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Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae. Histoid leprosy is considered an uncommon multibacillary form of leprosy characterized by presence of histoid lepromas which present as erythematous round or oval shaped glistening nodules. Most commonly this form of leprosy is seen in patients on irregular therapy with MDT. In this series we report a total of three cases with their clinical, histopathological and dermoscopic findings.
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Background & objectives: Contrary to overall declining trend in smokeless tobacco (SLT) use in India, an increase is observed in north-east (NE) India. This study examined the predictors of daily SLT use by gender and assessed the demographic and socio-economic characteristics that contribute to gender differences in SLT use in NE India. Methods: Data collected from 15,259 and 13,574 adults in the two rounds of Global Tobacco Adult Survey 1 and 2 for NE India during 2009-2010 and 2016-2017 were analyzed. Relative change, multivariable binary logistic regression and Blinder-Oaxaca decomposition analysis were used for analysis. Results: The findings suggest that among women in NE India, the daily SLT use significantly increased by 58 per cent between 2009-2010 to 2016-2017. Women residing in Nagaland, Manipur, Mizoram and Tripura were 3.5 and 2.5 times, respectively more likely to be daily SLT users compared to those in Assam. While age, education and wealth were the significant predictors of SLT use in both women and men, increased odds of SLT use were observed with women’s type of occupation and the State of residence. The majority of the gender differences in daily SLT use was explained by differences in work status (44%), age (26%), education (14%) and wealth status (9%) between men and women. Interpretation & conclusions: Increasing prevalence of SLT use amongst women in the NE States necessitates integration of gender-specific messages on harmful effects of SLT in the ongoing tobacco control programmes and development of culturally appropriate community-based interventions for cessation of SLT use.
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Corneal ulcer is a global burden which is an ocular emergency. The outcome of corneal ulcer depends on its management. Aetiology, microbiological flora and antibiotic sensitivity vary from region to region. We wanted to analyse the epidemiology of corneal ulcer in Barak valley region of Assam.METHODSThis is a cross-sectional study conducted from May 2017 to June 2018 at Silchar Medical College, Silchar, Assam, India. Cases of corneal ulcer in the study period were included. Corneal scrapping was done, and the sample was sent for Gram stain, KOH mount stain and culture-sensitivity testing.RESULTSA total of 122 patients were examined and 70 cases had positive microbiological findings. Pure bacterial isolates were found in 37 (52.8%) of the 70 cultures and pure fungal isolates in 23 (32.8%) of the cultures. Staphylococcus aureus was the most commonly isolated bacterial organism (42.5%). Out of fungal isolate, Aspergillus spp. (46.7%), was the commonest. Farmers were the most commonly affected work group.CONCLUSIONSAlthough the major aetiological agents in our study were bacterial, fungal ulcers were also seen in a significant proportion of patients. Staphylococcus was the major bacterial isolate and Aspergillus was the major fungal isolate.
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Purpose: The purpose of this study is to determine the ocular biometry characteristics and corneal astigmatisms using partial coherence laser interferometry in patients aged 40 years or above undergoing cataract surgery in a medical college in North-East India. Methods: In a hospital-based cross-sectional study, ocular biometry characteristics such as axial length (AL), anterior chamber depth (ACD), white-to-white (WTW) diameter, corneal power (K), and corneal astigmatisms (D) of consecutive eligible cataract patients in a medical college in North-East India between January 2015 and December 2017 were determined using the intraocular lens (IOL) master. Height and weight were also measured. Results: A cross-sectional study evaluated ocular biometry characteristics of 641 eyes in 641 eligible patients. The mean age was 64.04 ± 10.81 years. The mean AL, ACD, WTW, corneal power, IOL power, and body mass index (BMI) were 23.34 ± 1.12 mm, 3.12 ± 0.39 mm, 11.92 ± 0.54 mm, 44.41 ± 1.50 diopter (D), 20.53 ± 2.79 D, and 26.12 ± 4.32, respectively. Against-the-rule, with-the-rule, and oblique astigmatisms were 48.4%, 33.2%, and 18.4%, respectively. Corneal astigmatism of ?1 D was found in 292 eyes (45.55%) and >1.5 D in 182 eyes (28.39%). AL had statistically significant correlation with ACD, WTW, K, IOL power, height and weight but not with age. By multivariate analysis, AL was found to be associated with ACD, WTW, K and IOL power (P ? 0.05). The mean AL was negatively correlated with the mean K (R-square 0.138). Conclusion: This study is likely to provide the initial normative data for ocular biometry values in Indian adults 40 years or above, because such data is lacking in Indians using the IOL master. This will also help ophthalmologists in planning and improving the quality of surgical outcomes in phacoemulsification and phacorefractive surgeries by choosing the appropriate IOL and incision location.
