Anopheles subpictus B and its role in transmission of malaria in Odisha, India.

Odisha state is highly endemic for malaria and among several Anopheline species found in the state, Anopheles subpictus is known to be one of the most prevalent species. An. subpictus complex consists of four sibling species i,e A,B,C and D. However, no work has been conducted on prevalence of sibling species of An. subpictus in Odisha. Hence attempt was made to study the prevalence of sibling species of An. subpictus and their role in transmission of malaria in four districts i,e Angul, Khurda, Cuttack and Puri of Odisha using Mitochondrial Gene, Cytochrome C Oxidase subunit I (COI) known as DNA barcode. The sibling species B of An. subpictus with sporozoite were reported for the first time in Odisha.

Anopheline ecology and malaria transmission during the construction of an irrigation canal in an endemic district of Odisha, India.

BACKGROUND & OBJECTIVES: A new irrigation canal system is under construction in Dhenkanal district of Odisha, to increase the production of rice crop and thereby improve the living standard of farmers in the project area. Construction of canal may increase the transmission of malaria by creating vector breeding habitats. Knowledge about bionomics of vectors will support authorities for appropriate management of the disease in a changing ecological set up. The aim of this study was to assess the malaria transmission in the bank of the canal area under construction. METHODS: The entomological survey was carried out in three seasons, winter, summer and rainy during the period November 2008-October 2010 in the study area. Adult mosquitoes were collected by using suction tubes and flash lights. Mosquito species identification was done by using standard keys, separated according to abdominal conditions and were kept in an isopropanol for further molecular analysis of sibling species, presence of sporozoites and human blood meal. Larvae were collected by dippers and reared in the laboratory, and the emerged adults were identified to species. The epidemiology of malaria was evaluated from the data collected by the State Health Department. Insecticide succeptibility test was done by WHO method. RESULTS: The adult mosquito collection from the study area showed the prevalence of 14 species belonging to three genera, i.e. Anopheles, Culex and Aedes. The per man hour densities (PMHD) of An. culicifacies were 3.8, 1.4, 4.8; that of An. annularis were 2.1, 1, 2.1; and that of An. fluviatilis were 1.4, 0.3, 0.6 during winter, summer and rainy seasons respectively. Sibling species identified were: An. culicifacies A, B, C and D, An. annularis A and An. fluviatilis S. Sporozoite rates of An. culicifacies A and C were 1.1 and 0.5% respectively and that of An. annularis A was 2% (reported for the first time in the state). Both the vectors (An. culicifacies and An. annularis) showed resistance to DDT and malathion and were susceptible to deltamethrin, whereas An. fluviatilis was susceptible to all the three insecticides tested. INTERPRETATION & CONCLUSION: Anopheles culicifacies, An. fluviatilis and An. annularis were prevalent in all the three seasons. The artificial ponds and seepage pools of canal are the major breeding sites for An. culicifacies and An. annularis. Thus, in the canal command area, control of malaria transmission requires use of insecticide-treated bednets and use of biolarvicides (seepage pools) and larvivorous fish (artificial ponds) wherever feasible.

An unusual case of transient cortical blindness with sagittal sinus thrombosis in a case of Henoch-Schonlein purpura.

INTRODUCTION: Henoch-Schonlein purpura (HSP) is one of the most common causes of small vessel vasculitis in children, but sometimes may have an atypical presentation. OBJECTIVE: To report an unusual case of transient cortical blindness in a patient with Henoch-Schonlein purpura. CASE: A 3-year-old female child was brought with the complaint of diffuse abdominal pain and hematochezia, which was preceded by high grade fever and cough. Three days later she developed hematuria, hematemesis, melena and hemoptysis along with palpable purpura. Four days later she became irritable and developed a few episodes of generalized tonic clonic seizure, followed by cortical blindness. The CT scan of the brain showed bilateral non-enhancing occipital hypodensity. The magnetic resonance venography showed thrombosis in transverse and sigmoid sinus. She was treated with corticosteroids and her mental status and vision improved. CONCLUSION: The HSP can cause transient cortical blindness, and recovery is good if therapy is initiated at the appropriate time.

