Impact of 28 year old agroforestry systems on soil carbon dynamics in Eastern Himalayas.

Globally, various estimates are available on the above-ground (plant parts) carbon (C) sequestering potential of agroforestry systems (AFSs). However, information on soil organic carbon (SOC) sequestration potential is limited for AFSs. Furthermore, the impacts of AFSs established for the restoration of C in degraded soils (prone to soil erosion, C and nutrients loss, etc.) of Himalayas are rarely investigated. Thus, a study was conducted on an agroforestry block established in 1989 at the Indian Council of Agricultural Research (ICAR), Research Complex for North Eastern Hill (NEH) Region, Lembucherra, Tripura, India. The AFSs comprised of four multipurpose tree species viz., teak (Tectona grandis Linn), sissoo (Dalbergia sissoo Roxb. Ex DC.), eucalyptus (Eucalyptus globulus L.), and neem (Azadirachta indica A. Juss) in combination with pineapple (Ananas comosus L. merr.). Planted in three times replicated randomized block design. After 28 years of establishment, the impacts of these AFSs were assessed on SOC stocks and its fraction pools. Results revealed that sissoo + pineapple system stored the highest SOC stocks in 0-15 cm (22.1 ± 1.4 Mg/ha) and 30-60 cm (18.0 ± 4.3 Mg/ha) depths, whereas the SOC stocks in 15-30 cm (12.2 ± 1.2 Mg/ha) and 0-30 cm (34.0 ± 1.6 Mg/ha) were the highest under teak + pineapple. When considering the entire 0-100 cm soil profile, the SOC stocks ranged between 65.3 and 71.6 Mg/ha across the diverse AFSs which was significantly higher than that under cultivated land (52.8 ± 2.6 Mg/ha). The sissoo + pineapple system had the highest SOC stock in 0-100 cm (71.6 ± 5.8 Mg/ha). The share of passive carbon (PC, less labile + non-labile) pools to SOC stocks under AFSs followed the order of sissoo + pineapple > teak + pineapple > neem + pineapple > eucalyptus + pineapple. The PC or recalcitrant pools of SOC stocks at 0-100 cm were 54.2-60.6% under various AFSs. Results revealed that the establishment of AFSs with pineapple on degraded lands increased a significant amount of C and had a considerable effect on soil quality in comparison to C present in soils under cropland. Thus, a large scale adoption of AFSs may restore C lost through the cultivation of the crop in degraded lands and provide a feasible option for livelihood through concurrent cultivation of multipurpose tree species and agri-horticulture crops.

Unusual Presentation of Necrotic Erythema Nodosum Leprosum on Scalp: A Case Report.

Lepra reactions are acute episodes occurring during the disease process of leprosy and are of 2 types: type 1 or reversal reaction and type 2 reaction or erythema odosumleprosum (ENL). In the episodes of lepra reaction several parts are affected including face and extremities like oral cavity. In the present case report we reported a rare case of lepromatous leprosy with necrotic ENL involving scalp apart from the usual sites. A 58 year old married male presented to us with complaints of spontaneous onset, recurrent eruption of multiple reddish raised painful lesions. Biopsy from the infiltrated skin over the back showed atrophic epidermis, free Grenz zone, diffuse and periadnexal macrophage granulomas with predominant mononuclear infiltrate, appandageal atrophy, fibrosis around the neural structures and leukocytoclastic vasculitis. Fites stain showed strong positivity for M. leprae. His routine blood investigations showed anemia (Hb = 7.8 gm%), neutrophil leukocytosis (TLC = 17,600, DLC = P66L28M4E2) and raised ESR (80 mm in the first hour). These bullous and necrotic lesions in leprosy may be a manifestation of severe type II reactions in patients with very high bacillary load.

Comparative Study of Clinical and Sonographic Estimation of Foetal Weight at Term.

