Response of malaria vectors to conventional insecticides in the southern districts of Odisha State, India.

Background & objectives: Updating information on response (susceptible / resistant status) of vectors to the insecticides in use is essential to formulate and introduce appropriate resistance management strategy. Therefore, a study was undertaken in the 10 southern districts of Odisha State, which are endemic for Plasmodium falciparum malaria, to determine the insecticide susceptibility/ resistance status of Anopheles fluviatilis and An. culicifacies, the vectors of malaria. Methods: Mosquitoes were collected during September 2010 - February 2012 from 60 randomly selected villages in the 10 districts and blood-fed females were exposed to the diagnostic dosage of DDT (4.0%), malathion (5.0%) and deltamethrin (0.05%) for one hour. Mortality was recorded at 24 h after the exposure. The test mortality was corrected to the control mortality. Results: An. fluviatilis was susceptible to the three insecticides tested while, An. culicifacies was resistant to DDT and malathion in all the 10 districts except in two, where its response against malathion was under ‘verification required’ category. Against deltamethrin, An. culicifacies was susceptible in two districts; while in the other eight districts its response was under ‘verification required’ category. Interpretation & conclusions: Since An. fluviatilis the vector species primarily associated with transmission of malaria, was still susceptible to DDT, indoor residual spraying with DDT could be continued in the 10 districts. Also, in view of the large scale implementation of long lasting insecticidal nets and the signs of development of resistance in An. culicifacies to deltamethrin, response of the vectors to synthetic pyrethroids needs to be periodically monitored.

Comparison of Visual and Auditory Reaction Time of Hand and Foot in Young Adults Before and After Physical Training.

Present study was conducted to compare Visual Reaction Time (VRT) and Auditory Reaction Time (ART) of hand & foot in young adults before and after physical training. VRT & ART in milliseconds was determined with the help of “Response Analyzer” in 87 males and 13 females in the age group 17 to 25 years before and after physical training and compared. Both VRT & ART was significantly decreased in all four limbs after physical training of 6 months.

Comparison of Visual and Auditory Reaction Time of Right and Left Side in Right Handed Young Adults.

Present study was conducted to compare Visual Reaction Time (VRT) & Auditory Reaction Time (ART) of right and left side in right handed young adults .VRT & ART of right hand and left hand and right foot and left foot in milliseconds was determined with the help of “Response Analyzer” in 87 males & 13 females in the age group 17 to 25 years and compared. VRT of right hand and right foot was significantly shorter than that of left hand and left foot and ART of right hand and right foot was significantly shorter than that of left hand and left foot.

Fatal nitrobenzene poisoning: Some case reports and medicolegal aspects.

Nitrobenzene is a synthetic organic compound, pale yellow in colour, freely soluble in alcohol, with a pleasant odour like that of bitter almonds or shoe polish. It is widely used in chemical industry, and is present in commercial products such as shoe and metal polish, ink, paint remover and soap. Poisoning due to nitrobenzene is usually chronic in nature, mainly due to occupational exposure, except for a few acute cases of industrial accidents or suicides. We report three cases of fatal nitrobenzene poisoning through oral ingestion. All persons consumed alcohol prior to, or along with nitrobenzene. The alleged manner of poisoning was different in every case (one case each of homicide, suicide and accident). Clinical features, autopsy findings and medicolegal aspects of nitrobenzene poisoning are discussed.

Study of breast lump of 2246 cases by fine needle aspiration.

