either misleading or inconclusive. Also advanced diagnostic studies such as hepatobiliary iminodiacetic acid (HIDA) scan and endoscopic retrograde cholangio-pancreatography (ERCP) may show non- visualization of the gallbladder and erroneously lead providers to a diagnosis of cystic duct obstruction rather than Gallbladder Agenesis. So some patients are only finally diagnosed intraoperatively. Surgery in these patients becomes risky because unnecessary dissection while looking for the non-existent gallbladder can result in injury of the biliary tree, hepatic vasculature, or small bowel. Therefore, clinicians should keep Gallbladder Agenesis on their differential diagnosis list and imaging modalities such as magnetic resonance cholangiopancreatography (MRCP) should be obtained when other tests are inconclusive. We report a 48-year-old female presenting with chronic symptoms consistent with biliary colic and an equivocal US reported as cholelithiasis. She underwent laparoscopy during which the absence of the gallbladder was noted.
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Cardiac-resident macrophages (CRMs) play important roles in homeostasis, cardiac function, and remodeling. Although CRMs play critical roles in cardiac regeneration of neonatal mice, their roles are yet to be fully elucidated. Therefore, this study aimed to investigate the dynamic changes of CRMs during cardiac ontogeny and analyze the phenotypic and functional properties of CRMs in the promotion of cardiac regeneration. During mouse cardiac ontogeny, four CRM subsets exist successively: CX3CR1+CCR2-Ly6C-MHCII- (MP1), CX3CR1lowCCR2lowLy6C-MHCII- (MP2), CX3CR1-CCR2+Ly6C+MHCII- (MP3), and CX3CR1+CCR2-Ly6C-MHCII+ (MP4). MP1 cluster has different derivations (yolk sac, fetal liver, and bone marrow) and multiple functions population. Embryonic and neonatal-derived-MP1 directly promoted cardiomyocyte proliferation through Jagged-1-Notch1 axis and significantly ameliorated cardiac injury following myocardial infarction. MP2/3 subsets could survive throughout adulthood. MP4, the main population in adult mouse hearts, contributed to inflammation. During ontogeny, MP1 can convert into MP4 triggered by changes in the cellular redox state. These findings delineate the evolutionary dynamics of CRMs under physiological conditions and found direct evidence that embryonic and neonatal-derived CRMs regulate cardiomyocyte proliferation. Our findings also shed light on cardiac repair following injury.
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Background & objectives: Osteoporosis is a systemic skeletal disease, characterized by a low bone mass leading to increased bone fragility and hence, a greater susceptibility to the risk of fracture. Since age-related oxidative stress is one of the factors that has been implicated in developing low bone mineral density (BMD), leading to osteoporosis, this study wanted to explore the expression of antioxidant enzymes in individuals with osteoporosis. The present study focused on mapping polymorphism in an important antioxidant enzyme glutathione peroxidase 1 (GPx1) among osteoporosis and healthy Asian Indians. Methods: Dual-energy X-ray absorptiometry was used to assess BMD of individuals and was classified into normal (n=96) and osteoporotic (n=88) groups. Biochemical parameters such as vitamin D, total oxidant status (TOS), and GPx1 enzyme activity were estimated from plasma samples of recruited individuals. Quantitative real-time qRT-PCR was carried out using GAPDH as an endogenous control. Genomic DNA was isolated from whole blood, and polymorphisms were evaluated by sequencing. Results: The BMD was lower in osteoporotic individuals, and further analysis of biochemical parameters indicated significantly low 25-hydroxy vitamin D and GPx1 with higher TOS levels in osteoporotic as compared to healthy individuals. Furthermore, qRT-PCR revealed low expression of GPX1 in osteoporotic individuals. GPX1 sequence analysis of the promoter and two exons revealed the lower frequency of five alanine repeats in the osteoporotic individuals. Interpretation & conclusions: In this study, the in silico analysis revealed the lower frequency of five alanine repeats in exon 1 of GPX1 and high TOS to be associated with osteoporosis. However, no polymorphism was found in exon 2 of GPX1 among the two study groups.
