Durability, household usage and washing pattern of DuraNet© and Interceptor® long-lasting insecticidal nets in long-term field trials in India.

BACKGROUND & OBJECTIVES: Universal coverage of population with long-lasting insecticidal nets (LLINs) living in endemic areas inhabited by ethnic tribal communities or in difficult to reach areas was found effective for disease control where other interventions such as indoor residual spraying have limited success because of operational issues. Evaluation of different LLINs with varied insecticides and fabrics are being evaluated to meet the demand of new products. This study was undertaken on two brands of LLINs, DuraNet© and Interceptor® that varied in fabric and manufacturing technologies to assess the usability in field conditions for atleast three years. METHODS: In large-scale field trials DuraNet©, alpha cypermethrin incorporated polyethylene net, was evaluated in Odisha state while, Interceptor® net, alpha cypermethrin coated polyester net was evaluated in Chhattisgarh and Gujarat states for a period of three years following WHO guidelines. Durability, usage pattern and washing behavior were monitored through periodic surveys and physical examination of nets. RESULTS: Survivorship of both the nets was 84-100% and every night usage rate was >62% in all seasons. Washing frequency was largely within the prescribed limits. The proportion of DuraNet© with holes was 26.7% in year one 74% in year three. In Gujarat, proportion of Interceptor® nets with holes at six months was 33.3% increased to 87% in year three and in Chhattisgarh, 6.7% after six months to 93.3% after three years of use respectively. INTERPRETATION & CONCLUSION: Both the nets revealed a useful life of three years under the field condition.

Tandem mass spectra of ammonium ion, metal ion and ligated metal ion adducts of acyclic sugar derivatives.

The tandem mass (MS/MS) spectra of ammonium ion, metal ion and ligated metal ion adducts of chain-extended acyclic nitro-containing deoxyglucose and deoxygalactose derivatives have been studied. The ammonium adducts fragment primarily by elimination of ammonia followed by acetic acid, thus not giving much structural information. In contrast, cationization of these compounds by metal ions and ligated metal ions gave structurally informative and useful fragment ions on MS/MS. The metal ions and ligated metal ions play an important role in controlling and directing fragmentation. Retro-aldol fragmentation is facilitated by metal ions such as Li(+), Na(+), Ag(+) and Cu(+), whereas the adducts with higher alkali metal ions such as Rb(+) and Cs(+) fragment to give only the corresponding metal ions. The divalent metal ions such as Cu(2+) and Ba(2+) also induce retro-aldol fragmentation. However, the charge is carried by the aldehyde fragment in the case of Cu(2+) adducts, whereas the nitroalkane fragment carries the charge in the case of Ba(2+) adducts. Ligated metal ions such as ZnCl(+), CuCl(+), InCl(2) (+) and BaCl(+) also behave similarly and induce retro-aldol fragmentation in these acyclic sugars. Both the metal ion and ligated metal ion adducts can fragment by elimination of metal-containing neutral molecules.

House-scale evaluation of bifenthrin indoor residual spraying for malaria vector control in India.

