Survey of the present health & nutritional status of Shompen tribe of Great Nicobar Island.

BACKGROUND OBJECTIVES: Shompens are one of the two mongoloid tribes of Nicobar district. There is little information about their recent health status since the last survey which was conducted in 1998. Hence, a comprehensive health and nutritional survey was conducted in March 2017 to assess the changes. The survey was carried out by a joint team of various organizations including the ICMR-Regional Medical Research Centre and Tribal Welfare and Health Department both located in Port Blair. METHODS: A detailed health and nutrition survey of the Shompen community was planned by deputing a field research team. The survey included demographic data, anthropometric data, clinical examination, screening for the markers of infectious diseases, respiratory pathogens, tuberculosis and haemoglobinopathies. RESULTS: About half of the Shompen adults (both males and females) had a body mass index (BMI) of ≥23. However, Shompen children had a good nutritional status with no child suffering from undernutrition. As per BMI for age, none of the children <5 yr were under-nourished, while in the 5-17 yr group, 12 per cent of children were undernourished. Anaemia prevalence was about 48.3 per cent, with 54 per cent prevalence in females and 43.8 per cent in males. Fungal infection of the skin, acute respiratory infection and abdominal pain were the common morbidities observed. None had active pulmonary tuberculosis. Of 38 Shompens screened for IgG (immunoglobulin G) antibodies, 42.1 and 18.4 per cent were positive for measles and rubella, respectively. Seroprevalence of Leptospira was 35.5 per cent. The prevalence of hypertension was 13.2 per cent, whereas another 28.9 per cent were pre-hypertensive. INTERPRETATION CONCLUSIONS: The population structure of the Shompen is not skewed and under nutrition was not widely prevalent among the children of <5 yr. The other positive observations were the absence of malaria, filariasis and dengue. However, there was natural infection of measles and rubella. Fungal skin infection and intestinal parasitic infestations were widely prevalent. Although cardiovascular risk profile was low, there were signs of emerging risk of over-weight, hypertension and dyslipidaemia. These together with the high prevalence of smokeless tobacco use may have a serious effect on the cardiovascular disease susceptibility of the Shompen population in the future.

Report of a Rare Case of Pubic Symphysis Tuberculosis in an Eight-Year-Old Child: An Unusual Presentation of the Disease.

Tuberculosis is a well-known and ancient disease with a wide range of clinical presentations. Although tuberculosis is a well-known infectious disease, involvement of the symphysis pubis is rare, with only a few documented cases in the medical literature. Distinguishing it from other more common conditions, such as osteomyelitis of the pubic symphysis and osteitis pubis, is essential to avoid delay in diagnosis and to minimize morbidity, mortality, and complications. We present a rare case of tuberculosis of the symphysis pubis in an eight-year-old female from India who was initially misdiagnosed with osteomyelitis. Following the correct diagnosis and commencement of anti-tuberculosis chemotherapy, the patient demonstrated improvement in symptoms and hematological parameters at the three-month follow-up. This case emphasizes the importance of considering tuberculosis as a differential diagnosis in cases of symphysis pubis involvement, especially in areas with a high incidence of tuberculosis. Early diagnosis and appropriate treatment can prevent further complications and improve clinical outcomes.

Impact of repeated simulation on learning curve characteristics of residents exposed to rare life threatening situations.

Background: Little is known about the learning curve characteristics of residents undertaking simulation-based education. It is important to understand the time for acquisition and decay of knowledge and skills needed to manage rare and difficult clinical situations. Method: Ten anaesthesiology residents underwent simulation-based education to manage a cannot intubate cannot ventilate scenario during general anaesthesia for caesarean section. Their performance was measured using an assessment tool and debriefed by two experienced anaesthesiologists. The parameters against which the performance was judged were grouped into preoperative assessment, preoperative patient care, equipment availability, induction sequence, communication and adherence to airway algorithm protocol. The scenario was repeated at 6 and 12 months thereafter. The residents' acquisition of knowledge, technical and non-technical skills were assessed and compared at baseline, 6 months and end of 12 months. Result: The skills of preoperative assessment, preoperative care and communication quickly improved but the specific skill of managing a difficult airway as measured by adherence to an airway algorithm required more than 6 months (CI at 6 vs 12 months: -3.4 to -0.81, p=0.016). The skills of preoperative assessment and preoperative care improved to a higher level quickly and were retained at this improved level. Communication (CI at 0 vs 6 months: -3.78 to -0.22, p=0.045 and at 6 vs 12 months : -3.39 to -1.49, p=0.007) and difficult airway management skill were slower to improve but continued to do so over the 12 months. The compliance to machine check was more gradual and showed an improvement at 12 months. Conclusion: Our study is unique in analysing the learning curve characteristics of different components of a failed obstetric airway management skill. Repeated simulations over a longer period of time help in better reinforcement, retention of knowledge, recapitulation and implementation of technical and non-technical skills.

