The National Academy of Vectors and Vector Borne Diseases in India: two decades of progress.

The National Academy of Vector Borne Diseases (NAVBD) was founded at Bhubaneswar in 1994, by Dr AP Dash, along with 15 like-minded scientists from all over India. NAVBD is a non-profit academic organization in India, dedicated to advancing and promoting knowledge on vectors and vector-borne diseases, and encouraging scientists and members of the academy to conduct research on vectors and vector-borne diseases. NAVBD convenes national and international seminars, symposia and workshops to exchange knowledge on recent advances in the field of vectors and vector-borne diseases and raise public awareness. Plans are under way to expand the Academy’s activities to the rest of the South- East Asia Region.

Original research paper patterns of head injuries in fatal road traffic accidents in a rural district of Maharashtra- autopsy based study.

Road traffic accidents are the major causes of death worldwide. Head injury is the single most common cause of mortality in road traffic accidents; head being the most vulnerable part of the body. The present study was undertaken on 138 victims of road traffic accidents, died due to head injury to find out the patterns of head injuries, their age and sex distribution and site distribution of different types of fractures. The highest incidence was seen in age group of 21-30 years and males clearly outnumbered females. In the present study, most of the incidents occurred between 1200 to 1800 hours. The maximum number of victims (39.57%) died while on the way to hospital. The motor-cyclists were the commonest group of victims and trucks being the commonest offending vehicles. Intracranial haemorrhages were seen in 113 cases, skull fractures were found in 95 cases and injury to brain in 51 cases. Linear fracture of skull with basal fracture was the commonest type and temporo-parietal region was involved predominantly. Subdural haemorrhage was the commonest haemorrhage observed.

Precontrol observations on lymphatic filariasis & geo-helminthiases in two coastal districts of rural Orrisa.

BACKGROUND & OBJECTIVE: Lymphatic filariasis (LF) is a major public health problem in India, accounting for 40 per cent of the global burden. The World Health Organization has launched a global programme to eliminate LF by 2020 and India is a signatory to it. Orissa, an eastern Indian State has long been known to be endemic for LF. Prior to implementation of mass drug administration programme it is important to collect baseline data on filariasis and geo-helminthiases in the State. The present cross-sectional survey was therefore carried out between February and December 2001 to obtain baseline information on both LF and geo-helminthiases before application of the control measures. METHODS: The study was carried out in rural areas of Puri and Ganjam districts in two phases. In phase I, the distribution of microfilaraemia in two district was mapped out in randomly selected primary health centres (PHCs), and 12 microfilaraemic villages were identified in each district by cluster analysis for the phase II study. In phase II, detailed clinical and parasitological survey for LF and geo-helminthiases was carried out following the standard procedures. RESULTS: Wuchereria bancrofti was found to be widely prevalent in Puri district with certain pockets of Brugia malayi while W. bancrofti was the only species in Ganjam district. The microfilaraemia (Mf) rate was found to be 9.5 and 11.1 per cent; and circulating filarial antigenaemia (CFA) was 16.8 and 17.8 per cent in Puri and Ganjam respectively. The geometric mean intensity (GMI) of Mf per ml of blood among positive individuals was 387 in Puri and 454 in Ganjam. The overall disease rate in Puri was 7.9 and 8.9 per cent in Ganjam. The prevalence of chronic manifestations was found to be significantly higher (P<0.001) than the acute manifestations in both the districts. The prevalence of geo-helminthiases was 31.8 per cent in Puri and 42.1 per cent in Ganjam; and the heavy infection was found to be significantly higher (P<0.001) in Ganjam compared to Puri district. INTERPRETATION & CONCLUSION: The present study identified LF and geo-helminthiases as widely distributed health problem in rural areas of coastal Orissa which warrants intervention measures along the lines recommended by the global programme for elimination of LF and geo-helminthiases to reduce the disease burden.

Common congenital cyanotic heart defects--diagnosis and management.