The purpose of this study was to analyze breast lesions causing breast lump with special reference to patients younger and older than 30 years of age diagnosed by fine-needle aspiration (FNA) and to evaluate the histology of the cases diagnosed as suspicious of malignancy in FNA. All patients who underwent FNA during four years period (2000-2004) were included in this study. The FNA procedure was performed and interpreted by the experienced pathologists. Histological evaluation of the suspicious cases in FNA was done and was based on excisional biopsy or mastectomy specimen. Out of 2246 FNA performed, 1840 were diagnosed as non-malignant, 6 atypical ductal hyperplasia, 52 suspicious of malignancy and 348 as malignant. The most common non-malignant lesions included 975 (43%) fibroadenosis, 180 (8%) fibroadenoma, 126 (6%) abscess and 96 (4%) fibrocystic changes. The patients were further divided into two groups: group I consisted of 918 patients aged 30 years and younger and group II consisted of 1328 patients above 30 years. In group I, 444 (48.4%) were diagnosed as fibroadenosis and only 15 (1.6%) cases were malignancies. In group II 531 (40%) were fibroadenosis and 333 (25%) were malignant. Patients more than 30 years old had significantly higher malignancy diagnoses (P<0.001). The odds of being diagnosed as malignant tumor among the higher age group patients (>30 years) is 21 times larger (confidence interval 12.4, 35.6) than the younger patients (<30 years). In 63% (27/43) of the suspicious cases, malignancy was diagnosed in histological examination. Cancer and Fibroadenosis are two most common causes of breast lumps in Nepal. Incidence of malignancy is significantly lower in patients aged 30 years and younger than in patients aged older than 30 years. Suspicious FNA cases should be evaluated histologically to rule out malignancy.

One gene, many phenotypes.

"Phenotype" is the visible or quantifiable effect of the expression of a gene, whereas the specific genetic constitution responsible for a phenotype is called "genotype". It was hoped that phenotype could be accurately predicted if the genotype could be characterized. But, the relationship between the genotype and phenotype is not straightforward. Similar genetic lesions can have entirely different phenotypes. In recent years, there has been tremendous progress in the understanding of the genetic basis of diseases. The extent to which it will be possible to relate findings at the DNA level to the clinical phenotype is difficult to delineate on many occasions. The elucidation of mechanisms underlying genotype-phenotype discrepancies is important as it will influence the use of DNA-based tests in the diagnosis, therapy and counseling of individuals affected with genetic disorders. This issue is pertinent to almost every aspect of medical practice and research in this post-genome era. In this article, we have tried to summarize those factors which are responsible for varied manifestations of lesion(s) in a single gene.

Study of clinical profile and antibiotic sensitivity pattern in culture positive typhoid fever cases.

OBJECTIVES: The present study was designed to analyze the clinical profile and antibiotic sensitivity pattern in the cases of culture positive typhoid fever. METHOD: The study was conducted over a period of 1 year. Total of 46 culture positive cases of Typhoid fever were included in the study. The sensitivity pattern of isolates from blood culture was recorded. The modes of presentation, clinical course, lab investigation reports were also recorded. RESULTS: Out of 46 cases, 33 (71.7%) were males and 13 (28.3%) were females. Average age of presentation was 26.17 years. Fever was present in all patients. Resistance of S .typhi to amoxycillin, chloramphenicol and co-trimoxazole were significantly high. Ciprofloxacin showed resistance in 2 (4.3%) cases. Sensitivity to ceftriaxone was 100% in our study. CONCLUSION: Typhoid fever is one of the most common health problem in Nepal. Various drugs are being used in the treatment of typhoid fever, in the mean time resistance to many of them are emerging. An appropriate antibiotic has to be initiated only after culture sensitivity in typhoid fever.

Hemoglobin E-beta thalassemia: factors affecting phenotype.

The phenotype of E-beta-thalassemia is affected by several genetic factors. The aim of this study was to analyze severity of E-beta-thalassemia and correlate with HbE, HbF, E/F ratios, beta-mutation and Xmn I polymorphism. Thirty cases of E-beta-thalassemia (23 with childhood onset) were studied. HbE levels were quantitated by HPLC. Xmn1 polymorphism and beta-mutations were studied by PCR-RFLP and ARMS respectively. Commonest features were pallor (100%), splenomegaly (74%), and hepatomegaly (65%), 43% (10/23) were on regular transfusions at diagnosis. One case presented with paraplegia. Patients heterozygous for Xmn I polymorphism (+/-) had later onset (>3 yrs) compared to homozygous (-/-) absence (0.5-2.8 yrs). Most (69.6%) showed beta-mutation IVS 1-5 (G-->C). Negative correlation was found between age of onset and HbE. Thus, presentation is similar to previously reported Thai cases. Heterozygosity of Xmn I polymorphism also delays disease onset. Early diagnosis facilitates appropriate management and prenatal diagnosis.