Brainwave Self-Regulation During Bispectral IndexTM Neurofeedback in Trauma Center Nurses and Physicians After Receiving Mindfulness Instructions.

Fifty-seven level I trauma center nurses/physicians participated in a 4-day intervention to learn relaxed alertness using mindfulness-based instructions and EEG neurofeedback. Neurofeedback was provided by a Bispectral IndexTM (BIS) system that continuously displays a BIS value (0-100) on the monitor screen. Reductions in the BIS value indicate that power in a high-frequency band (30-47 Hz) is decreased and power in an intermediate band (11-20 Hz) is increased. A wellbeing tool with four positive affect and seven negative affect items based on a 5-category Likert scale was used. The wellbeing score is the sum of the positive affect items (positive affect score) and the reverse-scored negative affect items (non-stress score). Of functional concern were four negative affect items rated as moderately, quite a bit, or extremely in a large percent. Of greater concern were all four positive affect items rated as very slightly or none at all, a little, or moderately in over half of the participants. Mean and nadir BIS values were markedly decreased during neurofeedback when compared to baseline values. Post-session relaxation scores were higher than pre-session relaxation scores. Post-session relaxation scores had an inverse relationship with mean and nadir BIS values. Mean and nadir BIS values were inversely associated with NFB cognitive states (i.e., widening the visual field, decreasing effort, attention to space, and relaxed alertness). For all participants, the wellbeing score was higher on day 4 than on day 1. Participants had a higher wellbeing score on day 4 than a larger group of nurses/physicians who did not participate in the BIS neurofeedback trial. Eighty percent of participants demonstrated an improvement in the positive affect or non-stress score on day 4, when compared to day 1; the wellbeing, non-stress, and positive affect scores were substantially higher on day 4 than on day 1. Additionally, for that 80% of participants, the improvements in wellbeing and non-stress were associated with reductions in day 3 BIS values. These findings indicate that trauma center nurses/physicians participating in an EEG neurofeedback trial with mindfulness instructions had improvements in wellbeing. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT03152331. Registered May 15, 2017.

Hypertonic saline administration and complex traumatic brain injury outcomes: a retrospective study.

Although hypertonic saline (HTS) decreases intracranial pressure (ICP) with traumatic brain injury (TBI), its effects on survival and post-discharge neurologic function are less certain. We assessed the impact of HTS administration on TBI outcomes and hypothesized that favorable outcomes would be associated with larger amounts of 3% saline. This is a retrospective study of consecutive-patients with the following criteria: blunt trauma, age 18-70 years, intracranial hemorrhage, Glasgow Coma Scale score (GCS) 3-12, and mechanical ventilation ≥ 5 days. The need for craniotomy or craniectomy denoted surgical decompression patients. Amounts of HTS were during the first-5 trauma center days. Traits for the 112 patients during 2012-2016 were as follows: GCS, 6.8 ± 3.2; subdural hematoma, 71.4%; cerebral contusion, 31.3%, ICP device, 47.3%; surgical decompression, 51.8%; ventilator days, 14.8 ± 6.7; trauma center mortality, 13.4%; and no commands at 3 months 35.5%. In surgically decompressed patients, trauma center mortality was greater with ≤ 8.0 mEq/kg sodium (38.9%) than with > 8.0 mEq/kg (7.5%; P = 0.0037). In surgically decompressed patients, following commands at 3 months was greater with ≥ 1400 mEq sodium (76.9%) than with < 1400 mEq (50.0%; P = 0.0489). For trauma center surviving non-decompression patients with no ICP device, those following commands at 3 months received more sodium (513 ± 784 mEq) than individuals not following commands (82 ± 144 mEq; P = 0.0142). For patients with a GCS 5-8, following commands at 3 months was greater with ≥ 1350 mEq sodium (92.3%) than with < 1350 mEq (60.0%; P = 0.0214). In patients with subdural hematoma or cerebral contusion, following commands at 3 months was greater with ≥ 1400 mEq sodium (84.2%) than with < 1400 mEq (61.8%; P = 0.0333). Patients with ICP > 20 mmHg for ≤ 10 hours (mean hours 2.0) received more sodium (16.5 ± 11.5 mEq/kg) when compared to ICP elevation for ≥ 11 hours (mean hours 34) (9.4 ± 6.3 mEq/kg; P = 0.0139). These observations demonstrate that hypertonic saline administration in patients with complex traumatic brain injury is associated with 1) mitigation of intracranial hypertension, 2) trauma center survival, and 3) following commands at 3 months post-injury.

