The burden of submicroscopic and asymptomatic malaria in India revealed from epidemiology studies at three varied transmission sites in India.

Malaria in India, while decreasing, remains a serious public health problem, and the contribution of submicroscopic and asymptomatic infections to its persistence is poorly understood. We conducted community surveys and clinic studies at three sites in India differing in their eco-epidemiologies: Chennai (Tamil Nadu), Nadiad (Gujarat), and Rourkela (Odisha), during 2012-2015. A total of 6,645 subject blood samples were collected for Plasmodium diagnosis by microscopy and PCR, and an extensive clinical questionnaire completed. Malaria prevalence ranged from 3-8% by PCR in community surveys (24 infections in Chennai, 56 in Nadiad, 101 in Rourkela), with Plasmodium vivax dominating in Chennai (70.8%) and Nadiad (67.9%), and Plasmodium falciparum in Rourkela (77.3%). A proportional high burden of asymptomatic and submicroscopic infections was detected in community surveys in Chennai (71% and 71%, respectively, 17 infections for both) and Rourkela (64% and 31%, 65 and 31 infections, respectively). In clinic studies, a proportional high burden of infections was identified as submicroscopic in Rourkela (45%, 42 infections) and Chennai (19%, 42 infections). In the community surveys, anemia and fever were significantly more common among microscopic than submicroscopic infections. Exploratory spatial analysis identified a number of potential malaria hotspots at all three sites. There is a considerable burden of submicroscopic and asymptomatic malaria in malarious regions in India, which may act as a reservoir with implications for malaria elimination strategies.

The use of mosquito repellents at three sites in India with declining malaria transmission: surveys in the community and clinic.

BACKGROUND: Repellents such as coils, vaporizers, mats and creams can be used to reduce the risk of malaria and other infectious diseases. Although evidence for their effectiveness is limited, they are advertised as providing an additional approach to mosquito control in combination with other strategies, e.g. insecticide-treated nets. We examined the use of repellents in India in an urban setting in Chennai (mainly Plasmodium vivax malaria), a peri-urban setting in Nadiad (both P. vivax and P. falciparum malaria), and a more rural setting in Raurkela (mainly P. falciparum malaria). METHODS: The use of repellents was examined at the household level during a census, and at the individual level in cross-sectional surveys and among patients visiting a clinic with fever or other symptoms. Factors associated with their use were examined in a multivariate analysis, and the association between malaria and the use of repellents was assessed among survey- and clinic participants. RESULTS: Characteristics of participants differed by region, with more people of higher education present in Chennai. Use of repellents varied between 56-77 % at the household level and between 32-78 % at the individual level. Vaporizers were the main repellents used in Chennai, whereas coils were more common in Nadiad and Raurkela. In Chennai and Nadiad, vaporizers were more likely to be used in households with young male children. Vaporizer use was associated with higher socio-economic status (SES) in households in Chennai and Nadiad, whereas use of coils was greater in the lower SES strata. In Raurkela, there was a higher use of coils among the higher SES strata. Education was associated with the use of a repellent among survey participants in Chennai and clinic study participants in Chennai and Nadiad. Repellent use was associated with less malaria in the clinic study in Chennai and Raurkela, but not in the surveys, with the exception of the use of coils in Nadiad. CONCLUSIONS: Repellents are widely used in India. Their use is influenced by the level of education and SES. Information on effectiveness and guidance on choices may improve rational use.

A Study of Clinical, Bacteriological & Histopathological Correlation in Leprosy Cases attending a Government Medical College in Western Odisha: Some Observations.

The study was undertaken in VSS Institute of Medical Sciences to observe the clinical, bacteriological and histological diagnosis of leprosy patients attending the hospital who consented to undergo slit skin smear (SSS) examination, punch biopsy and participate in the study. Fifty leprosy patients aged 5 to 70 years, which included 41 male and 9 female patients participated in the study. These included 4 TT, 24 BT, 2 BB, 5 BL and 15 ILL clinically diagnosed patients as per the IAL classification (1982 ). SSS were undertaken from 4 sites, stained with ZN stain and BI calculated as per Ridley Scale. Four patients were skin smear negative all TT). Of the 24 BT patients enrolled in the study, 11 were skin smear negative while 13 were smear positive (BI ranging from 1+ to 4+); Both the BB cases, all 5 BL cases, and all the 15 LL cases were smear positive (BI range 2+ to 6+). Histologically there was complete parity and correlation in.the TT group, while the correlation was observed to be 83%, 50%, 60%, and 93% in the clinically diagnosed BT, BB, BL and LL patients respectively. The sample size in the study was small, however, the overall bacteriological skin smear negativity/positivity correlation was observed to be 53.6% for paucibacillary (TT+BT) disease and 100% for MB (BB, BL and LL) disease Histological correlation was 100%, 83%, 50%, 60% and 93% respectively for clinically diagnosed TT, BT, BB, BL and LL disease. A sizeable number of BT patients were found to be bacteriologically positive and were therefore being treated with lesser number of drugs as well duration under programme conditions, Although there is inter-observer variation and overlapping of clinical and histological diagnosis in the borderline patients (BT, BB & BL), bacteriological and histological confirmation helps in deciding on adequate treatmeht and should be undertaken.

