The coding complete genomic sequence of a feline panleukopenia virus detected from a domestic cat (Felis catus) in Chattogram, Bangladesh.

The coding complete genome sequence of the feline panleukopenia virus (FPLV), detected from an indigenous cat in Bangladesh, has been determined. The genome spans 4,842 bp and contains four protein-coding genes. The genome will contribute to a comprehensive understanding of the genetic traits and evolutionary trends of FPLV.

Exploring Serum Zinc and Copper Levels as Potential Biomarkers in Polycystic Ovary Syndrome: A Cross-Sectional Study From Northeast India.

Introduction Polycystic ovary syndrome (PCOS) is a prevalent hormonal disorder characterized by irregular menstrual cycles, ovarian cysts, and elevated androgen levels. The potential association between trace elements, specifically copper (Cu) and zinc (Zn), and PCOS has been explored, but a definitive relationship remains unclear. This study aims to investigate the levels of these trace elements in women with PCOS and their potential implications. Methods The study, conducted at Gauhati Medical College & Hospital, involved 60 individuals with PCOS and a matched control group. Ethical approval was obtained, and participants provided written informed consent. The study spanned from July 2021 to June 2022, utilizing a hospital-based case-control study design. Diagnostic criteria adhered to the Rotterdam criteria, and serum copper and zinc levels were quantified using a double-beam UV spectrophotometer. Results In the PCOS group, the mean age was 23.01 ± 3.60 years, while the control group had a mean age of 23.34 ± 3.59 years, with no significant age difference. Mean copper levels were 147.32 ± 16.53 µg/dl in PCOS and 106.88 ± 15.60 µg/dl in controls, indicating a significant increase in PCOS (p < 0.0001). Mean zinc levels were 93.99 ± 6.76 µg/dl in PCOS and 85.42 ± 12.69 µg/dl in controls, also significantly higher in PCOS (p < 0.0001). Conclusion The study highlights significant differences in serum copper and zinc levels between women with PCOS and healthy controls, suggesting potential implications for the syndrome's pathophysiology. Further research is warranted to elucidate the precise roles of these trace elements in PCOS and explore therapeutic interventions.

High prevalence of ciprofloxacin resistance in Escherichia coli isolated from chickens, humans and the environment: An emerging one health issue.

The emergence of antimicrobial resistance in commensal bacteria poses a serious public health burden worldwide. Commensals can disseminate the resistance genes to pathogenic bacteria causing life-threatening infections. This cross-sectional study was designed to investigate the antimicrobial resistance pattern and molecular mechanism(s) of ciprofloxacin resistance in commensal E. coli from three major one health components (humans, animals and the environment) in Bangladesh. Samples were randomly collected from broiler chickens, broiler farm environments and hospitalized human patients from the same geographical area. Isolation and identification of E. coli were performed following standard bacteriological techniques. Antimicrobial susceptibility testing (AST) was performed by disk diffusion and broth microdilution methods. Mutation at the quinolone-resistance determining region (QRDR) was analyzed by sequencing. Of 450 samples, a total of 287 (63.8%; 95% CI 59.2-68.1%) E. coli strains was isolated, where 240 (83.6%; 95% CI 78.9-87.5%) strains were phenotypically resistant to ciprofloxacin. The prevalence of ciprofloxacin-resistant E. coli in broiler chicken, broiler farm environments and hospitalized human patients are 77.6%, 88.8% and 89% respectively. In AST against nine antimicrobials, all the isolates were found to be multidrug-resistant (MDR). The minimum inhibitory concentration (MIC) of ciprofloxacin was ranged from 4 to >128mg/L. Point mutations were detected in several sites of QRDR, specifically at 83 and 87 amino acid positions in gyrA gene, and 56, 57, 78, 80 and 84 amino acid positions in parC gene. Mutations resulted in amino acid substitutions. Phylogenetic analysis of gyrA and parC gene sequences showed a close relationship between the strains isolated from different sources. This study demonstrates a high prevalence of ciprofloxacin resistance in commensal E. coli in humans, animals and environment interface and their genealogically similarity poses an alarming public health consequence.

First molecular detection of avian polyomavirus from captive psittacine birds in Bangladesh, together with confirmation of beak and feather disease virus co-infection.