Nutritional status of Onges of Little Andaman Island - Current state and the change over the last fifteen years.

Onges, an indigenous vulnerable tribe, inhabit the Little Andaman Island. Study undertaken during 1997, recorded high prevalence of undernutrition among children. Subsequently, food rationing was modified by Andaman and Nicobar administration. In the present study, health and nutritional status of this tribe was assessed in 2013 after a gap of 15 years. All individuals in the tribe were included. Various health parameters, viz, nutritional anthropometry, haemoglobin level, fasting sugar, lipids and intestinal parasites were investigated. Prevalence of stunted growth and underweight among children of 0-5 years was 86.4%. Severe underweight were more prevalent (40%), as compared to those recorded 15 years ago (10%), and the difference was statistically significant (P < 0.05). There has been a substantial improvement in the overall nutritional status of children in the age group of <18 years. The prevalence of wasting has halved and that of stunting and wasting has come down to one-third of that observed in 1997. Prevalence of anaemia significantly declined from 87% in 1997 to 51% 15 years later.

Cytosolic phospholipase A2 (cPLA2) IVA as a potential signature molecule in cigarette smoke condensate induced pathologies in alveolar epithelial lineages.

BACKGROUND: Smoking is one of the leading causes of millions of deaths worldwide. During cigarette smoking, most affected and highly exposed cells are the alveolar epithelium and generated oxidative stress in these cells leads to death and damage. Several studies suggested that oxidative stress causes membrane remodeling via Phospholipase A2s but in the case of cigarette smokers, mechanistically study is not yet fully defined. In view of present perspective, we evaluated the involvement of cytosolic phospholipase A2 (cPLA2) IVA as therapeutic target in cigarette smoke induced pathologies in transformed type I and type II alveolar epithelial cells. METHODS: Transformed type I (WI26) and type II (A549) alveolar epithelial cells were used for the present study. Cigarette smoke condensate (CSC) was prepared from most commonly used cigarette (Gold Flake with filter) by the Indian population. CSC-induced molecular changes were evaluated through cell viability using MTT assay, reactive oxygen species (ROS) measurement using 2,7 dichlorodihydrofluorescin diacetate (DCFH-DA), cell membrane integrity using fluorescein diacetate (FDA) and ethidium bromide (EtBr) staining, super oxide dismutase (SOD) levels, cPLA2 activity and molecular involvement of specific cPLA2s at selected 24 h time period. RESULTS: CSC-induced response on both type of epithelial cells shown significantly reduction in cell viability, declined membrane integrity, with differential escalation of ROS levels in the range of 1.5-15 folds and pointedly increased cPLA2 activity (p < 0.05). Likewise, we observed distinction antioxidant potential in these two types of lineages as type I cells had considerably higher SOD levels when compared to type II cells (p < 0.05). Further molecular expression of all cPLA2s increased significantly in a dose dependent manner, specifically cytosolic phospholipase A2 IVA with maximum manifestation of 3.8 folds. Interestingly, CSC-induced ROS levels and cPLA2s expression were relatively higher in A549 cells as compared to WI26 cells. CONCLUSIONS: The present study indicates that among all cPLA2s, specific cPLA2 IVA are the main enzymes involved in cigarette smoke induced anomalies in type I and type II lung epithelial cells and targeting them holds tremendous possibilities in cigarette smoke induced lung pathologies.

Antimicrobial and antimalarial properties of medicinal plants used by the indigenous tribes of Andaman and Nicobar Islands, India.

