What are the experiences of supportive care in people affected by brain cancer and their informal caregivers: A qualitative systematic review.

PURPOSE: To critically synthesise qualitative research to understand experiences of supportive care in people affected by brain cancer and their informal caregivers. METHODS: A qualitative systematic review was conducted according to the Joanna Briggs methodology and has been reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Guidelines. Electronic databases were searched by an expert systematic review librarian for all qualitative studies irrespective of research design. All publications were double screened by two reviewers using a pre-determined exclusion and inclusion criteria. The review was managed using Covidence systematic review software. Methodological quality assessment and data extraction were performed. Qualitative findings accompanied by illustrative quotes from included studies were extracted and grouped into categories, which created the overall synthesised findings. RESULTS: A total of 33 studies were included which represented a total sample of 671 participants inclusive of 303 patients and 368 informal caregivers. There was a total of 220 individual findings included in this review, which were synthesised into two findings (1) caregivers and patients perceived supports which would have been helpful and (2) caregiver and patient experiences of unmet supportive care needs. CONCLUSION: This review highlighted the suffering and distress caused by brain cancer and associated treatments. Both patients and their informal caregivers experienced disconnect from themselves in renegotiating roles, and a profound sense of loneliness as the physical deterioration of the disease progressed. Both patients and informal caregivers reported similar unmet needs within the current service provision for brain cancer. However, what is apparent is that current cancer services are provided solely for patients, with little or no consideration to the support needs of both the patient and their informal caregiver. Service re-design is needed to improve care coordination with individualised informational support, implementation of holistic needs assessments for both the patients and their caregivers, better community support provision, improved opportunities for emotional care with early referral for palliative care services. IMPLICATIONS FOR CANCER SURVIVORS: It is recommended that members of the multidisciplinary brain cancer team reflect on these findings to target holistic needs assessments and develop shared self-management care plans for both the patient and the informal caregiver.

Population genetic structure and association mapping for iron toxicity tolerance in rice.

Iron (Fe) toxicity is a major abiotic stress which severely reduces rice yield in many countries of the world. Genetic variation for this stress tolerance exists in rice germplasms. Mapping of gene(s)/QTL controlling the stress tolerance and transfer of the traits into high yielding rice varieties are essential for improvement against the stress. A panel population of 119 genotypes from 352 germplasm lines was constituted for detecting the candidate gene(s)/QTL through association mapping. STRUCTURE, GenAlEx and Darwin softwares were used to classify the population. The marker-trait association was detected by considering both the Generalized Linear Model (GLM) and Mixed Linear Model (MLM) analyses. Wide genetic variation was observed among the genotypes present in the panel population for the stress tolerance. Linkage disequilibrium was detected in the population for iron toxicity tolerance. The population was categorized into three genetic structure groups. Marker-trait association study considering both the Generalized Linear Model (GLM) and Mixed Linear Model (MLM) showed significant association of leaf browning index (LBI) with markers RM471, RM3, RM590 and RM243. Three novel QTL controlling Fe-toxicity tolerance were detected and designated as qFeTox4.3, qFeTox6.1 and qFeTox10.1. A QTL reported earlier in the marker interval of C955-C885 on chromosome 1 is validated using this panel population. The present study showed that QTL controlling Fe-toxicity tolerance to be co-localized with the QTL for Fe-biofortification of rice grain indicating involvement of common pathway for Fe toxicity tolerance and Fe content in rice grain. Fe-toxicity tolerance QTL qFeTox6.1 was co-localized with grain Fe-biofortification QTLs qFe6.1 and qFe6.2 on chromosome 6, whereas qFeTox10.1 was co-localized with qFe10.1 on chromosome 10. The Fe-toxicity tolerance QTL detected from this mapping study will be useful in marker-assisted breeding programs.

Predictive accuracy of Demirjian's, Modified Demirjian's and India specific dental age estimation methods in Odisha (Eastern Indian) population.

This study is aimed at finding the predictive accuracy of Demirjian's (D), modified Demirjian's (MD) and India specific age estimation methods (AA) Indian specific age estimation methods in 522 healthy children of Odisha population among 3-18 years. Correlations between chronological age (CA) and derived age (DA) by above mentioned methods were evaluated by Wilcoxon signed rank test and Pearson's correlation analysis. Analysis of mean absolute error concluded that D and MD predicted the CA with fair accuracy, whereas, AA had lower accuracy in Odisha children. Odisha specific polynomial regression formula, derived in this study is showing a strong correlation with CA (r=0.84). Comparison of mean absolute error of D, MD, AA and Odisha specific method indicated a better predictive accuracy of Odisha specific method.