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Background & objectives: Serial national level serosurveys in India have provided valuable information regarding the spread of COVID-19 pandemic in the general population, but the impact of the ongoing pandemic on the tribal population in India is not well understood. In this study, we evaluated the seroprevalence of COVID-19 antibodies in the tribal population of Odisha post-second wave (September 2021). Methods: A population-based, age-stratified, cross-sectional study design was adopted for the survey, carried out in seven tribal districts of Odisha from 30th August to 16th September 2021. A multistage random sampling method was used where serum samples were tested for antibodies against the SARS-CoV-2 nucleocapsid (N) protein in each district, and a weighted seroprevalence with 95 per cent confidence interval (CI) was estimated for each district. Results: A total of 2855 study participants were included from the seven tribal districts of Odisha in the final analysis. The overall weighted seroprevalence was 72.8 per cent (95% CI: 70.1-75.3). Serological prevalence was the highest among 18-44 yr (74.4%, 95% CI: 71.3-77.3) and from Sambalpur district [75.90% (66.90-83.10)]. Among participants, 41.93 per cent had received at least one dose of any COVID-19 vaccine. Kandhamal district had the highest number of fully immunized participants (24.78%), and in Sundergarh district, most of the study participants (58.1%) were unimmunized.Interpretation & conclusions: This study found high seroprevalence against SARS-CoV-2 in the tribal population of Odisha. The vaccination coverage is at par with the general population, and efforts to address some knowledge gaps may be needed to improve the coverage in the future
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Background & objectives: Serosurvey of COVID-19 provides a better estimation of people who have developed antibodies against the infection. Undertaking such a serosurvey in certain districts of India which are densely populated with prominent tribes can provide valuable information regarding seropravelance of SARS-CoV-2 antibodies among such indigenous populations. In this context, two rounds of population-based, cross-sectional serosurveys for SARS-CoV-2 IgG antibody were carried out in Jharkhand, a tribal-dominated State of India, to compare the seroprevalence of SARS-CoV-2 infection and to determine the associated demographic risk factors. Methods: The surveys were carried out in June 2020 and February 2021 in ten districts of the State of Jharkhand. Blood samples were collected from the residents of the selected districts by random sampling and tested for anti-SARS-CoV-2 antibodies using an automated chemiluminescence immunoassay platform. A total of 4761 and 3855 eligible participants were included in round 1 and round 2, respectively. Results: The age- and gender-standardized seroprevalence for COVID-19 during round 1 was 0.54 per cent (0.36-0.80) that increased to 41.69 per cent (40.16-43.22) during round 2 with a gap of eight months in between. The seropositivity among male and female participants was 0.73 and 0.45 per cent, respectively, during the first round and 51.35 and 33.70 per cent, respectively, during the second round. During the first round, 17.37 per cent of the participants were tribal with seropositivity of 0.24 per cent (0.02-0.87), and during the second round, 21.14 per cent were tribal with seropositivity of 39.14 per cent (35.77-42.59). Compared to tribal group, non-tribal participants had an adjusted odds of 1.24 (95% confidence interval=1.04-1.48) for SARS-CoV-2 seropositivity. Interpretation & conclusions: COVID-19 seroprevalence was found to be low during the first round (0.54%) of the survey, possibly due to the travel restrictions during lockdown better adherence to social distancing and wearing of face masks among the people. Understanding the dynamics of SARS-CoV-2 transmission and the susceptibility to infection at the individual as well as community level will inform decision and help policy makers to design and implement effective public health strategies to mitigate the pandemic in this State.
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Background & objectives: COVID-19 pandemic has triggered social stigma towards individuals affected and their families. This study describes the process undertaken for the development and validation of scales to assess stigmatizing attitudes and experiences among COVID-19 and non-COVID-19 participants from the community. Methods: COVID-19 Stigma Scale and Community COVID-19 Stigma Scale constituting 13 and six items, respectively, were developed based on review of literature and news reports, expert committee evaluation and participants’ interviews through telephone for a multicentric study in India. For content validity, 61 (30 COVID-19-recovered and 31 non-COVID-19 participants from the community) were recruited. Test–retest reliability of the scales was assessed among 99 participants (41 COVID-19 recovered and 58 non-COVID-19). Participants were administered the scale at two-time points after a gap of 7-12 days. Cronbach’s alpha, overall percentage agreement and kappa statistics were used to assess internal consistency and test–retest reliability. Results: Items in the scales were relevant and comprehensible. Both the scales had Cronbach’s ? above 0.6 indicating moderate-to-good internal consistency. Test–retest reliability assessed using kappa statistics indicated that for the COVID-19 Stigma Scale, seven items had a moderate agreement (0.4-0.6). For the Community COVID-19 Stigma Scale, four items had a moderate agreement. Interpretation & conclusions: Validity and reliability of the two stigma scales indicated that the scales were comprehensible and had moderate internal consistency. These scales could be used to assess COVID-19 stigma and help in the development of appropriate stigma reduction interventions for COVID-19 infected, and mitigation of stigmatizing attitudes in the community.
