Prevailing practice patterns in keratoconus among Indian ophthalmologists

Objective: The past few years have seen a rapid advancement in the management of keratoconus (KC). However, there is no prescribed standard of care for the management of KC. This study evaluated the prevailing practice patterns among Indian ophthalmologists in the diagnosis and treatment of KC via an online survey. Methods: This was a survey?based cross?sectional study in which a questionnaire (Supplement 1) was created. Questions pertaining to the practicing experience, setting of practice, and training background were asked in addition to the investigations done and decision making in KC management. Responses were collected via Survey Monkey (Survey Monkey, Palo Alto, California, USA) and statistical analysis performed using R software (4.1.3). Results: The survey was answered by 273 ophthalmologists. Pentacam was the most used topographer (195 users), followed by Orbscan (41 users), Sirius (34 users), and Galilei (3 users). The lowest limit of pachymetry for performing collagen crosslinking (CXL) was 400? for most practitioners. More than half the respondents (50.55%) did not perform photorefractive keratectomy (PRK) or intracorneal ring segment (ICRS) implantation in a suitable patient. Accelerated 10?minute protocol (9 mW/cm2 for 10 minutes) was the most commonly (54.21%) used for CXL, followed by Dresden protocol (3 mW/cm2 for 30 minutes) (36.63%). When a patient was unsuitable for CXL, 55.31% surgeons advise contact lens (CL) trial, 35.16% surgeons advise keratoplasty, 26.74% surgeons perform stromal augmentation, and 7.69% surgeons advise spectacle correction. Corneal scar was the most common indication (49.45%) for performing keratoplasty. Conclusion: Topography remains the most used diagnostic modality for initial diagnosis. Optical coherence tomography and epithelial mapping are increasingly being used for early diagnosis of KC. Not all ophthalmologists were comfortable performing ICRS or PRK. When patients are unsuitable for CXL, CL trial remains the most frequently advised option followed by keratoplasty.

Overall and Event Free Survival of Childhood Cancer - Report From a Hospital-based Cancer Registry in Northern India, 2013-21

Objectives: Using data from a hospital-based cancer registry (HBCR) in the private sector in Northern India, we provide overall survival (OS) and event-free survival (EFS) for childhood cancer patients. Methods: All newly diagnosed childhood (age <18 years) cancer patients in our HBCR registered between March 1, 2013 till July 31, 2021 were eligible. 3-year and 5-year OS (death was an event), EFSc (death, progression/relapse was an event), and EFSa (death, progression/relapse, abandonment of treatment was an event) were calculated using the Kaplan-Meier method. Regression analysis was done to see their association with demographic, diagnostic and treatment variables. Results: 705 newly diagnosed children (36.2% female) with cancer were registered. Common cancers were leukemias (26%), CNS tumors (20%) and bone tumors (16%). 202 (28.6%) had experienced an event at median follow up of 1.95 years (range 0-8.14 years), which included 23 (3.3%) who abandoned treatment. The 3- year OS, EFSc, EFSa were 70.8%, 64.4% and 63.6%, respectively. Correspondingly, 5-year OS, EFSc, EFSa were 66%, 58.6% and 57.5%, respectively. There was no significant difference by age group, gender, nationality, and if cancer directed treatment initiated elsewhere. The OS, EFSa and EFSc by the main and the extended International Childhood Cancer Classification categories varied significantly (P<0.001). Conclusion: We add more recent registry-based OS data on childhood cancer in India and present the first estimates on EFS.

Histopathological spectrum of adult renal tumours: A single center experience and review of literature

Background: Renal tumors constitute approximately 3% of all malignancies in adults. They form a heterogenous group with variable morphological, immunohistochemical, and molecular features. Aim: The objective of this study was to analyze the spectrum of adult renal tumors at a tertiary care center and study the demographic and histomorphological features. Materials and Methods: In this study, 55/87 nephrectomy specimens resected for adult renal tumors during a 1-year period were analyzed retrospectively. Results: There were 4 benign (7.2%) and 51 (92.7%) malignant tumors. There was a male preponderance with a male: female ratio of 3.42:1. The tumors were seen to occur equally in both kidneys. The most common tumor was clear cell renal cell carcinoma (RCC), the conventional type accounting for 65.5% of our study group. There were one each of multilocular cystic renal neoplasm of low malignant potential, papillary RCC, chromophobe RCC, Mit family RCC, oncocytoma and angiomyolipoma and two clear cell papillary RCC during this 1-year period. Uncommon tumors included neuroendocrine carcinoma (1), epithelioid angiomyolipoma (1), mixed epithelial stromal tumor (1), Ewings sarcoma (2), and glomangioma (1). Five cases of urothelial carcinoma of renal pelvis/ureter also were present. Conclusion: This article gives an overview of the spectrum of adult renal tumors at a tertiary care center with an in-depth literature review providing recent advances in each category of tumors.

