Non-communicable diseases risk factors and their determinants: A cross-sectional state-wide STEPS survey, Haryana, North India.

BACKGROUND: Recent studies have documented high variation in epidemiologic transition levels among Indian states with noncommunicable disease epidemic rising swiftly. However, the estimates suffer from non-availability of reliable data for NCDs from sub populations. In order to fill the knowledge gap, the distribution and determinants of NCD risk factors were studied along with awareness, treatment and control of NCDs among the adult population in Haryana, India. METHODS: NCD risk factors survey was conducted among 5078 residents, aged 18-69 years during 2016-17. Behavioural risk factors were assessed using STEPS instrument, administered through an android software (mSTEPS). This was followed by physical measurements using standard protocols. Finally, biological risk factors were determined through the analysis of serum and urine samples. RESULTS: Males were found to be consuming tobacco and alcohol at higher rates of 38.9% (95% CI: 35.3-42.4) and 18.8% (95% CI: 15.8-21.8). One- tenth (11%) (95% CI: 8.6-13.4) of the respondents did not meet the specified WHO recommendations for physical activity for health. Around 35.2% (95%CI: 32.6-37.7) were overweight or obese. Hypertension and diabetes were prevalent at 26.2% (95% CI: 24.6-27.8) and 15.5% (95% CI: 11.0-20.0). 91.3% (95% CI: 89.3-93.3) of the population had higher salt intake than recommended 5gms per day. CONCLUSION: The documentation of strikingly high and uniform distribution of different NCDs and their risk factors in state warrants urgent need for evidence based interventions and advocacy of policy measures.

Prevalence of bronchial asthma and its associated risk factors in school-going adolescents in Tier-III North Indian City.

BACKGROUND: Asthma is one of the most common chronic diseases of childhood and a major health problem not only in India but globally. Despite multifold increase in prevalence, there is paucity of data on bronchial asthma from non-metro cities. The objectives were to find prevalence of bronchial asthma and various risk factors that are associated in this age group and determine the extent of under diagnosis. MATERIALS AND METHODS: A cross-sectional study involving 927 students from four government and three private schools was conducted using International Study of Asthma and Allergies in Childhood questionnaire. RESULTS: Prevalence of bronchial asthma in adolescents was 13.1% (n = 121) of which 10.3% had episodes in the past 1 year. Prevalence was higher among males (8.77%) compared to females (4.33%). About 77.7% of total asthmatics were newly diagnosed cases. Prevalence was significantly higher among those having pets at home (P < 0.001), belonging to higher socioeconomic status (P = 0.021), using smoke-producing fuel at home (firewood/cow dung/kerosene; P = 0.032), and with history of smoking among family members (P = 0.035). Among current asthmatics, 72.3% reported cold/rhinitis (54.6% in March-May duration), 63.6% nocturnal dry cough, 50.5% sleep disturbances, and 38.9% speech disturbances in the past 1 year. CONCLUSION: The study shows higher prevalence of bronchial asthma in school-going population (11-16 years) compared to other parts of Northern India possibly attributable to rapid industrialization and post harvesting season when the study was carried out. Preventive interventions need to be taken to reduce disease burden at community level.

Hepatitis C vaccine. Need of the hour.

Hepatitis C virus (HCV) was first identified in 1989. HCV is a small, enveloped RNA virus. Globally, 3-4 million persons are infected with HCV each year, and are at risk of developing liver cirrhosis and/or liver cancer. The common modalities of the spread of hepatitis C infection are blood transfusions, injection drug use, unsafe therapeutic injections, and healthcare-related procedures. The standard treatment for hepatitis C has been combination antiviral therapy with interferon (IFN) and ribavirin, which are effective against all the genotypes of hepatitis viruses (pan-genotypic). A 12-month course of Peg-IFN/ribavirin treatment costs > $20 000. New HCV-specific antiviral drugs, especially in combination, have shown very high cure rates; however, the annual cost for a single subject ($82 000) make these unaffordable in most of the world. There is no hepatitis C vaccine. However, several vaccines in development, and some have shown promising preclinical results. Over the last few years, numerous HCV vaccine approaches have been assessed in mice and primates, but only a few vaccines have progressed to human trials. The challenge to develop HCV vaccine is to move into larger at-risk or infected populations to test efficacy.

Evaluating the inhibitory potential of sulindac against the bleomycin-induced pulmonary fibrosis in wistar rats.

The present study examined the protective effect of sulindac on bleomycin-induced lung fibrosis in rats. Animals were divided into saline group, bleomycin group (single intra-tracheal instillation of bleomycin) and bleomycin+sulindac (orally from day 1 to day 20). Bleomycin administration reduced the body weight, altered antioxidant status (such as superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase and glutathione) while it increased the lung weight, hydroxyproline content, collagen deposition and lipid peroxidation. However, simultaneous administration of sulindac improved the body weight, antioxidant status and decreased the collagen deposition in lungs. Moreover, the levels of inflammatory cytokine tumour necrosis factor-α increased in bleomycin-induced group, whereas, on treatment with sulindac the levels of tumour necrosis factor-α were found reduced. Finally, histological evidence also supported the ability of sulindac to inhibit bleomycin-induced lung fibrosis. The results of the present study indicate that sulindac can be used as an agent against bleomycin-induced pulmonary fibrosis.