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Objectives@#A primary brain tumor starts to grow from brain cells, and it occurs as a result of errors in the DNA of normal cells. Therefore, this study was carried out to analyze the two-dimensional (2D) texture, morphology, and statistical features of brain tumors and to perform a classification using artificial intelligence (AI) techniques. @*Methods@#AI techniques can help radiologists to diagnose primary brain tumors without using any invasive measurement techniques. In this paper, we focused on deep learning (DL) and machine learning (ML) techniques for texture, morphological, and statistical feature classification of three tumor types (namely, glioma, meningioma, and pituitary). T1-weighted magnetic resonance imaging (MRI) 2D scans were used for analysis and classification (multiclass and binary). A total of 102 features were calculated for each tumor, and the 20 most significant features were selected using the three-step feature selection method, which included removing duplicate features, Pearson correlations, and recursive feature elimination. @*Results@#From the predicted results of multiclass and binary classification, a long short-term memory binary classification (glioma vs. meningioma) showed the best performance, with an average accuracy, recall, precision, F1-score, and kappa coefficient of 97.7%, 97.2%, 97.5%, 97.0%, and 94.7%, respectively. @*Conclusions@#The early diagnosis of primary brain tumors is very important because it can be the key to effective treatment. Therefore, this research presents a method for early diagnoses by effectively classifying three types of primary brain tumors.
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Okra production in eastern India at present is severely threatened by whitefly-mediated okra enation leaf curl disease(OELCuD). Identification of resistant genotype and understanding the genetic control and biochemical relationship of OELCuD resistanceare prerequisite for developing an effective breeding strategy. This study was conducted employing six populations (P1, P2, F1, F2, BC1 andBC2) of two selected (resistant 9 susceptible (R9S)) crosses. Associationship between severity of OELCuD and biochemical parametersof parents and hybrids at preflowering and flowering stages was studied. Segregation pattern of the genotypes in F2 generation showingOELCuD reaction of two crosses suggested that two duplicate recessive genes was operative for resistance to OELCuD. Generation meananalysis revealed involvement of both additive and nonadditive effects in the inheritance of disease resistance. Hence, postponement ofselection in later generations or intermating among the selected segregates followed by one or two generations of selfing to break theundesirable linkage and allow the accumulation of favourable alleles could be suggested for the development of stable resistant genotypeagainst this disease. Higher peroxidase activity and total phenol content in leaf emerged as reliable biochemical markers for early selectionof genotype resistant to OELCuD.
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Bone metastasis from lung primary is not uncommon and about one-third of bone metastases originate from lung. However, skull bone metastasis is uncommon from lung carcinoma. Metastasis to skull bone and scalp as an initial presentation of lung carcinoma is a very rare phenomenon. We have diagnosed a case of calvarial metastasis with scalp swelling as an initial presentation of adenocarcinoma of lung by fine-needle aspiration cytology in an aged female. Radiologically, it was suggested as tuberculous lesion but cytology gave the correct diagnosis. Here, we present a rare case of calvarial metastasis as a presentation of adenocarcinoma of lung in an elderly female
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Direct massively parallel sequencing of SARS-CoV-2 genome was undertaken from nasopharyngeal andoropharyngeal swab samples of infected individuals in Eastern India. Seven of the isolates belonged to the A2aclade, while one belonged to the B4 clade. Specific mutations, characteristic of the A2a clade, were alsodetected, which included the P323L in RNA-dependent RNA polymerase and D614G in the Spike glycoprotein. Further, our data revealed emergence of novel subclones harbouring nonsynonymous mutations, viz.G1124V in Spike (S) protein, R203K, and G204R in the nucleocapsid (N) protein. The N protein mutationsreside in the SR-rich region involved in viral capsid formation and the S protein mutation is in the S2 domain,which is involved in triggering viral fusion with the host cell membrane. Interesting correlation was observedbetween these mutations and travel or contact history of COVID-19 positive cases. Consequent alterations ofmiRNA binding and structure were also predicted for these mutations. More importantly, the possibleimplications of mutation D614G (in SD domain) and G1124V (in S2 subunit) on the structural stability of Sprotein have also been discussed. Results report for the first time a bird’s eye view on the accumulation ofmutations in SARS-CoV-2 genome in Eastern India.