Congenital cyanotic heart defects are leading causes of neonatal and infant mortality. These babies, if left untreated, deteriorate rapidly in hours. There lies the urgency of early diagnosis and management. The author has elaborated the issue, in brief, in this article.

A clinico-epidemiological perspective of lymphatic filariasis in Satyabadi block of Puri district, Orissa.

BACKGROUND & OBJECTIVES: Lymphatic filariasis is a major public health problem in the coastal district of Orissa. However, no systematic studies have been done to document the prevalence of microfilaraemia/disease in different regions of the State. Therefore, the present cross sectional study was undertaken during 1996-97 to obtain information on the clinical and epidemiological status of the disease in Satyabadi block area of Puri district, known to be endemic for filariasis. METHODS: Night blood smear survey and clinical examinations were performed on 4646 individuals aged 0-> or = 60 yr from systematically selected households of 17 randomly selected villages of the Block. Microfilaraemia was detected by thick drop technique using 20 microliters of peripheral blood and microfilariae (mf) density by nucleopore filtration technique collected during 1900-2300 h. RESULTS: The prevalence of microfilaraemia was observed to be 14.8 per cent; 13.3 per cent Wuchereria bancrofti, 1.4 per cent Brugia malayi and 0.09 per cent had mixed infections. Geometric mean microfilaraemia density (infected persons only) was found to be 1288 per ml in case of W. bancrofti and 204 per ml in case of B. malayi. The disease rate was observed to be 19.8 per cent; 12.85 per cent had acute manifestations and 6.97 per cent had chronic manifestations. INTERPRETATION & CONCLUSION: The rate of acute disease manifestations was observed to be significantly higher (P < 0.001) than chronic manifestations. There was a male preponderence among the affected individuals (P < 0.001). The interesting observations of the study were the occurrence of occult filarial manifestations viz., tropical pulmonary eosinophilia (TPE) in 0.47 per cent cases and other associated manifestations like asymptomatic microscopic haematuria, monoarticular arthritis and filarial associated respiratory diseases in 0.50, 0.24 and 0.19 per cent of cases respectively. The present study indicates that the area is highly endemic for lymphatic filariasis with active transmission.

Cardiac abnormalities in birth asphyxia.

Cardiac abnormalities in birth asphyxia were first recognised in the 1970s. These include (i) transient tricuspid regurgitation which is the commonest cause of a systolic murmur in a newborn and tends to disappear without any treatment unless it is associated with transient myocardial ischemia or primary pulmonary hypertension of the newborn (ii) transient mitral regurgitation which is much less common and is often a part of transient myocardial ischemia, at times with reduced left ventricular function and, therefore, requires treatment in the form of inotropic and ventilatory support (iii) transient myocardial ischemia (TMI) of the newborn. This should be suspected in any baby with asphyxia, respiratory distress and poor pulses, especially if a murmur is audible. It is of five types (A to E) according to Rowe's classification. Type B is the most severe with respiratory distress, congestive heart failure and shock. Echocardiography helps to rule out critical left ventricular obstructive lesions like hypoplastic left heart syndrome or critical aortic stenosis. ECG is very important for diagnosis of TMI, and may show changes ranging from T wave inversion in one lead to a classical segmental infarction pattern with abnormal q waves. CPK-MB may rise and echocardiogram shows impaired left ventricular function, mitral and/or tricuspid regurgitation, and at times, wall motion abnormalities of left ventricle. Ejection fraction is often depressed and is a useful marker of severity and prognosis. Treatment includes fluid restriction, inotropic support, diuretics and ventilatory resistance if required (v) persistent pulmonary hypertension of the newborn (PPHN). Persistent hypoxia sometimes results in persistence of constricted fetal pulmonary vascular bed causing pulmonary arterial hypertension with consequent right to left shunt across patent ductus arteriosus and foramen ovale. This causes respiratory tension and right ventricular failure with systolic murmur of tricuspid, and at times, mitral regurgitation. Treatment consists of oxygen and general care for mild cases, ventilatory support, ECMO and nitric oxide for severe cases. Cardiac abnormalities in asphyxiated neonates are often underdiagnosed and require a high index of suspicion. ECG and Echo help in early recognition and hence better management of these cases.