Integrating Role of Immunity in Cancer: Journey from Immune Surveillance to Tumour Escape

Cancer immunoediting is crucial to understand the success or failure of a tumor. Immune system plays dual roles in tumor development and progression, promoting or suppressing tumor depending on tumor microenvironment and the events that lead to initiation of carcinogenesis. The immune system has potential to recognize and destroy tumors, and thus function as a primary defense mechanism against cancer. On the other hand, unresolved immune responses can result in the growth and progression of cancer. Objectives: The host immune system determines tumour fate in three phases (Elimination, Equilibrium and Escape) and ac- cording to this theory, it blocks adaptive and innate tumour responses or promotes conditions that favour tumour progression. Conclusion: The purpose of this review is to emphasise the importance of immunity in tumour promotion and suppression.

Scleral thickness in normal Indian eyes measured using spectral domain anterior segment optical coherence tomography

Purpose: To establish normative data on anterior scleral thickness using the spectral domain anterior segment optical coherence tomography (AS?OCT). Methods: In total, 200 eyes of 100 healthy subjects underwent AS?OCT scans in the temporal and nasal quadrants. The scleral + conjunctival complex thickness (SCT) was measured by a single examiner. Mean SCT was analyzed for differences across age groups, gender, and location (nasal versus temporal). Results: Mean age was 46.4 ± 18.3 (21–84) years; male to female ratio was 54:46. Mean SCT (nasal + temporal) of the right eye (RE) was 682.3 ± 64.2 ?m in males and 660.6 ± 57.1 ?m in females. In the left eye (LE), it was 684.6 ± 64.9 ?m in males and 661.8 ± 49.3 ?m in females. These differences between male and female for both eyes were statistically significant (P = 0.006 and P = 0.002). The mean SCT of temporal and nasal quadrants in the RE was 678.54 ± 57.50 and 666 ± 66.2 ?m, respectively. In the LE, the temporal mean SCT quadrant was 679.6 ± 55.8 ?m, and the nasal was 668.6 ± 63.6 ?m. Age had a negative correlation with SCT (?0.62 ?m/year; P = 0.03), and males had a higher temporal SCT than females (22 ?m higher; P = 0.03). After adjusting for age and gender in a multivariate analysis, temporal SCT was significantly (P < 0.001) higher than nasal SCT. Conclusion: In our study, mean SCT decreased with age and males had a higher temporal SCT. This is the first study to evaluate scleral thickness in the Indian population, and the data can be used as a baseline for comparing variations in scleral thickness in disease.

A series of fetal reductions and their outcomes at a tertiary care center in North Karnataka: Fetal reduction series: A boon?

Fetal reduction is a novel method that aims to reduce a higher-order gestation to lower-order pregnancy to reduce both maternal and perinatal adverse outcomes. One of the methods of fetal reduction is by intracardiac injection of KCl under ultrasound guidance. Here, we present a case series ofeight women who had undergone fetal reduction. All of them were trichorionic triamniotic triplets at the time of reduction. In seven women, the reduction was done to twin gestation, whereas one reduction was to singleton pregnancy. Out of eight cases, only one carried to full term and underwent vaginal delivery. One case was lost to follow-up and 2 women underwent expulsion. A total of nine live births were reported with 8 babies going to the neonatal intensive care unit for low birth weight and preterm care. Fetal reduction is an important method that needs to be widely practiced and reported to improve maternal and perinatal outcomes in multifetal gestation.