In an area of India where the main rural malaria vector, Anopheles culicifacies Giles, has developed triple resistance to DDT, HCH, and malathion sprayed indoors in antimalaria program, bifenthrin (10% wettable powder) was evaluated in a randomized house-scale trial between July 1999 and March 2000. Entomological impact of four serial doses of bifenthrin (25, 50, 100, and 200 mg/m2) sprayed in rooms in five villages was compared with malathion (2 g/m2) and unsprayed control. An. culicifacies was 100% susceptible to bifenthrin (0.1%), but only 57% to malathion (5%) test papers. Contact bioassays were carried out on sprayed surfaces for 24 wk, and 24 h mortality in An. culicifacies was recorded. Bifenthrin 100- and 200-mg doses caused > or = 80% mortality until 24 wk. The 50-mg dose caused > or = 80% mortality on tin, wood, and mud surfaces for 24 wk, and on brick walls for 16 wk. Bifenthrin 25-mg dose produced > or = 80% mortality for 24 wk on tin, 20 wk on mud walls, 16 wk on brick walls, and 8 wk on wood surfaces. Persistence of > or = 80% mortality did not differ for 25- and 50-mg doses on any surface except on wood (P < 0.05). Malathion sprayed in three rounds of 6 wk apart caused > or = 80% mortality for 16 wk on the brick and mud walls, and for 20 wk on the tin and wood surfaces. Bifenthrin 25- and 50-mg doses produced a similar impact on the densities of An. culicifacies and other mosquitoes but a superior one to malathion or control. Bifenthrin 25-mg dose caused least excitorepellency. Overall, efficacy of bifenthrin was superior to malathion. Considering the duration of the persistence of significant insecticidal action of bifenthrin on the most common surfaces (mud and brick walls), least excito-repellency and a relative impact on the mosquito densities, the 25-mg dose was the most superior among all the four doses evaluated.

Solitary nodular goiter. Review of cytomorphologic features in 441 cases.

OBJECTIVE: To study the cytomorphologic features of solitary nodular goiters (SNG). STUDY DESIGN: May-Grünwald-Giemsa-stained smears in 441 SNG diagnosed by ultrasonography and fine needle aspiration (FNA) and found to have optimum cellular material at review were subjected to detailed cytologic assessment. The age of the patients ranged from 11 to 75 years, with a median of 35. Male: female ratio was 69:372. The parameters for cytologic assessment included cellularity, colloid content, acinar formation, papillary formation, intranuclear cytoplasmic inclusions, nuclear grooves, marginal vacuoles, Hürthle cells and various inflammatory cells. Histopathology reports on thyroidectomy specimens were available in 27 cases from two Delhi hospitals. RESULTS: Hyperplastic nodules (68 cases) differed significantly from colloid goiters (269 cases) by having more cases with excessive cellularity, acinar formation and marginal vacuoles (P < .001). There was also a significant difference with respect to papillary formation and moderate-to-excessive colloid content (P < .001). As compared to hyperplastic nodules, neoplasms (60 cases) had a significantly higher number of cases with papillary formation, intranuclear inclusions and nuclear grooves but lower number of cases with marginal vacuoles (P < .01-.001). Among neoplasms, usual papillary carcinoma (19 cases) differed from follicular neoplasms (20 cases) with respect to acinar formation, papillary formation and nuclear grooves (P < .001). A significant difference was also observed with respect to colloid content and nuclear inclusions. Follicular variant of papillary carcinomas (FVPC) (10 cases) emerged as a distinct cytologic entity following review and differed from usual papillary carcinomas in having a higher number of cases with acinar formation, tubular formation and marginal vacuoles (P < .01-.001) and lower number of cases with nuclear grooves (P = .05). FVPC also differed from follicular neoplasms with respect to papillary formation, tubular formation, intranuclear inclusions and nuclear grooves (P < .01-.001). Overall cytohistologic agreement was achieved in 24 of 27 (88.9%) cases. CONCLUSION: Detailed cytologic assessment of FNA smears-in SNG was helpful in highlighting parameters that differentiate between various types of goiters.

HCH and DDT residues in human and bovine milk at Hardwar, India.

Concentrations of HCH and DDT in human and bovine milk were determined in two areas under malaria control namely, BHEL, Hardwar with bioenvironmental control strategy and rural and urban areas of Bahadrabad PHC of Hardwar district with residual spraying of insecticides. Mean HCH and DDT residues in human milk in BHEL were 0.027 and 0.021 mg/kg, while from Bahadrabad were 0.089 and 0.149 mg/kg respectively. Similarly, mean HCH and DDT contents in bovine milk from BHEL were 0.019 and 0.008 mg/kg, while 0.058 and 0.029 mg/kg, respectively from Bahadrabad. Statistically significant differences were recorded in HCH and DDT levels in human and bovine milk samples between BHEL and Bahadrabad areas of Hardwar district. The mean levels of HCH and DDT in bovine milk samples did not exceed the maximum residual limit of 0.05 mg/kg from BHEL whereas, 38.5% samples from Bahadrabad area exceeded this limit.