A comparative study of prevalence and spatial distribution of major Anopheline vector fauna in a hyper- and a hypomalaria endemic district of Odisha, India with special reference to onset of first wet season.

The state's retrospective findings indicate the incidence of malaria deaths, which is more during the onset of first monsoon season. Based upon this fact, our objective was to study the distribution pattern of major Anopheles vectors in two endemic districts viz. Kalahandi and Cuttack of Odisha, India that differ significantly according to malariogenic stratification, under the impact of first monsoon shower. A comparative study of vector abundance, predominance, their habitats, resting site preference, impact of abiotic rhythm (light/dark period) on vector distribution, gonotrophic status as well as sporozoite rate was established in a high and a low endemic district of Odisha, when the degree of malaria transmission elevates to its peak level Anopheles culicifacies was found to be predominant in hyperendemic Kalahandi district while Anopheles subpictus was abundant in hypo-endemic Cuttack district. Both primary vector An. culicifacies and the secondary vector An. subpictus mostly prefer CS (Cattle shed) compared to HD (Human dwelling) in Kalahandi district where as there was slight shifting of resting habitat of An. culicifacies from CS to HD in Cuttack district. Anopheles culicifacies prefers to rest on wall besides objects in Kalahandi while no such site preference was observed in Cuttack district. On the other hand, distribution of An. subpictus was highly influenced by the daily rhythm of light/dark cycle (i.e. day and night) in Cuttack. The gonotrophic condition revealed the high tendency of the predominant vectors towards endophilic resting. The sporozoite rate was 0.66% in Kalahandi and nil in Cuttack district. The proper monitoring of vector prevalence and distribution, at least during the peak transmission period can avert a perpetuated upsurge in malaria.

Perennial malaria transmission and its association with rainfall at Kalahandi district of Odisha, Eastern India: A retrospective analysis.

India contributes substantially to global malaria incidents. Vector dynamics is the significant determinant of malaria risk. Hence, knowledge on the interaction between rainfall, malaria cases and malaria vector density can be very useful for controlling malaria transmission. Kalahandi was screened for malaria cases, Anopheline vector density and their temporal relationship with rainfall. Epidemiological data was obtained from National Vector Borne Disease Control Programme, Odisha, India. Three years vector population study was carried out. Rainfall data was obtained from a database maintained by the Govt. of Odisha and was analysed using Univariate ANOVA and Pearson correlation co-efficient tests using R-prog. Malaria was found to be prevalent throughout the year attaining peak between July to August and another peak in December, amidst which the clinical malaria cases being recorded implied highest incidents in the month of July. The results estimated the seasonality of the population of An. culicifacies, An. fluviatilis and An. annularis over the region and determined the influence of rainfall on the vector population dynamics. Simple linear regression analysis suggested that at one month lag monthly rainfall (P=0.0007) was a significant meteorological factor. Rainfall seemed to be one of the best malaria predictors because of its positive correlation with proliferation of malaria cases in conjunction with An. culicifacies density making malaria a serious health issue in Kalahandi.

Perennial malaria transmission and its association with rainfall at Kalahandi district of Odisha, Eastern India: A retrospective analysis

@#India contributes substantially to global malaria incidents. Vector dynamics is the significant determinant of malaria risk. Hence, knowledge on the interaction between rainfall, malaria cases and malaria vector density can be very useful for controlling malaria transmission. Kalahandi was screened for malaria cases, Anopheline vector density and their temporal relationship with rainfall. Epidemiological data was obtained from National Vector Borne Disease Control Programme, Odisha, India. Three years vector population study was carried out. Rainfall data was obtained from a database maintained by the Govt. of Odisha and was analysed using Univariate ANOVA and Pearson correlation co-efficient tests using R-prog. Malaria was found to be prevalent throughout the year attaining peak between July to August and another peak in December, amidst which the clinical malaria cases being recorded implied highest incidents in the month of July. The results estimated the seasonality of the population of An. culicifacies, An. fluviatilis and An. annularis over the region and determined the influence of rainfall on the vector population dynamics. Simple linear regression analysis suggested that at one month lag monthly rainfall (P=0.0007) was a significant meteorological factor. Rainfall seemed to be one of the best malaria predictors because of its positive correlation with proliferation of malaria cases in conjunction with An. culicifacies density making malaria a serious health issue in Kalahandi.