STABILITY TOLERANCE OF SUNFLOWER OIL -IN-WATER EMULSION EMULSIFIED BY SOYA LECITHIN FOR FOOD GRADE ACIDS

Oil-in-water emulsion has promised values in food, pharmaceutical, drug, cosmetic and allied industries. The stable emulsion with long shelf life increases its utility. Many avouring agents are used to increase shelf life as preservative or commercial value. Food grade acids are used to in the emulsion preparation which enhances the taste or avour. The present study focuses the usage of acetic acid, phosphoric acid and oxalic acid. The emulsions for different acids are prepared ranging concentration from 0.001 to 0.003M using lecithin as emulsier and sunower oil. Experiments were done to study organoleptic properties with respect to basicity and dissociation constant values. The colour of the primary emulsion was creamy white and sustainable for acetic acid emulsion to 28 day at experimental temperature 10, 25 and 40 0C. Oxalic acid is recorded a low pH value 1.88 for 0.003 M emulsion solution in compare with acetic acid (3.63) and phosphoric acid (2.32).The relative conductance measurement for oxalic acid shows a very high value 5.6mS to acetic acid 0.257mS and phosphoric acid 0.247 mS. The rst dissociation constant value 5.6x10-2 of oxalic acid is larger relatively compare to phosphoric acid 7.5 x 10-3 and acetic acid 1.8 x10-5. Basicity of acids increases from acetic acid (mono basic), oxalic acid (dibasic) to phosphoric acid (tri-basic).These results strongly supports that basicity and dissociation constant values of acids conspicuously inuence the stability of the emulsion. Higher value of dissociation constant value and basicity, lower the stability of the emulsion.

Management of corneal perforations in dry eye disease: Preferred practice pattern guidelines

Corneal perforations in eyes with dry eye disease (DED) are difficult to manage due to the interplay of several factors such as the unstable tear film, surface inflammation, and the underlying systemic disease affecting the wound healing process, and the eventual outcome. A careful preoperative examination is required to identify the underlying pathology, and status of ocular surface and adnexa, rule out microbial keratitis, and order appropriate systemic workup in addition to assessing the perforation itself. Several surgical options are available, which include tissue adhesives, multilayered amniotic membrane grafting (AMT), tenon patch graft (TPG), corneal patch graft (CPG), and penetrating keratoplasty (PK). The choice of procedure depends upon the size, location, and configuration of the perforation. In eyes with smaller perforations, tissue adhesives are effective treatment modalities, whereas AMT, TPG, and CPG are viable options in moderate-sized perforations. AMT and TPG are also preferable in cases where the placement of a bandage contact lens may be a challenge. Large perforations require a PK, with additional procedures such as tarsorrhaphy to protect the eyes from the associated epithelial healing issues. Conjunctival flaps are considered in eyes with poor visual potential. The management of the acute condition is carried out in conjunction with measures to improve the tear volume bearing in mind the chances of delayed epithelialization and re-perforation in these cases. Administration of topical and systemic immunosuppression, when indicated, helps improve the outcome. This review aims to facilitate clinicians in instituting a synchronized multifaceted therapy for the successful management of corneal perforations in the setting of DED.

Management of cataract in dry eye disease: Preferred practice pattern guidelines

Cataract surgery is one of the most commonly performed ophthalmic surgeries in the world. Dry eye disease (DED) is found to coexist in most patients with cataracts due to the overlapping age groups of both these conditions. Preoperative evaluation for DED is important to improve outcomes. A pre-existing DED affecting the tear film is likely to affect biometry. Moreover, special intraoperative considerations are needed in eyes with DED to reduce complications and improve postoperative outcomes. Dry eye disease (DED) is known to occur following an uneventful cataract surgery or a pre-existing DED is likely to worsen following cataract surgery as well. In these situations, despite a good visual outcome, patient dissatisfaction is common owing to the distressing DED symptoms. This review aims to summarize the preoperative, intraoperative, and postoperative considerations when performing cataract surgery in the presence of a coexisting DED.