A cross sectional comparative study was conducted at Dhaka National Medical College, Dhaka from January to June 2012, to observe the accuracy of clinical and ultrasonographic estimation of foetal weight at term in our environment. Seventy five pregnant women who fulfilled the inclusion criteria had their foetal weight estimated independently using clinical and ultrasonographic methods. Accuracy was determined by percentage error, absolute percentage error and proportion of estimates within 10% of actual birth weight (birth weight fetus of +10%). Statistical analysis was done using the paired t-test, the Wilcoxon signed-rank test, and the chi-square test. The study sample had an actual average birth weight of 2989.60 ± 408.76 (range 2310-4000 gm). Overall, the clinical method overestimated birth-weight, while ultrasound underestimated it. The mean absolute percentage error of the clinical method was more than that of the sonographic method, and the number of estimates within 10% of actual birth weight for the clinical method (41.3%) was less than for the sonographic method (57.3%); the difference was not statistically significant. In the low birth-weight (<2,500 gm) group, the mean absolute percentage error of sonographic estimates were significantly smaller. Significantly more sonographic estimates (75%) were within 10% of actual birth-weight than those of the clinical method (0%). No statistically significant difference was observed in all the measures of accuracy for the normal birth-weight range of 2,500-<4,000 gm and in the macrosomic group (≥ 4,000 gm). Clinical estimation of birth-weight is as accurate as routine ultrasonographic estimation, except in low-birth-weight babies.

Outcome of Surgical Treatment in Medically Refractory Epilepsy.

The aim of epilepsy surgery is not only to control seizures but also to curtail future adverse neurological sequelae and improve quality of life. Epilepsy surgery is a viable treatment option for selected cases of medically refractory epilepsy. A study was carried out with a series of 34 cases who underwent epilepsy surgery at Sree Chitra Tirunal Institute for Medical Science & Technology, Kerala, India during July, 2010 to December, 2010. Clinical features, operative procedures and early response to treatment were cha'racterized. Among 34 cases, main clinical manifestation was recurrent seizures. All cases were evaluated by Video Electro Encephalogram (EEG) & Magnetic Resonance Imaging (MRI) of brain with epilepsy protocol. Nearly 58% cases were diagnosed as mesial temporal sclerosis who were treated by anterior temporal lobectomy (ATL) with amygdalohippocampectomy (AH). Excision of epileptogenic foci was confirmed by preoperative Electro Cardiogram. Early response to surgery was good. However, a prolonged longitudinal follow up is essential for accurate assessment of seizure outcome.

Mosquito-borne diseases in Assam, north-east India: current status and key challenges.

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 vector-borne diseases in Assam and to address the key challenges.

Quality and shelf life evaluation of pork nuggets incorporated with fermented bamboo shoot (Bambusa polymorpha) mince.

Pork nuggets were processed by incorporating fermented bamboo shoot mince and their physico-chemical, microbiological and sensory characteristics were evaluated during 35 day storage at refrigeration temperature (4±1 °C). Addition of fermented bamboo shoot significantly affects the pH, moisture, protein, fat, fiber, instrumental color values and texture profiles of nuggets, especially at 6% and 8% addition levels. Nuggets with 6% and 8% FBSM had significantly lower TBARS values at the end of the storage period (i.e. 0.39 and 0.33 mg malonaldehyde/kg respectively) compared to the control (0.84 mg malonaldehyde/kg). Bamboo shoot addition significantly improved the microbial and sensory qualities of the pork nuggets. Incorporation of fermented bamboo shoot at 8% level increased the shelf life of pork nuggets by at least two weeks i.e. from 21 days to 35 days at 4±1 °C compared to the control.

Lepromatous leprosy with an uncommon presentation: a case report.

28 yr old male presented with asymptomatic nodules and few well to ill defined papules on ears, asymmetrical nerve enlargement and evanescent tender nodules on the extremities without any infiltration of the skin and madarosis. Slit skin smear done from normal skin was BI 6+. Skin biopsy showed features of lepromatous leprosy.

Demographic and clinical profile of myelopathy patients.