Malaria outbreak in a non endemic tribal block of Balasore district, Orissa, India during summer season.

A focal outbreak of malaria at Sialimal sub-centre of Balasore district of Orissa was reported during the month of March, 2010. Three villages of the above block were affected. Regional Medical Research Centre, Bhubaneswar has conducted an entomological survey and a central clinic simultaneously, with door to door household survey to identify the fever cases. Within a span of 18 days around 172 fever cases were reported with Slide Positivity Rate (SPR) of 24.4% and Pf % of 81%. The malaria epidemiological data of the sub-centre area for last three years indicates that the area is non endemic for malaria (API was 0.81). Entomological survey revealed the presence of three known vectors of malaria i.e. Anopheles culicifacies, Anopheles annularis and Anopheles subpictus (local vector). Per Man Hour Density (PMHD) of these three species were 4.2, 2.8 and 10.8 respectively. Plasmodium falciparum sporozoites were detected in two An. culicifacies, in one An. annularis and in one An. subpictus. Larval density of Anopheline mosquitoes per dip ranged between 12 to 20. The vectors were found to be resistant to DDT but susceptible to synthetic pyrethroid. With this finding necessary remedial measures were taken by the government to curtail the transmission.

Hooch blindness: a community study report on a few indoor patients of toxic optic neuropathy following consumption of adulterated alcohol in West Bengal.

INTRODUCTION: Hooch blindness following consumption of adulterated alcohol has been known for centuries. OBJECTIVE: To study cases of mass alcohol intoxication followed by Hooch blindness in eastern India. MATERIALS AND METHODS: Ten patients of toxic amblyopia collected from a community mass intoxication following consumption of adulterated alcohol were studied. The parameters studied were the findings of ocular examination, applanation tonometry, automated perimetry and visual-evoked potential (VEP). As a part of the special investigations fundus photography and OCT were done. Routine blood examination, fasting lipid profile, postprandial blood sugar estimation were done . All patients were treated with injections of methyl prednisolone and Hydroxy cobalamine, antioxidants and local neuro-protective agents. RESULTS: Along with diminished vision (from NPL to 3/60), marked pallor of the disc without any other retinal change were noted. The amplitude on VEP was significantly reduced. However, visual improvement (up to 6/18) in 7 patients was observed within 6 weeks of treatment. CONCLUSION: Hooch blindness in India can be prevented by creating awareness among the target population and reducing the cost of country liquor.

An unusual case of anisocoria in a child with bleeding aneurysm of posterior communicating artery and idiopathic thrombocytopenic purpura (ITP).

BACKGROUND: ITP can give rise to bleeding episodes in different parts of the body including the central nervous system with various systemic manifestations. CASE: An eight-year old female child, diagnosed as a case of chronic ITP for last two years, developed intense headache and vomiting for a few days before admission. This was associated with right sided mid dilated pupil with brisk reaction to light. MRI-angiography showed a bleeding aneurysm of posterior communicating artery. The features of raised intra cranial tension subsided with conservative management but the anisocoria persisted. CONCLUSION: A bleeding aneurysm can manifest with anisocoria as a sign of partial third cranial nerve palsy.

Cortical blindness and paraplegia following hypoxic ischemic encephalopathy as a complication of common krait bite.