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The objective of present study was to investigate the effect of endogenous minerals (Zn and Ca), seminal proteins and oxidative stress on semen quality of crossbred bulls. Two crossbred bulls with history of good initial quality, high sperm motility percentage, and freezable ejaculates and poor initial quality, low sperm motility percentage, and donating mostly non-freezable ejaculates (Bull B), respectively were utilized. Six ejaculates from each bull were used and categorized into high progressive motile as good quality and low progressive motile as poor quality ejaculates groups. Total 24 ejaculates were taken during entire period of study. The level of Zn, Ca in seminal plasma and Ca in sperm pellets was found significantly (P<0.05) higher in good quality ejaculates of Bull A compared to poor quality ejaculates of Bull B; however, the level of reactive oxygen species and malondialdehyde was significantly higher (P<0.05) in poor quality ejaculates of Bull B compare to good quality ejaculate of Bull A. The 25 kDa protein band was prominent only in good quality ejaculate of Bull A. It was concluded that several proteinaceous antioxidant enzymes which may be present in 25 kDa band and minerals like Zn and Ca as a cofactors of these enzymes could be responsible for good quality semen ejaculates of Bull A
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Background: Over the past three decades, medical methods of abortion have been developed throughout the world and are now the standard methods of providing abortion care in addition to surgical methods. There are various differences between the two methods. In this study, evaluating the fall in haemoglobin levels in abortions conducted by misoprostol and D and E in women with pregnancy failure.Methods: Total of 80 women who fulfilled the criteria were included in the study. Inclusion and exclusion criteria applied and Hb levels noted on day 1 and 15 during follow up. In addition to this induction abortion interval and side effects of both the methods were also studied. Participants assigned to medical treatment received 800 μg of misoprostol inserted into posterior vaginal fornix i.e., day 1st and repeat dose on day 3 if no expulsion. Follow up done after 1 week and 15 days, if there was no expulsion, suction and evacuation was done. Participants assigned to dilatation and evacuation group would undergo the procedure in operation theatre. Statistical analysis done.Results: The mean induction to abortion interval in the misoprostol group was 9.1±2.1 hours (mean±SD). The mean hemoglobin level in the misoprostol group on day 15 was 9.7±1.12 and that in the D and E group was 10.26±1.31 p value (0.04), statistically significant.Conclusions: Proper counseling of the side effects in both the methods and prompt action to alarming signs are required to avoid major disaster.
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Background: Tuberculosis is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs. Tuberculosis is curable and preventable. It is estimated that 1/3rd of current global population is infected asymptomatically with tuberculosis, of which 5-10% will develop clinical disease during life time.Methods: This descriptive observational study was conducted in Tuberculosis Unit, Bagbazar, Kolkata. Initially demographic data and initial clinical data were collected. Then follow up data were collected until the end of treatment. Data were compiled and analysed. Frequency and percentages were calculated.Results: Male patients were more (69.12%). Majority (61.76%) of the patients were in the age group of 19-50 years of age, followed by 50-60 years (17.64%). Common presenting complaints were cough (61.76%), fever (63.24%), loss of appetite (54.41%), respiratory distress (11.76%), haemoptysis (10.29%), loss of weight (10.29%), swelling of gland (5.88%). Success rate (treatment completed and cured) was about 90%.Conclusions: Tuberculosis was found more in male and in active age group. Treatment of tuberculosis had a very high success rate.
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Background: Adolescents are at the peak of growth velocity and warrant special consideration as they undergo enormous psychological, physical as well as cognitive changes. The Government of India implemented friendly adolescent reproductive and sexual health (ARSH) clinics to improve healthcare services all over the country. However, there is lack of information on the sustainability of the programme.Methods: Community workers and public health workers from randomly selected twenty sub centres for intervention from West Tripura district and control from the adjacent Khowai district were selected. Knowledge prior and post intervention at both sites of the health workers was assessed by a self-administered questionnaire on 0 day, at 3, 6 and 12 months. Difference of knowledge score was analysed by paired t-test.Results: The mean knowledge score significantly differed at pre-intervention and immediately post intervention (p<0.01). The knowledge score was sustained even after 12 months of intervention among public (14.63±3.01) and community health workers (12.53±2.91). However, at the control site, a gradual decrease was noted over duration of 12 months. Intervention also considerably increased the utilization of ARSH clinics by both male and females in comparison to previous year’s data.Conclusions: The intervention and increased sustainability of acquired knowledge over 12 months seem to enhance the capacity for the adolescent clinics. Therefore, training the health workers to manage various sexual and reproductive health issues along with creating a friendly environment for adolescents is indispensable in the present setting.