A study on correlation of computer vision syndrome and dry eye disease and knowledge regarding its associated factors amongst health professionals

Purpose: To know the magnitude and determinants of dry eye syndrome among health professionals and to study the correlation of computer vision syndrome with dry eye disease. Methods: In total, 501 participants took part in the study, which included history followed by baseline ocular examination, which included visual acuity using Snellen’s chart and anterior segment examination using a slit lamp. Later, a questionnaire was administered to health professionals to be filled out for analysis in the present study. Results: The symptoms reported occasionally were burning (35.5%), itching (34.5%), foreign body sensation 22.6%, and tearing (35.3%). The majority of participants used mobiles and laptops (56.1%) as a display. Also, 53.3% of participants have heard about dry eye syndrome, and the source of information was from friends and doctors in 17% of participants. One hundred twenty?one participants (24.2%) had taken the consultation for ocular symptoms. Eighty?six participants had mild, 29 participants had moderate, and 6 participants had severe dry eye disease, respectively. Conclusion: The pandemic effect, and the drastic shift of educational media from the classroom to the digital platform have increased the use of mobiles, laptops, or other digital pads for learning. This has increased the risk for health professionals.

Dermoscopic features of basal cell carcinoma in skin of color: A retrospective cross-sectional study from Puducherry, South India

Background: Dermoscopy is useful in the diagnosis of basal cell carcinoma (BCC). However, most descriptions of the dermoscopic features of BCCs are in Caucasians (skin types I-III) and there is a paucity of data in dark-skinned Indian patients. Aims: The aim of this study was to describe the various dermoscopic features of BCC in dark-skinned patients from South India and correlate these with the histopathologic subtypes. Methods: A retrospective observational study of biopsy-proven cases of BCC was conducted at a tertiary care center in South India using nonpolarized contact dermoscopy. Results: Sixty BCCs in 35 patients predominantly of skin phototypes IV or V were studied. These included 32 nodular, 27 superficial and 1 infiltrative type of BCC. The most common dermoscopic features noted were maple leaf-like areas (61.7%), blue-white veils (53.4%), ulceration (48.4%) and short fine telangiectases (46.7%). Ulceration, blue-white veils and arborizing vessels were significantly associated with nodular BCCs, while maple leaf-like areas, red-white structureless areas, multiple small erosions and spoke wheel areas were noted with superficial BCCs. Limitations: The limitations of this study include its retrospective nature, the use of only nonpolarized light for examination, the lack of other histopathological variants of BCC as well as the lack of a comparison group. Conclusion: We report a dermoscopic study of BCC in dark-skinned patients from Puducherry, South India. The blue-white veil was observed in half of the patients and was significantly associated with nodular BCCs. The addition of the blue-white veil to the diagnostic criteria for pigmented BCC could improve the diagnostic accuracy of dermoscopy in Indian patients.

Formulation and Evaluation of Orodispersible Tablet Containing Combination of Phosphodiesterase-5 Inhibitor and Herbal Aphrodisiac

Purpose: Sildenafil citrate is widely used drug for the treatment of Erectile Dysfunction (ED) and Ginseng is a natural aphrodisiac reported to benefit this condition. The objective of the present study was to develop orodispersible tablets (ODTs) containing combination of Sildenafil citrate and Ginseng extract to improve the bioavailability, reduce the dosing frequency and thereby maintaining the therapeutic efficacy of the drug. Methods: The ODTs were prepared using superdisintegrants such as Croscarmellose sodium (CCS), povidone, and sodium starch glycolate (SSG) at varying concentrations (2%, 4% and 6%) by direct compression. The bitter taste of Sildenafil citrate was masked by Doshion resin. The optimized formulation based on least disintegration time (DT) was chosen to reformulate using sublimating agents such as camphor, menthol or thymol at varying concentrations (1%, 2%, 3%) to further reduce the DT. The compatibility of drug with excipients was investigated and the prepared formulations were evaluated for pre and post-compression parameters. Results: The post-compression parameters such as weight variation, hardness, friability, DT and in-vitro drug release was found within specified limit. The formulation with camphor (2%) had DT of 12 sec and drug release >90% within 5 min hence was considered as optimized formulation. The accelerated stability study and kinetics modelling was performed for optimized formulation. Conclusion: The formulated Sildenafil citrate and Ginseng ODT’s were found to be promising formulation with quicker DT and drug release which will eventually have higher bioavailability and better efficacy along with averting the issues of swallowing and improving patient compliance.