This descriptive type of cross sectional study was aimed to identify the demographic profile, clinical presentations of myelopathy and to find out the etiological factors associated with myelopathy. Total 65 patients having clinical features of myelopathy, admitted in Neurology and Medicine ward of Mymensingh Medical College Hospital from February 2009 to December 2010 were purposively studied. Patients underwent a detailed clinical evaluation followed by laboratory investigations and neuro-imaging studies. Out of 65 cases, 80.0% were male and 20.0% were female with mean age 39.15 ± 16.8 years. Highest number of cases (41.6%) was farmers. Most of the cases (72.3%) hailed from rural area. Mean duration of illness was 7.74 ± 15.8 months. 41.54% patients presented with paraplegia/paraparesis and 58.46% with quadriparesis/quadriplegia. 63.1% patients had sensory disturbance. It is observed that 58.5% had urinary sphincter disturbance and 21.5% had bowel sphincter disturbance. Among the causes of myelopathy found in this study, 29.23% patients had spondylotic myelopathy and 24.62% had transverse myelitis (ATM). In 12.31% patients the cause of myelopathy could not be identified. Myelopathy is more common in males and most of the patients are farmers. Spondylotic and Transverse myelopathy is the main etiology of compressive and non-compressive myelopathy respectively.

Effect of low dose levodopa on motor outcome of different types of stroke.

This case control study interventional study was carried out in Neurology out patient department of Bangabandhu Sheikh Mujib Medical University (BSMMU) from January 2004 to June 2005. The aim of the study was to investigate the effect of low dose levodopa on motor outcome of patients with stroke both ischaemic and haemorrhagic. A total of 97 patients of stroke confirmed by computerized tomography (CT) scan of brain were included in the study. Of them 51 were treated with levodopa 125mg (L group) and physiotherapy while 46 patients (NL group) were treated only with physiotherapy without levodopa. The patients were followed up every 2 weeks interval for 8 weeks. Motor outcome was measured in Rivermead Mobility Index (RMI). Comparison was made between L & NL group irrespective of stroke types at the end of 4th visit. Also the effect of levodopa was assessed separately in ischaemic & haemorrhaegic stroke. The results of the study showed that the age of stroke patients was 54.70±15.07 years in L group & 58.10±14.69 years in NL group. Ischaemic stroke patients were 72% and haemorrhagic stroke patients were 28%. The mean increase RMI score in L group irrespective of stroke subtypes was 6.9 while in NL group was 3.0. The increase in motor outcome was significantly higher in levodopa group than non-levodopa group (p<0.001). Similarly motor outcome measured in RMI score were significantly better individually in ischaemic & haemorrhagic stroke patients of L group than NL (p<0.001). So, the study result concludes that low dose levodopa improves motor outcome in patient with stroke both ischaemic and haemorrhagic.

A novel polymorphism in codon 25 of the KRAS gene associated with gallbladder carcinoma patients of the eastern part of India.

Gallbladder cancer (GBC) is more prevalent than other cancers in North India. The asymptomatic nature of the disease is a problem in the diagnosis and treatment. Analysis of oncogenes or tumor suppressor genes could be of importance in this regard. KRAS is the most frequently mutated member and is said to be one of the most activated oncogenes. The present study was aimed to determine the role of intragenic variants in the KRAS gene, in the progression of GBC in the eastern part of India. Sixty gallbladder carcinoma subjects (13 men and 47 women) with histologically proven diagnosis and 90 individuals (14 men and 76 women) who have no diagnosed cancer were included in the present study. All single-nucleotide polymorphisms present in exons 1 and 2 were analyzed by polymerase chain reaction followed by sequencing. We could not find the most frequently reported mutations at codons 12, 13, and 61 of the KRAS gene that occur in human malignancies. However, in this study, we detected one novel polymorphism at codon 25 (CAG>CAT; Gln25His) in exon 1 of the KRAS gene in both germline and tissue DNA. Multivariable logistic regression analysis with adjustment for age and sex revealed that the Gln25His variant of the KRAS gene was significantly associated with GBC. In silico analysis has validated the KRAS p.Q25H polymorphism as a disease-causing variant. Further, screening of the DNA samples in a cohort of ancestral tribal populations from various parts of the country without information on the phenotype, however, revealed the presence of the previously reported codon 12 and 25 polymorphisms, thereby indicating that the novel variant is population specific in the region.

Wash-resistance and field efficacy of Olyset net, a permethrin-incorporated long-lasting insecticidal netting, against Anopheles minimus-transmitted malaria in Assam, Northeastern India.