Avian polyomavirus (APV) is an emerging pathogen in many parts of the world responsible for causing significant mortality in captive psittacine birds. The virus spreads slowly, and transboundary movement of birds is one of the potential risk factors for the virus introduction in the naïve population. Bangladesh allows the import of birds, however there is currently no surveillance to screen for APV. Since we confirmed beak and feather disease virus (BFDV) infection in the captive population in our earlier investigation, we hypothesized that APV may also be circulating in Bangladesh. Feather samples were collected from 100 birds (90 psittacine and 10 non-psittacine). The polymerase chain reaction (PCR) was used to detect viral DNA together with sequencing and phylogenetic analysis. This first pilot study confirmed the presence (7%, 7/100) of APV in captive psittacine birds of Bangladesh and almost half (4%, 4/100) of the APV positive birds had the BFDV co-infection. All the PCR-positive birds were asymptomatic and found in live bird markets (LBMs). No significant variation was observed in the detection rate considering species (P = 0.94), age (P = 0.39) or sex (P = 0.55) of birds. According to the results of the phylogenetic study, the APV isolates found in Bangladesh appear to be unrelated to isolates from other geographical areas. These findings provide an evidence of APV circulating in Bangladesh, with or without the co-infection of BFDV. Additional studies are needed to investigate the occurrence of APV/BFDV co-infection in the larger population of Bangladesh and in countries where transboundary bird interaction with Bangladesh may be possible.

Colistin Resistance in Multidrug-Resistant Escherichia coli Isolated from Retail Broiler Meat in Bangladesh.

The emergence of colistin resistance in Escherichia coli is a global public health concern. Contaminated food can accelerate the spread of colistin-resistant E. coli to humans. This study aimed to detect and characterize colistin-resistant E. coli from broiler meat in Bangladesh. We analyzed 136 pooled broiler meat samples from 240 carcasses collected from 40 live bird markets in urban and rural areas and 8 metropolitan supermarkets. The mean count of E. coli in broiler meat samples collected from rural retail shops, metropolitan supermarkets, and urban retail shops was 5.3 ± 1.1, 4.1 ± 1.4, and 3.9 ± 0.8 log10 colony-forming unit per gram, respectively. Colistin-resistant E. coli (minimum inhibitory concentration >2 mg/L) was found in 78% (95% confidence interval 70.2-84.1%) of the samples. All colistin-resistant isolates harbored the mcr-1 gene, while the rest of the mcr genes (mcr-2 to mcr-9) were not detected. Most colistin-resistant E. coli isolates (98%) showed coresistance to tetracycline, sulfamethoxazole/trimethoprim followed by ciprofloxacin (95%). Alarmingly, all of the colistin-resistant isolates were found to be multidrug resistant. Phylogenetic analysis showed close similarities of the mcr-1 gene sequences of this study with many strains of Enterobacterales isolated from humans, animals, and the environment. This study detected colistin-resistant E. coli contamination in broiler meat, which can pose a serious public health threat.

Molecular Detection of Tetracycline-Resistant Genes in Multi-Drug-Resistant Escherichia coli Isolated from Broiler Meat in Bangladesh.

This study aimed to estimate the antimicrobial resistance (AMR) patterns and tetracycline-resistant gene profiles of Escherichia coli (E. coli) from broiler meat and livers sourced from live bird markets (LBMs) and supermarkets (SMs) in Chattogram, Bangladesh. In total, 405 samples were collected from SMs and LBMs, comprising muscle (n = 215) and liver (n = 190) samples. Disc diffusion tests were used to determine antimicrobial susceptibility profiles. PCR was used to identify E. coli and tetracycline-resistant genes. Over half (57%) of the chicken product samples were positive for E. coli. The AMR profiling of these isolates showed that the highest prevalence of resistance was against sulphamethoxazole-trimethoprim (89%), followed by tetracycline (87%), ampicillin (83%), and ciprofloxacin (61%). Among the antimicrobials listed by the World Health Organization as critically important, E. coli isolates were found to be resistant to cephalexin (37%), gentamicin (32%), and colistin sulfate (21%). A large proportion of E. coli demonstrated multi-drug resistance (MDR). Most (84%) of the tetracycline-resistant isolates encoded tetA. Of the remaining isolates, 0.5% encoded tetC, 6.0% encoded two genes, and 3.6% of isolates were tetD, which was newly identified by this study in Bangladesh. Broiler products in Bangladesh are frequently contaminated with multi-drug-resistant E. coli, with differential carriage of tetracycline genes. The prevalence of tetracycline resistance among E. coli indicates a concern for poultry health and welfare regarding the management of colibacillosis. It also indicates growing public health risks of AMR among broiler-associated pathogens, which can be transferred to humans via the food chain. Appropriate control measures should be developed and implemented, focused on the rational use of antimicrobials in poultry farming systems, to mitigate risk from this drug-resistant zoonotic pathogen from foods of animal origin and to protect public health.

