Retinopathy of prematurity care in peripheral districts in Odisha, India: Pilot for a sustainable model

The outcome of a retinopathy of prematurity (ROP) program initiated in five districts of Odisha over 3 years with partnerships between the government and non-government organizations was prospectively analyzed. The mentoring partners trained the district ophthalmologists and neonatal care providers; the program was handed over when the trainees were considered competent enough to diagnose and treat babies with ROP. During the project period (July 2016–June 2019), 3058 babies were examined; ROP was detected in 33.81% (n = 1034) and 5.06% (n = 159) babies required treatment. At the end of the project, ROP screening was possible in all five districts, and treatment was possible in three districts. ROP care nodal centers were built in one government medical college. To strengthen the initial gain, we recommend creating an Odisha Retinopathy of Prematurity (OD-ROP) steering committee with private–public partnerships to support the program and monitor its progress in other districts of Odisha.

Effect of Laboratory Stressor onArterial Compliance inYoung Women

Introduction: Coronary Heart Disease (CHD) is lower in women in comparison to male which is attributedto the effect of estrogen on vascular system. However, report on estrogen replacement therapy in menopausalwomen on blood pressure reactivity is inconsistent. The psychosocial stressors of daily life trigger elevatedsympathetic response which is an important independent cardiovascular risk factor. Therefore, the presentstudy intends to determine the effect of laboratory stressor on arterial compliance in young women duringdifferent phases of menstrual cycle.Methods: It is a cross-sectional, observational study conducted on 24 students of 18-22 years of age group.The participants attended two sessions in late follicular (days 12-15) and luteal phase (days 21-24). Theanthropometric parameters and detailed menstrual history were recorded. They were exposed to a 5-minMental Arithmetic Stress Test (MAST). Peripheral SBP, DBP, central SBP, DBP, Heart rate (HR), AugmentationIndex, and brachial ankle pulse wave velocity (baPWV) were recorded before and during the test. Paired ttest was performed to compare the means of the parameters and linear regression analysis was done toexamine the association between cardiovascular parameters and MAST score in both phases. ANCOVA wasdone to examine the difference in MAST response between follicular and luteal phases.Results: BMI and WHR of the subjects were mostly within normal limits with few exceptions. Heart rate wassignificantly decreased during MAST in follicular phase. However, baPWV was increased significantly duringMAST in both phases. There was an increasing trend in other parameters during MAST in both phasesexcepting pulse pressure. No association between cardiovascular parameters and MAST score was revealedby linear regression analysis. There was no significant difference in MAST score in both phases.Conclusions: An increasing trend of cardiovascular parameters during MAST was observed because ofelevated sympathetic activity. A decrease in HR was observed in certain participants during both phaseswhile performing MAST. This decline in peripheral vascular response may enhance the risk of majorcardiovascular events in future. This study therefore concludes that the effect of laboratory stressor in theform of Mental Arithmetic Stress Test (MAST) superimposed on the effect of ovarian hormones, decreasesarterial compliance as measured indirectly by baPWV.

Influence of tobacco chewing on oral health: A hospital-based cross-sectional study in Odisha

