SARS-CoV-2 antigen detection in deceased bodies: implications for infection prevention

Background & objectives: High transmissibility of the SARS-CoV-2 has significant implications on healthcare workers’ safety, preservation, handling, transportation and disposal of the deceased bodies. The objective of this study was to detect SARS-CoV-2 antigen in nasopharyngeal samples and its implications in handling and care of COVID-19 deceased bodies. Methods: A study was conducted at a dedicated COVID-19 centre on deceased individuals from April to December 2020. Rapid antigen test (RAT) and reverse transcription (RT)-PCR was compared on all the SARS-CoV-2 positive cadavers recruited in the study. Results: A total of 115 deceased individuals were included in the study. Of these, 79 (68.7%) were male and 36 (31.3%) were female and majority were in the age group of 51-60 yr [31 (27%)]. SARS-CoV-2 antigen test was positive in 32 (27.8%) and negative in 83 (72.1%) individuals. The mean time interval between deaths to the sample collection was 13.2 h with interquartile range of eight to 20 h. Reverse transcription (RT)-PCR was used as the reference test and 24 (20.9%) cases were true positive; 93.6 per cent [95% confidence interval (CI) 88.8-98.4%] sensitivity, 45.2 per cent (95% CI 35.5-55%) specificity, 60.2 per cent (95% CI 50.6-69.8%) positive predictive value and 88.8 per cent (95% CI 82.7-95%) negative predictive value of antigen test was computed. Interpretation & conclusions: SARS-CoV-2 antigen test was positive beyond 19 h in COVID-19 deceased individuals. Antigen test was found to be highly sensitive in the deceased. Patients, suspected of having died due to COVID-19, can be screened by this method. As infectiousness of the virus in the deceased bodies cannot be directly concluded from either the antigen or RT-PCR test, yet possible transmission cannot be completely ruled out. Strict infection control measures need to be followed during the handling and clearance of COVID-19 cadavers.

Digital Competence Among Research Scholars In Relation To Their Academic Achievement And Selected Demographic Variables

In the present study digital competence and academic achievement of 100 research scholars of various streams of Punjabi University, Patiala were studied. Teachers' Digital Competence Scale by Ramkrishna (2017) was used to collect the data pertaining to the digital competence of research scholars and one demographic data sheet developed by the investigators was used to collect information about gender, stream of study, experience of research work and academic achievement. Gathered data were analyzed by using the statistical techniques. The results show that the level of digital competence of research scholars has various levels and no research scholar possess high level of digital competence. Academic achievement of research scholars has also various levels. There is no significant difference in digital competence of research scholars with regard to gender and research experience. There is significant difference in digital competence of research scholars with regard to stream of study. Research scholars from the stream of education and languages are less competent in digitalization as compared to the research scholars from the stream of engineering, management & science. Moreover, the high academic achievers are more digitally competent as compared to low academic achievers. Further, there is significant and positive relationship between digital competence and academic achievement. So we conclude that the high digital competence enhance the academic achievement.

A Comparative Clinical Study of Haritkyadi Churna Virechan and Jivantyadi Lepam in the Management of Kitibha Kustha (Psoriasis)

Patients with skin conditions frequently endure physical, emotional, and socioeconomic forms of social embarrassment. Up to 3.5% of the global total and 0.44%-2.8% of Indians suffer with the unpleasant dermatological disorder psoriasis. It is a widespread, chronic, non-infectious skin condition that can affect either sexes and affect any age, with incidence rates ranging from childhood to age one. It is characterized by well-defined, slightly elevated, dry, erythematous macules with silvery scales and a characteristic extensor distribution. In contrast to other dermatological disorders, psoriasis manifests as systemic symptoms like arthritis. The prevalence is highest in the third and fourth decades of life, when patients become unable of doing daily tasks. For some patients, social humiliation is a significant factor which leads to an increase in suicidal ideation. To raise public awareness, the 29th October has been designated as World Psoriasis Day. The Ayurvedic term for skin is "Charma" or "Twacha." Twacha is derived from the word Dhatu-twacha samvarne, which means body covering. The broad categories of Kushtha have been used to discuss all skin conditions in Ayurveda. There are two types of Kustha in Ayurveda. Mahakustha and Kshudra Kustha. Kitibha kustha belongs to Kshudra kustha.