Determination of levels of HCH and DDT in soil, water and whole blood from bioenvironmental and insecticide-sprayed areas of malaria control.

Concentrations of HCH and DDT in soil, water and whole blood were determined in two areas under malaria control. These were, (i) bioenvironmental control of malaria at BHEL, and (ii) residual spraying of insecticides in rural and urban area of Bahadrabad PHC of Hardwar district. Mean concentrations of HCH in soil and whole blood samples from BHEL was 2.26 micrograms/kg and 1.20 micrograms/l and from Bahadrabad 61.12 micrograms/kg and 24.3 micrograms/l respectively. Similarly, the mean concentration of DDT in soil and whole blood from BHEL was 3.68 micrograms/kg and 4.71 micrograms/l, while in Bahadrabad 270.51 micrograms/kg and 38.13 micrograms/l respectively. HCH and DDT were never detected in any water samples from BHEL area, while the mean concentration of these compounds in water of Bahadrabad area was 0.18 and 0.07 microgram/l respectively. Residual level of HCH and DDT were 27 and 73.5 times higher in soil and 20.2 and 8.1 times higher in whole blood samples from Bahadrabad as compared to their corresponding values from BHEL respectively.

Corrosive esophageal strictures: predictors of response to endoscopic dilation.

Twenty-one patients with corrosive esophageal strictures underwent contrast-enhanced CT of the chest to determine (1) the esophageal wall thickness at the stricture site and (2) its correlation with number of sessions required for adequate dilation. Average esophageal wall thickness was defined as the mean thickness of all four walls at the site of the stricture, whereas the size of the thickest wall was taken as maximal esophageal wall thickness. Average esophageal wall thickness (8.52 +/- 0.61 mm; range, 5.4 to 13.5 mm) and maximal esophageal wall thickness (11.63 +/- 0.83 mm; range, 5.4 to 20 mm) were significantly higher in patients with corrosive esophageal strictures than normal esophageal wall thickness (2.70 +/- 0.04 mm, p < .01). These patients required a mean of 5.70 +/- 1.42 sessions for achieving adequate dilation. Age, sex, grade of dysphagia, and cause and site of the stricture did not influence the number of sessions required for adequate dilation. On multivariate analysis, maximal esophageal wall thickness (p < .01) but not average esophageal wall thickness or stricture length was independently associated with the number of sessions required for adequate dilation. Patients with maximal esophageal wall thickness of 9 mm or more required a significantly higher number of sessions for adequate dilation than did those with wall thickness of less than 9 mm (7.57 +/- 1.80 versus 1.42 +/- 0.27, p < .05).(ABSTRACT TRUNCATED AT 250 WORDS)

Ultrasound guided fine-needle aspiration cytology: diagnosis of hydatid disease of the abdomen and thorax.

Eight cases of hydatid disease of the abdomen and thorax were diagnosed by fine-needle aspiration (FNA) cytology under ultrasound guidance. The age of the patients ranged from 28 to 60 yr with a median of 34.5 yr; the male to female ratio was 2:6. None of the cases were diagnosed clinically as hydatid diseases but following ultrasonography suspicion of hydatid cyst was raised in two cases. The locations of cysts were the liver in six cases, the lung in one case, and the mediastinum in one case. FNA yielded clear fluid in five cases and turbid fluid in three cases. Laminated cyst wall, scolices, and hooklets were observed in one case, scolices and hooklets were present in two cases, and laminated cyst wall along with hooklets were seen in two cases. The remaining three cases showed only laminated cyst walls which yielded positive reaction with periodic acid-Schiff reaction. Inflammatory cell reaction in the form of neutrophils was observed in four cases, including the three cases where turbid fluid was aspirated. Epithelioid cell reaction was present in one case. None of our eight cases showed any untoward allergic reaction following FNA.