In this study, methanol extracts of six medicinal plants (Alstonia macrophylla, Claoxylon indicum, Dillenia andamanica, Jasminum syringifolium, Miliusia andamanica and Pedilanthus tithymaloides) traditionally used by Nicobarese tribes of Andaman and Nicobar Islands were studied for antimicrobial and antimalarial activities as well as preliminary photochemical analysis. Plants were collected from Car Nicobar of Andaman and Nicobar Islands and the ethnobotanical data were gathered from traditional healers who inhabit the study area. The methanol extracts were obtained by cold percolation method and the antimicrobial activity was found using agar well diffusion method. Among the plants tested, J. syringifolium, D. andamanica, C. indicum were most active. The antimalarial activity was evaluated against Plasmodium falciparum chloroquine-sensitive MRC-2 isolate. The crude extract of M. andamanica showed excellent antimalarial activity followed by extracts of P. tithymaloides, J. syringifolium and D. andamanica. The chemical injury to erythrocytes was also carried out and it showed that, there were no morphological changes in erythrocytes by the methanol crude extracts. The in vitro antimicrobial and antimalarial activity might be due to the presence of alkaloids, flavonoids, triterpenes, sterols, tannins and saponins in the methanol extracts of tested plants.

Elucidating the richness of bacterial groups in the gut of Nicobarese tribal community - Perspective on their lifestyle transition.

Lifestyle and dietary habits are crucial features that can alter the gut microbiome of humans. Humans, along with their gut microbes, have coevolved in order to sustain themselves in different environments. They were able to adapt themselves to the dietary sources available in their environment. The relation between humans and their gut microbiota and the link with coevolution forms an interesting aspect of research. To understand this association, the participation of ancient communities with less exposure to urbanization is a prerequisite. The current study quantifies the richness of bacterial groups in the gut of Nicobarese. This group of population is an ethnic community of Nicobar group of islands, who have migrated from the remote to rural and urban areas. Alterations in the dominant bacterial groups in relation to their lifestyle transition were emphasized, by comparing the participants from remote, rural and urban settings. The remote cohort remains diverse and stable than the other two cohorts and had higher numbers of Bacteroidetes. Prevotella forms the dominant genus in the Bacteroidetes phylum, indicating the carbohydrate-rich diet of remote Nicobarese. Whereas, the urban cohort is dominated by Bifidobacterium group rather than the Bacteroidetes. Implications of dietary patterns, the transition to different lifestyles and their impact on the microbiota among these cohorts are discussed.

Livestock vaccination in India: an analysis of theory and practice among multiple stakeholders.

An effective and efficient disease prevention and control strategy is of paramount importance to improve the quality and quantity of livestock production in the Indian context. Although livestock vaccination is considered an emerging innovation of socioeconomic importance in the Indian dairy industry, the rate of adoption and diffusion of vaccination technology is very low at field level. In this context, the authors examined the efforts of the Government of India to protect livestock health and control disease, considered the lessons learnt from rinderpest eradication, looked at field practices and the reality on the ground, and studied the perceptions of multiple stakeholders with regards to the relevance, profitability and sustainability of vaccination. In this study, the authors consider policy implications for the Indian dairy industry using the responses of 360 dairy farmers, 80 research scientists and 40 extension workers in India. The study revealed that scientists and extension experts rated vaccination highly in terms of its relevance, profitability and sustainability, while the perception of farmers was less favourable. The study also observed that, even after implementation of various disease control programmes with heavy financial expenditure, there was a wide gap between farmers and scientists and between farmers and extension workers with regards to their perceptions of the relevance, profitability and sustainability of vaccination, while the gap was very narrow between scientists and extension workers. It can be concluded, therefore, that there is a need to generate innovations for disease control that are perceived as relevant, profitable and sustainable so as to encourage higher levels of diffusion and adoption at field level. This study recommends that farmers partner with researchers and extension workers to ensure effective generation and transfer of new dairying technologies, leading to higher production and productivity in the Indian dairy sector.