Density functional study of neutral and anionic AlO(n) and ScO(n) with high oxygen content.

The electronic and geometrical structures of neutral and negatively charged AlO(5), AlO(6), AlO(7), AlO(8), AlO(9), AlO(10), AlO(11), AlO(12), AlO(15), AlO(16), and AlO(18) along with the corresponding series of ScO(n) and ScO n- oxides were investigated using density functional theory with generalized gradient approximation. We found that these species possess geometrically stable isomers for all values of n = 5-12, 15, 16, 18 and are thermodynamically stable for n = 5-7. The species with n = 16 are found to be octa-dioxides M(η(1)-O(2))(8) while the species with n = 15 and 18 are penta-ozonides (η(2)-O(3))M(η(1)-O(3))(4) and hexa-ozonides M(η(1)-O(3))(6), respectively. Geometrical configurations of a number of the lowest total energy states of Al and Sc oxides are different. Especially, drastic differences are found for the anion AlO n- and ScO n- pairs at n = 9, 10, and 11. The Sc-O bonds are longer than the Al-O bonds by ≈0.2 Å, which, in turn, slightly affects the corresponding interoxygen bond lengths. The charges on metal atoms are close to +2e in both Al series and to +1.5e in both Sc series. As an extra electron is delocalized over ligands in the presence of a large positive charge on the metal atom of the anions, the electron affinity (EA) of the neutrals along with the ionization energies of the anions are large and exceed the EAs of the halogen atoms in a number of cases.

Development and Validation of a Stability-indicating UV Spectroscopic Method for Candesartan in Bulk and Formulations.

A simple, specific, accurate and stability-indicating UV- Spectrophotometric method was developed for the estimation of candesartan cilexitil, using a Shimadzu, model 1700 spectrophotometer and a mobile phase composed of methanol: water in the ratio of 9:1 at wave length (λ(max)) 254 nm. Linearity was established for candesartan in the range of 10-90 µg/ml. The percentage recovery of was found to be in the range of 99.76-100.79%. The drug was subjected to acid, alkali and neutral hydrolysis, oxidation, dry heat, UV light and photolytic degradation. Validation experiments performed to demonstrate system suitability, specificity, precision, linearity, accuracy, interday assay, intraday assay, robustness, ruggedness, LOD, and LOQ. While estimating the commercial formulation there was no interference of excipients and other additives. Hence this method can be used for routine determination of candesartan cilexetil in bulk and their pharmaceutical dosage forms. The proposed method for stability study shows that there was appreciable degradation found in stress condition of candesartan.

Superhalogen properties of CumCln clusters: theory and experiment.

Using a combination of density functional theory and anion photoelectron spectroscopy experiment, we have studied the structure and electronic properties of CuCl(n)(-) (n = 1-5) and Cu(2)Cl(n)(-) (n = 2-5) clusters. Prominent peaks in the mass spectrum of these clusters occurring at n = 2, 3, and 4 in CuCl(n)(-) and at n = 3, 4, and 5 in Cu(2)Cl(n)(-) are shown to be associated with the large electron affinities of their neutral clusters that far exceed the value of Cl. While CuCl(n) (n ≥ 2) clusters are conventional superhalogens with a metal atom at the core surrounded by halogen atoms, Cu(2)Cl(n) (n ≥ 3) clusters are also superhalogens but with (CuCl)(2) forming the core. The good agreement between our calculated and measured electron affinities and vertical detachment energies confirm not only the calculated geometries of these superhalogens but also our interpretation of their electronic structure and relative stability.