Burden of iodine deficiency disorders and its association with various sociodemographic variables in a district of North East India.

Introduction: Iodine is one such micronutrient, the deficiency of which can impair the mental growth and development of young children and is the leading cause of preventable mental impairment. The present study has been conducted to study the prevalence of iodine deficiency disorders (IDDs) and its association with various sociodemographic variables among children (6-12 years) residing in the East Khasi Hills district of Meghalaya. Methods: The sample size was 2700 with a multistage 30 cluster sampling method. A questionnaire was used to collect data on the various sociodemographic variables. The weight and height of each child were recorded as per the standard procedure. In order to assess goitre, children were examined as per standard procedures prescribed by the National Iodine Deficiency Disorder Control Programme (NIDDCP). Results: A total of 2700 children were interviewed in total. Out of these, 1365 (50.5%) were males. The total goitre rate was found to be 195 (7.22%), indicating that IDDs are a mild public health problem in the study area. The median (interquartile range) urinary iodine excretion levels were 150 (108.05-189.37) mg/L. With respect to weight-for-age, it was observed that 93 (3.9%) children were severely underweight and 389 (16.8%) had severe stunting. A significant association was observed between goitre with the age group of children (p <.00001), maternal education (p <.00001), prevalence of stunting (p <.00001), and underweight (p <.05).

Plasma neutrophil gelatinase-associated lipocalin (NGAL): A candidate biomarker to detect early acute kidney injury (AKI) for at-risk intensive care admissions.

Introduction: Acute kidney injury (AKI) is a presentation of an underlying heterogeneous group of conditions that leads to impairment of filtration and excretion of nitrogenous waste products from the body. A prompt early diagnosis to detect AKI is a mandate due to the associated risk of high mortality and morbidity. We tested the sensitivity and specificity of plasma neutrophil gelatinase-associated lipocalin (NGAL), a potential biomarker of AKI, versus serum creatinine, the gold standard laboratory test. Materials and Methods: A cross-sectional diagnostic type study was conducted from February 2015 to January 2017 after obtaining the institutional ethics clearance certificate. Individuals admitted to the intensive care unit (ICU) of a tertiary care hospital of northeast India who were diagnosed with septicemia, heart failure, and ketoacidosis and individuals on nephrotoxic drugs such as aminoglycosides were included in the study. Serum creatinine and plasma NGAL of all individuals were estimated using suitable methods within 24 h of admissions. Results: Considering all inclusion and exclusion criteria, 138 individuals were included in the study. The area under the curve (AUC) for plasma NGAL on day 1 of admission was 0.800 (95% confidence interval [CI]: 0.712-0.882). In the study, we estimated a plasma NGAL cut-off value of 391 ng/mL (with an odds ratio of 9.89) within the day of admission. Conclusion: Plasma NGAL is a candidate biomarker of AKI with acceptable sensitivity and specificity (AUC of 0.80) that can predict AKI in our setup before serum creatinine is raised, thereby asking for a prompt intervention to reduce the mortality and morbidity associated with AKI.

Evidence of circulation of beak and feather disease virus in captive psittacine and non-psittacine birds in Bangladesh.