En Inde, l'amélioration qualitative et quantitative de la productivité des élevages passe nécessairement par la mise en place de stratégies efficaces et efficientes de prévention et de contrôle des maladies animales. Les producteurs de lait et de produits laitiers considèrent la vaccination du bétail comme une innovation importante au plan socio-économique mais le niveau d'adoption et de diffusion des technologies vaccinales demeure très faible sur le terrain. Ce constat a incité les auteurs à effectuer une étude visant à analyser les efforts déployés par le gouvernement indien pour protéger la santé du bétail et pour lutter contre les maladies, à déterminer le niveau de prise en compte des leçons de l'éradication de la peste bovine, et à décrire les pratiques et la situation concrète sur le terrain ainsi que la manière dont les diverses parties prenantes perçoivent la pertinence, la rentabilité économique et les effets dans le temps de la vaccination. Dans cette étude, les auteurs ont interrogé 360 éleveurs de vaches laitières, 80 chercheurs et 40 agents de vulgarisation en Inde afin de déterminer les effets des politiques zoosanitaires sur le secteur de l'élevage laitier indien. L'étude a montré que la pertinence, la rentabilité économique et les effets dans le temps de la vaccination étaient perçus très favorablement par les chercheurs et par les agents de vulgarisation, tandis que la perception des éleveurs était moins positive. L'étude a également permis de constater que l'écart manifeste entre la perception des éleveurs d'un côté et celle des chercheurs et des agents de vulgarisation de l'autre concernant la pertinence, la rentabilité et l'effet dans le temps de la vaccination subsistait même après la mise en oeuvre à grands frais de programmes de lutte contre les maladies animales, tandis que cet écart était minime entre les chercheurs et les agents de vulgarisation. Les auteurs concluent sur la nécessité de veiller à ce que les innovations mises en place en matière de lutte contre les maladies animales soient perçues comme pertinentes, rentables et durables, afin de promouvoir une meilleure appropriation et diffusion de ces méthodes sur le terrain. Les auteurs préconisent le recours à des partenariats entre les éleveurs, les chercheurs et les agents de vulgarisation afin d'assurer une conception et un transfert efficaces des technologies dans le secteur de la production de lait et d'améliorer ainsi la production et la productivité du secteur laitier indien.

En el contexto de la India, para mejorar la producción bovina tanto en calidad como en cantidad es de capital importancia disponer de una estrategia eficaz y eficiente de prevención y control de enfermedades. Aunque la vacunación del ganado está considerada una innovación incipiente de gran importancia socioeconómica para el sector lechero del país, sobre el terreno se dan índices muy bajos de adopción y difusión de las técnicas de vacunación. En tales circunstancias, los autores examinaron las iniciativas del Gobierno de la India para proteger la salud del ganado y combatir sus enfermedades, repasaron las enseñanzas extraídas de la erradicación de la peste bovina, observaron la praxis y las realidades sobre el terreno e indagaron en la percepción que tienen numerosos interlocutores del sector de la pertinencia, rentabilidad y sostenibilidad de las vacunaciones. A partir de las respuestas aportadas por 360 productores, 80 investigadores y 40 agentes de extensión del país, los autores estudian las repercusiones normativas para la industria lechera india. El proceso puso de manifiesto que los científicos y especialistas en extensión otorgan a la vacunación un lugar de privilegio por lo que respecta a su pertinencia, rentabilidad y sostenibilidad, mientras que a los productores les merece una opinión menos positiva. Los autores observaron igualmente que, aun tras la implantación de diversos programas de lucha zoosanitaria que supusieron cuantiosas inversiones económicas, existía un gran desfase entre los productores, por un lado, y los científicos y agentes de extensión, por el otro, en cuanto a la valoración que hacían de la pertinencia, rentabilidad y sostenibilidad de las vacunaciones, mientras que las opiniones de científicos y agentes de extensión apenas diferían. Cabe concluir, por lo tanto, que para inducir sobre el terreno mayores niveles de adopción y difusión es indispensable generar innovaciones de lucha zoosanitaria que sean percibidas como algo pertinente, rentable y sostenible. Los autores recomiendan que los productores trabajen en asociación con los investigadores y agentes de extensión para lograr así que se generen y transfieran eficazmente nuevas tecnologías de producción lechera, lo que a su vez redundará en un aumento de la producción y productividad del sector lechero indio.

GC/MS profiling, in vitro anti-leptospiral and haemolytic activities of Boesenbergia rotunda (L.) Mansf. used as a medicinal plant by Nicobarese of Andaman and Nicobar Islands.

