Socio-ecological vulnerability and resilience of mountain communities residing in capital-constrained environments.

The study evaluated perceived reactions and counter-actions of Himalayan communities to climate change. The evaluation was conducted through identification and characterization of 62 socio-environment-specific indicators in three altitude zones (< 1200 m asl (zone A), 1200-1800 m asl (zone B), and > 1800 m asl (zone C)) in Pauri district, Uttarakhand, India, using a bottom-up, indicator-based approach. Indicators with higher significance for the local economy, livelihoods, or conservation were selected and assimilated into dimensions of vulnerability and resilience. Finally, these were integrated into a sustainable livelihood framework in an approach intended to calculate vulnerability and resilience jointly. The results indicated that the vulnerability and resilience of the mountain communities studied varied widely along the altitude gradient, due to variations in socioeconomic profile, livelihood requirements, resource availability, accessibility, and utilization pattern, and climate risk. The overall values for vulnerability (exposure + sensitivity-adaptive capacity) and resilience (exposure + sensitivity-restorative capacity) were, respectively, 0.34 and 0.28 in zone A, 0.54 and 0.37 in zone B, and 0.65 and 0.59 in zone C. There was a significant difference in contribution of indicators to vulnerability and resilience along the altitudinal gradient was recorded. Strategies for dealing with site-specific vulnerability are required and should address bottlenecks in accessibility and availability of food, water, and healthcare; sustainable utilization of forest resources; educational attainment and skill enhancement; and migration. These results extend current knowledge among the research community and policymakers on socio-ecological changes affecting mountain communities. To reduce the policy level gap between bottom-up and top-down approaches, we suggest precautionary and ongoing site-specific traditional practices and modern adaptation practices, leading to effective and efficient handling of local issues in the context of climate change.

Assessment of climate change pattern in the Pauri Garhwal of the Western Himalayan Region: based on climate parameters and perceptions of forest-dependent communities.

This study assessed the climate change in Pauri district, Uttarakhand, India, a region highly vulnerable to climate change with potentially high loss of livelihoods and lives. The scale of change in the district's climate was analyzed using meteorological station data (1901-2000) and grid data (1985-2015). Perceptions of climate change among forest-dependent communities in three altitude zones (< 1200 m asl (zone A); 1200-1800 m asl (zone B), and > 1800 m asl (zone C)) in the study region were surveyed with respect to 14 climate-specific indicators. Annual mean, maximum, and minimum temperature of seasonal data indicated increasing trends except monsoon. Percentage cloud cover showed an increase, of approximately 3%, while diurnal temperature displayed decreasing trends. Rainfall in the district showed a decreasing trend, with more than 50% of years 1985-2015 receiving less rainfall than the annual average. More than 90% of respondents in zones A and B, and around 65-70% respondents in zone C, reported changes in climate parameters. These findings confirm the long-term observable changes in climate in the region and demonstrate the utility of station data, grid data, and surveys of local communities' perceptions when analyzing climate change. The analysis provided important clues about the nature of climate changes in the district. The results can be used to reduce the gap between bottom-up understanding and top-down policies and to formulate precautionary and ongoing site-specific adaptation practices for communities in different altitude zones in the study region, leading to effective and efficient mitigation of climate change impacts.

Ras signaling pathway in the chemopreventive action of different ratios of fish oil and corn oil in experimentally induced colon carcinogenesis.

Dietary factors play a significant role in colon cancer. The essential polyunsaturated fatty acids (PUFAs), n-3 PUFAs, and n-6 PUFAs exert inverse effect on cancer. This study was designed to understand the mechanism of chemopreventive action of different ratios of fish oil (FO) and corn oil (CO) in colon carcinoma. Wistar rats were divided into 3 groups: Group 1 received purified diet whereas Groups 2 and 3 received modified diet with FO:CO (1:1) and FO:CO (2.5:1), respectively. The groups were further subdivided into controls receiving ethylenediamine-tetra acetic-acid and treated groups received dimethylhydrazine-dihydrochloride (DMH)/wk for 4 wk. Animals sacrificed 48 h after last injection constituted initiation phase and that sacrificed after 16 wk constituted post-initiation phase. Differential effect of different ratios of FO and CO was analyzed in isolated colonocytes. In both phases, DMH treatment showed an increase in pan Ras, Raf, MEK1/2, extracellular signal regulated kinase (Erk)1/2, and c-fos levels. Akt levels were increased in post-initiation phase only. Treatment with FO + CO (1:1) + DMH decreased pan Ras, MEK1/2 and Erk1/2 levels in post-initiation phase whereas Raf and c-fos were decreased in both phases. Treatment with FO + CO (2.5:1) + DMH decreased Ras, Raf, MEK1/2, Erk1/2, and c-fos levels in both phases. Akt was decreased in post-initiation phase only. The chemo-preventive action of FO and CO may be mediated by time- and dose-dependent effect.

Epidemiology of a new focus of localized cutaneous leishmaniasis in Himachal Pradesh.