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Objectives@#The purpose of this retrospective epidemiological study was to determine the etiology and pattern of maxillofacial injuries in a pediatric population. @*Materials and Methods@#Data for pediatric maxillofacial trauma patients aged 12 years and younger who were registered at the Department of Pediatric and Preventive Dentistry, Dr. R. Ahmed Dental College and Hospital, Kolkata, India, were reviewed and examined. Patients who were treated between October 2016 and September 2018 were analyzed according to age, sex, cause of injury, frequency and site of facial fractures, and soft tissue injuries. The chi-square tests were carried out for statistical analyses with a significance level of 5%. @*Results@#Of 232 patients with a mean age of 6.77±3.25 years, there were 134 males (57.8%) and 98 females (42.2%). The overall male to female ratio was 1.39:1. The most common causes of injuries were falls (56.5%) and motor vehicle accidents (16.8%). Incidence of falls decreased significantly with age (P<0.001). Dentoalveolar injuries (61.6%) and soft tissue injuries (57.3%) were more common than facial fractures (42.7%). Mandibular fractures (82.8%) were the most common facial fractures, and perioral or lip injuries were the most prevalent injuries in our patient population. There was a positive association between facial fractures and soft tissue injury (P<0.01) (odds ratio 0.26; confidence interval 0.15-0.46). @*Conclusion@#Falls were the leading cause of maxillofacial trauma in our sample of children, and the most common site of fractures was the mandible.
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The severity of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), greatly varies from patient to patient. In the present study, we explored and compared mutation profiles of SARS-CoV-2 isolated from mildly affected and severely affected COVID-19 patients in order to explore any relationship between mutation profile and disease severity. Genomic sequences of SARS-CoV-2 were downloaded from Global Initiative on Sharing Avian Influenza Data (GISAID) database. With the help of Genome Detective Coronavirus Typing Tool, genomic sequences were aligned with the Wuhan seafood market pneumonia virus reference sequence and all the mutations were identified. Distribution of mutant variants was then compared between mildly and severely affected groups. Among the numerous mutations detected, 14,408C>T and 23,403A>G mutations resulting in RNA-dependent RNA polymerase (RdRp) P323L and spike protein D614G mutations, respectively, were found predominantly in severely affected group (>82%) compared with mildly affected group (T mutation in the non-coding region of the genome was also found predominantly in severely affected group (p T, a silent mutation, also appeared in relatively high frequency in severely affected group compared with mildly affected group, but the difference was not statistically significant (p = 0.06). We concluded that spike protein D614G and RdRp P323L mutations in SARS-CoV-2 are associated with severity of COVID-19. Further studies will be required to explore whether these mutations have any impact on the severity of disease.
ABSTRACT
The severity of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), greatly varies from patient to patient. In the present study, we explored and compared mutation profiles of SARS-CoV-2 isolated from mildly affected and severely affected COVID-19 patients in order to explore any relationship between mutation profile and disease severity. Genomic sequences of SARS-CoV-2 were downloaded from Global Initiative on Sharing Avian Influenza Data (GISAID) database. With the help of Genome Detective Coronavirus Typing Tool, genomic sequences were aligned with the Wuhan seafood market pneumonia virus reference sequence and all the mutations were identified. Distribution of mutant variants was then compared between mildly and severely affected groups. Among the numerous mutations detected, 14,408C>T and 23,403A>G mutations resulting in RNA-dependent RNA polymerase (RdRp) P323L and spike protein D614G mutations, respectively, were found predominantly in severely affected group (>82%) compared with mildly affected group (T mutation in the non-coding region of the genome was also found predominantly in severely affected group (p T, a silent mutation, also appeared in relatively high frequency in severely affected group compared with mildly affected group, but the difference was not statistically significant (p = 0.06). We concluded that spike protein D614G and RdRp P323L mutations in SARS-CoV-2 are associated with severity of COVID-19. Further studies will be required to explore whether these mutations have any impact on the severity of disease.
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Primary squamous cell carcinoma (SCC) of the colon and rectum is a rare malignancy. Overall there are less than 150 cases which have been reported and the first was case was reported in 1919. We report a case of pure SCC involving the sigmoid colon. A 55 year old woman presented with chief complaints of bleeding per rectum for 5 months, anorexia and abdominal pain. Histological diagnosis of SCC was made by colonoscopy biopsy. Later it was confirmed by immunohistochemistry (IHC). Any other possible primary sites of malignancy were excluded. Complete surgical resection was performed. The prognosis of this disease seems to be worse than that of adenocarcinoma