Differential gene expression analysis in germinating and dormant teliospores of Tilletia indica using RNA seq approach

Karnal bunt of wheat is an important quarantine disease that interrupts India’s wheat trade in the international market. The whole transcriptome of germinating and dormant teliospores of Tilletia indica was performed using the RNA Seq approach to identify germination-related genes. Approximately 63 million reads were generated using the RNA sequencing by the Illumina NextSeq500 platform. The high-quality reads were deposited in NCBI SRA database (accession: PRJNA522347). The unigenes from the pooled teliospores were 16,575 having unigenes length of 28,998,753 bases. The high-quality reads of germinating teliospores mapped on to 21,505 predicted CDSs. 9,680 CDSs were common between dormant and germinating teliospores of T. indica. 11,825 CDSs were found to be in germinating teliospores while only 91 were unique in dormant spores of pathogen. The pathway analysis showed the highest number of pathways was found in germinating spores than dormant spores. The highest numbers of CDSs were found to be associated with translation (431 in number), transport and catabolism (340), signal transduction (326), and carbohydrate metabolism (283). The differential expression analysis (DESeq) of germinating and dormant teliospores showed that 686 CDS were up-regulated and 114 CDS were down-regulated in the germinating teliospores. Significant germination-related genes in the spores were validated using qPCR analysis. Ten genes viz. Ti3931, Ti6828, Ti7098, Ti7462, Ti7522, Ti 9289, Ti 8670, Ti 7959, Ti 7809,and Ti10095 were highly up-regulated in germinated teliospores which may have role in germination of spores.Further, these differentially expressed genes provide insights into the molecular events. This first study of transcriptome will be helpful to devise better management strategies to manage Karnal bunt disease.

Challenges of Second-hand Smoke: Are We Asking the Right Questions?

Second-hand tobacco smoke as defined by WHO is the smoke emitted by a smoker or released from a burnt cigarette or any tobacco product. It is highly prevalent all over the globe but its serious health implications are often neglected by the public and the scientific community alike. Second-hand smoke has everlasting impact on all the body’s major organs, especially among the vulnerable population of children, pregnant ladies, people with chronic diseases and senior citizens. Although India started its war against this menace earlier than other counties, all its efforts remain bootless as its approach and implementation have a wide range of lacunae. This review aims to give a big picture of second-hand smoke, highlighting its pathophysiological changes in the body, socioeconomic impact, various strategies, and the gap that prevents these strategies from finding a favorable result in India. It becomes all the more important to reduce its impact owing to the increase in prevalence among youth reducing their vitality, derailing the society and the nation. It is recommended that the health authorities approach this health problem with utmost seriousness as a laid-back approach could welcome this silent killer’s known and unknown repercussions

Social determinants of diabetic retinopathy and impact of sight-threatening diabetic retinopathy: A study from Pune, India

Purpose: Diabetes?related retinopathy is the leading cause of blindness in India. The study was carried out with the purpose of studying the association of sight?threatening diabetic retinopathy (STDR) with socioeconomic factors and demonstrating the impact of STDR on the affected individual. Methods: A mixed methods (quantitative and qualitative) research design was used. The study participants were divided into two groups for quantitative analysis. The control group consisted of non–sight?threatening diabetic retinopathy, whereas the study group consisted of sight?threatening diabetic retinopathy. Apart from demographics, data on comorbidities, type and duration of diabetes mellitus (DM), health insurance status, and socioeconomic data were collected from each individual. A statistical test (Chi?square) was performed to study the association between socioeconomic (SE) classes and STDR. For the qualitative part, a few people were chosen. Face?to?face interviews were conducted in depth. Results: A total of 207 individuals, were recruited, of which 69 had STDR and the remaining 138 had non?STDR. The incidence of STDR was high among patients with lower socioeconomic class (SEC) (upper lower and lower), and univariate analysis revealed a strong association between STDR and SEC, the presence of comorbidities, presence of health insurance, type and duration of DM, and P value <0.05. SEC, in contrast, emerged as an independent risk factor for STDR in multivariate analysis. STDR had a devastating effect on all patients interviewed. The financial impact was most likely the most severe. Conclusion: People with lower SEC are more likely to suffer from STDR?related vision loss. The impact of such vision loss on individuals is multifaceted, including a negative impact on social and work life, psychological well?being, and, most importantly, a significant financial impact.