Leaves of the plant Boesenbergia rotunda are used by the Nicobarese tribe of Andaman and Nicobar Islands, India, to prepare traditional medicine for treating fever, headache and body ache. In the present investigation, methanol fraction of these leaves were analysed by GC/MS that revealed the presence of 25 compounds. The anti-leptospiral activity of methanol crude extract was determined by both microdilution and macrodilution methods. The MICs of the extract were tested against 24 pathogenic leptospiral strains and ranged between 62.5-125 µg/mL in both microdilution and macrodilution. The range of MBCs was 250 and 500 µg/mL in macrodilution and microdilution respectively. The crude extract was subjected to cytotoxic studies and found to have negligible or no haemolytic activity, exhibiting IC50 values of greater than 4 mg/mL. Further in vivo studies are needed to investigate the pharmacological and toxicological properties of Boesenbergia rotunda, before it can be considered as a new anti-leptospiral agent.

Herbal medicine & healthcare practices among Nicobarese of Nancowry group of Islands - an indigenous tribe of Andaman & Nicobar Islands.

BACKGROUND & OBJECTIVES: Tribal people often depend on herbal medicines and the traditional knowledge practitioners (TKPs) serve as their healthcare service providers. This study was an attempt to document the use of medicinal plants by the Nicobarese of Nancowry group of Islands. METHODS: Field survey was conducted in all the five inhabited Islands of the Nancowry group of Islands. All the TKPs were interviewed with a questionnaire-guided ethnomedicinal survey protocol. Voucher specimens of all the cited plants (botanic species) were collected and a Community Biodiversity Register of Nicobarese of Nancowry was prepared. RESULTS: A total of 77 TKPs were identified, who together were using 132 medicinal plant species belonging to 113 genera and 62 families. The TKPs were treating a total of 43 ailments. Seven endemic and three rare plant species were recorded. The most common plant part used was leaves. Remedies were usually prepared using water as the excipient. Routes for administration of medicinal plant preparations were oral, topical and others. The information collected from the TKPs were collated in the form of Community Biodiversity Registers. INTERPRETATION & CONCLUSIONS: The present survey shows that the medicinal plants play a pivotal role in the healthcare of the Nicobarese tribe of Nancowry group of Islands. Efforts to document the medicinal plant species and the formulations used by them are necessary to prevent the loss of this precious knowledge.

Medicinal Plants Used by the Nicobarese Inhabiting Little Nicobar Island of the Andaman and Nicobar Archipelago, India.

BACKGROUND: This study is an attempt to document the medicinal plants used by the tribal community of Little Nicobar Island. Despite modern healthcare facilities, tribals often consume medicinal herbs, with traditional knowledge practitioners (TKPs) serving as local medical experts. OBJECTIVES: The aim is to conduct an ethnomedicinal survey among the Nicobarese, whose medicinal practices are yet to be documented. METHODS: Field research was conducted in all five villages of Little Nicobar Island, situated in the southernmost part of the Andaman and Nicobar Archipelago, during 2012-2013. Seven TKPs were interviewed using a questionnaire-guided ethnomedicinal survey protocol. The data obtained were analyzed using the informant consensus factor (ICF) and use value. Voucher specimens of all the cited plant species were deposited at the Regional Medical Research Centre (Indian Council of Medical Research), Port Blair. RESULTS: Uses of 34 medicinal plant species, belonging to 23 families encompassing 32 genera, were recorded during the survey. These 34 species are employed to treat a total of 16 ailments. The highest ICF (1.00) was obtained for respiratory diseases. The Euphorbiaceae family exhibited the highest number of citations, and plants with the highest use values were Glochidion calocarpum Kurz, Senna occidentalis (L.) Link, Ocimum tenuiflorum L., and Passiflora suberosa L. Of the medicinal plants reported, the most common growth form was herbs. Remedies were generally prepared using water. The medicinal plant preparations were administered topically or orally. INTERPRETATION AND CONCLUSIONS: Traditional knowledge of herbal medicines is handed down orally through generations. These plants attained a significant role under the healthcare of the Nicobarese residing in Little Nicobar Island. Efforts to ensure their documentation are necessary in order to prevent its loss, either because of natural calamities or lack of interest among younger generations in carrying out their tradition.

