Netting the malaria menace: Distribution and utilization of long-lasting insecticidal net in a malaria endemic area in Bankura, West Bengal.

BACKGROUND & OBJECTIVES: Long-lasting insecticidal net (LLIN) is considered to be a highly effective intervention against malaria under National Vector Borne Disease Control Programme in India. A cross-sectional study was undertaken to assess the coverage and utilization of LLIN and the factors related thereto. METHODS: A survey of 1300 households was carried out in Ranibandh block of Bankura district in West Bengal, India, using lot quality assurance sampling (LQAS) method. Coverage/utilization of 80% was considered as minimum acceptable norm. The weighted sample size was calculated from each village of the block. The sociodemographic, economic information of the household along with the availability and use of LLIN was collected through interview and observation. RESULTS: In total, 7320 individuals including 840 children ≤ 5 yr were visited. Overall coverage of adequate LLIN was 65.4% (± 1.5%) and for children ≤ 5 yr, it was 60.5% (± 1.3%). Overall, 66.1% (± 1.4%) people of all ages and 63.7% (± 1.4%) children ≤ 5 yr slept under LLINs in the night before the survey. Out of 26 sub-centres, distribution of LLINs in 10 sub-centres was below the accepted norm, whereas utilization was sub-optimal in 19 sub-centres. In only 18.2% (± 0.5%) households, LLINs remained hanging during daytime. Poverty, caste, education, perception regarding malarial morbidity and preventive action of LLIN were associated significantly with the distribution of LLIN. Similarly, poverty (AOR = 2.14), threat perception regarding malarial morbidity (AOR = 1.51) and mortality (AOR = 2.52) were positively associated with the use of LLIN. Full utilization of bednets by under-fives of the households was higher in villages with sub-centres. INTERPRETATION & CONCLUSION: Around two-third population of the study area was effectively covered with LLIN. Higher proportion of socially marginalized people received LLIN. Threat perception regarding malaria was directly associated with both receipt and use of LLIN. Behaviour change communication on utilization along with adequate access to LLIN needs to be strengthened.

Study on the quality and stability of compost through a Demo Compost Plant.

This study is concerned with the performance of a Demo Compost Plant for the development of acceptable composting technology in Bangladesh. The Demo Compost Plant was setup at the adjacent area of an existing compost plant located at Khulna city in Bangladesh. Four different composting technologies were considered, where Municipal Solid Waste (MSW) were used as a raw material for composting, collected from the adjacent areas of the plant. Initially the whole composting system was conducted through two experimental setups. In the 1st setup three different types of aerators (horizontal and vertical passively aerator and forced aerator) were selected. For a necessary observation four piles, using only MSW as the input materials in the first three compost pile, the fourth one was the existing Samadhan's compost pile. Based on the analysis of the experimental findings, the horizontal passively aerated composting technique is suitable for Bangladesh as it had better performance for reducing composting period than that of the others. It was being observed from the quality parameters of compost in the both 1st and 2nd setup that as the waste directly come from kitchen, degradation rate of waste shows a positive result for reducing this waste and there is no possibility of toxic contamination, when it would be used as a soil conditioner. Though there is no significant improvement in the quality of the final product in the 2nd setup as comparing with the 1st setup but it fulfills one of the main objectives of this study is to reduce the whole composting period as well as immediate management of the increasing amount of waste and reducing load on landfill. Selfheating tests reveal that degree of stability of compost with respect to maturation period was remained in the acceptable level, which was further accelerated due to the use of organic additives.

Junctures to the therapeutic goal of diabetes mellitus: Experience in a tertiary care hospital of Kolkata.

INTRODUCTION: The World Health Organization has declared India as the "diabetic capital" of the world. In controlling of such chronic, mostly asymptomatic disease, patients' role can't be overemphasized. AIMS: To assess the level of compliance to anti-diabetic therapies and to ascertain the determinants of non-compliance, if any. MATERIALS AND METHODS: A cross-sectional observational study was conducted for 3 months in a diabetic clinic of R G Kar Medical College and Hospital, Kolkata. Data were collected by interviewing the patients, examining their prescriptions and laboratory reports and anthropometry after obtaining informed consent. RESULTS: Blood report at the point of data collection revealed controlled glucose homeostasis in 38.93% patients but evaluation of past 3 months report showed only 24.3% had control over hyperglycemia. Glycemic control was seen to be positively related to short duration of disease, compliance to therapies, and high knowledge about diabetes. Compliance to therapies found in 32.22% of study subjects was in turn associated with short duration of disease. House-wives showed poor compliance; insulin treatment with or without oral-anti-diabetic agent showed better compliance. Knowledge of diabetes was significantly high among higher educated; poor among women, house-wives, and rural people. CONCLUSION: Patient-providers collaboration is to be developed through a patient-centered care model based on the mutual responsibility of both so that each patient is considered in the mesh of his/her other goals of life and helped to promote empowerment to take informed decision for behavioral change conducive to control the disease.

A study on habits of tobacco use among medical and non-medical students of Kolkata.