BACKGROUND: A case report of a successful recovery from paraplegia and cortical blindness following anti-venom injection for a snake bite by a common krait is reported here. CASE: A 14-year old male patient was bitten by a common krait. On admission to a tertiary level hospital, he was started with antivenom serum. But the patient developed sudden respiratory distress following anaphylactic shock and he was kept on ventilation. The patient was discharged with paraplegia with loss of vision. He was diagnosed as a case of cortical blindness due to hypoxic ischemic encephalopathy. Subsequently, the patient recovered from paraplegia and regained visual acuity of 6/60 in both eyes (best corrected). The boy was reexamined after four years. CONCLUSION: Evaluation of victims of neurotoxic snake bite for early signs of respiratory depression and prompt respiratory assistance, even if anti-venom is not available, is most essential as a life saving measure.

Effect of construction of an irrigation canal on malaria situation in two primary health centres of Dhenkanal district of Orissa, India.

To assess the impact of irrigation canals on malaria transmission, a study was conducted in Dhenkanal district of Orissa, India. The district is situated in the central part of Orissa and hyperendemic area for malaria. A canal system is being constructed for irrigation in the district, which passes through Parjang and Analabereni Primary Health Centres (PHC), endemic for malaria. The water has been released only up to Parjang (Canal with water -CWW) area during the end of 2004 and construction work is still going on in Analabereni PHC (Canal under construction-CUC). Retrospective clinical data (2001-2008) collected from health services from two study sites showed average Slide Positivity Rate (SPR) before release of water (2001-2004) was 9.25% and 18.04% in CWW and CUC areas, respectively. After release of water (2005-2008) the SPR was 5.77% and 10.19%, in CWW and CUC areas, respectively. The average Annual Parasite Incidence (API) was 7.66 and 22.67 in CWW and CUC areas before the release of water and 5.32 and 12.28 after release of water, respectively. A point fever survey was conducted in 2009 which revealed the presence of Plasmodium falciparum (Pf) and P. vivax (Pv) in both study areas. The survey found SPR of 18.82% and 24.54%, and Pf percentages of 75% and 85%, in CWW and CUC areas, respectively. The present study revealed the presence of two malaria vectors, Anopheles culicifacies and Anopheles annularis in the area. Vector Per Man Hour Density was 2.38 in CWW and 2.69 in CUC for An. culicifacies and 1.46 and 1.54 for An. annularis respectively. The sporozoites rates were found to be 3.6 and 3.8 for CWW and CUC, respectively. The present study reveals that, the construction of canal system did not increase the malaria prevalence during post water release period - implying that the malaria control programme was effective although still more intensive situation specific vectors control programme need to be continued simultaneously so that malaria transmission can be curtailed.

Rapid spread of chikungunya virus infection in Orissa: India.

BACKGROUND & OBJECTIVES: A large number of cases of undiagnosed fever and joint pain were reported from different parts of the State of Orissa since February 2006. Epidemiological and laboratory investigation were carried out to confirm the cause of emerging illness, which was provisionally suspected as Chikungunya (CHIK) fever. METHODS: Upon getting the reports of suspected CHIK like illness in different parts of the State, epidemic investigations were carried out in the outbreak affected villages. Case history was recorded, clinical examination undertaken and blood samples collected for seroconfirmation for CHIK IgM antibody using ELISA based kit. Simultaneously vector survey was also carried out. RESULTS: With no previous record of CHIK infection in the State, the first outbreak was confirmed during February 2006. Subsequently, the infection spread to 13 of 30 districts in different episodes covering 79 villages till November 2007. Attack rate was 9-43 per cent in the different outbreaks with average seropositivity of 24 per cent to CHIK specific IgM. Morbidity was high though no deaths were recorded. Aedes aegypti and Ae. albopictus were identified as the possible vectors for transmission. INTERPRETATION & CONCLUSIONS: The report confirmed emergence of CHIK infection in the State of Orissa, India, and its spread to a larger geographic zone in a short period which warrants public health measures to control further spread.

A process report on physical and psychological determiners of social functioning in leprosy patients.