Beak and feather disease virus (BFDV) is an emerging pathogen in many parts of the world that is responsible for causing beak and feather disease in birds. Since the virus is highly persistent in the environment and spreads by contact, birds raised in captivity are at a high risk of infection. Breeding, trading, and rearing of captive birds are becoming increasingly popular in many countries, including Bangladesh, increasing the risk of BFDV infection. However, it is unknown whether BFDV is circulating in captive birds in Bangladesh. This study was designed to conduct the first pilot survey to test the hypothesis that BFDV is circulating in Bangladesh. Feather samples were collected from 100 birds of 10 psittacine and two non-psittacine species from a breeding flock, three live-bird markets (LBMs), and two household flocks. Polymerase chain reaction (PCR) was used to detect the rep gene, together with sequencing and phylogenetic analysis. This study confirmed that BFDV is circulating in Bangladesh, with a positivity rate of 37%. The majority (78.38%) of PCR-positive birds were asymptomatic. The detection rate was higher in birds from the breeding flock (54.05%) than in LBMs (37.84%) and household flocks (8.11%) (P = 0.01). No significant variation was observed when considering the species (P = 0.14) and sex (P = 0.75) of the birds. Phylogenetic analysis suggested that the BFDV isolates found in LBMs and household flocks are genetically related to isolates from breeding flocks in the area as well as to many other isolates from different regions of the world. Further research needs to be done to determine the impact of this virus in the wider population.

Molecular detection and risk factors associated with multidrug-resistant Campylobacter jejuni from broiler cloacal and meat samples in Bangladesh.

The gastrointestinal tract of poultry is a potential source of Campylobacter jejuni. Here, the prevalence, risk factors, antimicrobial susceptibility profile and genetic relationship of C. jejuni were studied in broilers from farms and meat from live bird markets (LBMs) and super shops (SS). Pooled cloacal samples were obtained from farms in six districts of Bangladesh between June 2019 and March 2020. Pooled meat samples were obtained from LBMs and SS in the Chattogram district. Microbial culture, polymerase chain reaction (PCR), antimicrobial susceptibility tests were used to detect multidrug-resistant C. jejuni. A positive PCR amplicon was validated by mapA partial gene sequencing and subsequent phylogenetic analysis. In total, 12.5% (95% CI: 8.5-17.7%) of farms (N = 216) and 27.1% (95% CI: 15.28-41.85%) of LBMs and SS (N = 48) tested positive for C. jejuni. Moreover, 98% of the isolates were multidrug-resistant, with 86% resistant to five or more antimicrobial groups. Multivariable logistic regression analysis showed a downtime of <14 days, no separate footwear for shed access, and more than one person entering the sheds were significantly associated with C. jejuni colonization. Phylogenetic analysis revealed a strong relationship between C. jejuni strains obtained in Bangladesh and strains isolated in India, South Africa and Grenada from humans, pigs and bats. This study revealed significant contamination of broiler meat with Campylobacter spp. and C. jejuni. Potential sources of contamination and anthropogenic factors associated with the alarming prevalence of C. jejuni identified in this study would aid in reducing the growing risks of broiler-associated pathogens.

Antimicrobial resistance profiling and burden of resistance genes in zoonotic Salmonella isolated from broiler chicken.

BACKGROUND: Salmonella is frequently found in poultry of which only motile serovars have zoonotic significance due to their potential to induce human gastrointestinal infections. Antimicrobial resistance, being a public health concern, the emergence of multidrug-resistant (MDR) Salmonella serotypes affecting food chain has greater impact worldwide. AIM: Information on circulation of zoonotic Salmonella strains in commercial poultry farm level is limited in many parts of the world. This cross-sectional study was aimed to investigate the zoonotic Salmonella strains circulating in the broiler farm environment with their detailed antimicrobial resistance profiling. METHODS: Pooled faecal samples were collected randomly from commercial broiler farms of Chattogram district, Bangladesh. Standard bacteriological procedure was followed to isolate Salmonella, and identification was confirmed by genus specific polymerase chain reaction (PCR). After phenotypic characterisation of resistance profile against eight antimicrobials by disc diffusion technique, all strains were screened by PCR for some selected resistance genes. RESULTS: Out of the 350 samples, Salmonella was isolated and identified from 86 samples. In antimicrobial sensitivity testing, more than 98.8% isolates showed resistance to ampicillin and 94.2% to tetracycline followed by enrofloxacin (56%) and ciprofloxacin (50%). Notably, 94% isolates were found to be MDR. The results of PCR assays revealed that 81.4% of the isolates were carrying the tetA gene, 19.8% the tetB and 10.47% the tetC gene. The prevalence of the isolates bearing the blaTEM , blaCTX-M and Sul-I gene were 95.4%, 7.0 % and 37.2 %, respectively. CONCLUSION: There is a great risk to secure healthy poultry products due to the circulation of these MDR zoonotic Salmonella.

