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Background: Urinary tract infection (UTI), a common bacterial infection managed in general practice, is the second most common cause for antibiotic use in primary care setting. Antibiotic prescription is mostly empirical in UTI and it is imperative to choose one highly sensitive drug against the common pathogens. Aims and Objectives: In this study, it has been tried to find out the magnitude of community-acquired UTI in a rural population of West Bengal, its causative agents, and the sensitivity pattern of urinary isolates to reduce the development of antibiotic resistance. Materials and Methods: This is an observational, cross-sectional study over 1 year in a rural tertiary care hospital in West Bengal. Culture and sensitivity reports generated from diagnosed UTI patients from the different OPDs of the hospital were analyzed. Results: Out of 603 reports analyzed, culture-positive reports were 463. Escherichia coli was identified to be the most predominant (61.7%) followed by Staphylococcus aureus (17.3%). The sensitivity report of the empirically given antibiotics shows that among the oral antibiotics, nitrofurantoin was the most sensitive one (92%) followed by ciprofloxacin (83.1%) and ofloxacin (66%). Among the injectables, amikacin (84.5%) and ceftazidime (81.8%) were the antibiotics having the highest sensitivity. Conclusion: The sensitivity among the uropathogens to the commonly used antibiotics shows higher resistance rate toward norfloxacin, cephalexin, cotrimoxazole, ampicillin, amoxicillin, co-amoxiclav, and cefuroxime. Oral antibiotics such as nitrofurantoin and ciprofloxacin and parenteral antibiotic amikacin have found to be of higher sensitivity among all organisms identified clubbed together.
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Background: Type 2 diabetes mellitus (DM) is mainly due to multifactorial of which insulin resistance and deficiency in the incretion are two important pathophysiological factors. Vildagliptin, an oral hypoglycemic agent, acts by inhibiting dipeptidyl peptidase-4 enzyme, often uses as a first line drug along with metformin to enhance outcome. Aim and Objective: The aim of this study was to compare the effectiveness and safety of vildagliptin 50 mg twice daily dose with vildagliptin 100 mg sustained release tablet (SR) once daily in Type 2 DM patients and uncontrolled with metformin monotherapy. Materials and Methods: Adult patients with Type 2 DM fulfilling the inclusion criteria were randomized in two groups. Group 1 patient received metformin 1000 mg/day in two divided dose and tablet vildagliptin 50 mg 2 times daily, while Group 2 patients received metformin 1000 mg/day in two divided dose along with vildagliptin 100 mg SR once daily. Fasting plasma glucose (FPG), postprandial plasma glucose (PPPG), and glycated hemoglobin (HbA1C), were measured at baseline, on week 4, week 8, and week 12 visits. Liver function test (SGOT), SGPT, Serum Bilirubin), kidney function test electrolytes, serum urea, serum creatinine), and body weight also measured in first visit and in 12th week. Results: HbA1C, FPG, and PPPG all three decreased equally at 12 week from their respective baseline values (P < 0.05) in both groups. There is no statistically significant alteration of liver enzymes and in serum bilirubin level from baseline to 12th week in both groups. Conclusion: Vildagliptin 100 mg SR once daily dose is equally effective and safe as 50 mg twice daily dose in terms of reducing HbA1C, FPG, and PPPG when it is used along with metformin 1000 mg.
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Background: Although a good number of individual household latrines have been constructed in Bihar during the past few years, still, a huge task remains to be completed. The paper is based on the study of “concurrent monitoring of LSBA/SBM [G] in select districts of Bihar”. Objectives: The aim is to understand different dimensions of the sanitation situation in Bihar. The objective is to suggest policy based on the findings. Materials and Methods: This study is based on primary data collected at the household level and public institutions in six districts of Bihar. Results: The analysis reveals that except a few categories, socioeconomic indicators such as religion, economic condition, or educational attainments have no significant impact on having a latrine at the household level. The variations in the construction of latrines among different districts emphasize that the public program needs to be implemented more effectively. It is also found that women are more vulnerable in a situation of open defecation. Conclusion: The challenge is to encourage people for the sustained use of the constructed latrines. This puts emphasis on changing the behavioral pattern of the people. This requires organizing a continuous awareness generation program with the aim to change the behavior.