Structure and spectroscopic properties of iron oxides with the high content of oxygen: FeO(n) and FeO(n)(-) (n = 5-12).

The electronic and geometrical structures of oxygen-rich neutral and negatively charged FeO(5), FeO(6), FeO(7), FeO(8), FeO(9), FeO(10), FeO(11), and FeO(12) clusters were obtained using density functional theory with generalized gradient approximation. With the exception of FeO(11) and FeO(12), all clusters are found to possess a large number of isomers composed of oxo, peroxo, superoxo, and ozonide fragments that are closely spaced in total energy, especially for n = 7 and 8. The preferable structures of FeO(12) are composed of superoxo groups with different orientations. All the neutral species possess rather large electron affinities, which range from 3.24 eV (FeO(8)) to 3.95 eV (FeO(5)). Although all of the lowest energy states were found to possess positive vibrational frequencies and thus are geometrically stable, the states are thermodynamically unstable against dissociation to FeO(4) + (n - 4)/2 O(2) for n = 6, 8, 10, and 12 and FeO(5) + (n - 5)/2 O(2) for n = 7, 9, and 11. In particular, the decay of FeO(12) is exothermic by 34 kcal/mol.

Primary intracranial germinoma presenting as a central skull base lesion.

We report an unusual case of primary intracranial germinoma involving the sphenoid bone and sinus. To the best of our knowledge, paranasal sinus and bone invasion of primary intracranial germinoma has not been previously reported. Recognition of this rare form of presentation by imaging is important because early radiation and chemotherapy can result in a cure of this neoplasm.

Archform in cleft palate--a computerized tomographic classification.

This prospective study was conducted in King George's Medical College, Lucknow, India amongst fifty cleft lip and palate cases to study the various arch forms. The maxillary arch form was traced from Computer Tomograph sections of all the cases pre and post-operatively. The various patterns of arch forms as observed from CT tracings exhibiting U & V shaped with sub-types denominated as posteriorly--convergent (c), divergent (d) and parallel (p). This simplified classification can be used in pediatric dentistry practice.

Quality of water for drinking and agriculture in and around a mines in Keonjhar District, Orissa.

For optimum utilization of water resources, it is necessary to know both the quantity as well as quality of water. This paper describes the assessment of the quality of water of a mining area in the Keonjhar district of Orissa for drinking and agricultural purpose. The water quality for drinking purposes and for agricultural purposes was found to be suitable, however to give the final conclusion it requires the study of biological parameters.

A simple quantitative in vitro macrophage migration assay.

An in vitro macrophage chemotaxis model using mouse peritoneal non-elicited resident macrophage cells and chemotaxins containing mediators of non-specific elicitors such as oyster glycogen or sodium caseinate has been described. Macrophage cells accumulation in mouse peritoneal cavity was maximum at 48 hr after injecting (i.p.) oyster glycogen (2.5%) or sodium caseinate (12%), 0.5 ml/mouse. Chemotaxins containing mediators were prepared from these mice by peritoneal lavage and termed as routine 'diluted' cocktail and 'concentrated (3 times)' cocktail. Chemotaxis assays were carried out in a modified Boyden chamber using a 48-well microchemotaxis assembly. In vitro results showed higher macrophage chemotaxis response against the 'concentrated' cocktails as compared to routine 'diluted' cocktail. Macrophages exhibited cell density dependent increase in the responsiveness to chemoattractant and macrophage cell density of 4 x 10(6) per ml concentration in the upperwell was found to be optimum. Macrophage responsiveness was seen better with sodium caseinate cocktail as compared to oyster glycogen in vitro as well as in vivo. DMSO (Dimethyl Sulphoxide) solvent (0.25% conc.) did not interfere with normal macrophage chemotaxis. Both CO2 incubator (5% CO2 in air) and BOD incubator with humidified chamber favoured chemotaxis. In vitro test system described can be used as a model to study the effect of anti-inflammatory compounds directly on the macrophage chemotaxis.

A comparative study of experimental caecal amoebiasis and the evaluation of amoebicides.