Management and rehabilitation of leprosy patients needs information aoout the social acceptance and its association with physical and psychological problems of the affected person. Ninety three leprosy patients (72 male and 21 female) were selected from outpatient department of the hospitals/clinics and their demographic and clinical informations were recorded. The patients were screened for common menta diseases using GHQ-60 (Bengali version). The social functioning was assessed using SSFI. Mean age was 35.19 +/- 12.5 years, 69.9% of the subjects were from urban areas. Multibacillary cases accounted for 60.2% of the cases, 21.5% of the patients had deformity, 53.8% of the patients screened positive for common psychiatric diseases. Social functioning impairment of mild, moderate and severe level was 9.7%, 82.8, and 7.5% respectively. On Univariate analysis, presence of deformity was the only variable showing significant association with moderate to severe degree of social impairment. Using decision tree (Exhaustive CHAID) analysis, presence of deformity along with urban residence was strongly predicted severe social functioning impairment. The results of the study show the need to formulate suitable psychosocial intervention strategy especially in the context of high psychiatric morbidity.

Genetic regulation of catecholamine synthesis, storage and secretion in the spontaneously hypertensive rat.

Understanding catecholamine metabolism is crucial for elucidating the pathogenesis of hereditary hypertension. Here we integrated transcriptional and biochemical profiling with physiologic quantitative trait locus (eQTL and pQTL) mapping in adrenal glands of the HXB/BXH recombinant inbred (RI) strains, derived from the spontaneously hypertensive rat (SHR) and normotensive Brown Norway (BN.Lx). We found simultaneous down-regulation of five heritable transcripts in the catecholaminergic pathway in young (6 weeks) SHRs. We identified cis-acting eQTLs for Dbh, Pnmt (catecholamine biosynthesis) and Vamp1 (catecholamine secretion); enzymatic activities of Dbh and Pnmt paralleled transcripts, with pQTLs for activities mirroring eQTLs. We also detected trans-regulated expression of Vmat1 and Chga (both involved in catecholamine storage), with co-localization of these trans-eQTLs to the Pnmt locus. Pnmt re-sequencing revealed promoter polymorphisms that result in decreased response of the transfected SHR promoter to glucocorticoid, compared with BN.Lx. Of physiological pertinence, Dbh activity negatively correlated with systolic blood pressure in RI strains, whereas Pnmt activity was negatively correlated with heart rate. The finding of such cis- and trans-QTLs at an age before the onset of frank hypertension suggests that these heritable changes in biosynthetic enzyme expression represent primary genetic mechanisms for regulation of catecholamine action and blood pressure control in this widely studied model of hypertension.

Common genetic variants in the chromogranin A promoter alter autonomic activity and blood pressure.

Chromogranin A (CHGA) is stored and released from the same secretory vesicles that contain catecholamines in chromaffin cells and noradrenergic neurons. We had previously identified common genetic variants at the CHGA locus in several human populations. Here we focus on whether inter-individual variants in the promoter region are of physiological significance. A common haplotype, CGATA (Hap-B), blunted the blood pressure response to cold stress and the effect exhibited molecular heterosis with the greatest blood pressure change found in Hap-A/Hap-B heterozygotes. Homozygosity for three minor alleles with peak effects within the haplotype predicted lower stress-induced blood pressure changes. The G-462A variant predicted resting blood pressure in the population with higher pressures occurring in heterozygotes (heterosis). Using cells transfected with CHGA promoter-luciferase reporter constructs, the Hap-B haplotype had decreased luciferase expression compared to the TTGTC (Hap-A) haplotype under both basal conditions and after activation by pre-ganglionic stimuli. The G-462A variant altered a COUP-TF transcriptional control motif. The two alleles in transfected promoters differed in basal activity and in the responses to COUP-II-TF transactivation and to retinoic acid. In vitro findings of molecular heterosis were also noted with the transfected CHGA promoter wherein the diploid combination of the two G-462A alleles gave rise to higher luciferase expression than either allele in isolation. Our results suggest that common genetic variants in the CHGA promoter may regulate heritable changes in blood pressure.