Background: Smokeless tobacco use in the Indian subcontinent is a part of many religious and cultural rituals and has gained a degree of social acceptance. The deleterious effects of smokeless tobacco are not as well-known as those produced by smoking. Objectives: The study was carried out to assess the influence of tobacco chewing on the oral health of adult patients attending the dental outpatients department of Khordha district headquarter, Odisha. Methods: A hospital-based cross-sectional study was conducted among 25–64-year-old patients attending the dental outpatient department of Gopabandhu Khordha district headquarter hospital. A total of 512 study participants, who were age and sex matched, were stratified into four age groups such as 25–34 years, 35–44 years, 45–54 years, and 55–64 years old. Oral health status of the participants was assessed using modified WHO Oral Health Assessment Form (2013). Pearson's Chi-square test, binary and multinomial logistic regression was performed to determine the relationship between oral health problems and tobacco chewing. Results: Among the tobacco chewers, 59.8% had gingival bleeding, 40.6% had periodontal pockets, 30.1% had loss of attachment, 48.4% had attrition, and 4.3% had potentially malignant disorders. Compared to the nonchewers, these oral problems were significantly higher among the chewers. Whereas dental caries experience was significantly lower among the chewers (40.6%) compared to the nonchewers (54.7%). Compared to the nonchewers, chewers had 1.71 times increased odds for gingival bleeding, 1.71 times increased odds for periodontal pockets, 2.39 times increased odds for loss of attachment, and 2.49 times increased odds for attrition, which were statistically significant. Conclusion: Hence, the study revealed that tobacco chewing definitely had an influence on oral health, with statistically significant increase in oral health problems in chewers compared to nonchewers. Moreover, loss of attachment and potentially malignant disorders increased significantly with the frequency of tobacco chewing. Periodontal pockets, attrition, and loss of attachment significantly increased with the duration of the chewing habit.

Correlation of obesity & comorbid conditions with chronic venous insufficiency: Results of a single-centre study

Background & objectives: Chronic venous insufficiency (CVI) is a common clinical problem among obese patients. This study was conducted to evaluate the impact of body mass index (BMI) and associated morbidities such as diabetes, hypertension and hypothyroidism on venous disease clinical scores as per Clinical, Etiological, Anatomical, Pathological (CEAP) classification. Methods: In this study, adult patients with BMI more than 30 kg/m2 with signs of CVI were evaluated clinically and by using Duplex ultrasonography of venous system. The patients with C0, C1, C2, C3 and C4, C5, C6 clinical scores in CEAP classification were grouped as lower and higher clinical scores of CVI, respectively. Results: Of the 200 enrolled patients, 147 (73.5%) were males and were associated with higher grades of clinical scores (P=0.051). Superficial venous system was involved in 96 per cent patients and 91 per cent patients had reflux in the sapheno-femoral junction. A negative association was observed between hypertension and male gender (P=0.001). Higher BMI was associated with higher clinical scoring (P=0.053). BMI >40 kg/m2 was associated with primary aetiology (P=0.007) of CVI. There was no correlation between superficial, deep or perforator incompetence with BMI (P=0.506). Duplex-confirmed significant reflux was observed in patients with higher BMI (P=0.006). Age and BMI were positively correlated with clinical score (r=0.176; P=0.013 & r=0.140; P=0.049), respectively. Interpretation & conclusions: Our findings indicated that elderly male patients with high BMI seemed to be at a higher risk of advanced clinical grades of CVI. The impact of comorbid conditions such as diabetes, hypertension and hypothyroidism on CVI could not reach at significance in the present study.

Primitive neuroectodermal tumors of kidney: Our experience in a tertiary care center.

OBJECTIVES: Primitive neuroectodermal tumors (PNET) are rare highly aggressive neoplasms. The diagnosis is made by histopathology with the support of immunohistochemistry (IHC) and cytogenetics. The aggressive multimodality treatment is recommended for the management of these tumors. The purpose of our study is to review our experiences in the diagnoses and treatment of PNET of the kidneys. MATERIALS AND METHODS: We retrospectively reviewed the data of all the patients, who were treated for the PNET of the kidneys at our institute between April and March 2011 and compared with the available literature. RESULTS: A total of eight patients were treated for PNET of the kidney. Out of the eight patients, four were males and four females. Nearly 50% of our patients had inferior vena caval thrombus at the time of presentation. The diagnosis was made on histopathology supported by IHC. Out of the eight patients, one patient had intraoperative death due to massive pulmonary thromboembolism and another died on the 7th post‑operative day due to disseminated intravascular coagulation and multiorgan failure. Rest six patients were treated with post‑operative chemotherapy or a combination of chemotherapy and radiotherapy. For these six patients, overall median survival was 45 months with a 3 year disease‑free survival of 66% and 5 year survival of 44%. CONCLUSIONS: PNET of the kidneys are rare peripheral neuroectodermal tumors with an aggressive clinical course. These tumors carry a very poor prognosis. An aggressive treatment approach using a combination of surgery, chemotherapy and radiotherapy is recommended for a reasonable survival in these tumors.