Case of Schizencephaly: a case report.

Schizencephaly is a rare developmental disorder of neuronal migration, characterized by early focal destruction of the germinal matrix and surrounding brain before the cerebral hemispheres are fully formed at 1-5 months of gestation .The lesion is most likely related to multiple aetiologies including genetic, toxic, metabolic, vascular or infectious agents. This case is reported due to its rarity. The prevalence of schizencephaly is very uncommon internationally.

Spectrum of holoprosencephaly.

OBJECTIVE: To conduct a clinical study of holoprosencephaly (HPE). METHOD: Thirteen cases of HPE were studied regarding their clinical features, family history, and prenatal and imaging studies. Chromosomal analysis was done whenever fresh sample was available. RESULTS: Six cases were antenatally detected by ultrasound; four cases were stillborn. Three cases were identified by neuroimaging done a part of evaluation of developmental delay or cleft lip. Eleven of them had facial anomalies characteristics of HPE. Two of these had subtle facial features and microcephaly. Karyotype was abnormal in 2 of 7 cases studied. CONCLUSION: Most of the cases of HPE present antenatally or at birth. Milder forms like lobar and semilobar can present as developmental delay during infancy. Facial anomalies are usually associated with HPE. Chromosomal study of the case and clinical examination of the parents is essential for providing information regarding risk of recurrence to the family.

ICTs application for better health in Nepal.

Technologies with the ability to send information in a fast, efficient and cheap fashion--such as the Internet-can provide dramatic improvements in access to information, advice and care. This article explores the strengths and weaknesses of Internet to augment traditional health services and supply new ones. In doing so, it presents concrete cases in the developing world, with reference to Nepal, where Internet is being used for health-related activities--ranging from patient/doctor consultation through database services, to the management of epidemics.

Role of percutaneous fine needle aspiration cytology (FNAC) in detection of lung, pleural and mediastinal tumours--a study of 162 cases.

Percutaneous fine needle aspiration cytology (FNAC) was employed in 162 cases of lung, pleural and mediastinal tumours without the aid of fluoroscopy. There were 143 males and 19 females. Analysis of results showed that the age of the patients ranged from 3 years to 85 years. 135 cases were lung tumours, 25 cases were mediastinal tumours and 2 cases were malignant pleural mesotheliomas. Correlation with histopathology showed diagnostic accuracy of malignant lung and pleural tumours was 97.1% while the accuracy of the exact categorisation of the lesion was 92%. Diagnostic accuracy of mediastinal lesions was 96%. There was no false positive report. No complication was encountered in this procedure.

Precocious desynapsis of XY-bivalent in mouse germinal cells: influence of mitomycin C on tumour-bearing and normal mice.

A comparative study on the cytotoxic potential of anticancer-antibiotic mitomycin C has been made on tumour-bearing and normal mice considering precocious desynapsis of sex bivalent as parameter. The study indicates a strikingly differential effect of the drug on the phenomenon in two different types of mice. The administration of mitomycin C at therapeutic dose although enhances the frequency of precocious desynapsis of XY-bivalent in non-tumour (normal) mice to a significant extent (compared to control), the same drug at the same dose fails to produce a similar effect on tumour-bearing specimens. Discussions have been made on: (i) the probable cause for this differential effect, (ii) the mechanism of mitomycin action on precocious desynapsis of sex bivalent and, (iii) the possible significance of the findings in relation to cancer chemotherapy.