Effectiveness of smartphone otoscope in management of ear ailments at primary healthcare level

Background: To work out efficacy of smartphone otoscope for managing ear ailments at primary healthcare level. Methods: Prospective study carried out at a co-located primary care clinic and secondary referral facility. With this plan, the PHC was equipped with a smartphone otoscope for diagnosing common ear problems. The doctor then forwarded patient's ear imaging to the referring hospital's otolaryngologist. The otolaryngologist reviewed the history to make remote diagnosis before providing the PHC provider with recommendations for treatment. Information on patients' demographics, outpatient diagnoses, symptom durations, affected side, treatments received, and outcomes was collected. This information was used to determine whether or not a smartphone otoscope may be used to improve healthcare for patients suffering from common ear illnesses without sending them to more specialized facilities. Results: 150 patients were enrolled; 53.3% were male and 46.7% female. Participants aged between 3 and 83 years, with a mean of 44.6. Eighty-two (48%) of the cases presented with left ear, sixty (40%) with right ear, and eighteen (12%) for both sides. The typical course of ear infection lasted 6.5 (2, 15) days. Out of 150 patients, 33 (22%) were deemed cured, 117 (78%) demonstrated improvement in symptoms. The technique was praised by primary care physicians, who said they learned more about otolaryngology. Conclusions: The ability of primary care physicians to manage common and straightforward ear ailments is greatly enhanced by the use of smartphone otoscopes. Thus, improving patient satisfaction and the strain on medical facilities.

Roots of change: intergenerational cycle of adolescent fatherhood in rural Jharkhand and Odisha

Background: Numerous studies have documented an intergenerational cycle of adolescent motherhood, wherein daughters of adolescent mothers are more likely to follow suit. This pattern may result from biological predisposition, heritable attitudes, or the socioeconomic environment influenced by early childbirth. Surprisingly, the same cycle among young fathers remains unexplored in India. This research paper seeks to enrich the existing body of knowledge by shedding light on the intergenerational cycle of adolescent fatherhood in the rural Jharkhand and Odisha, possibly as a first of its kind study. Methods: A case control study was conducted between June 2023 to August 2023 amongst adolescent males residing in rural areas of Jharkhand and Odisha states with sample size of 228 using multi-stage sampling technique. Results: The study did not reveal statistically significant association between adolescent fathers of this generation and adolescent fathers or adolescent mothers of previous generation, unlike in the case of adolescent mothers. Conclusions: To address adolescent reproductive sexual Health challenges in rural Jharkhand and Odisha effectively, it is imperative to emphasize targeted educational campaigns with cultural sensitivity, actively involve adolescent males and maintain a steadfast long-term commitment to fostering cultural transformation.

Alleviating Damage Extent and Enhancing Yield through Ridge Planting Techniques in Maize (Zea mays L.) during Excess Soil Moisture Stress

Waterlogging is one of the major constraints limiting maize (Zea mays L.) production in India and might become more common due to irregular precipitation pattern due to climate change. The objective of this investigation was to evaluate the efficacy of planting techniques by examining of physio-morphological, and productivity of excess water sensitive maize (Zea mays L.), under excess soil moisture stress (ESM). A field experiment was conducted during the kharif season 2020 at G.B. Pant University of Agriculture and Technology, Pantnagar. The experiment consisting of two planting methods (flat and ridge), under ponding conditions (30 DAS for 7 days) along with non-ponded condition was laid out in factorial randomized block design with three replications. The recommended dose of nutrients was120:60:40kgN: P2O5:K2O/ha. The physio-biochemical and yield characteristics of the plants at different times interval after planting were evaluated. Growing of maize on ridge bed maintain comparatively aerobic condition and give better anchorage to sturdy in excess moisture resulting lowest crop lodging (12.06%) and higher yield (3501kg/ha) by 7.2% compare to flat system (3268kg/ha). In comparison to non-ponded and ponded plant showed significantly maximum growth, however lowest crop lodging percent.