Holy basil (Ocimum sanctum Linn.) leaf extract enhances specific cognitive parameters in healthy adult volunteers: A placebo controlled study.

Introduction: Ocimum sanctum (OS), known as Holy basil, has been documented to possess neuroprotective, cognition-enhancing and stress relieving effects in animal models. However there is paucity of clinical studies to document these effects. Materials and methods: Effect of OS on parameters related to cognition and stress in humans was evaluated with administration of 300 milligram capsules of ethanolic leaf extracts of Ocimum sanctum (EtOS) or placebo per day, over 30 days. Results: Intra-group comparison of Sternberg and Stroop test showed improvement in both the placebo and EtOS groups, however, the improvement stabilized after day 15 in the placebo group. Intergroup comparison revealed a significant improvement of the following cognitive parameters in the EtOS as compared to the placebo: reaction time (RT) and error rate (ER) of Sternberg test, RT of neutral task of Stroop, RT and ER of interference task of Stroop. The intra-group comparison of P300 latency, salivary cortisol, and State-Trait Anxiety Inventory showed improvement over time in the EtOS group alone, though the inter-group difference was significant in the P300 latency alone. There were no changes in heart rate (HR), ΔHR, or galvanic skin response (GSR) or ΔGSR. Conclusion: Ocimum sanctum leaf extract seems to have potential cognition-enhancing properties in humans.

Prospects, Technological Aspects and Limitations of Probiotics – A Worldwide Review.

The term “probiotics” (meaning “for life” in Greek) refers products containing live microorganisms, which increase the population of friendly intestinal bacteria upon ingestion. Several new dairy product formulations containing probiotic cultures are being developed with such microbes which when consumed offer potential health benefits viz. increased resistance to infectious diseases - particularly of the intestine, decreased duration of diarrhea, reduction in blood pressure, reduction in serum cholesterol concentration and allergy, stimulation of phagocytosis by peripheral blood leucocytes, modulation of cytokine gene expression, adjuvant effects, regression of tumors, reduction in carcinogen products, increased tolerance to lactose in lactose intolerant population etc. In addition, all potential benefits could not be achieved from just one type or strain of organism. Examples of probiotic microorganisms used in foods include Lactococcus lactis, Lactobacillus sp., Streptococcus, Enterococcus, Bifidobacterium sp., Pediococcus, Propionibacteria sp. This review paper highlights the benefits, technological aspects, world scenario and limitations of probiotic foods.

Study of Microbial Population and Enzyme Activities in Intercropped Peanut Rhizosphere with Different Nutrient Application.

The aim of this study was to investigate the effect of different levels of chemical fertilizers (CF) alone or in combination with farmyard manure (FYM) under lime or no lime amelioration on biological properties of the rhizosphere soil of peanut, grown as intercrop with sabai grass (Eulaliopsis binata (Retz.) C.E. Hubb) in an acid lateritic soil. The effect of five fertilization levels viz., no CF (F0), CF @ 20:40:30 (F1), CF @ 40:80:60 (F2) kg ha-1 NPK, F1 + 2.5 t FYM ha-1 (F3) and F2 + 5 t FYM ha-1 (F4) with (2 t ha-1) and without lime application were studied on the bacterial density, dehydrogenase and phosphatase enzyme activities (i.e. acid and alkaline phosphomonoesterases), nitrogen accumulation in nodules and phosphorus solubilizing power at 25, 50, 75 and 100 days after sowing of peanut for two years. Results showed significant effects of fertilization levels and growth stages of the crop on the microbial activities. Populations of symbiotic nitrogen fixing and phosphorus solubilizing bacteria, soil enzyme activities, nitrogen accumulation in nodules and phosphorus solubilizing power in the FYM+CF treated plots significantly increased compared to sole CF treatments under both lime and no lime application. Lime application improved the activity of dehydrogenase and alkaline phosphomonoesterase enzymes, while decreased acid phosphomonoesterase activity. This study revealed that integrated application of optimum level of inorganic fertilizer, farmyard manure along with lime could improve the biological properties of an acid lateritic soil as well as the growth of peanut under sabai grass-peanut intercropping system.