Development of Toxoplasma gondii vaccine: A global challenge.

Toxoplasmosis is caused by the protozoan parasite T. gondii. Humans and other warm-blooded animals are its hosts. The infection has a worldwide distribution; one-third of the world's population has been exposed to this parasite. There are three primary ways of transmission: ingesting uncooked meat containing tissue cysts, ingesting food and water contaminated with oocysts from infected cat feces and congenitally. Those particularly at risk of developing clinical illness include pregnant women, given that the parasite can pose a serious threat to the unborn child if the mother becomes infected while pregnant, and immunosuppressed individuals such as tissue transplant subjects, AIDS subjects, those with certain types of cancer and those undergoing certain forms of cancer therapy. Maternal infections early in pregnancy are less likely to be transmitted to the fetus than infections later in pregnancy, but early fetal infections are more likely to be severe than later infections. In the absence of an effective human vaccine, prevention of zoonotic transmission might be the best way to approach the problem of toxoplasmosis and must be done by limiting exposure to oocysts or tissue cysts. Vaccine development to prevent feline oocyst shedding is ongoing, mostly with live vaccines. The S48 strain Toxovax is a live vaccine originally developed for use in sheep, but when used in cats inhibits sexual development of T. gondii. This vaccine is used in sheep to reduce tissue cyst development. The T-263 strain of T. gondii is a live mutant strain designed to reduce or prevent oocyst shedding by cats by developing only partial infection in the feline intestinal tract.

Human papilloma virus vaccines: need to be introduced in India.

Human papilloma viruses (HPVs) infect the skin and mucosal epithelium of both men and women. There are about 100 types of HPVs, which are differentiated by the genetic sequence of the outer capsid protein L1. More than 30 types of HPVs are sexually transmitted. Most cases of carcinoma of the cervix are caused by HPV. Cervical cancer is one of the most common forms of cancer in women is the second biggest cause of female cancer mortality worldwide. The worldwide incidence of cervical carcinoma is 529,000 per year, and mortality is 275,000, of which an estimated 88% of deaths occur in developing countries. At least 20 million people worldwide are already chronically infected. Over 80% of cases of cervical carcinoma occurs in developing countries, with 25% estimated to occur in India. At least 50% of sexually active men and women encounter genital HPV at some time in their lives. Cervical cancer is ranked as the most frequent cancer in women in India. India has a population of approximately 366 million women above 15 y of age, who are at risk of developing cervical cancer. The current estimates indicate approximately 132,000 new cases diagnosed and 74,000 deaths annually in India, accounting for nearly one-third of the global cervical cancer deaths. HPV can be prevented by vaccination. Two types of HPV vaccines are available, as Gardasil and Cervarix, both of which are highly effective at preventing HPV infection. HPV vaccine is administered in a three-dose series administered by intramuscular injection, either in the deltoid muscle or in the antero-lateral thigh. The second and third doses should be administered 2 and 6 mo after the first dose respectively. The minimum interval between the first and second doses should be 4 weeks, between the second and third dose should be 12 weeks.

Japanese encephalitis vaccine: need of the hour in endemic states of India.

Japanese encephalitis (JE), a mosquito-borne arboviral infection, is the leading cause of viral encephalitis in Asia. Most worldwide cases of JE are reported annually from the People's Republic of China (PRC), Korea, Japan, Southeast Asia, the Indian subcontinent, and parts of Oceania. JE virus is transmitted by Culex mosquitoes particularly of the Culex vishnui group (C. tritaeniorhynchus). Humans get infected following a bite by an infected mosquito. However, since humans cannot transmit infection, further spread does not take place between humans. Most human cases of JE are asymptomatic. Infection leads to overt encephalitis in only 1 of 20-1,000 cases. Encephalitis usually is severe, resulting in a fatal outcome in 25% of cases and residual neuropsychiatric sequelae in 30% of cases. The World Health Organization (WHO) estimates that there are at least 50,000 serious cases of the disease in Asia each year. Approximately 10,000 of those subjects die, mostly children. JE Outbreaks have been reported from most states and union territories in India through the years. In India, the risk is highest in the monsoon and post-monsoon period. The proposed immunization strategy for India is based on the regional experience and builds off of the three pillars of JE control, i.e., Surveillance for cases of encephalitis, Vector control and Vaccination. The Cell Culture Derived Live SA-14-14-2 Vaccine is based on a stable neuro-attenuated strain of JE virus (SA-14-14-2). It was first licensed for use in 1988 in People's Republic of China, and current usage is over 60 million doses per year. It is also licensed in India, South Korea and Nepal. JE vaccines are available in 5-dose vials as a lyophilized powder that looks like a milky-white crisp cake; this is rehydrated with 2.5 mL diluent. The dose is 0.5 mL administered subcutaneously for all ages and containing not less than 5.4 log PFU of live JE virus (JEV).

Heterozygous puffing patterns in polytene chromosomes of a mosquito, Culex quinquefasciatus

Cromossomos politênicos de núcleos de túbulos de Malpighi em exemplares adultos de Culex quinquefasciatus exibem puffs heterozigotos. Aparentemente a heterozigosidade manifesta-se como uma diferença no tempo de formaçäo dos puffs entre os dois homólogos. Diferenças morfológicas na atividade de puffing de homológos podem ter um papel importante na evoluçäo de dípteros