INTRODUCTION: The long-lasting insecticidal nets are ready-to-use, pretreated nets, which do not require retreatment for 4-5 years. Olyset nets that are made of high-density polyethylene monofilament yarn with 2% w/w permethrin incorporated (corresponding to 1 g/m(2)) are type-2 in which insecticide is incorporated into the polymers and are wash resistant. In these, insecticide migrates to the surface of the netting fiber to be bioavailable against mosquitoes and other insect pests. STUDY SITE AND OBJECTIVES: The present study was a village scale, field-based trial that was conducted in Plasmodium falciparum predominant area of Assam to assess feasibility, acceptability, and sustainability of this intervention against vector populations and disease transmission. We here report the research findings of Olyset net as an intervention against Anopheles minimus-transmitted malaria in foothill area of Assam for the first year of observations beginning July 2005 till June 2006. RESULTS: An. minimus, the mosquito vector species, was observed to be fully susceptible to permethrin. Follow-up investigations revealed that An. minimus mosquitoes had virtually disappeared in Olyset net villages, which was corroborated by data on human bait mosquito-landing catches. There was a consistent decline in the malarial incidence in Olyset net intervention villages, and the overall impact on the malarial transmission was significant compared to untreated net and no-net control villages for the corresponding study period. The bioavailability of insecticide on Olyset netting fiber was consistent (100% kill effect) up to 10 months of monitoring, and was observed to be wash resistant even after the 20th wash at fortnightly intervals. CONCLUSIONS: The Olyset nets were safe to use, wash resistant, and assessed to be operationally feasible, community-based intervention for sustainable management of disease vectors against malaria. Community compliance and acceptance was high, and users reported decreased nuisance due to biting mosquitoes.

Borderline tuberculoid leprosy--an unusual presentation: a case report.

A twenty-six year old lady presented herself with multiple erythmatous, scaly, well-defined, hypo-esthetic plaques over bilateral soles, face and left leg. Histopathology revealed features consistent with borderline tuberculoid leprosy.

Temporal lobe involvement in Japanese encephalitis: problems in differential diagnosis.

BACKGROUND AND PURPOSE: On MR imaging and CT, Japanese encephalitis (JE) shows lesions in the thalami, substantia nigra, basal ganglia, cerebral cortex, cerebellum, brain stem, and white matter, whereas temporal lobe involvement is characteristically seen in Herpes simplex encephalitis (HSE). Temporal lobe involvement in JE may cause problems in differentiating it from HSE. We undertook this study to show the temporal lobe involvement pattern in JE and highlight differentiating features from temporal lobe involvement in HSE. METHODS: Sixty-two patients with JE underwent CT or MR imaging or both. MR imaging was done in 53 and CT in 53. The diagnosis of JE was confirmed by cerebrospinal fluid (CSF) IgM enzyme-linked immunosorbent assay. RESULTS: Eleven (17.7%) patients showed temporal lobe involvement with abnormal MR imaging in all. All the patients showed hippocampal involvement. Two patients showed extension of lesions into the amygdala and uncus with insular involvement in 1. The rest of the temporal lobe was spared. All patients had thalamic and substantia nigra involvement with basal ganglia involvement in 7. Six of 9 CT scans were abnormal and the temporal lesions were seen in 2. CONCLUSIONS: The temporal lobe involvement pattern is fairly characteristic and mostly involves the hippocampus, usually sparing the rest of the temporal lobe. This and the concurrent involvement of the thalami, substantia nigra (SN), and basal ganglia allow differentiation from HSE. However, if the temporal lobe involvement is more severe, laboratory tests may be the only way to differentiate it from HSE, and it may be prudent to start antiviral therapy in the interim period.

Necrotic erythema nodosum leprosum.

A 30 year-old farmer presented himself with mild degree fever, joint pain and multiple ulcers of 15 days' duration. Ulcers were multiple, well-defined, irregular in shape with necrotic base and elevated, sloppy margins over anus, forearms, wrists, buttocks, lower half of thighs and shins. A few of the ulcers were covered with black-coloured scab. They were tender and with serosanguinous discharge. Black atrophic scars and ill-defined, irregular, brown black-pigmented macules of various sizes were present over thighs and legs. Excision biopsy of the ulcer showed features of erythema nodosum leprosum. The patient was treated with systemic corticosteroids.

