RESUMEN
Background: Childhood cancers are emerging as an essential concern in India where there is lack of a specific programme component or policy to address childhood cancer control. There is limited information on the status and quality of childhood cancer care services in India. This paper describes the childhood cancer care services available at secondary and tertiary-level hospitals in India through a cross sectional study design. Methods: The survey was conducted in 137 tertiary-level and 92 secondary-level hospitals in 26 states and 4 Union Territories (UTs), ensuring a uniform representation of public and private care hospitals. The study tool collected data on the organisational infrastructure, type of oncology services, health workforce, equipment, treatment and referral protocols, and treatment guidelines. Descriptive statistics was used to primarily present the health service status and data on childhood cancer care services in proportions and mean. Findings: A dedicated pediatric oncology department was available in 41.6% of the public, 48.6% of private, and 64% Non Government Organization (NGO) managed tertiary-level hospitals. In 36 (39%) of the 92 hospitals providing secondary care, childhood cancer care was provided. The availability of bone (41.5%) and positron emission tomography (PET) scans (25.9%) was lower in public tertiary hospitals, whereas histopathology, computerised tomography (CT scan), and magnetic resonance imaging (MRI) were lower in public secondary hospitals than private and NGO managed hospitals for the corresponding level of care. Most tertiary hospitals had the required supportive care facilities except for play therapy and hospice care. Less than 50% of the public tertiary hospitals had stocks of the four categories of cancer-treating drugs and essential infrastructure for radiotherapy and chemotherapy. Most secondary-level hospitals not treating childhood cancer had referral linkages with tertiary hospitals. Interpretation: The situational analysis of childhood cancer care services in India showed the concentration of availability of childhood cancer care services at the tertiary level of health care. There were gaps in the availability of specialised pediatric oncology care in all the tertiary hospitals. The availability of childhood cancer care services was higher in private and NGO-managed hospitals than in public hospitals. Integration of childhood cancer as a part of the national cancer control response should be taken up as a matter of priority. The need of the hour is to formulate a childhood cancer policy that will enable timely access to care universally. Funding: World Health Organization, India provided funding and technical support.
RESUMEN
The antigenic heterogeneity of Orientia in India is still unknown in many disease endemic areas. The present study aims to characterize the strains of O. tsutsugamushi circulating in Nagaland, Northeast India. Two patients clinically diagnosed with ST and hospitalized in Mon district hospital, Nagaland were identified from whom eschar tissues were collected. Both patients demonstrated antibodies against O. tsutsugamushi along with positive PCR amplification for 56 âkDa gene. The prototype strain TA763 shared 90.4% homology with the sequences. Both the sequences formed a distinctive cluster demonstrating 100% similarity with strains identified from Thailand, Vietnam, China and southern parts of India.
Asunto(s)
Orientia tsutsugamushi , Tifus por Ácaros , Humanos , India/epidemiología , Orientia tsutsugamushi/genética , Filogenia , Reacción en Cadena de la Polimerasa , Tifus por Ácaros/diagnóstico , Tifus por Ácaros/epidemiología , Análisis de Secuencia de ADNRESUMEN
BACKGROUND: Flea-borne rickettsioses have been limitedly explored in the Indian sub-Himalayan belt, including the North Eastern Region (NER) of India. This study investigates the presence of rickettsiae hosts and their probable pathogens in the disease-endemic hilly state of the NER of India. METHODS: Entomological surveys were carried out in disease-reporting localities in a hilly state in India. Fleas collected from domesticated animals were processed for detection of a Rickettsia-specific 17-kDa gene. RESULTS: Sequence analysis revealed Rickettsia felis in six flea pools (40%), Candidatus Rickettsia senegalensis in two pools (13.3%) and Rickettsia asembonensis in one pool (6.6%). CONCLUSIONS: Our findings suggest Ctenocephalides felis, Ctenocephalides canis and Pulex irritans as potential carriers of R. felis and R. felis-like organisms in India.