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Background: Carcinoma of the gall bladder (GB) is the commonest malignancy of the biliary tract. Ultrasound (US) guided Fine Needle Aspiration Cytology (FNAC) plays a major role in early detection of malignancy in a suspicious GB lesion. The aim of this study was to evaluate the safety and diagnostic accuracy of US guided FNAC in detection of GB malignancy, to find the association of gall stones with GB malignancy, to study the ultrasound pattern of GB malignant mass and demographic profile of the disease in North eastern India.Methods: The study was conducted retrospectively in Dr. B. Borooah Cancer Institute, Guwahati from January 2016 to December 2017. A total number of 173 patients suspected to have GB malignancy were subjected to US guided FNAC.Results: Total 161 patients were positive for malignancy with significant female majority. There were 124 female (77.02%) and 37 males (22.98%) in the range of 29 to 82 years. Male female ratio was 1:3.5. One was diagnosed as xanthogranulomatous cholecystitis and another was chronic cholecystitis. FNAC remained inconclusive in 2 patients. There was no major procedure related complication. Adenocarcinoma was the most common malignancy found in 146 patients (98.68%). Cholelithiasis was associated in 88.19% of malignant lesions.Conclusions: US-guided FNAC is a safe, highly accurate and reliable procedure for early detection of GB malignancy.
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Background: Violence against women is an extensively recognised public health problem but grossly underreported. The study plans to assess the magnitude as well as factors associated with domestic violence among ever married women. Methods: This cross sectional study was conducted among ever married women attending a tertiary care health centre using a semi structured questionnaire adapted from the WHO Multi-country Study on Women’s Health and Life Experiences. Descriptive statistics along with univariate and multivariate logistic regression analysis were performed to see for associations. A P- value of <0.05 was taken as significant. Results: The mean (SD) age of the respondents was 32.0±7.9 year. More than half of the respondents 278(53.6%) have faced some form of violence during their marital life. Verbal form of violence 218(78.4%) was the commonest followed by physical violence 134(48.2%). The risk of ever having faced violence was significantly associated with increasing number of children, husband being a smoker and husband being an alcohol user (P < 0.05). Conclusion: The prevalence of violence was relatively high as equated to other evidence from across the country. A primary prevention activity by raising public awareness and changing the gender-related attitudes towards women at a societal as well individual level is needed.
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Both, the tobacco caterpillar Spodoptera litura (Fabricius) and the cotton bollworm Helicoverpa armigera (Hübner), are serious polyphagous pests causing considerable loss to crops. Indiscriminate use of chemical pesticides for controlling them has rather resulted in their resistance development. Microbial pesticides, Bacillus thuringiensis in particular, play an important role in pest management. Here, we isolated Bacillus thuringiensis-like bacteria from the soil samples primarily collected from North East region of India along with some states viz., Haryana, Punjab, Maharashtra, West Bengal and Uttarakhand and studied their toxicity against the above two insect pests at 10 µg/g along with standard strain B. thuringiensis subsp. kurstaki HD-1 and at 1 µg/g Pseudomonas fluorescens based MVPII expressing Cry1Ac toxin and AUG-5. Isolates AUG-5 and GTG-7 proved toxic to more than 75% larvae on the 4th as well as 7th day of the treatment of the neonates of H. armigera. The AUG-5 isolate was also effective against S. litura. Ten effective isolates (AUG-5, GTG-4, GTG-7, GTG-9, GTG-42, GTG-64, GTG-70, GTG-3S, GTG-4S and GTG-6S) were characterized using biochemical and 16S rDNA analysis. Nearly, all the isolates tested positive for utilizing monosaccharides. All selected B. thuringiensis isolates showed resistance to ampicillin and co-trimoxazole except AUG-5 to co-trimoxazole. AUG-5 and GTG-7 were highly toxic to both insects, and possessed cry1, cry1A and cry2 genes. These isolates AUG-5 and GTG-7 also contained high Cry1Ac (104.8 and 88.32 ng/mg) and Cry2Ab (3792 and 1305.9 ng/mg), respectively in their spore-crystal complex. Both, AUG-5 and GTG-7 isolates, could be considered for further development as bioinsecticides. The present study has established the diversity and richness of B. thuringiensis-like isolates in soils collected from north-eastern region of India.