Host feeding patterns of malaria vectors of Orissa, India.

Blood meals of 1,491 Anopheles fluviatilis sensu lato (s.l.), 1,690 An. culicifacies s.l., 719 An. annularis s.l., and 358 An. varuna sensu stricto were examined by gel diffusion method. The overall anthropophilic index (AI) was 78.9%, 1.6%, 3.2%, and 6.7% for An. fluviatilis, An. culicifacies, An. annularis, and An. varuna, respectively. Out of 4 anopheline species studied, only 0.2% of An. culicifacies blood meals contained blood from humans and cattle. Anopheles fluviatilis and An. culicifacies revealed seasonality in their anthropophilic index. An. fluviatilis showed a human forage ratio of more than 1, whereas An. culicifacies, An. annularis, and An. varuna had forage ratios of 2.6, 2.5, and 2.4, respectively, for bovine. There was a correlation between the Al of An. fluviatilis and the malaria slide positivity rate. This study suggests that the use of repellent, insecticide-treated nets will be effective for controlling biting mosquitoes inside houses in Orissa.

Retrospective analysis of epidemiological investigation of Japanese encephalitis outbreak occurred in Rourkela, Orissa, India.

There was an outbreak of Japanese encephalitis (JE) during July/August of 1993 in Rourkela City of Orissa, India. Among the serum samples, 40% of the sera showed antibodies against JE, while 17% of the sera showed recent infection to dengue virus. As many as 15 species of mosquitos were encountered in and around the affected areas. Species like Culex tritaeniorhynchus, Cx, vishnui, Cx. pseudovishnui and Cx. bitaeniorhynchus constituted 19% of the total collections. The above species were resistant to DDT and dieldrin, but susceptible to malathion.

Disappearance of malaria vector Anopheles sundaicus from Chilika Lake area of Orissa State in India.

Malaria has declined around Chilika Lake (85 degrees 20'E, 19 degrees 40'N) in Orissa State, India, from hyperendemicity in the 1930s to hypoendemicity during recent decades. Six decades ago, 21 spp. of Anopheles mosquitoes (Diptera: Culicidae) were recorded from this area, including the well known Indian malaria vectors An. culicifacies Giles, An. fluviatilis James, An. maculatus Theobald, An. stephensi Liston and An. sundaicus (Rodenwaldt), the last formerly regarded as the main vector locally. Surveys of Chilika area during 1995-96 found 8 spp. of culicine plus 14 spp. of anopheline mosquitoes, the latter comprising An. subpictus Grassi sensu lato, An. hyrcanus (Pallas) s.l., An. vagus Dönitz, An. annularis van der Wulp s.l., An. culicifacies Giles s.l., An. aconitus Dönitz, An. varuna Iyengar, An. barbirostris van der Wulp s.l., An. philippinensis Ludlow, An. ramsayi Covell, An. jeyporiensis James, An. pallidus Theobald, An. tessellatus Theobald and An. karwari James in decreasing order of abundance. Among indoor-resting female mosquitoes, the anthropophilic index was 4-7% and some species (An. culicifacies, An. subpictus, An. vagus) tended to enter houses for resting after blood-feeding outside. Females of potentially infective age (three-parous) were obtained for An. culicifacies (11%) and An. annularis (<2%), the more abundant established vector in this coastal area, but not for small samples of An. subpictus and An. vagus. Anophelines reported previously but not found in our survey were An. fluviatilis, An. jamesii Theobald, A. maculatus, An. splendidus Koidzumi, An. stephensi, An. theobaldi Giles and the former main vector An. sundaicus.

Neuroendocrine cell type-specific and inducible expression of the chromogranin B gene: crucial role of the proximal promoter.