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Technology socialization process has operationally been defined as the interactive summation of all possible responses to a technology application process in terms of adoption, rejection, discontinuance and reinvention. Here, this interactive summation is measured against a set of standard practices applied in pulse enterprises and the level of socialization as measured against a “recommended technology”. The following specific objectives are set to intervene the present study. Those are, to generate basic information on socialization of pulse crop in the study area to identify and standardize the variables, dependent and independent, impacting on both socialization of pulse crop in the study area, to elucidate inter and intra level interaction between dependent variables i.e. Socialization with those of selected socio economic and ecological variables, to delineate the micro level policy based on the empirical result on effective socialization process. The study has been carried out in two developed block namely Chakdah and Haringhata of Nadia District in West Bengal. The multistage purposive and random sample techniques were the key to contrast sampling design in the present study. The following variables, gross return, area under pulse cultivation, training received, yield, farmer’s attitude towards pulse cultivation have been found generating significant functional impacts on the predicted character, technology Socialization. The statistical tools like mean, standard deviation and coefficient of variation, coefficient of variation, coefficient of correlation, multiple regression, step down multiple regression and path analysis. The study also responded to the inquiry as to where and how the classical crop production process can be replaced with pulse crop and whereas this replacement will be much rewarding and beneficiary to the common farmer. The determinants like gross return, area under pulse crop, training received, productivity of pulse crop and farmer’s attitude are decisively characterizing the socialization process of pulse crop.
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Waste is a ceaselessly developing issue at worldwide and territorial just as at neighborhood levels. Due to vigorous globalization and product proliferation in recent years, more waste has been produced by the soaring manufacturing activities. The social ecology of waste recycling implies the structural, functional and managerial intervention of waste generation process. The specific objective of the research was to isolate and identify the system variables characterizing and the management of waste recycling process and to estimate intra and inter level of interaction amongst and between the variables for respective, inductive and interactive contribution. The present study takes a look into the approach, process and impact of ongoing waste management process, followed by the both kalyani and jalpaiguri municipalities. A set of agro-ecological, socio-economic and techno managerial factors have been developed by selecting two sets of operating variables: Independent Variables: Age(x1), Education(x2), Family member(x3), Total cost of energy(x4), Household land(x5), Income(x6), Expenditure of family(x7), Volume of waste generation per household(x8), Water consumption per day(x9), Total bio diversity(x10), Impact of waste management on health(x11), Impact of waste management on agriculture(x12), Impact of waste management on livestock(x13), Impact of waste management on water(x14), Impact of waste management on soil(x15), Impact of waste management on micro flora and fauna(x16), Exposure to media(x17),Training received(x18), Participation on waste recycling programmer (x19), Perception on environmental impact of waste management(x20), Waste management at household level with value addition by percentage (x21a), Waste management at household level with value addition by percentage (x21b). Dependent variables: Volume of waste used for different purposes (y1). The following independent variables have come out with stark contribution on this consequent variable. Result suggested that in terms of variable, behavior and responses there have been stark differences between jalapaiguri and kalyani municipal areas. In kalyani, some few variables like perception of environmental impact on waste management, waste management at household level with value addition by percentage, impact of waste management on agriculture have recorded the distinct contribution on volume of waste used for different purposes and in jalpaiguri total household land, volume of waste generation from household, water consumption per day have gone in the determinant way. So, in kalyani and jalpaiguri municipal areas these variables have maximum influence on the dependent variable. Household wastes mostly are bio degradable in nature. It can be converted to organic manure which has a great nutritional value for plants and if these bio wastes can be converted into organic manure then amount of waste will be reduced. Not only bio waste but we can use non bio degradable wastes for energy production also.