Yield, Fruit Body Diameter and Cropping Duration of Oyster Mushroom (Pleurotus sajor caju) Grown on Different Grasses and Paddy Straw as Substrates.

The present experiment aimed at finding the suitability of some grasses as cost effective alternative substrates, for cultivation of one species of oyster mushroom viz., Pleurotus sajor caju (Fr.) Singer in eastern India. Relative efficacy three grasses viz., kash grass (Saccharum spontaneum L.), sabai grass (Eulaliopsis binata C.E. Hubb (Retz.)) and lemon grass (Cymbopogon citrates Stapf.) was tested by using each of them either as whole substrate or in combination with the conventional substrate i.e., paddy straw in 3:1, 1:1, and 1:3 ratios. Results revealed that the maximum yield of mushroom was recorded under paddy straw with biological efficiency of 85.9%. However, no significant difference in yield was found when 25% or 50% of the conventional substrate (paddy straw) was replaced by lemon grass and sabai grass. The results indicated that grasses which are available in plenty in the forests and wastelands of lateritic uplands of eastern India can be utilized successfully as promising substrate for the commercial cultivation of Pleurotus sajor caju.

Influence of Soil Ameliorants, Manures and Fertilizers on Bacterial Populations, Enzyme Activities, N Fixation and P Solubilization in Peanut Rhizosphere under Lateritic Soil.

The aim of this study was to investigate relative efficacy of different organic wastes like farmyard manure (FYM) and water hyacinth (WH) and industrial wastes like paper factory sludge (PFS) on balancing with chemical fertilizers (CF) along with soil ameliorants viz., lime (L) or rice husk ash (RHA), another industrial waste, on dry matter production and biological properties of the rhizosphere soil of peanut (Arachis hypogaea), grown as intercrop with sabai grass (Eulaliopsis binata) in acid lateritic soil. Population of symbiotic nitrogen fixing and phosphorus solubilizing bacteria, activity of dehydrogenase and phosphatase enzymes (i.e. acid and alkaline phosphomonoesterases), nitrogen accumulation in nodules and phosphorus solubilizing power of rhizosphere soil were measured after 25, 50, 75 and 100 days after sowing (DAS) of peanut for two years. Results showed significant effects of nutrient sources and growth stages of the crop on the microbial activities. Higher values of all the biological properties and plant growth parameters were recorded significantly under the integrated application of CF and any of the organic or industrial wastes over sole application of CF. Among three organic or industrial wastes WH was superior to others regarding microbial activities at 25 DAS, whereas PFS became superior at 50, 75 and 100 DAS. Application of lime or RHA improved the activity of dehydrogenase and alkaline phosphomonoesterase enzymes, while decreased acid phosphomonoesterase activity. This study revealed that integrated application of organic or industrial wastes, soil ameliorants and inorganic fertilizer, could improve the biological properties of an acid lateritic soil as well as the dry matter production of peanut, intercropped with sabai grass under lateritic soil.

Mycobacterium avium intracellularae complex associated extrapulmonary axillary lymphadenitis in a HIV-seropositive infant--a rare case report.

Opportunistic infections by Mycobacterium avium intracellulare complex in HIV infected patients, though common in adults, are rarely seen in infants. We herewith report an interesting case of an eight month old infant presenting with isolated axillary lymphadenitis, later on diagnosed to be tubercular lymphadenitis by Mycobacterium avium intracellulare and finally proved to be seropositive for HIV infection born to previously undetected HIV seropositive parents.