Impact of cataract surgery on quality of life in rural areas of Jharkhand: a community based cross-sectional study

Background: Cataract is the leading cause of blindness in India, accounting for approximately 66.2% of all blindness cases and accounting for 71.2% of all visual impairment cases. This study was conducted in 5 blocks of East Singhbhum and Saraikela-Kharsawan districts of Jharkhand to determine burden of cataract and the impact of cataract surgery on quality of life in the rural population. Methods: Community based cross sectional study was conducted between January 2023 to April 2023 among individuals residing in rural areas of Jharkhand using multi-stage sampling with a sample size of 692 individuals. Results: Prevalence of cataract amongst the study population was 23% (159) and there was a statistically significant improvement in the quality-of-life post cataract surgery. Conclusions: High prevalence of cataract increases the burden on existing health care system. Ongoing research and initiatives should focus on improving early detection and referral, providing comprehensive post-operative care to reduce the burden of cataract and improve the quality-of-life outcomes among the individuals.

Ranula – threefold habituation.

Intraoral swellings present as a diagnostic challenge to the clinician, the most bourgeois being mucocele & ranula. An intraoral ranula has been defined as a retention cyst due to ductal obstruction & fluid retention of the sublingual salivary gland on the floor of the mouth. The name “ranula” has been derived from the latin word “Rana” meaning “Frog.” We hereby report a case of triennial recurrent ranula located in the floor of mouth, treated successfully by surgical excision by injecting an irreversible impression material to delineate the cystic lining of the lesion, after which the patient recovered unvariedly.

Immunophenotypic and intracellular cytokine profile of Indian patients with tuberculosis with and without human immunodeficiency virus co-infection.

Background. Tuberculosis (TB) occurs in more than 50% of human immunodeficiency virus (HIV) infected Indian patients. This study was carried out to determine the immunophenotypic and intracellular cytokine profile of patients with HIV-TB co-infection. Patients and Methods. Fifteen patients with HIV-TB co-infection and 15 each with TB alone and healthy individuals were studied. Immunophenotypic analysis and intracellular cytokines were measured using appropriate antibodies on a flowcytometer. Results. Percentage of CD3+ did not differ significantly in the three groups. The ratio of CD4+ : CD8+ was reversed among patients with TB and HIV-TB. CD19+ and CD25+ were present on fewer cells of healthy individuals but this was not statistically significant. Significantly higher percentage of cells of patients with TB and HIV-TB were CD69 positive. Interferongamma (INF-g ) and tumour necrosis factor-alpha (TNF-a) levels are significantly reduced in the CD4+ cells of patients with HIV-TB when compared with those with TB and healthy individuals. In CD8+ cells of patients with HIV-TB, levels of TNF-a are higher when compared with the other two groups. Interleukin-2 (IL-2) producing cells were not significantly different in any of the above subsets. Monocytes in individuals with HIV-TB had significantly higher interleukin-6 (IL-6) and TNF-a. Conclusions. T-helper cells among patients with HIV-TB have significantly lower cytokine production. T-suppressor cells and monocytes produce more TNF-a. These findings may be significant in view of recent attempts to treat HIV-TB coinfected patients with anti-TNF therapy.

Prevention of opportunistic infections in HIV infection by pentoxiphylline.

BACKGROUND & OBJECTIVES: Levels of tumour necrosis factor (TNF) are increased in patients with HIV infection leading to increased apoptosis and reduced CD4 cell life. Pentoxiphylline is a TNF inhibitor with properties that might make it useful for the treatment of HIV infection. These include improved cell mediated immunity and inhibition of viral replication. We carried out this study to determine the therapeutic utility of pentoxiphylline in improving constitutional manifestations, preventing opportunistic infections and sustaining CD4 counts among asymptomatic HIV infected individuals (i.e., those with no opportunistic infection). METHODS: Individuals with HIV infection who were over 18 yr of age and free of opportunistic infections were recruited in the study and followed up 4 weekly. CD4 counts were measured using a flowcytometer using anti-human CD4 intervals. Pentoxiphylline was prescribed in a dose of 400 mg thrice daily. RESULTS: Thirty three (18 males) patients with HIV infection were studied. During their follow up (mean 12.5 +/- 5.6 months) one patient each developed cryptococcal meningitis and fibrocavitary tuberculosis. Weight increased from 51.3 +/- 7.4 kg at baseline to 55.3 +/- 7.4 kg (P<0.05). Malaise, fatigue and appetite improved in all those with these complaints, except the two with opportunistic infections. Mean CD4 counts were 184 +/- 36.4/microl at baseline and increased to 210 +/- 28.6/microl3 at four weeks (P<0.05). The patients had stable CD4 counts over the follow up period since then, i.e., within 25 per cent of the previous levels. INTERPRETATION & CONCLUSION: Pentoxiphylline therapy in HIV infected individuals, who were free of opportunistic infections, improved their body weight, minimized opportunistic infections, increased and sustained CD4 counts. Given the low cost of the drug it could be recommended for the use in individuals who are at a high risk of developing opportunistic infections.