Ethnomedicinal knowledge among Karens of Andaman & Nicobar Islands, India.

ETHNOPHARMACOLOGICAL RELEVANCE: This study documents the use of medicinal plants by Karens of Middle Andaman, of the Andaman and Nicobar Islands. In spite of the availability of modern medicines, Karens preferred herbal remedies provided by the Traditional Knowledge Practitioners (TKPs), who served as their healers. Hence, the aim of this study was to collect information from TKPs and determine the significance of plants utilized for medicinal purposes. The informant consensus factor (ICF) in relation to medicinal plants used was also estimated and analysed. MATERIALS AND METHODS: Field research was conducted in three villages of Middle Andaman, inhabited by Karens, during October 2010 - February 2013. TKPs were interviewed with a questionnaire-guided ethno-medical survey protocol. The data obtained were analysed using the informant consensus factor (ICF) and use value (UV). Voucher specimens of all the cited plants were deposited at Regional Medical Research Centre (ICMR), Port Blair. RESULTS: Use of 78 medicinal plant species belonging to 71 genera encompassing 48 families was recorded during the survey. These plants were used to treat 38 different ailments, and divided into ten categories of use. The highest ICF value (0.79) was observed for infections and infestations. The Zingiberaceae and Fabaceae families exhibited the highest number of species, and the plants with the highest use values were Typha angustifolia L., Millingtonia hortensis L. f. and Piper betle L. The most common growth form observed were herbs (42%). Among the several plant parts used, leaves were mostly preferred for preparation of medicines. Water was the main excipient used for mixing the herbs. CONCLUSIONS: This study documents the use of medicinal plants by Karens of the Andaman and Nicobar Islands. Phytochemical and pharmacological aspects of these plants need to be studied, to confirm their efficacy and safety, and determine their potential use in modern medicine.

Anti-leptospiral activities of an endemic plant Glyptopetalum calocarpum (Kurz.) Prain used as a medicinal plant by Nicobarese of Andaman and Nicobar Islands.

Leaves of an endemic plant Glyptopetalum calocarpum are used by Nicobarese tribes of Andaman and Nicobar Islands, India, to prepare traditional medicine for treating fever. In the present investigation, pharmacologically active compounds were isolated from this plant and their antimicrobial efficacy was evaluated against the leptospiral strains. The anti-leptospiral activity of six plant-derived compounds was determined by both microdilution and macrodilution methods. Two out of six compounds, namely lupenone and stigmasterol, showed anti-leptospiral activity. The minimum inhibitory concentrations of the two compounds tested against pathogenic leptospiral strains belonging to 10 serovars were in the range of 100-200 µg/mL. The range of minimum bactericidal concentrations was 400-800 µg/mL. Compounds lupenone, stigmasterol, lupeol, ß-amyrin and ß-amyrin acetate had negligible or no haemolytic activity, exhibiting IC50 values of greater than 5 mg/mL. Further in vivo studies are needed to investigate the pharmacological and toxicological properties of G. calocarpum before it can be considered as a new anti-leptospiral agent.

Ethno medicine and healthcare practices among Nicobarese of Car Nicobar - an indigenous tribe of Andaman and Nicobar Islands.

ETHNOPHARMACOLOGICAL RELEVANCE: This study is an attempt to document the use of medicinal plants by Nicobarese tribe from the Car Nicobar Island of Andaman and Nicobar Islands. Inspite of the availability of modern healthcare facilities tribal people often take herbal medicines and Traditional Knowledge Practitioners (TKPs) serve as the local medical experts in Car Nicobar Island. AIM OF THE STUDY: The present study was to conduct an ethnomedicinal survey among the TKPs of Nicobarese tribe of the inhabitants of Car Nicobar Island, Andaman and Nicobar Islands, India. MATERIALS AND METHODS: Field research was conducted in 15 villages of Car Nicobar Island during March 2011-February 2012. TKPs were interviewed with a questionnaire-guided ethnomedical survey protocol. The data obtained were quantitatively analysed using the informant consensus factor (ICF) and use value (UV). Voucher specimens of all cited plants were collected and deposited at Regional Medical Research Centre (ICMR), Port Blair. RESULTS: Use of 150 medicinal plant species, belonging to 122 genera encompassing 59 families were recorded during the survey. These 150 species are employed to treat 47 different medicinal uses, divided into nine categories of use. The highest ICF (0.68) was obtained for the gastrointestinal system. The Euphorbiaceae family exhibited the highest number of citations, and the species with the highest UVs were Morinda citrifolia L., Tabernaemontana crispa Roxb. and Colubrina asiatica (L.) Brongn. Of the medicinal plants reported, the most common growth form was shrubs (28%). Among several parts of individual plant species which are used, leaves constitute the major portion in preparation of medicines. Remedies were generally prepared using water as the excipient. CONCLUSIONS: This study is an attempt to document the use of medicinal plants from the Car Nicobar Island of the Andaman and Nicobar Islands. Future phytochemical and pharmacological studies are needed to confirm the efficacy and safety of the identified plants.