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Scientists throughout the world are in search of novel modified biopolymer to fabricate smart drug delivery systems based on hydrogel formulations using several cross-linkers like glutaraldehyde, glyoxal, epichlorhydrin, adipic acid dihydrazide, carbodiimide, genipin, etc. Agents that are fused into the polymeric structure like isocyanates, glutaraldehyde, polyepoxides, etc., and are extremely toxic in nature. In addition, these are susceptible to percolate out into the body on biodegradation of polymeric structure. As an alternative to these toxic cross-linking agents, the periodate-Schiff base staining technique is widely being used for cross-linking in biology and biochemistry. The mechanism of this cross-linking technique is based on the reaction in-between the Schiff reagent and the aldehydes produced via the periodate oxidation. During the past few decades, several researchers have already been studied on the natural gums and also, developed their dialdehyde derivatives via the periodate oxidation technique. These periodate oxidized gums are being used to cross-link gelatin, other proteins and chitosan to develop various smart systems for drug delivery, tissue engineering, wound dressing, edible films, etc. The current review presents a comprehensive discussion of the available reported literature on the periodate oxidation of various gums and their use as natural cross-linker.
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A field experiment was carried out at Agriculture Farm, Palli Siksha Bhavana, Visva-Bharati, Sriniketan, West Bengal, India during kharif season of 2015 to compare rice cultivation in conventional transplanting (CT) and system of rice intensification (SRI) in terms of energy use, energy input output relationship and green house gas emission. Results showed that regardless of cultivars, conventional transplanting consumed 62.39% higher energy over SRI. Maximum energy input was associated with non renewable and indirect sources. Higher dose of nitrogenous fertilizer had contributed to 32.35% and 26.26% to the total input energy in CT and SRI respectively. Energy use efficiency (13.22), energy productivity (6.94 kg MJ-1), energy profitability (12.22) and energy intensity (4.60 MJ Rs-1) of hybrid rice varieties were noted higher in SRI. Maximum green house gas emission from rice field was also attributed to fertilizer nitrogen followed by diesel in both the system. Total green house gas emission in CT was estimated to 834.85 (kg CO2ha-1) i.e. 1.8 times of SRI. Engirdling different energy indices, total input energy and green house gas emission, the system of rice intensification was emerged as the most energy efficient and sustainable rice production system in resource stricken areas (Red Lateritic Zone).
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Aim: The present study was undertaken to find out the possibilities of induced breeding of Catla catla, at low water temperature using fibre reinforced (FRP) tanks in a carp hatchery. Methodology: Brood fish of C. catla was maintained in 0.1 ha pond with proper feeding and pond management. Six induced breeding programmes: 3 in April (pre-monsoon) and 3 in June (monsoon) of 2017 were conducted with C. catla using synthetic hormone, Ovasis intra-peritoneally. The relationship between temperature variation and latency period, effective spawning period, fecundity, hatching start time, hatching duration and spawn production with its recovery was observed. Results: The latency period (time gap between injection and first egg release) was very high and ranged between 653.3 and 721.6 min for breeding in the pre-monsoon and ranged between 446.6 and 480 min for monsoon period. In pre-monsoon, the effective spawning period between 86.6 and 116.6 min and in monsoon between 53.3 and 73.3 min; both varied significantly (p˂0.05). In pre-monsoon period, the average water temperature during larval incubation in hatching pool ranged between 21.58 and 22.58ºC, whereas during monsoon period it ranged between 30.1 and 30.4ºC. The spawn production was 0.13 to 0.22; and 0.47 to 0.65 (lakh kg-1 b. wt. of female) in pre-monsoon and monsoon period, respectively, and showed a significant difference (p˂0.05). Interpretation: This report on breeding of C. catla in the temperature range of 18.6-24.7oC indicates the possibility of spawn production of Indian Major Carp in the north east hilly region states of India
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Low-grade myofibroblastic sarcoma (LGMS) represents an atypical tumor composed of myofibroblasts with a predilection for the head and neck, especially in the tongue and oral cavity, with a high tendency to local recurrence and metastasis, even after a long period. LGMS arising from maxillary sinus and buccal mucosa are not very common. To the best of our knowledge, only 55 cases of low-grade myofibroblastic sarcoma have been reported and only four cases of LGMS of maxillary sinus and three cases of LGMS of buccal mucosa have been reported in world literature. We report two cases of LGMS of the maxillary sinus and buccal mucosa, discussing clinical, histological, inmunohistochemical and therapeutic features.