A Delphi consensus on the nomenclature and diagnosis of lichen planus pigmentosus and related entities

Background: Although well known in clinical practice, research in lichen planus pigmentosus and related dermal pigmentary diseases is restricted due to lack of consensus on nomenclature and disease definition. Aims and Objectives: Delphi exercise to define and categorise acquired dermal pigmentary diseases. Methods: Core areas were identified including disease definition, etiopathogenesis, risk factors, clinical features, diagnostic methods, treatment modalities and outcome measures. The Delphi exercise was conducted in three rounds. Results: Sixteen researchers representing 12 different universities across India and Australia agreed to be part of this Delphi exercise. At the end of three rounds, a consensus of >80% was reached on usage of the umbrella term ‘acquired dermal macular hyperpigmentation’. It was agreed that there were minimal differences, if any, among the disorders previously defined as ashy dermatosis, erythema dyschromicum perstans, Riehl’s melanosis and pigmented contact dermatitis. It was also agreed that lichen planus pigmentosus, erythema dyschromicum perstans and ashy dermatosis did not differ significantly apart from the sites of involvement, as historically described in the literature. Exposure to hair colours, sunlight and cosmetics was associated with these disorders in a significant proportion of patients. Participants agreed that both histopathology and dermatoscopy could diagnose dermal pigmentation characteristic of acquired dermal macular hyperpigmentation but could not differentiate the individual entities of ashy dermatosis, erythema dyschromicum perstans, Riehl’s melanosis, lichen planus pigmentosus and pigmented contact dermatitis. Limitations: A wider consensus involving representatives from East Asian, European and Latin American countries is required. Conclusion: Acquired dermal macular hyperpigmentation could be an appropriate conglomerate terminology for acquired dermatoses characterised by idiopathic or multifactorial non-inflammatory macular dermal hyperpigmentation

Commentators View on Medicinal Plants of Sushrutokta Salsaradi Gana Regarding their Controversial Botanical Identity: A Review

Sushruta Samhita is one of the foundational literature included in the Brihat traiye literatures of Ayurveda. Out of 37 different Ganas mentioned in Sutra Sthana of Sushruta Samhita, Dravya-sangrahaniya-adhyaya; Salsaradi-gana is one of them in which 23 medicinal plants have been described. Classically Salsaradi-gana is clinically indicated for Kushta (skin diseases), Prameha (diabetes mellitus), Pandu (anemia), and Kapha-medo-vishoshana (anti-hyperlipidaemic) disease. For this study, a review of the original commentary of Acharya Dalhana and Acharya haranchandra on Sushruta Samhita and the scientific research papers published on the medicinal plants listed in the Salsaradi-gana of Sushruta Samhita in indexed journals is done. Out of 23 medicinal plants mentioned 8 plants have controversial identification. The controversy in the identification of these medicinal plants is seen directly affecting the pharmacological action and clinical efficacy. Those 8 plants’ controversial identity is cleared with the establishment of a genuine plant for each of the plants through scientific and classical justification.

Challenges faced by frontline health managers during the implementation of COVID-19 related policies in India: A qualitative analysis

Background & objectives: The COVID-19 pandemic exposed the strengths and weaknesses of the healthcare systems across the world. Many directives, guidelines and policies for pandemic control were laid down centrally for its implementation; however, its translation at the periphery needs to be analyzed for future planning and implementation of public health activities. Hence, the objectives of this study were to identify the challenges faced by frontline health managers in selected States in India during the pandemic with regard to implementation of the COVID-19-related policies at the district level and also to assess the challenges faced by the them in adapting the centrally laid down COVID-19 guidelines as per the local needs of the district. Methods: A qualitative study using the grounded theory approach was conducted among frontline district-level managers from eight different States belonging to the north, south, east and west zones of India. The districts across the country were selected based on their vulnerability index, and in-depth interviews were conducted among the frontline managers to assess the challenges faced by them in carrying out COVID-19 related activities. Recorded data were transcribed verbatim, manually coded and thematically analyzed. Results: Challenges faced in implementing quarantine rules were numerous, and it was also compounded by stigma attached with the disease. The need for adapting the guidelines as per local considerations, inclusion of components of financial management at local level, management of tribal and vulnerable populations and migrants in COVID context were strongly suggested. The need to increase human resource in general and specifically data managers and operators was quoted as definite requirement. Interpretation & conclusions: The COVID-19 guidelines provided by the Centre were found to be useful at district levels. However, there was a need to make some operational and administrative modifications in order to implement these guidelines locally and to ensure their acceptability.