A Study to Evaluate the Association Between Thyroid Function and Serum Potassium Level in Diagnosed Cases of Diabetic Nephropathy.

Introduction Coexistence of diabetes mellitus and thyroid diseases is common. One of the main microvascular complications of diabetes is diabetic nephropathy (DN) and it is found to be the leading cause of chronic kidney disease. The aim of the present study was to assess the association between hypothyroidism and serum potassium levels in diabetic nephropathy patients. Materials and methods A cross-sectional study was conducted from March 2020 to January 2021. We enrolled 100 patients with DN along with 50 healthy controls belonging to the same localities. Serum potassium, creatinine, thyroid-stimulating hormone (TSH) and total triiodothyronine (T3) levels of all the cases were measured to establish the correlation of serum potassium along with each parameter separately. Results Serum potassium, creatinine, TSH levels were increased in all the cases of diabetic nephropathy showing positive correlations of serum potassium with serum TSH and serum creatinine levels with correlation coefficient values 0.71 and 0.7 respectively and serum T3 levels were decreased in all the cases significantly showing negative correlation with serum potassium levels with correlation coefficient value -0.34. Conclusion Estimation of serum TSH and T3 levels along with serum potassium levels is important and helpful in patients with diabetic renal disease. Changes in thyroid parameters like decreased TSH or increased T3 are significantly associated with deterioration in the severity of renal function in diabetic patients.

Knowledge, Attitude, and Practices on Antimicrobial Use and Antimicrobial Resistance among Commercial Poultry Farmers in Bangladesh.

Antimicrobial resistance (AMR) has become an emerging health issue globally, posing a threat to zoonotic pathogens and foodborne diseases. In Bangladesh, the poultry sector supplies the majority of the demand for animal-source protein. The irrational and excessive use of antimicrobials (AMU) has been observed in the poultry sector. The development of AMR is associated with many factors, including the knowledge and attitudes of poultry farmers. Therefore, AMR reduction requires intervention from all the stockholders, including the farmers who are considered as end users of antimicrobials. This current research conducted a cross-sectional study to assess the knowledge, attitudes, and practices (KAP) of poultry farmers on AMU and AMR in Bangladesh. We determined the KAP of poultry farmers (broiler and layer farmers) of some selected districts of the country using a tested and paper-based questionnaire. The results demonstrated that most of the respondents have insufficient KAP regarding AMU and AMR. The respondents used a variety of antimicrobials primarily in the treatment of various diseases in poultry. One-third of the farmers did not seek antimicrobials from registered vets. Instead, they depended on others or themselves. The factor score analysis further revealed that the farmers' demographic and socioeconomic variables were significant factors influencing the KAP. An adjusted logistic regression analysis showed that older farmers with 9-12 years of farming experience and graduate-level education, engaging in medium-sized layer farming, were more likely to have correct KAP on AMU and AMR. Further, farmers from the Cox's Bazar region showed correct knowledge, whereas farmers of the Chattogram region showed a correct attitude towards AMU and AMR. A Spearman's rank-order correlation revealed a positive association between knowledge-attitudes and knowledge-practices. The findings of the current investigation provide baseline evidence about the KAP of poultry farmers from low-income resources and offer insights into designing interventions and policies for the use of AMU and AMR in Bangladesh.

Role of serum C-reactive protein and interleukin-6 as a predictor of intra-abdominal and surgical site infections after elective abdominal surgery.

INTRODUCTION: Infections after surgeries considerably increase patients' hospital stay, thereby prolonging patients' early return to productive life. At the same time, the cost of hospitalization also increases. Therefore, if objective tests can predict infections before it actually happens, then more preventive measures in the form of upgrading antibiotics can be taken which might prevent patients from developing serious infections and thereby reduce morbidity and mortality of surgery. MATERIAL AND METHODS: It was a prospective cross sectional study to assess the efficacy of acute phase reactants C-reactive protein (CRP) and interleukin 6 (IL 6) in predicting infections in patients undergoing routine general surgical operations. A total of 74 patients were included in the study. Laparoscopic surgical procedures were not included in the study to maintain uniformity in the procedures. Data so collected were analyzed by using SPSS version 22. RESULTS: A total of 27 patients developed wound infections postoperatively. The mean rise in the levels of CRP and IL 6 was higher in those patients who developed postoperative wound infections. The positive predictive value and negative predictive value was found to be better with IL 6 than with CRP. CONCLUSION: It may be concluded that a serial estimation of CRP and IL 6 postoperatively can predict infections and may be utilized routinely in general surgical practice.