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Purpose: To determine the levels of dopamine in tear fluid and demonstrate the use of tear fluid as a non-invasive source for dopamine measurements in humans. Methods: The study cohort included 30 clinically healthy individuals without any pre-existing ocular or systemic conditions. Matched tear fluid (using Schirmer's strips and capillary tubes) and plasma were collected from the subjects. Dopamine levels were evaluated using direct competitive chemiluminescent enzyme-linked immunosorbent assay (ELISA), dopamine kit (Cloud Clone Corp, TX, USA). Results: Significantly higher dopamine levels were found in the tear fluid compared to plasma in the study subjects. The level of dopamine was 97.2 ± 11.80 pg/ml (mean ± SEM), 279 ± 14.8 pg/ml (mean ± SEM), and 470.4 ± 37.64 pg/ml (mean ± SEM) in the plasma and in the tears collected using Schirmer's strips and capillary tubes, respectively. Conclusion: Dopamine was detectable in all the tear fluid samples tested and was also found to be at a higher concentration than in plasma samples. Tear fluid can be used as a non-invasive sample source to monitor dopamine levels.
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Background & objectives: Bartonella henselae causes infections which closely resemble febrile illness and chronic diseases such as tuberculosis and haematological malignancies. There are not many studies on Bartonella infections from India. The present study was undertaken to diagnose B. henselae infection in diverse clinical conditions in a tertiary care hospital in north India. Methods: A total of 145 patients including those with fever and lymphadenopathy, infective endocarditis and neuroretinitis were enrolled in the study. Whole blood, serum and lymph node aspirate and valvular vegetations if available, were obtained. Samples were plated on chocolate agar and brain-heart infusion agar containing five per cent fresh rabbit blood and were incubated at 35°C for at least four weeks in five per cent CO2with high humidity. Immunofluorescent antibody assay (IFA) was done for the detection of IgM antibodies in the serum using a commercial kit. Whole blood was used to perform polymerase chain reaction (PCR) for the citrate synthase gene (gltA). Results: IFA was positive in 11 of 140 (7.85%) patients and PCR was positive in 3 of 140 (2.14%) patients. Culture was negative in all the cases. A higher incidence of Bartonella infection was seen in patients with fever and lymphadenopathy (n=30), seven of whom were children. In ophthalmological conditions, four cases were IFA positive. Interpretation & conclusions: The present study shows that the threat of Bartonella infection is a reality in India. It is also an important treatable cause of fever and lymphadenopathy in children. Serology and PCR are useful tests for its diagnosis. Clinicians should consider Bartonella infection in the differential diagnosis of febrile illnesses and chronic diseases.