The relationship between MMP-2 rs243865, MMP-9 rs398242 and CXCL-12 rs1801157 gene polymorphisms with Japanese encephalitis disease and disease outcome in North Indian population

Background & objectives: Japanese encephalitis virus (JEV) is one of the most important causes of acute and uncontrolled inflammatory disease in Asia. Matrix metalloproteinases (MMPs) and chemokines play a detrimental role in the host response to JE disease, aetiology, and disease outcome. Evidently, MMPs are widely circulated in the brain and regulate various process including microglial activation, inflammation, blood-brain barrier disruption as well as affects central nervous system (CNS). The present study was to assess the association of single nucleotide polymorphisms of MMP-2, MMP-9 and chemokine (CXCL-12/SDF1-3’) in the north Indian population. Methods: We performed case-control study comprising of 125 patients and 125 healthy controls in north Indian population. Genomic DNA was extracted from whole blood and gene polymorphism have been determined by PCR-RFLP method. Results: MMP-2, MMP-9 and CXCL-12 gene was not significantly associated with JE disease, but homozygous (T/T) genotype of MMP-2 was statically associated with disease outcome (p=0.05, OR=0.110). A/G and G/G genotype of CXCL-12 was significantly associated with severity of disease. (p=0.032, OR=5.500, p=0.037, OR= 9.167). The serum level of MMP-2 was observed significantly increased in JE patients with homozygous (T/T) genotype whereas increased MMP-9 level was associated with heterozygous genotype. Interpretation & conclusion: MMP-2, MMP-9 and CXCL-12 gene polymorphism were not associated with JE susceptibility, but MMP-2 may be contributed to disease protection. CXCL-12 was associated with disease severity. In our concern this is the first report from northern India.

Chemical constituents and strong larvicidal activity of Solanum xanthocarpum among selected plants extracts against the malaria, filaria, and dengue vectors

Background & objectives: The role of mosquitoes is instrumental in the transmission of various diseases. Mosquitoeborne diseases account for a significant share of the global burden of total infectious diseases. Vector control is the principal method for the control of these mosquito-borne diseases. Plant-derived insecticides serve as an effective alternative to chemical insecticides. The present study has been undertaken to assess the larvicidal potential of methanol and petroleum ether extracts of leaves of Solanum xanthocarpum, Parthenium hysterophorus, Manihot esculenta, and Chamaecyparis obtusa. Methods: Larvicidal activity was tested against the early four-stage instar larvae of laboratory-reared susceptible strains of the malaria vector, Anopheles stephensi, dengue fever vector, Aedes aegypti, and the lymphatic filariasis vector, Culex quinquefasciatus at 20 to 120 ppm concentrations. Further, liquid chromatography-mass spectrometry (LC-MS) and gas chromatography-mass spectroscopy (GC-MS) analyses were carried out to identify the bioactive compounds present in the methanolic leaf extracts of Solanum xanthocarpum for designing a larvicidal product in future. Results: After 72 h of exposure high larvicidal activities were observed in methanolic and petroleum ether leaves extract of S. xanthocarpum against An. stephensi, Ae. aegypti and Cx. quinquefasciatus. The larvicidal activities for methanol and petroleum ether leaf extract of S. xanthocarpum with LC50 = 09.201 and 12.435 ppm and LC90 = 21.578 and 27.418 ppm for An. stephensi; LC50 = 11.450 and 10.026 ppm and LC90 = 26.328 and 22.632 ppm for Ae. aegypti and LC50 = 12.962 and 13.325 ppm and LC90 = 26.731 and 30.409 ppm for Cx. quinquefasciatus, respectively, were found to be most effective. GC-MS analysis revealed 43 compounds, amongst these phytol (13.09%), 3-allyl-2- methoxy phenol (9.55%), (9Z, 12Z)-9, 12-octadecadienoyl chloride (7.93%), linoleic acid (5.45%), alpha-tocospiro B (5.08%) and hexadecanoic acid (4.35%) were identified as major compounds. Interpretation & conclusion: Present work showed that leaf extracts of S. xanthocarpum are a source of potential natural candidate that possess several phytochemicals which can be explored further for the development of ecologically safer mosquito control products.