Lumpy skin disease outbreak in cattle population of Chattogram, Bangladesh.

BACKGROUND: Lumpy skin disease (LSD) is an important viral disease causing significant economic losses in commercial livestock production. In mid-2019, an outbreak of LSD has been reported in cattle population from different parts of Bangladesh including Chattogram division. A cross-sectional surveillance study was undertaken from August 2019 to December 2019 to investigate the prevalence and associated risk factors of LSD in cattle in Chattogram district. METHODS: A total of 3,327 cattle from 19 commercial farms were examined for the LSD specific skin lesions and associated risk factors. A total of 120 skin biopsies were collected from the suspected animal for the confirmation of the disease using molecular detection and histopathological examination. Partial genome sequencing and phylogenetic analyses were performed on selected viral isolates. RESULTS: The overall clinical prevalence of LSD in the study population was 10% (95% confidence interval [CI]: 9.4%-11%) where the highest farm level outbreak frequency was 63.33% (95% CI: 45.51%-78.13%) and the lowest 4.22% (95% CI: 3.39%-5.25%). Crossbred and female cattle showed a significantly higher prevalence of the disease compared to their counterparts. Introduction of new animals in farms was found to be one of the most significant risk factors in the transmission of the disease. All suspected skin biopsies were positive for LSD virus (LSDV) infection with granulomatous and pyogranulomatous dermatitis was revealed on histopathology. Phylogenetic analysis based on the inverted terminal repeat region of the LSDV gene suggested that the locally circulating strain was closely related to the strains isolated from the Middle East and North African countries. CONCLUSIONS: The data generated in this study would be beneficial to the field veterinarians and animal health decision makers in the country as well as it will aid in taking appropriate measures to prevent further relapse or outbreak of this disease in future.

Idiopathic post prandial glucose lowering, a whistle blower for subclinical hypothyroidism and insulin resistance. A cross-sectional study in Tertiary Care Centre of northeast India.

BACKGROUND AND AIMS: There has been a lot of confusion in management of apparently healthy individuals whose post prandial plasma glucose levels were lower than fasting levels. It has been observed that many clinicians do send for repeat tests to rule out analytical error since there is common knowledge that post prandial glucose should be higher than fasting glucose level. Blood glucose level is regulated by a fully integrated mechanism with complex interplay of hormones and enzymes on metabolic pathways. Increase or decrease of thyroid hormones can break this equilibrium leading to alterations of carbohydrate metabolism. The objective for this study was to look for subclinical hypothyroidism (SCH) and insulin resistance (IR) in Idiopathic Post prandial glucose lowering and the correlation between thyroid stimulating hormone (TSH) with IR in them. METHODS: A cross-sectional study with subgroup analysis, 34 cases and 34 controls. Cases comprises of otherwise healthy individuals whose post prandial glucose is lower than fasting glucose and controls as those healthy individual whose post prandial glucose is higher than fasting. Thyroid hormones and insulin were measured in fasting serum samples. Homeostasis model assessment for IR was calculated as per formula. RESULTS: Among the 34 cases with idiopathic post prandial glucose lowering, 76% (n = 26) had subclinical hypothyroidism and 61% (n = 21) had insulin resistance. A positive correlation (r = 0.55) was observed between Thyroid-Stimulating hormone (TSH) and Index of insulin resistance and homeostatic model assessment (HOMA-IR) and was statistically significant with P < 0.1. CONCLUSIONS: The study highlights the importance of evaluating glycoregulatory hormones like thyroid hormones and insulin in cases with idiopathic post prandial glucose lowering for early diagnosis and prevention of overt clinical diseases like Hypothyroidism and Diabetes Mellitus.

Study of Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency and Genotype Polymorphism of G6PD B and G6PD (A+/A-) in Patients Treated for Plasmodium vivax Malaria in a Tertiary Care Hospital in North East India.