Caspase 1 and caspase 8 in HIV infected patients with and without tuberculosis.

BACKGROUND: Caspase 8 is involved in apoptosis mediated by Fas and p55 tumor necrosis factor receptor ligation in HIV infection. Apoptosis is partially mediated by interleukin-1beta-converting enzyme (caspase-1). AIMS: We determined apoptosis, using caspase-1 and caspase-8, among patients with HIV infection, with and without tuberculosis (TB), those with TB alone and healthy individuals. SETTING AND DESIGN: Cross-sectional analysis of caspase-1 and caspase-8 among patients with HIV infection, with and without TB, those with TB alone and healthy individuals. MATERIALS AND METHODS: Nineteen HIV infected patients with TB (HIV+/TB+) and 20 with HIV infection without TB (HIV+/TB-) were studied. Fifteen individuals with TB alone were disease controls (HIV-/TB+) and 20 were healthy controls (HIV-/TB-). Caspases were measured by single-step ELISA using commercially available monoclonal antibodies. STATISTICAL ANALYSIS: Two-way ANOVA and Pearson's correlation coefficient. RESULTS: Mean CD4 counts of HIV+/TB+ were lower than HIV+/TB- (p<0.05). OD value of caspase 1 in HIV+/TB+ was 0.295+0.05, while that in HIV+/TB- it was 0.302+0.18. It was 0.293+0.07 in HIV-/TB+ and in HIV-/TB- the values were 0.287+0.06. OD value of caspase 8 in HIV+/TB+ was 0.307+ 0.07, lower than HIV+/TB- (0.927+0.25). It was 0.008+0.03 in HIV-/TB+ and in HIV-/TB-, 0.074+0.004. Values of caspase 8 in patients with HIV infection (with/without TB) were higher than those with TB alone or healthy individuals (p<0.01). Levels of caspase 8 in HIV+/TB- were higher than patients with HIV+/TB+ (p<0.01). CONCLUSION: Levels of caspase-1 are not different irrespective of presence or otherwise of TB and HIV infection. Fas-related apoptosis is higher in HIV infection. With concomitant TB, levels of caspase 8 were lower as compared with those without TB.

Beta2 microglobulin as a surrogate marker for HIV infection: good correlation with CD4 counts.

To determine if beta-2 microglobulin (beta2M) levels were elevated in our HIV infected patient population and if it could be used as a surrogate marker for disease progression. Thirty-eight HIV infected individuals and 26 age and sex-matched controls were studied. Measurement of CD4 cell count was carried out on a flowcytometer using anti-human CD4 monoclonal antibody and beta2M was measured by an enzyme immunoassay. Mean levels of HIV infected individuals were 1.29 +/- 0.52 mg/L and were significantly higher than 0.74 +/- 0.07 mg/L, the value of controls (p value <0.01). There was a negative correlation between CD4 counts and beta2M levels (r-value-0.79, p value <0.001). Beta2M levels in HIV infected individuals who have no opportunistic infection are elevated and these levels correlate with the CD4 counts. Beta2M can be used for the clinical follow-up of patients with HIV infection.

Animal models of hepatic encephalopathy.