A comparative study of prevalence and spatial distribution of major Anopheline vector fauna in a hyper- and a hypomalaria endemic district of Odisha, India with special reference to onset of first wet season

@#The state’s retrospective findings indicate the incidence of malaria deaths, which is more during the onset of first monsoon season. Based upon this fact, our objective was to study the distribution pattern of major Anopheles vectors in two endemic districts viz. Kalahandi and Cuttack of Odisha, India that differ significantly according to malariogenic stratification, under the impact of first monsoon shower. A comparative study of vector abundance, predominance, their habitats, resting site preference, impact of abiotic rhythm (light/dark period) on vector distribution, gonotrophic status as well as sporozoite rate was established in a high and a low endemic district of Odisha, when the degree of malaria transmission elevates to its peak level Anopheles culicifacies was found to be predominant in hyperendemic Kalahandi district while Anopheles subpictus was abundant in hypo-endemic Cuttack district. Both primary vector An. culicifacies and the secondary vector An. subpictus mostly prefer CS (Cattle shed) compared to HD (Human dwelling) in Kalahandi district where as there was slight shifting of resting habitat of An. culicifacies from CS to HD in Cuttack district. Anopheles culicifacies prefers to rest on wall besides objects in Kalahandi while no such site preference was observed in Cuttack district. On the other hand, distribution of An. subpictus was highly influenced by the daily rhythm of light/dark cycle (i.e. day and night) in Cuttack. The gonotrophic condition revealed the high tendency of the predominant vectors towards endophilic resting. The sporozoite rate was 0.66% in Kalahandi and nil in Cuttack district. The proper monitoring of vector prevalence and distribution, at least during the peak transmission period can avert a perpetuated upsurge in malaria.

HIV counseling and testing in a tertiary care hospital in Ganjam district, Odisha, India.

BACKGROUND: Human immunodeficiency virus (HIV) counseling and testing (HCT) conducted at integrated counseling and testing centers (ICTCs) is an entry point, cost-effective intervention in preventing transmission of HIV. OBJECTIVES: To study the prevalence of HIV among ICTC attendees, sociodemographic characteristics, and risk behaviors of HIV-seropositive clients. MATERIALS AND METHODS: It was hospital record-based cross-sectional study of 26,518 registered ICTC clients at a tertiary care hospital in Ganjam district, Odisha, India over a 4-year period from January 2009 to September 2012. RESULTS: A total of 1732 (7.5%) out of 22,897 who were tested for HIV were seropositive. Among HIV-seropositives, 1138 (65.7%) were males, while 594 (34.3%) were females. Majority (88.3%) of seropositives were between the age group of 15-49 years. Client-initiated HIV testing (12.1%) was more seropositive compared to provider-initiated (2.9%). Among discordant couples, majority (95.5%) were male partner/husband positive and female partner/wife negative. Positives were more amongst married, less educated, low socioeconomic status, and outmigrants (P<0.0001). Risk factors included heterosexual promiscuous (89.3%), parent-to-child transmission 5.8%, unknown 3.1%, infected blood transfusion 0.8%, homosexual 0.5%, and infected needles (0.5%). CONCLUSIONS: There is need to encourage activities that promote HCT in all health facilities. This will increase the diagnosis of new HIV cases. The data generated in ICTC provide an important clue to understand the epidemiology in a particular geographic region and local planning for care and treatment of those infected with HIV and preventive strategies for those at risk especially married, young adults, and outmigrants to reduce new infections.

Primary meningococcal arthritis of sacroiliac joint: a rare case report.

Infection of the sacroiliac joint is a rare entity. Clinical signs and symptoms are usually nonspecific and result in delayed diagnosis. We report a rare case of primary meningococcal arthritis of right sacroiliac joint in an 11-year-old male child. Synovial fluid aspirated from the joint space showed Gram-negative diplococci which were confirmed as Neisseria meningitidis by culture and necessary biochemical tests followed by serogrouping by using polyvalent antisera. He was treated successfully with antibiotics.