Chromogranin B, a soluble acidic secretory protein, is widely distributed in neuroendocrine and neuronal cells, although not in other cell types. To identify the elements governing such widespread, yet selective, expression of the gene, we characterized the isolated mouse chromogranin B promoter. 5'-Promoter deletions localized neuroendocrine cell type-specific expression to the proximal chromogranin B promoter (from -216 to -91 bp); this region contains an E box (at [-206 bp]CACCTG[-201 bp]), four G/C-rich regions (at [-196 bp]CCCCGC[-191 bp], [-134 bp]CCGCCCGC[-127 bp], [-125 bp]GGCGCCGCC[-117 bp], and [-115 bp]CGGGGC[-110 bp]), and a cAMP response element (CRE; at [-102 bp]TGACGTCA[-95 bp]). A 60-bp core promoter region, defined by an internal deletion from - 134 to -74 bp upstream of the cap site and spanning the CRE and three G/C-rich regions, directed tissue-specific expression of the gene. The CRE motif directed cell type-specific expression of the chromogranin B gene in neurons, whereas three of the G/C-rich regions played a crucial role in neuroendocrine cells. Both the endogenous chromogranin B gene and the transfected chromogranin B promoter were induced by preganglionic secretory stimuli (pituitary adenylyl cyclase-activating polypeptide, vasoactive intestinal peptide, or a nicotinic cholinergic agonist), establishing stimulus-transcription coupling for this promoter. The adenylyl cyclase activator forskolin, nerve growth factor, and retinoic acid also activated the chromogranin B gene. Secretagogue-inducible expression of chromogranin B also mapped onto the proximal promoter; inducible expression was entirely lost upon internal deletion of the 60-bp core (from 134 to -74 bp). We conclude that CRE and G/C-rich domains are crucial determinants of both cell type-specific and secretagogue-inducible expression of the chromogranin B gene.

Plasmid curing from an acidophilic bacterium of the genus Acidocella.

Preservation of the acidophilic heterotroph, Acidocella sp. strain GS19h, at 4 degrees C in stab culture eliminated all indigenous plasmids from this bacterium. Growth at 42 degrees C initially caused changes in the plasmid profile followed by total elimination of plasmids after 10 cycles of growth. Concomitant to this loss of all plasmids, the cured derivatives became sensitive to CdSO(4) and ZnSO(4), and the MIC value of the salts dropped from 1 M for each in the case of parental strain to 2 mM and 5 mM, respectively, suggesting plasmid-mediated inheritance of metal resistance in this bacterium. The cured derivatives could not utilise lactose, indicating this metabolic activity to be plasmid-associated in this strain.

Bacillus sphaericus interferes with the development of Brugia malayi in Aedes aegypti.

Aedes aegypti (black-eyed Liverpool strain) were exposed to a sublethal dose (LD25) of Bacillus sphaericus and were fed to Mastomys coucha infected with Brugia malayi. The development of the filarial parasite was found to be arrested mostly at the second larval stage. The infection (P < 0.05), infectivity rates (P < 0.001) and L3 load (P < 0.001) were found to be reduced significantly in the treated group.

Transmission dynamics of filariasis in Khurdha district of Orissa, India.

A three year longitudinal study was carried out to quantify the different parameters of filarial transmission in an endemic area of Orissa State, India. Parasitological surveys revealed mean microfilaria rate, microfilaria density and median microfilaria density (MFD-50) to be 9.41, 19.23 and 7.33, respectively. The per man hour density of the vector, Culex quinquefasciatus varied from 24.2 to 66.0 with a peak in January. Infection rate varied from 0.9 to 27.5%, while infectivity rate ranged between 0.0 and 15.2%. Infectivity rate showed high correlation with microfilaria rate and per man hour density of adult mosquito. The highest numbers of first stage larvae (L1), second stage larvae (L2) and third stage larvae (L3) per mosquito were found to be 25, 22 and 11, respectively. Average L3 load per infective mosquito ranged from 1.0 to 7.2. L3 load showed high correlation with microfilaria rate (r = 0.845, p < 0.01) while no correlation was seen with microfilaria density.