Phytochemistry and Pharmacology of Calotropis gigantea — An update

Calotropis gigantea is a perennial herb known for its applications in traditional medicine. It has been efficiently used in Ayurveda, Unani, and Siddha medicinal systems for years. All the plant parts have been used as medicine owing to its analgesic, anthelmintic, astringent, anti-inflammatory, wound healing, sedative, anti-asthmatic, antimicrobial, antioxidant, procoagulant, hepatoprotective, hypoglycemic, and pregnancy interceptive properties. For instance, the leaves, latex, flowers, stem bark, root of the plant are used as expectorant, depilatory, in leprosy scabies of the scalp, eruptions on the body, piles, asthma, liver and spleen enlargement, and painful joint swellings. Moreover, the plant is beneficial for the treatment of various diseases including tumors, ulcers, and piles thereby providing great opportunity to be used in pharmaceutical industry for modern drug synthesis. Phytochemical constituents of the plant responsible for its pharmacological activities include alkaloids, triterpenoids, flavonoids, saponins, steroids, alcohol, fatty acids, esters of calotropeols, glycosides and proteases. Besides, there is a strong correlation between the chemical structures and therapeutic activity of C. gigantea. Therefore, present review tries to give a brief description of its phytochemical composition, ethnobotanical characteristics, and pharmacological activity.

Diagnostic Accuracy of Indian Scale for Assessment of Autism in Indian Children Aged 2-5 Years

Objective: To determine the diagnostic accuracy of Indian Scalefor Assessment of Autism (ISAA) in children aged between 2-5years.Design: Study of diagnostic accuracySetting: Tertiary level hospital, (November 2015 – November2017).Participants: A consecutive sample of 500 children withsuspected Autism (delay or regression of developmentalmilestones, delay or regression in speech, age-inappropriateunderstanding, behaviour, play and/or social interaction) wasrecruited.Procedure: Each child underwent an expert comprehensiveassessment of Autism (reference tool) that included history,observation, examination, diagnostic criteria for Autism SpectrumDisorder (ASD) of the Diagnostic and Statistical Manual of MentalDisorders’, 5th edition, Childhood Autism Rating Scale-2(CARS2), developmental status and adaptive function. This wasfollowed by the administration of ISAA (test tool) in Hindilanguage. Parameters of diagnostic accuracy and ReceiverOperating Characteristic curves were computed.Main Outcome Measures: ASD based on (i) expert assessment,(ii) CARS-2, and (iii) ISAA.Results: In children aged 2-3 years, sensitivity of ISAA was 100%(95% CI 98.2% -100%), specificity 28.9% (95% CI 17.7% to43.4%), positive likelihood ratio 1.4 and negative likelihood ratio 0.In 3-5 year olds, sensitivity was 99.6% (95% CI 97.6% to 99.6%),specificity 33.3% (95% CI 15.1% to 58.3%), positive likelihoodration 1.5 and negative likelihood ratio 0.01. The degrees ofautism based on the existing cut off values were inaccurate.Conclusions: ISAA has sub-optimal performance in diagnosingand assessing severity in 2-5 year old children.

An information, education and communication module to reduce dietary salt intake and blood pressure among tea garden workers of Assam

Objective High salt diet increases blood pressure. Tea garden workers (TGW) of Assam, India have high (60.8%) prevalence of hypertension (HTN), which may be due to consumption of extra salt (salt as side dish) and salted tea at work place and home. The present study evaluated an information, education and communication (IEC) module to reduce salt intake and blood pressure among TGW. Methods Two tea gardens (usual care and intervention) were selected at random covering a total population of 13,458. The IEC module consisting of poster display, leaflets, health rally, documentary show, individual and group discussion was introduced in the intervention garden targeting study participants, health care providers, key stake holders, school children and teachers. IEC intervention was continued for one year. Participants from usual care and intervention were followed at three monthly intervals and BP and other information were compared after one year. Results A total of 393 study participants (Non intervention: 194; intervention: 199) were included. After one year of follow up, consumption of extra salt was reduced significantly in the intervention participants (66.3 vs. 45.5%, p = 0.000). Intention to treat analysis revealed significant reduction in systolic [−6.4 (−8.6 to −4.2)] and diastolic [−6.9 (−8.1 to −5.7)] blood pressure after one year. Prevalence of HTN was reduced significantly (52.5 vs. 40.0%, p = 0.02) among them. Conclusions Our IEC module created awareness about risk of hypertension associated with high salt intake and could reduce dietary salt intake and BP.