Hepatic encephalopathy is a neuropsychiatric syndrome associated with acute liver failure, chronic parenchymal liver disease, or portosystemic anastomosis. Many approaches have been used to develop suitable models of hepatic encephalopathy, each with specific advantages and disadvantages. The most commonly used models have been the surgical hepatectomy and liver devascularization procedures, and hepatotoxins such as galactosamine and acetaminophen. Drug-toxicity models may be clinically more relevant. The specific requirements of experiments to study a particular aspect of encephalopathy also influence the choice of animal model. Animal models will play a central role in future research into hepatic encephalopathy to better understand its pathophysiology and to develop newer therapeutic modalities for this condition.

Nitric oxide derivative in bronchoalveolar lavage fluid from patients with idiopathic pulmonary fibrosis.

Idiopathic pulmonary fibrosis is a chronic inflammatory disorder of unknown aetiology with a number of inflammatory cells playing a role in its pathogenesis. In this study, we have attempted to find out the possible role of nitric oxide in its pathogenesis by way of measuring the nitrite and nitrate levels in the bronchoalveolar lavage fluid. Ten patients of histologically proved idiopathic pulmonary fibrosis and 10 controls (5 with normal chest skiagrams and 5 with sarcoidosis) were included in the study Bronchoalveolar lavage was carried out in these cases. The levels of nitrates and nitrites were increased in cases of idiopathic pulmonary fibrosis (0.77+/- 0.36 and 8.93 +/- 2.63 nmol/mg of protein) compared to those in controls (0.38 +/- 0.06 and 3.80 +/- 1.11, respectively for sarcoidosis patients); (0.39 +/- 0.13 and 6.56 +/- 1.61 for subjects with normal chest skiagrams). These differences were statistically significant (p < 0.05 to 0.01). These findings suggest a possible role of nitric oxide in the pathogenesis of idiopathic pulmonary fibrosis.

Decline in beta-2 microglobulin levels after antitubercular therapy in tubercular patients with HIV infection.

BACKGROUND: Infection with Mycobacterium tuberculosis results in a state of immune activation, more so, when there is concomitant HIV infection. Beta-2 microglobulin (B2M) is a useful marker to study the state of immune activation among the HIV infected. Objective. To study the modulation of B2M levels among patients with HIV/TB coinfection, to correlate it with the CD4 count and also to study the change in these levels after four weeks of therapy. MATERIAL AND METHODS: Twelve patients with HIV infection and having concomitant TB diagnosed on the basis of positive acid fast bacilli were studied both at baseline and then at four weeks. Fourteen HIV infected individuals who had no overt opportunistic infection at the time of the study were also studied along with fourteen age and sex matched healthy volunteers. CD4 counts were performed using a flowcytometer. B2M was measured using a commercially available ELISA kit. RESULTS: B2M levels in HIV/TB coinfected patients were 1.62+/-0.45 mg/L (range 1-2.7 mg/L) and were significantly higher (p<0.0002) when compared with healthy controls, whose levels were 0.74+/-0.05 mg/L (range 0.48-81 mg/L). The levels in HIV infected individuals free of opportunistic infections were 1.2+/-0.16 mg/L (range 0.78-1.92 mg/L) and were significantly lower than the levels in HIV/TB coinfected (p<0.017), but significantly higher than the levels in healthy controls (p<0.01). Four weeks of antitubercular therapy resulted in a decline in B2M to 1.08+/-0.26 mg/L (range 0.8-1.74 mg/L) and was statistically significant (p<0.012). There was no correlation between the CD4 counts and the pre-treatment levels of B2M among these patients. CONCLUSION: Patients with HIV/TB coinfection had significantly higher levels of B2M than individuals with HIV infection without associated opportunistic infection and healthy controls. Four weeks of anti-tuberculous therapy resulted in a significant decline in these levels.

Suppression of beta 2 microglobulin by pentoxiphylline therapy in asymptomatic HIV infected individuals.