Asunto(s)
Ctenocephalides , Infestaciones por Pulgas , Infecciones por Rickettsia , Rickettsia felis , Rickettsia , Siphonaptera , Animales , Ctenocephalides/microbiología , Infestaciones por Pulgas/epidemiología , Infestaciones por Pulgas/veterinaria , Humanos , Rickettsia/genética , Infecciones por Rickettsia/epidemiología , Infecciones por Rickettsia/microbiología , Infecciones por Rickettsia/veterinaria , Rickettsia felis/genética , Siphonaptera/microbiologíaRESUMEN
Tuberculosis (TB) patients show dysregulated immunity, iron metabolism, and anemia. In this study, circulatory cytokines, trace metals, and iron-related proteins (hepcidin, ferroportin, transferrin, Dmt1, Nramp1, ferritin, ceruloplasmin, hemojuvelin, aconitase, and transferrin receptor) were monitored in case (active tuberculosis patients: ATB) and control (non-tuberculosis: NTB and healthy) study populations (n = 72, male: 100%, mean age, 42.94 years; range, 17-83 years). Using serum elemental and cytokine levels, a partial least square discriminate analysis model (PLS-DA) was built, which clustered ATB patients away from NTB and healthy controls. Based on the PLS-DA variable importance in projection (VIP) score and analysis of variance (ANOVA), 13 variables were selected as important biosignatures [IL-18, IL-10, IL-13, IFN-γ, TNF-α, IL-5, IL-12 (p70), IL-1ß, copper, zinc, selenium, iron, and aluminum]. Interestingly, low iron and selenium levels and high copper and aluminum levels were observed in ATB subjects. Low circulatory levels of transferrin, ferroportin, and hemojuvelin with higher ferritin and ceruloplasmin levels observed in ATB subjects demonstrate an altered iron metabolism, which partially resolved upon 6 months of anti-TB therapy. The identified biosignature in TB patients demonstrated perturbed iron homeostasis with anemia of inflammation, which could be useful targets for the development of host-directed adjunct therapeutics.
Asunto(s)
Anemia , Selenio , Tuberculosis , Adulto , Humanos , Masculino , Aluminio , Ceruloplasmina , Cobre , Citocinas , Ferritinas , Interleucina-10 , Interleucina-6 , Hierro , Transferrina , Adolescente , Adulto Joven , Persona de Mediana Edad , Anciano , Anciano de 80 o más AñosRESUMEN
A single nucleotide change (C to T) in HLA-DQB1*01:03:01:03 results in the novel allele, HLA-DPA1*01:03:01:21.
Asunto(s)
Cadenas alfa de HLA-DP , Alelos , Cadenas alfa de HLA-DP/genética , Humanos , IndiaRESUMEN
HLA-C*08:01:01:05 differs from HLA-C*08:01:01:02 by one nucleotide deletion (T > -) at position 674 in intron 2.
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Antígenos HLA-C , Polimorfismo de Nucleótido Simple , Alelos , Antígenos HLA-C/genética , Humanos , India , Intrones/genéticaRESUMEN
This study investigated the association of seven widely known DNA repair gene polymorphisms (hOGG1 Ser326Cys, XRCC1 Arg194Trp, XRCC1 Arg280His, XRCC1 Arg399Gln, XPC Val499Ala, XPD Lys751Gln and ERCC1 Cys8092Ala) with dietary and environmental factors for Nasopharyngeal Carcinoma (NPC) susceptibility in Nagaland of Northeast India. The genotypes were determined in 128 NPC patients and 180 healthy controls by PCR-RFLP. XRCC1 Arg280His, XPC Val499Ala and ERCC1 Cys8092Ala were found to be associated with NPC risk. Tobacco smoking and burning of firewood for cooking were also found to be a risk factor for NPC. The haplotype analysis of five single-nucleotide polymorphisms (SNPs) XRCC1 Arg194Trp, XRCC1 Arg280His, XRCC1 Arg399Gln, XPD Lys751Gln and ERCC1 Cys8092Ala identified haplotype TGAAC to be significantly associated with NPC. Multifactor dimensionality reduction (MDR) analysis suggested ERCC1 Cys8092Ala to be the best one-factor model that could predict NPC risk. From this study, we conclude that examining the synergistic interactions of various gene-environmental factors together is a better approach to understand NPC susceptibility, instead of their individual effects.