Dipylidium caninum infection in a child: a rare case report.

Dipylidiasis is a zoonotic parasitic infestation caused by the dog tapeworm Dipylidium caninum. Human dipylidiasis has been rarely reported in English literature. Young children are mostly at risk of acquiring the infection due to their close association with dogs and cats. We report a rare case of Dipylidium caninum infection in a 4 year old male child. The diagnosis was based on microscopic examination of stool. Confirmation of the proglottid segments was done by histopathological examination. To the best of our knowledge this is the first human case of Dipylidium caninum reported from this part of the country.

Comparative cardioprotective effects and mechanisms of vitamin E and lisinopril against ischemic reperfusion induced cardiac toxicity.

The present study was undertaken to scientifically evaluate, validate and compare the cardioprotective effects of lisinopril (Lsp), an angiotensin converting enzyme (ACE) inhibitor and vitamin E (Vit E), an antioxidant in the setting of ischemia and reperfusion (I-R) injury. An open chest left anterior descending coronary artery occlusion and reperfusion induced myocardial injury cardiotoxicity model was used in the present study. Hemodynamic, biochemical and histopathological assessment of myocardial injury was undertaken. Pre-treatment (1 month) with Lsp (50 mg/kg) and Vit E (100 mg/kg) to healthy experimental controls did not adversely affect the histopathological architecture of the myocardium as well as the baseline antioxidant parameters. Subsequent to I-R injury, Lsp demonstrated modest antioxidant effects, superior recovery in left ventricular function as compared to the control IR group. Histopathological and biochemical assessment of injury confirmed the myocardial salvaging effect of this intervention. The cardioprotection afforded by Lsp was found to be superior as compared to Vit E treatment.

Karyotype analyses and studies on the nuclear DNA content in 30 genotypes of potato (Solanum tuberosum) L.

The cytophotometric estimation of 4C DNA content, and karyotypic and somatic chromosome number analyses were carried out in 30 genotypes comprising seven cultivars and 23 advanced breeding lines of Solanum tuberosum. Detailed karyotype analysis revealed genotype specific chromosomal characteristics and structural alterations in chromosomes of the genome, with a rare phenomenon of aneusomatic (2n = 4x + 2 = 50) condition in cv.K. Chandramukhi. The origin of this variation could be attributed to mitotic non-disjunction in the shoots giving rise to aneusomatic roots. Highly significant variations in the genome length, volume and total form percentage were noted at the cultivar level. The total chromosome length varied from 84.56 microm in cv.K. Pukhraj to 127.62 microm in MS/89-60, with an average value of 100.94 microm +/- 1.82. Total chromosome volume varied from 57.22 microm3 in MS/92-1090 to 132.64 microm3 in JW-160. Significant variations in the 4C DNA content (7.28-15.83 pg) were recorded at the cultivar level, with an exceptionally high DNA content (22.24 pg) in cv.K. Chandramukhi. This could be due to the aneusomatic condition of this genotype. Correlation studies revealed interdependence between the chromosomal and nuclear parameters of the genotypes. Structural alterations in the chromosomes, as well as loss or addition of highly repetitive sequences in the genome, caused variations in DNA content at the cultivar level. Variations in genomic structure and nuclear DNA content of the 48-chromosome genotypes suggest a genetic drift during microevolution, leading to the development of new cultivars.

Cell mediated immune status in carcinoma breast.

Thirty six cases of carcinoma breast were subjected to the assessment of CMI status by estimating different T lymphocyte parameters. The mean TPLC, T% and TTC in case of carcinoma were 1955/mm3 blood, 41% and 825/mm3 blood respectively which are evidently depressed than that of controls. This depression is progressive and clinical stage related, the least being in stage I and the most being in stage IV. The infiltrating varieties revealed a significant depression of T lymphocyte values than the non-infiltrating ones. Among the infiltrating types, IDC (T-38.9%) and Muc. Ca (T-29.1%) revealed most significant depression, thereby indicating worst prognosis. Six cases of IDCS, 2 cases of Medullary Ca and a solitary case of comedo Ca revealed a significant lymphocyte infiltration into the tumour cell mass proper. There was a depressed lymphocyte values but of lesser magnitude indicating a better prognosis. 6 cases without metastasis (clinical St. I) showed a lesser degree of depressed CMI than the cases with metastasis.