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Background: Human polyomavirus JC (JCV) is a widespread human virus with profound pathogenic potential. A study was undertaken to quantify JCV load in urine and peripheral blood samples of immunocompetent, apparently healthy tribal individuals of North‑Eastern part of West Bengal, India for the first time. Materials and Methods: One hundred and thirteen samples of urine or blood were collected from different tribal groups of this region. For the quantitative estimation of the viral load in each sample, real‑time polymerase chain reaction method using the SYBR Green dye was employed. Results: The viral load estimated was found in the range between 3.5 × 102 and 2.12 × 106 copies/ml of samples having a mean and median viral copy numbers of 8.67 × 105 and 9.19 × 105 copies/ml of sample respectively. Conclusion: The mean viral DNA load in urine samples of the studied immunocompetent population was found to be higher than that found in a study conducted in the USA, but lower than similar groups of Italy and healthy adult women in the USA. However when compared with median values of viral DNA loads in urine samples of immunocompetent human subjects of Kuwait, Portugal, and Switzerland the observed viral DNA load was found to be substantially higher.
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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.
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Mosquito-borne diseases, including malaria, Japanese encephalitis (JE), lymphatic filariasis and dengue, are major public health concerns in the north-eastern state of Assam, deterring equitable socioeconomic and industrial development. Among these, malaria and JE are the predominant infections and are spread across the state. The incidence of malaria is, however, gradually receding, with a consistent decline in cases over the past few years, although entry and spread of artemisinin-resistant Plasmodium falciparum remains a real threat in the country. JE, formerly endemic in upper Assam, is currently spreading fast across the state, with confirmed cases and a high case-fatality rate affecting all ages. Lymphatic filariasisis is prevalent but its distribution is confined to a few districts and disease transmission is steadily declining. Dengue has recently invaded the state, with a large concentration of cases in Guwahati city that are spreading to suburban areas. Control of these diseases requires robust disease surveillance and integrated vector management on a sustained basis, ensuring universal coverage of evidence-based key interventions based on sound epidemiological data. This paper aims to present a comprehensive review of the status of vectorborne diseases in Assam and to address the key challenges.
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Aims: Thyroid dysfunction is commonly encountered in pregnancy and can affect maternal and Fetal outcomes. Limited data are available from north east India on the prevalence of various thyroid disorders in pregnancy. The present study was hence conducted to evaluate the prevalence of thyroid disorders in a large government hospital in Assam. Study Design: Prospective cohort study. Place and Duration of Study: Sample: Department of endocrinology and department of obstetrics, Gauhati medical college, Guwahati between may 2011 to April 2013. Methodology: Pregnant women irrespective of gestational age attending the antenatal clinic of Gauhati medical college were screened for thyroid dysfunction by estimation of serum free t34 (FT4), TSH and thyroid peroxidase antibodies (TPOAB). Subjects with known thyroid disorders, chronic illness or on medications known to affect thyroid status were excluded from the study. Results were interpreted as per the American thyroid association (ATA) 2011 guidelines. Results: A total of 542 pregnant women were enrolled for this prospective cohort study. The mean age was 23.85±4.04 yrs. Of the 542 women screened, 69.18% were Euthyroid, 21.58% had subclinical hypothyroidism (SCH), 5.35% had overt hypothyroidism (OH), hyperthyroidism was observed in 2.39% and 1.47% had gestational Thyrotoxicosis. TPOAB were positive in 18.08% of women. Conclusion: A high prevalence of thyroid disorders specially hypothyroidism were seen in this study using the newer ATA diagnostic criteria emphasizing the need for screening of all women during pregnancy.