Introduction Glucose-6-phosphate dehydrogenase (G6PD) enzyme deficiency is the most common enzymopathy in humans, and its distribution has been historically described to be closely associated with that of malaria. North East India provides optimal conditions for transmission of malaria and bears a considerable burden of Plasmodium vivax (P. vivax) malaria. Primaquine, a mainstay in the treatment of vivax malaria, may trigger episodes of acute hemolysis in patients with G6PD deficiency. The present study sought to delineate the frequency and genotypes of G6PD deficiency among patients suffering from vivax malaria infections.  Methods Blood specimens from 80 individuals diagnosed with vivax malaria underwent enzyme assay for G6PD deficiency. Samples with deficient phenotype underwent isolation of DNA using a genomic DNA isolation kit (Qiagen India Pvt. Ltd., New Delhi, India). The genomic DNA underwent amplification, serial denaturation, annealing, extension, final extension followed by digestion with restriction endonucleases Nla III and Fok I. The digested products were subjected to horizontal agarose electrophoresis for the separation of digested fragments. Samples without nucleotide 376 adenine→guanine (A→G) mutation were classified as G6PD B. Those with the mutation were further classified into G6PD A(+) and G6PD A(-) based on the presence of Nla III site. Results Twenty-seven out of 80 individuals (33.75%) with P. vivax malaria were found to have G6PD deficiency, of which a majority (n=24) had G6PD B genotype. Three individuals had Asparagine→Aspartic Acid mutation at position 376 (A→G), of which G6PD A(+) and G6PD A(-) were present in two and one cases, respectively. Conclusion G6PD deficiency was noted in about a third of patients with vivax malaria. Since primaquine therapy is contraindicated in this group of patients, there is a rationale for looking into screening patients with vivax malaria from the region prior to primaquine therapy. Further large scale studies may substantiate this and help in better genotypic and geographic characterization of G6PD deficiency in the region.

Iodine Deficiency Disorders in Children in East Khasi Hills District of Meghalaya, India.

OBJECTIVE: To assess the prevalence of iodine deficiency disorders among school-going children in Meghalaya. METHODS: Multi-stage 30 cluster sampling with probability proportionate to size (PPS) method was used. Children (age 6-12years) were examined clinically for goiter. Urinary iodine excretion (UIE) was performed by spectrophotometric method. Iodine content in the salt was analyzed using iodized salt test kits. RESULTS: A total of 195 (7.22%) out of 2700 children had goiter on examination. Goitre prevalence was significantly associated with wasting (P<0.05) and stunting (P <0.001). The median (IQR) UIE level was 150 (108.05 - 189.37) µg/dL. Nineteen (9.74%) children had severe iodine deficiency (UIE<20µg/L). Iodine content was above the recommended level of 15 ppm in 95.9% salt samples. A positive correlation was observed between household salt consumption and UIE levels (r=0.25; P<0.001). CONCLUSIONS: Iodine deficiency disorder is a public health problem in Meghalaya, which needs to be addressed.

Clinical and Laboratory Presentation of Hydatid Disease: A Study From Northeast India.

Introduction Hydatid disease is an immense health problem in developing countries. The diagnosis of hydatid cyst is often difficult because of its protean manifestations. Our objective was to evaluate the various clinical and laboratory presentations of hydatid disease and various modalities of treatment from a tertiary care center. Materials and methods We reviewed the clinical and laboratory features of patients presenting with hydatid cyst through retrospective analysis from January 2018 to December 2019 from a tertiary care hospital in northeast India. Results Of the 26 adult patients with hydatid cysts who were part of the study, 14 (53.8%) were males and 12 (46.2%) were females. The mean age was 34.6 years. The most common site of involvement was the liver (69%) followed by lung (19.2%) and brain (7.7%). Palpable mass in the right upper quadrant of the abdomen was the most common symptom (88.3%) for liver hydatid cyst followed by pain abdomen (66.6%). Systemic symptoms like fever and weakness were present in most of the patients. The majority of patients (80%) were from rural areas. Conclusion Hydatid cysts present with varied symptomatology. History of exposure to infected animals may not be present. A high degree of clinical suspicion combined with meticulous history and clinical examination supported by laboratory investigations are required for its diagnosis.