Analysis of Retinal Nerve Fibre Layer Changes in Cases of Phacomorphic Angle Closure Post Phacoemulsification

Introduction: To investigate the retinal nerve fibre layer (RNFL) changes after an acute attack of phacomorphic angle closure. Methods: This prospective study involved 25 cases of phacomorphic angle closure that underwent phacoemulsification and intraocular lens insertion after intraocular pressure lowering. Apart from visual acuity and intraocular pressure (IOP), RNFL thickness was measured by optical coherence tomography (OCT) at 3–6 months post attack. Result: All cases had mean phacomorphic duration of <10 days. Postoperatively, best correct Snellen visual acuity was 0.42±0.23 and IOP at 6 months was 13.92 ± 2.41 mmHg. There was no difference RNFL between the attack and contralateral eye at 3 months post attack (both
p = 0.102). At 6 months post attack, there was significant thinning in the average (p <0.001), superior (p =<0.001), and inferior (p = 0.001) RNFL. Patients with <5 days duration of phacomorphic angle closure are likely to have reasonable postoperative vision. Conclusion: An acute episode of phacomorphic angle closure can trigger an accelerated RNFL thinning despite normal IOP and open angles, most noticeable in the superior and inferior quadrants, occurring between 3 and 6 months post attack. There is a need of long term follow up of such patients.

In Vitro Periodontal Ligament Cell Viability in Different Storage Media

Abstract The aim of this study was to evaluate the viability of periodontal ligament cells of avulsed teeth in three different storage media. Forty-five mature premolars extracted for orthodontic therapeutic purposes were randomly and equally divided into three groups according to the storage medium: milk (control), rice water and egg white. After placing extracted teeth for 30 min in storage media, the scrapings of the periodontal ligament (PDL) were collected in Falcon tubes containing collagenase in 2.5 mL of phosphate buffer saline and were incubated for 30 min and centrifuged for 5 min at 800 rpm. Cell viability was analyzed by Trypan blue exclusion. Rice water had a significantly higher number of viable cells compared to egg white and milk. There was no statistically significant difference between egg white and milk. Rice water may be able to maintain PDL cell viability of avulsed teeth better than egg white or milk.

Resumo O objetivo deste estudo foi avaliar a viabilidade das células do ligamento periodontal de dentes avulsionados armazenados em três diferentes meios. Quarenta e cinco pré-molares com formação radicular completa extraídos por razões terapêuticas foram aleatoriamente distribuídos em três grupos, de acordo com o meio de armazenagem: leite (controle), água de arroz e clara de ovo). Após armazenar os dentes avulsionados por 30 min no meio, raspas do ligamento periodontal (LPD) foram coletadas em tubos Falcon contendo 2,5 mL de solução tamponada de soro fosfatado, incubadas por 30 min e a seguir centrifugadas por 5 min a 800 rpm. A viabilidade celular foi analisada pelo método de exclusão do Azul de Trypan. A água de arroz teve um número significativamente maior de células viáveis em comparação com o leite e a clara de ovo. Não houve diferença estatisticamente significativa entre o leite e a clara de ovo. A água de arroz pode ser capaz de manter a viabilidade das células do PDL de dentes avulsionados, melhor que o leite ou a clara de ovo.

Distribution of blood pressure & correlates of hypertension in school children aged 5-14 years from North East India.

Background & objectives: Elevated blood pressure (BP) in the young predicts serious cardiovascular events in the adults. High prevalence of adult hypertension reported from Assam, North east (NE) India may be linked with elevated blood pressure in the childhood. The present study was an attempt to describe the distribution of BP and correlates of hypertension in children aged 5-14 yr. Methods: A total of 10,003 school children from 99 schools of Dibrugarh district, Assam, NE India, were surveyed by stratified random cluster method. Blood pressure, demographic and anthropometric information were recorded. Blood pressure was categorized in to normal, prehypertension, stage I and stage II hypertension. Results: Girls had significantly higher (104.2 ± 12.0 vs. 103.2 ± 11.6 mm Hg, p<0.001) mean systolic blood pressure (SBP) than boys. Both SBP and diastolic blood pressure (DBP) revealed significant correlation with age, height, weight and BMI in overall and in gender specific analysis. Hypertension was found in 7.6 per cent school children (Boys: 7.3%, Girls: 7.8%). In multivariable analysis older age (OR 3.3, 95% CI: 2.82-3.91), children from tea garden community (OR 1.3, 95% CI: 1.08-1.55) and other community (OR 1.4, 95% CI: 1.18-1.73) and overweight (OR 1.5, 95% CI: 1.1-2.1) were independently associated with hypertension. Interpretation & conclusions: Mean blood pressure in the young school children of 5-14 yr was high. A programme comprising screening, early detection and health promotion through school health programmes may help prevent future complications of hypertension.