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Background: The incidence of gall bladder cancer (GBC) is very high in this part of the world and there is little information on the descriptive epidemiology of GBC from our population. Methods: A retrospective study on the data set of hospital cancer registry was analyzed. The data set consisted of patient information registered during the period of January 2011 to December 2012. The cases included for the present study were histologically confirmed and radiologically diagnosed cases of GBC. All the cases were retrospectively analyzed for gender, age, urban-rural residences, religion of patients and their educational levels. Descriptive statistics was calculated and Chi square test was done to see the significance differences among categories. Results: A total of 837 cases of GBC were registered, F:M was 2.33, median age in females and males was 54 and 50 years respectively, majority of cases in both the genders were seen in 50-59 years of age, 81.1% patients were from rural areas and 18.8% from urban areas, Chi square on comparison with other cancers showed p<0.05, and there was no major religious and educational pattern of GBC seen in our population. Conclusion: In our population females are at high risk especially past 40 years of age and rural population with its varied environmental, lifestyles and infective agents should be investigated for possible risk factor in the causation of GBC.
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Background: Dengue is rapidly becoming established in north-east India and spreading, on account of rapid urbanization and population movement, with reported morbidity and attributable death cases. This study aims to determine the seasonal abundance of Aedes (Stegomyia) albopictus and Aedes (Stegomyia) aegypti in Guwahati metropolis and suburban settlements; to characterize the breeding resources for these mosquitoes; and to ascertain the status of their susceptibility to adulticides and larvicides. Methods: Mosquito larval surveys were carried out in different localities in both Guwahati city and adjoining suburbs from January to December 2013, to determine the seasonal abundance of disease vectors and their breeding preferences. The insecticide susceptibility status of mosquito adults and larval populations of both Aedes aegypti and Aedes albopictus was ascertained, using World Health Organization standard diagnostic concentrations and test procedures. Results: The study revealed that both Aedes aegypti and Aedes albopictus are widely abundant in Guwahati city and suburbs, and breeding in a wide variety of resources. Aedes albopictus, however, was the predominant mosquito species in suburbs, breeding preferentially in flower vases, cut-bamboo stumps and leaf axils. Aedes aegypti was the most common in the city, breeding predominantly in discarded tyres, cement tanks and used battery boxes. Both Aedes aegypti and Aedes albopictus were resistant to dichlorodiphenyltrichloroethane (DDT; 4%), but susceptible to malathion (5%), and exhibited a varied response to pyrethroids. However, larval populations of both these mosquito species were susceptible to larvicides, including malathion (1.0 mg/L), temephos (0.02 mg/L) and fenthion (0.05 mg/L), at much lower dosages than diagnostic concentrations. Conclusion: Given the seasonal abundance and case incidence in city areas, it is highly probable that Aedes aegypti is the predominant mosquito vector transmitting dengue virus. The study results have direct relevance for the state dengue-control programme, for targeting interventions and averting outbreaks and spread of disease.
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The main objective of this article is to document and represent the medicinal herb used for the preparation of Apong by the Mising tribal community. North-East India is inhabited by many indigenous tribes and as a part of their socio-cultural life, most of these tribes prepare their own household liquors, mostly using rice grains as the substrate. Each of the tribes also prepares their own unique starter cultures to carry out fermentation, and each type is a mixture of different parts of various plant species. There are 39 plants documented here which possess distinct medicinal values. The paper reflects the rich ethno medicinal values of the herbs. The informations are collected by the active field survey in three villages of Sibsagar district in Assam, and through the available local literature. This review will help to researchers and scholars to investigate the proper bio-molecules and its’ accessible pharmacological responses. The further scrutiny and evaluation of the safety parameters of each component of the herb used in Apong may be investigate to develop a pharmacologically potent lead molecule.