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Genus Mycoplasma, belonging to the class Mollicutes, encompasses unique lifeforms comprising of a small genome of 8,00,000 base pairs and the inability to produce a cell wall under any circumstances. Mycoplasma pneumoniae is the most common pathogenic species infecting humans. It is an atypical respiratory bacteria causing community acquired pneumonia (CAP) in children and adults of all ages. Although atypical pneumonia caused by M. pneumoniae can be managed in outpatient settings, complications affecting multiple organ systems can lead to hospitalization in vulnerable population. M. pneumoniae infection has also been associated with chronic lung disease and bronchial asthma. With the advent of molecular methods of diagnosis and genetic, immunological and ultrastructural assays that study infectious disease pathogenesis at subcellular level, newer virulence factors of M. pneumoniae have been recognized by researchers. Structure of the attachment organelle of the organism, that mediates the crucial initial step of cytadherence to respiratory tract epithelium through complex interaction between different adhesins and accessory adhesion proteins, has been decoded. Several subsequent virulence mechanisms like intracellular localization, direct cytotoxicity and activation of the inflammatory cascade through toll-like receptors (TLRs) leading to inflammatory cytokine mediated tissue injury, have also been demonstrated to play an essential role in pathogenesis. The most significant update in the knowledge of pathogenesis has been the discovery of Community-Acquired Respiratory Distress Syndrome toxin (CARDS toxin) of M. pneumoniae and its ability of adenosine diphosphate (ADP) ribosylation and inflammosome activation, thus initiating airway inflammation. Advances have also been made in terms of the different pathways behind the genesis of extrapulmonary complications. This article aims to comprehensively review the recent advances in the knowledge of pathogenesis of this organism, that had remained elusive during the era of serological diagnosis. Elucidation of virulence mechanisms of M. pneumoniae will help researchers to design effective vaccine candidates and newer therapeutic targets against this agent.
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Introduction: Small incision cataract surgeries may be performed using various surgical incisions, namely, superior, supero-temporal and temporal. Each method has its own advantages and disadvantages. Supero-temporal incision is considered the best as it produces least induced astigmatism. The purpose of this study was to compare the postoperative induced astigmatism in superior and superotemporal incision group in small incision cataract surgery. Material &Method- This study was conducted on cataract surgery patients admitted in M.R.A Medical College, Ambedkarnagar. Fifty patients were selected for study, out of which 30 received superior and 20 received superotemporal incision. Preoperative keratometric and post operative 6 weeks keratometric readings were analysed. Results-Superior incision is better for with the rule astigmatism and worst for against the rule astigmatism, while superotemporal incision is equally good for both with the rule and against the rule astigmatism. Conclusion-Superotemporal incision is better than superior as it produces least astigmatism with good visual acquity.
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Syphilis affects nearly 1.36 million pregnant women, majority of these cases being concentrated in the developing countries. We aimed at analysing the 11 years’ trends in syphilis seroprevalence in antenatal clinics (ANC) and STD clinic cases. Laboratory data of syphilis cases from 2002-2012 were retrospectively analysed. Out of the total 73642 cases, 393 (0.53%) tested positive for Syphilis. A statistically signifi cant decline in syphilis prevalence was found in both ANC and STD clinic cases. The efforts of various interventional programs should continue to make the screening and treatment facilities readily accessible to continue the decline in syphilis seropositivity.
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Infection with dengue virus (DENV) is the most rapidly spreading mosquito-borne viral disease in the world. The clinical spectrum of dengue, caused by any of the four serotypes of DENV, ranges from mild self-limiting dengue fever to severe dengue, in the form dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Increased rates of hospitalization due to severe dengue, during outbreaks, result in massive economic losses and strained health services. In the absence of specifi c antiviral therapy, control of transmission of DENV by vector management is the sole method available for decreasing dengue-associated morbidity. Since vector control strategies alone have not been able to satisfactorily achieve reduction in viral transmission, the implementation of a safe, effi cacious and cost-effective dengue vaccine as a supplementary measure is a high public health priority. However, the unique and complex immunopathology of dengue has complicated vaccine development. Dengue vaccines have also been challenged by critical issues like lack of animal models for the disease and absence of suitable markers of protective immunity. Although no licensed dengue vaccine is yet available, several vaccine candidates are under phases of development, including live attenuated virus vaccines, live chimeric virus vaccines, inactivated virus vaccines, subunit vaccines, DNA vaccines and viral-vectored vaccines. Although some vaccine candidates have progressed from animal trials to phase II and III in humans, a number of issues regarding implementation of dengue vaccine in countries like India still need to be addressed. Despite the current limitations, collaborative effects of regulatory bodies like World Health Organization with vaccine manufacturers and policy makers, to facilitate vaccine development and standardize fi eld trials can make a safe and effi cacious dengue vaccine a reality in near future.