Streptococcal pharyngitis, rheumatic fever and rheumatic heart disease: Eight-year prospective surveillance in Rupnagar district of Punjab, India.

Background. Rheumatic fever (RF)/rheumatic heart disease (RHD) continue to be a neglected public health priority. We carried out a registry-based control project, prospective surveillance and sample surveys to estimate the burden of disease. Methods. We trained healthcare providers and established a surveillance system for the 1.1 million population of Rupnagar district in Punjab. In sample surveys conducted among schools, physicians examined the sampled children. Children with a cardiac murmur were investigated by echocardiography. Throat swabs were obtained from a sub-sample, and group A streptococci (GAS) were identified and emm typed by standard laboratory methods. We estimated the morbidity rates for RF/RHD from surveillance data and school surveys using a correction factor to account for under-registration of cases in the registry. Results. A total of 813 RF/RHD cases were registered from 2002 to 2009. Of the 203 RF and 610 RHD cases, respectively, 51.2% and 36.7% were males. In the age group of 5–14 years, RF was more common (80%) than RHD (27%). The prevalence of RF/RHD in 5–14-year-old students was 1.0/ 1000 (95% CI 0.8–1.3). The school survey indicated that about two-thirds of the RF/RHD cases were enrolled in the hospital-based registries. Based on the school survey, the prevalence of RF/RHD was estimated to be 143/100 000 population. In the registry, the annual incidence of acute RF was estimated to be at least 8.7/100 000 children in the age group of 5–14 years. The prevalence of GAS was 2% (13/656) in children with sore throat and 0.5% (14/2920) among those not having sore throat. Typing of 27 GAS revealed 16 emm types. We estimate that about 1000 episodes of GAS pharyngitis lead to one episode of acute RF. Conclusion. RF/RHD continue to be a public health problem in Punjab, India.

Determinants of Indian physicians’ satisfaction & dissatisfaction from their job.

Background & objectives: Physicians’ satisfaction/dissatisfaction from their job is an important factor associated with health service that deals with human life. This study was conducted to ascertain overall level and proportion of physicians’ satisfaction from their job as well as to identify those components that influenced it. Method: A comprehensive customized questionnaire was used with Section A to assess demographic profile of physicians and Section B to assess satisfaction. Response to each question was devised using Likert scale. Likert scale responses were converted to normal scale so that statistical procedures could be naturally developed. A total of 170 physicians were selected using multistage sampling. Questionnaire was administered on one to one basis to avoid non-response. Precise and contextualized descriptive and inferential statistical procedures were used for analysis. Result: Of the 140 physicians, 103 (74%) were satisfied from their job with average score of 19.15 ± 11.46 while 37 (26%) were dissatisfied with average score -09.27 ± 06.30. Nine out of 15 components were found significant (P<0.05). Conclusion: Comparative assessment of the present results with those of other studies revealed that satisfaction percentage of Indian physicians and those of the developed countries were almost the same. Perhaps, magnitude of satisfaction level (average score) of the Indian physicians were towards the lower side. Nine determinants, identified in this study can be used safely to assess any professionals’ satisfaction.

FEV1, FVC, FEV1/FVC ratio in children of 7-14 years of age from Western Rajasthan.