Asunto(s)
Dieta , Predisposición Genética a la Enfermedad , Exposición por Inhalación , Carcinoma Nasofaríngeo/genética , Neoplasias Nasofaríngeas/genética , Polimorfismo de Nucleótido Simple , Ventilación , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Culinaria , Reparación del ADN/genética , Femenino , Estudios de Asociación Genética , Haplotipos , Humanos , India/epidemiología , Masculino , Persona de Mediana Edad , Carcinoma Nasofaríngeo/epidemiología , Neoplasias Nasofaríngeas/epidemiología , Factores de Riesgo , Adulto JovenRESUMEN
HLA-DQB1*03:01:01:07, intron 1 [1217(AâG)] and intron 2 [2138 (TâC)] substitutions generate HLA-DQB1*03:01:01:23 and HLA-DQB1*03:01:01:24, respectively.
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Alelos , Cadenas beta de HLA-DQ/genética , Humanos , India , Intrones/genéticaRESUMEN
Two nucleotide changes in the 3'-UTR of HLA-C*07:02:01:01 results in the novel allele, HLA-C*07:02:01:97.
Asunto(s)
Genes MHC Clase I , Antígenos HLA-C , Alelos , Frecuencia de los Genes , Antígenos HLA-C/genética , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , IndiaRESUMEN
HLA-DQB1*05:03:01:04 differs from HLA-DQB1*05:03:01:01 by one nucleotide substitution at position 5075 (A>G).
Asunto(s)
Alelos , Cadenas beta de HLA-DQ/genética , Humanos , IndiaRESUMEN
One nucleotide substitution (G>A) in codon 41 of HLA-C*04:03:01:01 results in the novel allele, HLA-C*04:400.
Asunto(s)
Genes MHC Clase I , Antígenos HLA-C , Alelos , Codón , Antígenos HLA-C/genética , Humanos , IndiaRESUMEN
One nucleotide substitution (C>T) in codon 228 of HLA-C*04:06:01 results in the novel allele, HLA-C*04:06:03.
Asunto(s)
Antígenos HLA-C , Mutación Silenciosa , Alelos , Codón , Antígenos HLA-C/genética , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , IndiaRESUMEN
One nucleotide substitution (A>T) in intron 1 of HLA-DPA1*02:01:01:02 results in the novel allele, HLA-DPA1*02:01:01:12.
Asunto(s)
Cadenas alfa de HLA-DP , Alelos , Cadenas alfa de HLA-DP/genética , Humanos , India , Intrones/genéticaRESUMEN
One nucleotide substitution in codon 127 of HLA-DQB1*03:01:01:07 results in the novel allele, HLA-DQB1*03:404.
Asunto(s)
Alelos , Exones/genética , Cadenas beta de HLA-DQ/genética , Humanos , IndiaRESUMEN
A single nucleotide change (T to C) in HLA-B*15:02:01:01 results in the novel allele, HLA-B*15:02:01:04.
Asunto(s)
Genes MHC Clase I , Antígenos HLA-B , Alelos , Antígenos HLA-B/genética , Humanos , IndiaRESUMEN
A single nucleotide change (C to T) in HLA-B*38:02:01 results in the novel allele, HLA-B*38:02:01:02.
Asunto(s)
Genes MHC Clase I , Antígenos HLA-B , Alelos , Antígenos HLA-B/genética , Humanos , IndiaRESUMEN
Thirteen nucleotide substitutions in intron 1 of HLA-DPA1*02:01:01:09 results in a novel allele, HLA-DPA1*02:01:01:13.
Asunto(s)
Cadenas alfa de HLA-DP , Alelos , Cadenas alfa de HLA-DP/genética , Humanos , India , Intrones/genéticaRESUMEN
One nucleotide substitution (C > G) in 3'-UTR of HLA-C*04:01:01:01 results in the novel allele, HLA-C*04:01:01:78.
Asunto(s)
Genes MHC Clase I , Antígenos HLA-C , Alelos , Antígenos HLA-C/genética , Humanos , IndiaRESUMEN
A single nucleotide change in HLA-DPA1*01:03:01:01 results in the novel null allele, HLA-DPA1*01:29N.
Asunto(s)
Cadenas alfa de HLA-DP , Alelos , Cadenas alfa de HLA-DP/genética , Humanos , IndiaRESUMEN
Two nucleotide changes in the 3'untranslated region of HLA-C*07:06:01:01 results in the novel allele, HLA-C*07:06:01:06.