Serum lipid response to introducing ghee as a partial replacement for mustard oil in the diet of healthy young Indians.

Ghee (clarified butter) has generally been assumed to be hypercholesterolaemic on the basis of its composition but there is hardly any study to support or refute the assumption. The present study was conducted on sixty-three healthy, young, physically active adult volunteers (52 male, 11 female). The study design was that of a randomized controlled trial with a parallel design. After a lead-in period of 2 wk, the subjects were randomly divided into two groups, Group A (n = 30; 25 male, 5 female) and Group B (n = 33; 27 male, 6 female). Group A (experimental) consumed for 8 wk a diet in which ghee provided 10% of the energy intake. The only other visible fat in the diet was mustard oil, and total energy from fats was 25% of the energy intake. Group B (control) consumed for 8 wk a similar diet except that all visible fat came from mustard oil. The serum total cholesterol level showed a significant rise in the experimental group at 4 wk; the rise persisted at 8 wk. A similar rise was also seen in HDL cholesterol. Hence the total cholesterol/HDL cholesterol ratio did not show any significant change. In the control group, there was a trend towards a fall in LDL cholesterol but the change was not significant. The study does not indicate any adverse effect of ghee on lipoprotein profile. However, more studies are needed on older subjects, hyperlipidaemic subjects, and on subjects following less healthy lifestyles before the results of this study can be extrapolated to the general population.

The effect of ingestion of egg on the serum lipid profile of healthy young Indians.

Thirty four healthy young volunteers (22 men, 12 women; age 25.7 +/- 5.8 years; BMI 20.8 +/- 2.3 kg/m2) participated in a randomized controlled cross-over trial on the effect of consuming one boiled egg every day for 8 wk on the serum lipid profile. The only significant change after 8 wk of egg consumption was an elevation of the total cholesterol/HDL cholesterol ratio. However, scrutiny of individual responses revealed that twelve of the subjects (10 men, 2 women) had a greater than 15% rise in the LDL cholesterol level after 8 wk of egg consumption. These subjects, considered hyperresponders, showed significant increases (P < 0.025) at both 4 wk and 8 wk after egg consumption in total cholesterol and LDL cholesterol levels, and at 8 wk in total cholesterol/HDL cholesterol ratio. The remaining 22 hyporesponders showed no change in any of the variables measured at 4 wk or 8 wk after egg consumption. In view of the high nutritional value of eggs, a blanket ban on eggs is not justified. However, since up to one-third of the population may be hyperresponders, knowing the response of an individual is important before making the egg a regular item of the diet.

Avian influenza a (H5N1): A preliminary review.

Humanity has been at the receiving end of many viral diseases since ages. Sudden emergence and re-emergence of new viral diseases in human beings has surprised the medical scientists from time to time. "Avian influenza" or "Bird flu" by H5N1 epidemics is one such surprise. Although many aspects about this disease are clear, there are some dark areas regarding vaccine development that need to be further explored and understood, so as to effectively contain the spread of this disease. The present article details out almost everything known about this interesting disease along with the review of the recent literature.

The effect of ingestion of egg on serum lipid profile in healthy young free-living subjects.

Egg is a major source of dietary cholesterol. Previous studies on the effect of egg on serum lipid profile have given conflicting results. Further, the serum lipid response to egg shows marked individual variation. Since the variation is at least partly genetically determined, and the response depends partly on the overall diet, studies on different ethnic groups are important. There is hardly any study on the subject available on Indians. In the present investigation, eighteen healthy young volunteers (7 male, 11 female) on a lacto-vegetarian diet were given one boiled egg per day for 8 wk in a randomized controlled cross-over study. Compared to the values obtained after 8 wk of egg-free period, the mean serum total cholesterol, LDL cholesterol, HDL cholesterol, total cholesterol/HDL ratio, VLDL cholesterol and triglycerides were not significantly different after 8 wk of egg consumption. However, the serum total cholesterol after 4 wk of egg consumption was significantly higher than the control values. Further, seven subjects out of 18 had an appreciable elevation of serum total cholesterol or LDL cholesterol, or both, after 8 wk of egg consumption. The study suggests that in young healthy Indian subjects on a vegetarian diet, consuming one egg per day raises serum cholesterol levels at 4 wk but in the majority baseline values are restored by 8 wk. However, some hyper-responders continue to have elevated serum cholesterol even at 8 wk. Knowing the response of an individual may be important before making egg consumption a regular habit.