Background: The knowledge of pulmonary function tests (PFTs) is a basic requirement to understand the respiratory physiology for all medical physiologists and clinicians Pulmonary Function Tests provide objective evidence of nature and severity of lung disease. Objective: To observe FEV1, FVC, FEV1/FVC ratio in healthy male and female school children from 7-14 years of age in Western Rajasthan and to find out the relationship of FEV1, FVC, FEV1/FVC ratio with their height, weight, BSA and sex Methods: The present study was carried out on 112 male and 76 female children of 7-14 years. For Pulmonary Function Tests, FEV1, FVC and FEV1/FVC along with anthropometric data of each subject was recorded.. Data were analyzed by unpaired t test, Pearson correlation coefficient test, simple and multiple regression analysis. Results: FVC and FEV1 values were found significantly (p<0.001) higher in male than those of female. Significant positive correlation of FVC and FEV1 whereas non significant negative correlation of FEV1/FVC were observed with age, height, weight, body surface area in all children. Conclusion: As the weight, age, height and BSA of subjects increases, FEV1 and FVC increases while FEV1/FVC ratio decreases in both the sexes.

Brain tumor and role of beta-carotene, a-tocopherol, superoxide dismutase and glutathione peroxidase.

The erythrocyte levels of the antioxidant enzymes SOD and GPx, and serum levels of antioxidants vitamins beta-carotene and beta-tocopherol were estimated in various types of brain tumors, and were compared with the levels in controls. Statistically significant (P<.001) diminished levels of beta-carotene, beta-tocopherol, SOD and GPx, were observed in all the brain tumor patients as compared to controls. Malignant tumor also showed a relative decrease in antioxidant levels as compared to benign tumors. Comparison of histopathological sections of brain tumors also suggested a inverse relationship between antioxidant level and grades of malignancy. Marked decrease in antioxidant levels may have a role in genesis of considerable oxidative stress in brain tumors. Furthermore, the degree of decline in antioxidant levels may indicate severity of malignancy in brain tumors.

Antimicrobial susceptibility pattern and prevalence of extended spectrum beta-lactamase (ESBLs) producing strains of Klebsiella pneumoniae from a major hospital in New Delhi.

Extended spectrum beta-lactamases (ESBLs) are plasmid mediated enzymes capable of hydrolyzing penicillins, broad spectrum-cephalosporins and monobactams. The ESBL producing K. pneumoniae strains are being reported from around the world including India. The present study was taken up to evaluate the ESBL production and in-vitro susceptibility of K. pneumoniae isolates from a hospital. The bacterial isolates collected during 2003 included 51 K. pneumoniae biochemically confirmed isolates from 395 patients admitted in various wards of a major hospital in New Delhi. The isolates were from pus, wound, pleural fluid, urine and tracheal aspirate of patients attending respiratory, urology and burns wards. Antimicrobial susceptibility was carried out by Kirby Bauer's disc diffusion technique using NCCLS criteria. A screening of ESBL production was done by Double-disc synergy test (DDST) and using E-test ESBL strips. The frequency of resistance among K. pneumoniae for the cephalosporins (cefoxitin, cefuroxime, cefotaxime, ceftazidime, and cefepime) and non-cephalosporins (aztreonam, piperacillin, chloramphenicol and trimethoprim-sulfamethoxazole) were in the range of 39.2-88.0% and 51.0-90.2% respectively. 14 different antimicrobial resistance profiles were recognized ranging from resistance to only four (n=6, 11.7%) to as many as ten (n=9, 17.7%). Among the 51 isolates of K. pneumoniae strains, a total of 36 (70.6%) could be identified as ESBL producers, that correlates with the high frequency of multi-drug resistant K. pneumoniae The study shows alarming rise in ESBL production among K. pneumoniae strains and high rate of resistance to a wide range of cephalosporin and non-cephalosporin group of antimicrobials.

Hepato and nephrotoxicity in rat exposed to endosulfan.

The indiscriminate and injudicious use of pesticides particularly endosulfan in agriculture and animal husbandry practices has considerably increased the risk of human health hazard. The present work was therefore undertaken to evaluate the toxic effect of endosulfan on the vital organs viz. liver and kidney of rat. Oral administration of endosulfan at the dose level of 10 mg/kg b.wt./day for two and four weeks showed toxic interference with the biochemistry and histology of rat liver and kidney. The biochemical parameters viz. Aspartate amino transferase, alanine amino transferase, acid phosphatase, alkaline phosphatase, bilirubin urea and creatinine were increased which clearly showed the hepato and nephrotoxic effect of endosulfan. Histopathologically the size of liver was increased, sinusoidal dilation, pyknotic nuclei, cytoplasmic degranulation and various nuclear aberrations were observed. Similarly pathological alterations viz. chronic glomerulonephritis, glomerulosclerosis, odenoma and glomerulus deposits were observed in the kidney.