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Background & objectives Endothelial nitric oxide is a potent vasodilator and impairment of its generation brought about by gene polymorphism is considered a major predictor for several diseases. A single nucleotide polymorphism G894T within exon 7 of endothelial nitric oxide synthase (eNOS-7) gene, resulting in a replacement of glutamic acid by aspartic acid, has been studied as a putative candidate gene for cardiovascular diseases. The pattern of eNOS-7 Glu298Asp variant in the Indian population is poorly known. The present study was planned to determine the prevalence of the variant of this gene among tea garden community in Assam, North-East India with high prevalence of hypertension. Methods Study participants of both sex aged ≥18 yr were recruited randomly from temporary field clinics established in tea gardens of Dibrugarh, Assam. Genomic DNA was extracted from 409 subjects by the conventional phenol-chloroform method. The prevalence of the eNOS exon 7 Glu298Asp variant was determined by polymerase chain reaction and restriction fragment length polymorphism analysis. Results The study population was in Hardy-Weinberg Equilibrium. The frequency of the eNOS GG, GT and TT genotypes was found to be 75, 22 and 3 per cent respectively and did not show any significant difference in gender wise analysis. Interpretation & conclusions Our results showed that the prevalence of the homozygous GG genotype was high (75%) and the rare mutant genotype (homozygous, TT) was 3 per cent in a population at risk with cardiovascular disease. Such population-based data on various polymorphisms can ultimately be exploited in pharmacogenomics.
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Adult , Aged , Aged, 80 and over , Cardiovascular Diseases/enzymology , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/genetics , Chromosomes, Human, Pair 7/genetics , Female , Genetic Predisposition to Disease/epidemiology , Genetic Predisposition to Disease/genetics , Genotype , Haplotypes/genetics , Humans , India/epidemiology , Male , Middle Aged , Mutation, Missense/genetics , Nitric Oxide Synthase Type III/genetics , Pharmacogenetics/methods , Polymorphism, Restriction Fragment Length/genetics , Polymorphism, Single Nucleotide/genetics , PrevalenceABSTRACT
Background & objectives: The National Vector Borne Disease Control Programme (NVBDCP), India has been promoting and scaling up the use of insecticide-treated nets (ITNs) in the tribal dominated malarious areas of north-east India. But, information on sleeping habits, bed net ownership and use practices, and feedback of communities in ITN - targeted areas is needed for formulating a strategic framework for upscaling the coverage of ITNs. We carried out a community-based cross-sectional survey in select areas of Nagaland and Mizoram (where ITNs were introduced) along with Assam (where ITNs were not introduced) to know the response of community. Methods: Following large scale introduction of ITNs during 2001-2002 in the north-eastern States of Nagaland and Mizoram by NVBDCP, India, a cross-sectional community-based survey was undertaken in April-May, 2003 covering 435 households of Nagaland and 464 households in Mizoram, using a structured questionnaire, to assess the demographic variables relevant to bed net use, bed net washing practices and acceptability of ITNs etc., for upscaling the coverage of ITNs in the surveyed communities. A total of 448 households in 8 villages in a non-ITN PHC area of Assam were served as the control area. Results: The average bet net usage per family (2.01 to 2.65). Bed net use was mostly seasonal in Nagaland where a majority (65.1-78.7%) used bed nets only during summers and monsoon as compared to the year round use in Mizoram (83.5%) and Assam (78.9%). Frequent washing of nets was most common in Assamese communities with 77 per cent households washing their nets at least once in a month. More than two third users favoured use of ITNs over the conventional indoor residual spray of DDT for malaria control. Interpretation & conclusion: ITNs are widely acceptable in the user communities and a demand for ITNs is evident in the non-user communities of north-east India. Approach of treating community owned nets through an efficient service delivery mechanism will be a viable option for upscaling the ITN coverage.