Transthoracic (percutaneous) fine needle aspiration cytology diagnosis of pulmonary tuberculosis.

OBJECTIVE: The present study was carried out to assess the utility of transthoracic (percutaneous) fine needle aspiration (FNA) cytology in the diagnosis of pulmonary tuberculosis. DESIGN: During a period of 6 years (1985-90), 202 ultrasound and computerized tomography (CT)-guided transthoracic FNA of pulmonary lesions were performed. Review of smears available in 190 cases revealed 38 (20%) cases of pulmonary tuberculosis. Age of the patients ranged from 11 months-75 years with a median of 40 years. The common clinical diagnoses were malignancy (14 cases), tuberculosis (8 cases) and pneumonitis (7 cases). The sites of FNA were lungs in 36 cases and pleural based lesions in 2 cases. RESULTS: Epithelioid granuloma without necrosis (type 1 reaction) were observed in 4 (10.5%) cases. Epithelioid granuloma with necrosis (type 2 reaction) and necrosis without epithelioid granuloma (type 3 reaction) were seen in 17 (44.7%) cases each. The overall rate of AFB positivity was 45.8%. The rate of acid-fast bacilli (AFB) positivity in type 1, 2 and 3 reactions were 0%, 38.5% and 60.0% respectively. CONCLUSION: This study shows that transthoracic (percutaneous) FNA is a useful means for diagnosis of pulmonary tuberculosis, especially when the clinical and/or radiological features are non-specific or point towards malignancy rather than tuberculosis.

Fine needle aspiration cytologic diagnosis of gastrointestinal tract lesions. A study of 78 cases.

Seventy-eight cases of gastrointestinal tract lesions were subjected to fine needle aspiration (FNA) cytology over a period of seven years. The age of the patients ranged from 1 to 85 years, and the male:female ratio was 47:31. Specific clinical diagnoses, such as carcinoma, lymphoma and tuberculosis, were offered in 27 cases only. The FNA was ultrasound guided in 52 cases; in 26 cases no imaging aid was available. Ultrasonography revealed that the mass lesions were located in the stomach (4 cases), in various parts of the intestine (46), in bowel/retroperitoneum (1) and in the paraaortic lymph nodes (1). The cytodiagnoses were adenocarcinoma (18 cases), non-Hodgkin's lymphoma (9), leiomyosarcoma (2), suspicious for malignancy (1), tuberculosis (23), nontuberculous infections (7) and inadequate (18). There was a significant difference (P < .05) in the inadequacy rate between ultrasound-guided FNA (15.4%) and nonguided FNA (38.5%).

Fine-needle aspiration diagnosis of intra-thoracic and intra-abdominal lesions: review of experience in the pediatric age group.

Review of fine-needle aspiration (FNA) smears from 121 pediatric patients with intra-thoracic and intra-abdominal lesions revealed 42 (34.7%) cases of neoplasms, 35 (28.9%) cases of tuberculosis, 12 (9.9%) cases of non-tuberculous inflammations, 4 (3.3%) cases of benign cystic lesions, and 28 (23.1%) inadequate/inconclusive cases. The age of the patients ranged from 20 days to 18 yr. Ultrasound and/or CT study done in 105 cases localized the lesions in following common sites: lungs (19 cases), mediastinum (22 cases), liver (14 cases), intestines (11 cases), and lymph nodes (17 cases). The neoplastic lesions consisted of 39 malignant, one suspicious, and two benign neoplasms. Among the neoplasms, the small round cell tumors were the most frequent (27 cases), followed by germ cell tumors (eight cases) and miscellaneous neoplasms (seven cases). The common small round cell tumors were non-Hodgkins lymphoma (eight cases), hepatoblastoma (seven cases), neuroblastoma (five cases), and nephroblastoma (three cases). A combined clinical, imaging, and FNA cytology approach was found to be useful in arriving at a tissue diagnosis.