Occurrence of asymptomatic microscopic haematuria in a filarial endemic area of Orissa, India.

To determine the frequency of occurrence of asymptomatic microscopic haematuria in filarial endemic area of Orissa, where the mf rate and disease rate were observed to be 14.8% and 37.2% respectively, clinical examination, night blood smear examination, morning midstream urine examination were conducted on 697 persons-randomly selected from all age groups in 8 villages of Puri tehsil. Out of them, 15.6% were found to have asymptomatic haematuria (Grade I-14.7%, Grade II-0.6%, Grade-III 0.3%). The prevalence of asymptomatic microscopic haematuria was observed to have positive statistical correlation with mf status (P < 0.001), filarial antigenaemia (Ag) (P < 0.001), antibody (Ab) (P < 0.001) and circulating immunocomplex antigen (CIC-Ag) (P < 0.001). The prevalence was also found to be increased with the progression of the disease process i.e. from endemic normal to chronic manifestations. None of the cases having Grade-II and III haematuria cases revealed any gross renal pathological lesions, when subjected to special investigations like X-ray, IVP, cystoscopy and urethroscopy.

Cardiac abnormalities in birth asphyxia.

Cardiac abnormalities in birth asphyxia were first recognised in 1970s. These include (i) transient tricuspid regurgitation which is the commonest cause of a systolic murmur in a newborn and tends to disappear without any treatment unless it is associated with transient myocardial ischemia or primary pulmonary hypertension of the new born (ii) transient mitral regurgitation which is much less common and is often a part of transient myocardial ischemia, at times with reduced left ventricular function and therefore, requires treatment in the form of inotropic and ventilatory support, (iii) transient myocardial ischemia (TMI) of the newborn. This should be suspected in any baby with asphyxia, respiratory distress and poor pulses especially if a murmur is audible. It is of five types (A to E) according to Rowe's classification. Type B is the most severe with respiratory distress, congestive heart failure and shock. Echocardiography helps to rule out critical left ventricular obstructive lesions like hypoplastic left heart syndrome or critical aortic stenosis. ECG is very important for diagnosis of TMI, and may show changes ranging from T wave inversion in one lead to a classical segmental infarction pattern with abnormal q waves. CPK-MB may rise and echocardiogram shows impaired left ventricular function, mitral and/or tricuspid regurgitation, and at times, wall motion abnormalities of left ventricle. Ejection fraction is often depressed and is a useful marker of severity and prognosis. Treatment includes fluid restriction, inotropic support, diuretics and ventilatory resistance if required, (v) persistent pulmonary hypertension of the new born (PPHN). Persistent hypoxia sometimes results in persistence of constricted fetal pulmonary vascular bed causing pulmonary arterial hypertension with consequent right to left shunt across patent ductus arteriosus and foramen ovale. This causes respiratory distress and cyanosis (sometimes differential). Clinical examination also reveals evidence of pulmonary arterial hypertension and right ventricular failure with systolic murmur of tricuspid and, at times, mitral regurgitation. Treatment consists of oxygen and general care for mild cases, ventilatory support, ECMO and nitric oxide for severe cases. Cardiac abnormalities in asphyxiated neonates are often underdiagnosed and require a high index of suspicion. ECG and Echo help in early recognition and hence better management of these cases.

Postoperative endocarditis due to Candida tropicalis.

In conclusion, we emphasize the importance of isolating the fungal agent from repeated blood cultures, particularly in infective endocarditis following heart surgeries.

Evaluation of cyfluthrin and fenfluthrin for their insecticidal activity against three vector mosquitoes.