Comparison of encapsulated versus nonencapsulated (14) C-urea breath test for the detection of Helicobacter pylori infection: a scintigraphy study.

BACKGROUND AND AIMS: (14) C-urea breath test ((14) C-UBT) is considered as "gold standard" for detection of active gastric H. pylori infection. However, till date no comparative study using encapsulated and non-encapsulated (14) C-UBT protocols has been conducted in same subjects in identical conditions. We monitored gastric fate of capsule containing (14) C-urea with real time display and compared sensitivities of these protocols at different time points of breath collection. METHODS: Non-encapsulated (14) C-UBT was performed using 74 kBq of (14) C-urea in 100 dyspeptic patients by collecting breath samples at 10, 15 and 20 minutes. Thereafter, within 2 days a gelatin capsule containing (14) C-urea along with 6.0 MBq of (99m) Tc-diethylene triamine penta-acetic acid was administered to each patient for real time display of capsule movement and its fate in gastrointestinal tract by gamma camera. Simultaneously, breath samples were collected for (14) CO2 measurement during image acquisition. RESULTS: Employing non-encapsulated (14) C-UBT, 74 out of 100 dyspeptic patients were found to be H. pylori positive. Discordant (14) C-UBT results were obtained in 4/74 (5.4%) cases using these two protocols. By employing encapsulated and nonencapsulated (14) C-UBT protocols, sensitivities of (14) C-UBT were found to be 90.5 versus 98.6% at 10 and 91.8 versus 97.2% at 15 minutes respectively; while these were 94.6 versus 100, 90.7 versus 98.6 and 83.7 versus 93.2% considering any one, two or all three positive values respectively. CONCLUSIONS: Incomplete/non-resolution of (14) C-urea capsule in stomach during the phase of breath collections appears to decrease sensitivity of encapsulated (14) C-UBT as compared to nonencapsulated protocol for detection of H. pylori infection.

Superiority of non-capsulated 14C-urea breath test over capsule based method for detection of Helicobacter pylori infection - a preliminary report.

BACKGROUND: 14C-urea breath test (14C-UBT) is employed as a 'gold standard' technique for the detection of active gastric Helicobacter pylori infection and is recommended as the best option for "test-and-treat" strategy in primary health care centers. AIM: To compare the performance of capsulated and non-capsulated 14C-UBT protocols for the detection of H. pylori infection in patients. METHODS: Fifty eight H. pylori infected patients underwent routine upper GI endoscopy and biopsies were processed for rapid urease test (RUT) and histopathology examination. Capsulated 14C-UBT was done in a novel way by using 74 kBq of 14C-urea along with 6.0 MBq of 99mTc-diethylene triamine penta-acetic acid (99mTc-DTPA) to simultaneously monitor the movement and the fate of ingested capsule after delineating the stomach contour by using 20.0 MBq of 99mTechnetium pertechnetate (99mTcO4-) under dual head gamma camera. Non-capsulated 14C-UBT was performed within 2 days of the previous test and the results of these protocols were compared. RESULTS: In 3 out of 58 H. pylori positive cases (5.17%), 14C-UBT results were found to be negative by using the capsulated method. Interestingly, on monitoring the real time images of the capsule in these cases it was found that misdiagnosis of H. pylori infection occurred mainly due to either rapid transit of the 14C-urea containing capsule from the upper gastric tract or its incomplete resolution in the stomach during the phase of breath collection. CONCLUSION: Use of non-capsulated '4C-UBT protocol appears to be a superior option than the conventional capsule based technique for the detection of H. pylori infection.