Sub-polar lepromatous leprosy presenting as urticarial wheals: a case report.

A 40-year male lepromatous leprosy patient presented with four, slightly erythematous patches, with multiple urticaria-like wheals, distributed over the body symmetrically and with thickened right ulnar and right common peroneal nerves. He was previously diagnosed as a case of chronic idiopathic urticaria. Slit skin smear from the patches and urticarial wheals showed a BI of 3+ and skin biopsy showed some features of borderline lepromatous leprosy (BL).

Tropical chronic pancreatitis.

Tropical chronic pancreatitis (TCP) is a juvenile form of chronic calcific non-alcoholic pancreatitis, seen almost exclusively in the developing countries of the tropical world. The classical triad of TCP consists of abdominal pain, steatorrhoea, and diabetes. When diabetes is present, the condition is called fibrocalculous pancreatic diabetes (FCPD) which is thus a later stage of TCP. Some of the distinctive features of TCP are younger age at onset, presence of large intraductal calculi, more aggressive course of the disease, and a high susceptibility to pancreatic cancer. Pancreatic calculi are the hallmark for the diagnosis of TCP and in non-calcific cases ductal dilation on endoscopic retrograde cholangiopancreatography, computed tomography, or ultrasound helps to identify the disease. Diabetes is usually quite severe and of the insulin requiring type, but ketosis is rare. Microvascular complications of diabetes occur as frequently as in type 2 diabetes but macrovascular complications are uncommon. Pancreatic enzyme supplements are used for relief of abdominal pain and reducing the symptoms related to steatorrhoea. Early diagnosis and better control of the endocrine and exocrine dysfunction could help to ensure better survival and improve the prognosis and quality of life of TCP patients.

Therapeutic efficacies of antimalarial drugs in the treatment of uncomplicated, Plasmodium falciparum malaria in Assam, north-eastern India.

In the Indian state of Assam, the current therapeutic efficacies of the drugs commonly used in the area for the treatment of uncomplicated, Plasmodium falciparum malaria were investigated. As is routine in this area, subjects found positive for P. falciparum malaria were initially treated with chloroquine (CQ). They were given sulfadoxine-pyrimethamine (SP) if this treatment failed, and subsequently quinine if the SP failed. The protocol of the World Health Organization's extended in-vivo test was used to follow parasite clearance and clinical cure. Therapeutic response was assessed by comparing the baseline (day-0) level of parasitaemia with that observed on day 3. Many (75.7%) of the 144 evaluable subjects were treatment successes after CQ, but six early (4.2%) and 29 (20.1%) late CQ-treatment failures were observed. Of the 34 CQ-treatment failures followed, 31 (91.2%) responded adequately to SP but the other three were early (one) or late (two) SP-treatment failures. Two (66.7%) of the SP-treatment failures responded adequately to parenteral quinine but the other (a late quinine-treatment failure) had to be given an artemisinin derivative to achieve a clinical cure. The foci in which multidrug-resistant cases of malaria are developing in India need to be identified quickly, so that such cases can be cured before the mutant strains of P. falciparum that are resistant to several drugs have a chance to become more widespread.

An outbreak of Plasmodium falciparum malaria due to Anopheles minimus in central Assam, India.

Epidemiological investigations were conducted in Nellie subcentre, PHC Jhargaon, under Morigaon district (Assam). The results of fever cases revealed 68 per cent slide positivity rate (SPR) and 40 per cent slide falciparum rate (SfR). The Pf proportion was > 87 per cent and remaining cases were P. vivax infections. An. minimus was incriminated as a malaria vector during the study period. The sporozoite rate was 3.08 per cent. The indoor man mosquito contact was 35 per bait/night as against 23 in outdoors. Results of susceptibility test revealed that the vector was still susceptible to both DDT and malathion at discriminating dosages. The study revealed that inadequate surveillance and vector control measures were contributing factors for malaria outbreak. In view of this, insecticide treated nets may be introduced to provide cost-effective control of malaria.