Caecal amoebiasis models (mouse, hamster and rat) were compared for amoebic infection and chemotherapeutic evaluation using a pathogenic strain of Entamoeba histolytica of human origin. Caecal infection in the hamster was of the acute type, with a large number of amoebae in the caecal tissue, whereas the amoebae in rats were seen in the lumen, on the mucosal surface. Amoebic lesions in the mouse caecum were of moderate severity. The mouse model responded to both metronidazole (tissue amoebicide) and diloxanide furoate (luminal amoebicide), whereas the hamster model only responded well to metronidazole and the rat model only to diloxanide furoate. Using the mouse as a primary screening model, a new oxadiazole compound, BTI 2405E, was found to have tissue and luminal amoebicidal activity. In rodent caecal models, a single dose of BTI 2405E was found to be more effective than one of metronidazole or diloxanide furoate. The mouse model appears to be the most useful for primary screening of anti-amoebic compounds.

Safety of ciprofloxacin therapy in children: magnetic resonance images, body fluid levels of fluoride and linear growth.

We evaluated the safety of ciprofloxacin administered in a dose of 15-25 mg/kg for 9-16 days, in a case series of 58 children who were between 8 months and 13 years of age. No arthropathy was observed during therapy and follow-up. Blinded evaluation of 22 pairs of nuclear magnetic resonance scans obtained before and between day 10 and 15 of therapy did not reveal any cartilage damage. After the first dose of ciprofloxacin (10 mg/kg), serum fluoride levels increased at 12 h in 15 of 19 (79%) patients; 24-h urinary fluoride excretion was higher on day 7 compared with basal values in 16 of 18 (88.9%) patients. Height z scores of 53 patients at a mean of 22.5 months of follow-up were not significantly different from basal scores (p = 0.12). In conclusion, ciprofloxacin may be recommended for use in children for short duration when effective alternative antibacterials are unavailable. However, there is a need for further studies to evaluate the tissue accumulation of fluoride and its potential to cause toxic effects.

Comparative pharmacokinetics and amoebicidal activity of metronidazole and satranidazole in the golden hamster, Mesocricetus auratus.

The pharmacokinetic properties of metronidazole and satranidazole were studied in the golden hamster (Mesocricetus auratus), at a dose of 80 mg/kg po. Blood and liver samples were collected at frequent time intervals and assayed for metronidazole and satranidazole by HPLC. Satranidazole exhibited significantly higher plasma concentrations than metronidazole at 1 and 2 h post-dose, but the comparative Cmax values were not significantly different. The satranidazole plasma elimination half-life of 1.01 h was significantly shorter than the corresponding metronidazole half-life of 3.62 h. The comparative liver pharmacokinetic parameters Cmax, Tmax and T1/2 did not differ significantly. Satranidazole however exhibited significantly higher liver concentrations at 1 h post-dose and Cmax and AUC0-infinity values were approximately 35% higher. The in-vivo amoebicidal activity of both compounds was evaluated in the acute hamster hepatic model of amoebiasis. Both metronidazole and satranidazole were administered as single graded doses po, and their dose-response profiles were characterized. Satranidazole demonstrated significantly greater amoebicidal activity than metronidazole with an ED50 value of 19.5 mg/kg, compared to an ED50 value of 45 mg/kg for metronidazole. These data suggest that higher plasma and liver concentrations of satranidazole and greater intrinsic potency probably contribute to superior amoebicidal activity in the hamster model of hepatic infection.

Activity of a new oxadiazole compound, against experimental infections with Entamoeba histolytica and Giardia lamblia in animal models.

BTI 2286E(+/-)-E-3-(4-methylsulphinylstyryl)-1,2,4-oxadiazole has demonstrated potent amoebicidal activity in a single-dose treatment against Entamoeba histolytica infection in the livers of golden hamsters and the caeca of mice, hamsters and rats. It has intra luminal activity against Entamoeba criceti, a natural infection in golden hamster, and anti-giardial activity against Giardia lamblia infection in suckling mice. BTI 2286E is more potent than metronidazole in extra intestinal, intra luminal amoebiasis models and has significant advantages in that it is non-mutagenic in the Ames test and has a shorter duration of effective treatment.

Caldwell-Luc operation without facial swelling.

Postoperative facial swelling remains the most common complication of Caldwell-Luc operation. Over a period of 5 years 128 Caldwell-Luc operations were performed on 76 patients. We have been able to reduce the incidence of postoperative facial swelling to only 5% of all cases, by using a wide sublabial incision, gentle tissue retraction, and avoidance of antibiotic soaked pack after completion of surgery. In none of the cases post operative bleeding was severe enough to warrant antral packing. Only one case required packing 6 h after completion of surgery. This method reduces morbidity of the operation significantly, cuts short the hospital stay and hence a much better patient compliance is achieved.