A new focus of localised cutaneous leishmaniasis has emerged along the Satluj River valley in the mountainous region of north west Himachal Pradesh. The main endemic region extends from Pooh subdivision of Kinnaur district to Kumarsain subdivision of Shimla district with adjoining Nirmand subdivision of Kullu District comprising 86 villages. The climate of the affected areas varies from temperate to subtropical. A total of 285 cases were recorded from 1988 to January, 2005. The age of these patients varied from 10 months to 75 years, with 63 children (<12Years), and a male to female ratio of 1: 0.9. The duration of disease was 15 days to 48 months with majority (85%) presenting between 1-6 months. The number of lesions varied from 1-8, and were mostly seen on exposed parts of the body. Morphologically, lesions were asymptomatic, dry, nodular or crusted nodulo-ulcerative plaques. Tissue smear positivity for amastigotes was 43%. The characterization of 14 strains of these Leishmania revealed presence of both Leishmania tropica (n=3) and Leishmania donovani (n=11). Identification of the 42 sandflies collected from the peridomestic environment of the patients, revealed Phlebotomus longiductus - 29, P. major 8, P. kandelaki 2, while 2 remained unidentified. The patients were treated with intralesional sodium stibogluconate and majority showed excellent response.

Intravitreal triamcinolone improves vision in eyes with chronic diabetic macular oedema refractory to laser photocoagulation.

PURPOSE: To evaluate the clinical and visual outcome of an intravitreal injection of triamcinolone in patients with diabetic macular oedema refractory to laser treatment. MATERIAL AND METHODS: Prospective, interventional nonrandomised case series of 24 eyes of 24 patients that underwent intravitreal injection of 4 mg triamcinolone for chronic diabetic macular oedema refractory to previous laser treatment. All patients had best corrected visual acuity (bcva) on the LogMAR scale, near vision, slit-lamp biomicroscopy for the presence of clinically significant macular oedema, and intraocular pressure check at 1, 3, and 6 months. RESULTS: The average duration of macular oedema before the injection was 38.2 months (range=6-120 months) with the mean number of laser treatments before the injection being 2.2 (range=1-5). The visual acuity improved in 19 of the 23 (83%) eyes at 1 month, 16 of the 21 eyes (76%) at 3 months and six of 11 eyes (55%) at 6 months follow-up. The mean bcva improved by an average of 10, nine, and six letters, respectively, compared to the baseline at 1, 3, and 6 months (P=0.0002 at 1 month and 0.001 at 3 months with the Wilcoxon signed-ranked test). The intraocular pressure rose by an average of 2.4, 2.8, and 2.7 mmHg at the same follow-up visits. CONCLUSION: Intravitreal triamcinolone appears to be promising in the short term, for improving the vision in eyes with chronic diabetic macular oedema unresponsive to conventional laser treatment. Randomised controlled trials utilising varying doses of steroid are now required to define optimum treatment regimens.

Does the site of filtration influence the medium to long term intraocular pressure control following microtrabeculectomy in low risk eyes?

AIMS: To evaluate the influence of varying surgical site on the medium to long term intraocular pressure (IOP) control in patients undergoing unenhanced small flap trabeculectomy (microtrabeculectomy) in eyes at low risk of failure. METHODS: A retrospective non-concurrent analysis was performed on two cohorts of patients who underwent unenhanced microtrabeculectomy at different sites by a single surgeon (SAV). The first cohort of eyes was part of a trial to study the astigmatic effect of microtrabeculectomy (results published elsewhere) and all had flaps centred at the 12 o'clock meridian (superior flaps). The second cohort consisted of eyes with flaps created on either side of the 12 o'clock-that is, superonasal in left eyes and superotemporal in right eyes. All case notes were reviewed for the preoperative and presenting IOPs, the number and duration of antiglaucoma medication use preoperatively and, postoperatively, any intraoperative, early, or late postoperative complications. All IOPs measured at 6 months and then yearly intervals were recorded. The baseline characteristics and IOPs at each follow up were compared between the eyes with the superonasal and superotemporal flaps of the non-12 o'clock group against those with superior flaps in the 12 o'clock group up to a maximum of 72 months. Survival was assessed by the site of microtrabeculectomy, with failure considered as any IOP above 22 and 15 mm Hg with or without medications. RESULTS: All patients had a minimum follow up of 12 months and 12/17 patients in the 12 o'clock group and 17/28 in the non-12 o'clock group completed the full follow up of 72 months. The IOPs at all points in time were lower in the left eyes with superonasal flaps compared to both the superior and the superotemporal groups. This difference was statistically significant between the three groups to the end of 4 years (p = 0.001) and remains clinically significant thereafter with the mean last recorded IOPs of 15.9, 12.4 (p = 0.03), and 14.3 mm Hg in the superior, superonasal and superotemporal groups respectively, with a smaller mean number of drops in the non-12 o'clock group. Kaplan-Meier curves showed a significantly better outcome for the cutoff IOP of 15 mm Hg in the superonasal group (p = 0.003) compared with both the other groups. CONCLUSION: Eyes with superonasal flaps achieve and maintain lower IOPs when compared with both the superior and superotemporal flaps. The results suggest that, when a low target IOP is desired, the site of surgery in an unenhanced filtering procedure should be superonasally sited.

Isolated posterior dislocation of the radial head in an adult.

Isolated posterior dislocation of the radial head was detected on X-ray in a patient following a vehicular accident. Such a dislocation without an associated fracture is extremely rare in adults. Immobilization of the elbow in full pronation and 90 degrees flexion for 4 weeks normalized the position of the head of the radius.