Pentoxiphylline, an inhibitor of tumor necrosis factor-alpha (TNF-alpha) has been used in the treatment of human immunodeficiency virus (HIV) infection. The inhibition of TNF-alpha results in decreased immune activation. Beta 2 microglobulin (beta 2 M) has been used as a surrogate marker to study the progression of HIV infection. The objective of this study was to see if use of pentoxiphylline resulted in any decline in beta 2 M levels. Twenty patients with HIV infection who were free of opportunistic infections at the time of inclusion in the study and 18 age and sex matched controls were studied. beta 2 M was measured using an enzyme immunoassay before and four weeks after the start of treatment with pentoxiphylline. Mean levels of beta 2 M before therapy were 1.51 +/- 0.77 mg/l (range 0.78-3.8 mg/l) and were significantly higher (P < 0.001) than the levels among controls [0.72 +/- 0.06 mg/l (range 0.46-0.88 mg/l)]. beta 2 M levels in patients declined to 0.85 +/- 0.22 mg/l (range 0.72-1.0 mg/l) after four weeks of therapy and this was statistically significant (P < 0.001). Use of pentoxiphylline for four weeks results in a significant decline in the levels of beta 2 M suggesting that the level of immune activation is reduced with the therapy.

Influence of cadmium on growth and development of Vicia faba Linn.

Influence of cadmium (Cd) on growth and development of broad bean (V. faba) was assessed in pot cultures with cadmium iodide (CdI2) in different concentrations ranging from 15 to 500 mg per kg of soil. There was a decline in plant height and total dry weight. Root size decreased most significantly with a corresponding reduction in the frequency of root nodules. Total soluble protein in leaf, stem and root suffered a pronounced loss with increasing concentration of cadmium. Chlorophyll a was the most sensitive pigment followed by chlorophyll b and carotenoids. Nitrate reductase activity too was adversely affected. Cadmium contamination induced abnormalities in stomata and trichomes.

Iodine loss from iodised salt on heating.

Iodine deficiency disorders constitute a major public health problem in India. The national IDD control programme (NIDDCP) relies solely on iodine supplementation through fortification of common salt with potassium iodate. However, data regarding iodine loss due to high temperatures of cooking procedure is scarce. Using iodometric titration methods, we calculated iodine content of iodised salt samples subjected to incremental heat up to 350 degree Celsius. The results of the study indicate a gradual but minimal loss of iodine content from the iodised salt samples when subjected to high temperature with a maximum loss noticed being 18.5% at 350 degree Celsius. We conclude that there is minimal loss of iodine from the salt fortified with potassium iodate when subjected to heating (temperature normally attained during cooling process).

Efficacy of standard ten millicurie dose of radio-iodine in management of autonomously functioning toxic thyroid nodules.

Therapeutic effect of radio-iodine treatment on thyroid patients with autonomously functioning toxic thyroid nodule was evaluated. Fifty one patients were given a standard dose of 10 mci of radioiodine (I-131) and were followed up for 2-3 years. The failure rate (relapse after 10 mci of radioiodine) of this regime was 10%. It was found that the nodules less than or equal to 3 cms. in size were completely cured after a dose of 10 mic. of radio-iodine therapy, over a follow up period of next 6 months. Patients having nodules larger than 3 cms. relapsed after first dose of 10 mci of radio-iodine, but were cured completely after the second dose of 10 mci of radio-iodine therapy. Tri-iodothyronine (T3) and thyroxine (T4) values were both found to be high before giving treatment in all the cases. Only one case developed hypothyroidism after radioiodine therapy.

Characterization of a wide host range plasmid pANV-6 from Citrobacter diversus.

pANV-6 is a 5.85 kb, streptomycin resistant, high copy number plasmid isolated from a multi drug resistant clinical isolate of C. diversus by transformation in Escherichia coli C-600. The plasmid was very stable, noncurable and could not be amplified with chloramphenicol. It was non-conjugative among Enterobacteriaceae hosts. Plasmid was transferred by transformation to several Gram negative and Gram positive hosts. These included Esch. coli, Serratia marcescens, Salmonella typhimurium, Klebsiella pneumoniae, Staphylococcus aureus, Corynebacterium glutamicum. From Staph. aureus it was transferred by conjugation to other Staph. aureus, Staph. epidermidis and Bacillus subtilis. Plasmid was incompatible with standard plasmids belonging to incompatibility groups H1, H2 = S,J,P and T of coliform bacteria. Plasmid has one site for restriction enzyme EcoRI and Pst I, three for Bgl 1 and non for Bgl 1, Bam HI, Hind III and X ba I.