Effect of partial replacement of visible fat by ghee (clarified butter) on serum lipid profile.

A randomised controlled trial with a parallel design was conducted on 24 healthy young volunteers who were divided into two groups. After a lead-in period of 2 wk, the experimental group (n = 11; 9 male, 2 female) had for 8 wk a lactovegetarian diet providing about 25% of the energy intake in the form of fat, of which ghee provided 10 en% and the remaining fat energy came from mustard oil and invisible fat. The control group (n = 13; 8 male, 5 female) had a similar diet except that all visible fat was in the form of mustard oil. In neither group was there any significant change in the serum lipid profile at any point in time. At 8 wk, 2 volunteers in the experimental group, and 1 volunteer in the control group had more than 20% rise in serum total cholesterol as compared to their 0 wk values. There was also an appreciable increase in HDL cholesterol at 8 wk in the experimental group, but it was not statistically significant. Consuming ghee at the level of 10 en% in a vegetarian diet generally has no effect on the serum lipid profile of young, healthy, physically active individuals, but a few individuals may respond differently.

Further biochemical characterization of Mycobacterium leprae laminin-binding proteins

It has been demonstrated that the alpha2 chain of laminin-2 present on the surface of Schwann cells is involved in the process of attachment of Mycobacterium leprae to these cells. Searching for M. leprae laminin-binding molecules, in a previous study we isolated and characterized the cationic proteins histone-like protein (Hlp) and ribosomal proteins S4 and S5 as potential adhesins involved in M. leprae-Schwann cell interaction. Hlp was shown to bind alpha2-laminins and to greatly enhance the attachment of mycobacteria to ST88-14 Schwann cells. In the present study, we investigated the laminin-binding capacity of the ribosomal proteins S4 and S5. The genes coding for these proteins were PCR amplified and their recombinant products were shown to bind alpha2-laminins in overlay assays. However, when tested in ELISA-based assays and in adhesion assays with ST88-14 cells, in contrast to Hlp, S4 and S5 failed to bind laminin and act as adhesins. The laminin-binding property and adhesin capacity of two basic host-derived proteins were also tested, and only histones, but not cytochrome c, were able to increase bacterial attachment to ST88-14 cells. Our data suggest that the alanine/lysine-rich sequences shared by Hlp and eukaryotic H1 histones might be involved in the binding of these cationic proteins to laminin

Gastro-intestinal effects of Indian spice mixture (Garam Masala).

Spices are a part of diet all over the world but the variety and quantity consumed in tropical countries is particularly significant. The intestinal transit time of Indians is shorter, and their stool weight larger than that of Europeans on a comparable fibre intake. Ingestion of chilli is associated with a faster whole gut transit time. There is hardly any human work on the effects of spices on intestinal transit or gastric emptying. To explore the effects of spices on gastro intestinal transit this study was conducted on 18 well nourished healthy human adult volunteers using Radiolabelled Idli with or without Garam Masala. On gastric scintigraphy the gastric emptying time was much faster in subjects when spicy meal was given. The t1/2 of the spicy meal, 40.09 +/- (p < 0.05) thus implying a faster transit through the stomach. In 17 out of the 18 subjects t1/2 of the spicy meal was consistently lower than that of spicefree meal. The lag phase of gastric emptying showed no significant difference. There was a tendency towards slower gastrocolic transit with Spicefree meal but more subjects need to be done to confirm this.