The EC50/EC90 concentrations of cyfluthrin and fenfluthrin were tested for their activity against different developmental stages of three important vector mosquitoes viz., Anopheles stephensi Liston, Aedes aegypti (Linn.) and Culex quinquefasciatus Say. The EC90 concentrations of both cyfluthrin and fenfluthrin showed ovicidal effect on An. Stephensi and Ae. aegypti whereas EC90 of cyfluthrin checked the hatching of eggs completely in Cx. quinquefasciatus. Fenfluthrin at EC50 concentration reduced the percentage of hatching significantly (p < 0.05) only in An. stephensi. Both the compounds were more active against the fourth larval instars of all mosquito species and cyfluthrin in culicines (17.3% Ae. aegypti = 9.1%) and fenfluthrin in anophenlines (An. stephensi = 36.8%) brought about maximum inhibition in adult emergence. Various types/degrees of morphogenetic aberrations were induced in all mosquito species on treatment with these compounds. Cyfluthrin treated female mosquitoes showed reduced fecundity rates in An. stephensi (p < 0.05), Cx. quinquefasciatus (p < 0.001) and fenfluthrin treated in An. stephensi (p < 0.5) and Ae. aegypti (p < 0.05). The fertility rates of all the mosquito species were significantly reduced (p < 0.001) by both the compounds.

Prevalence of G-6-PD deficiency in a malaria endemic tribal area of Orissa (India).

A total of 207 men belonging to Bhuyan, Juanga and Munda tribes and 108 non-tribal residents of Banspal block area of Keonjhar district of Orissa were screened for glucose-6-phosphate dehydrogenase (G-6-PD) deficiency, abnormal haemoglobin and malaria parasite. In the tribal group, G-6-PD enzyme deficiency was observed in 13.52 per cent as compared to 3.70 per cent in non-tribals. No abnormal haemoglobin was detected in the studied population, while 15.87 per cent of individuals were positive for Plasmodium falciparum. An extremely weak association was observed between malaria and G-6-PD deficiency.

Adrenocortical influence on histokinetics and lipid components of uropygial gland of immature chick.

Adrenocortical influence on uropygial gland of 10-day old male white leghorn chicken was assessed by suppressing glucocorticoid level with metyrapone and following corticosterone and deoxycorticosterone acetate (DOC) treatments (im), 100 micrograms each on alternate day for a period of 15 days. Metyrapone treatment resulted in significant atrophy of the uropygial gland with a severe regression of the glandular alveoli due to cytopycnosis, cellular disintegration and drastic cell loss. Concomitantly, there was a depletion of glandular lipid and its diester wax fraction. Corticosterone, administered simultaneously with metyrapone, counteracted severe adverse effects of the latter on the uropygial gland. In the normal chicken also corticosterone alone caused glandular hypertrophy with increased rate of cell renewal and cell growth within the alveoli and, to a lesser extent, augmented output of the glandular lipids. Simultaneous administration of corticosterone and testosterone propionate (TP), on the other hand, caused a moderate suppressive influence on this gland. DOC treatment alone or with metyrapone and TP failed to exert any noteworthy change in the uropygial gland excepting a moderate reduction of gland weight and a rise of glandular lipids observed after combined injections of DOC with TP and with metyrapone respectively.

Effect of drug treatment on the prevalence of intestinal parasites amongst school children in a sub-urban community.

The prevalence of intestinal protozoal and helminthic infection was studied over a period of one year amongst 297 school children, aged 5-20 yr in a sub-urban area. The overall prevalence rate of various protozoal infection, 15.82 per cent had only helminthic infection and 14.47 per cent had combined helminthic and protozoal infection. Ascaris lumbricoides infestation was found to be the commonest helminthic infection (61.70%) while giardiasis was the commonest protozoal infection (59.80%). The prevalence rates, one year after effective anti-protozoal and antihelminthic treatment was administered, were overall parasitic infection 25.92 per cent; only protozoal infection 17.50 per cent, only helminthic infection 5.72 per cent and combined infection 2.69 per cent. The reinfection rate was found to be 7.40 per cent and the fresh infection rate was found to be 11.4 and 39.8 per cent at the end of six months and one year respectively.