BACKGROUND: Age-old practice "using tobacco" is a well known major global concern as it victimizes all its lovers by a host of chronic noncommunicable diseases including cancer; all develop very slowly and silently, and can cause premature death. OBJECTIVES: To assess the pattern of tobacco use among the medical and nonmedical college students. MATERIALS AND METHODS: A cross-sectional descriptive study was carried out in Kolkata collecting anonymous data from 515 medical and 349 nonmedical college students of two medical and two general colleges, selected randomly. RESULT: Overall prevalence of tobacco use (18.3% vs 43.6%) and smoking (14.9% vs 40.7%) were significantly less in medical subjects, both across the sex and years of study. Lower rate of tobacco adoption at college level, higher quitting rate, correct knowledge regarding uselessness of filter attached with cigarette, and ill-effects of tobacco consumption were observed among medical participants. More nonmedical subjects were increasingly smoking compared to medical students. Filter-tipped cigarette was the top choice, and smoking was more prevalent mode of use among the nonmedical participants, most (62.3%) of whom were mild users. Curiosity was the top influencing factor for the initiation of tobacco use and two-third users wanted to quit. CONCLUSION: Although the mortal habits was comparatively less among medical students, the medical environment seemed to fail to curb the dreadful practice totally. Thereby it can be recommended that active behavior-changing communication is required for all sections of the society to tear out the social root of the problem instead of unimpressive vague health warnings in vogue.

Regulation of soluble guanylyl cyclase activity by oestradiol and progesterone in the hypothalamus but not hippocampus of female rats.

Oestradiol and progesterone act in the hypothalamus to coordinate the timing of lordosis and ovulation in female rats in part through regulation of nitric oxide (NO) and cyclic guanosine monophosphate (cyclic GMP) signalling pathways. Soluble guanylyl cyclase is an enzyme that produces cyclic GMP when stimulated by NO and plays a crucial role in the display of lordosis behaviour. We examined the effects of oestradiol and progesterone on the stimulation of cyclic GMP synthesis by NO-dependent and independent activators of soluble guanylyl cyclase in preoptic-hypothalamic and hippocampal slices. Ovariectomised Sprague-Dawley rats were injected with oestradiol (2 microg oestradiol benzoate, s.c.) or vehicle for 2 days. Progesterone (500 microg, s.c.) or vehicle was injected 44 h after the first dose of oestradiol. Rats were killed 48 h after the first oestradiol or vehicle injection, and hypothalamus and hippocampus were obtained. NO-dependent activation of soluble guanylyl cyclase was induced by NO donors, sodium nitroprusside or diethylamine NONOate; NO-independent activation of soluble guanylyl cyclase was induced with 3-(5'-hydroxymethyl-2'-furyl)-1-benzyl indazole and 5'-cyclopropyl-2-[1-2fluoro-benzyl)-1H-pyrazolo[3,4-b]pyridine-3-yl]pyridine-4-ylamine. The NO-dependent activators of soluble guanylyl cyclase produced a concentration-dependent increase in cyclic GMP accumulation and induced significantly greater cyclic GMP accumulation in preoptic-hypothalamic slices from animals treated with oestradiol and progesterone than in slices from rats injected with vehicle, oestradiol or progesterone alone. Hormones did not modify soluble guanylyl cyclase activation by NO-independent stimulators or influence NO content in preoptic-hypothalamic slices. Oestradiol and progesterone did not affect activation of soluble guanylyl cyclase in hippocampal slices by any pharmacological agent, indicating a strong regional selectivity for the hormone effect. Thus, oestradiol and progesterone, administered in vivo, enhance the ability of NO to activate soluble guanylyl cyclase in brain areas modulating female reproductive function without an effect on production of NO itself.

Effect of chitosan on lipid levels when administered concurrently with atorvastatin--a placebo controlled study.

In a placebo controlled trialthe lipid lowering effects of chitosan, a unique dietary fibre, was assessed when given along with atorvastatin 10 mg in patients with chronic coronary heart disease. Altogether 100 patients were studied. They were randomly allocated in two groups of 50 patients each. Patients of group A received atorvastatin 10 mg before dinner plus 2 g/day chitosan in two divided doses. The groupB patients received atorvastatin 10 mg plus placebo. Patients were followed up for a period of 6 weeks. There was significant reduction in mean body weight in group A patients (3.14% versus 1,29% of body weight, p<0.05). There was also a significant rise in HDL cholesterol value (3.8% versus 1.07%, p=0.02) in group A patients. However, there was no significant reduction in the mean values of total cholesterol, LDL cholesterol and triglyceride in the two groups, although group A patients showed marginally lower values.

A clinico epidemiological study on acute viral infection of brain among children admitted in North Bengal Medical College, West Bengal.

A clinico epidemiological prospective study was carried out on acute viral infection of brain among children admitted in a rural based medical college from September '99 to Oct '01. Out of 80 cases, 8 cases (10%) of aseptic meningitis, 35 cases (43.75%) of encephalitis and 37 cases (6.25%) of meningo-encephalitis were found. Overall case fatality was 47.5% and found higher (77%) among normally nourished children in comparison to malnourished children (47.5%). Virological investigation did not isolate any known Flavivirus, Herpes Simplex virus (HSV) and Measles virus; nor any serological evidence against these viruses.

Iodine deficiency disorders among school children of Dakshin Dinajpur District, West Bengal.

Iodine deficiency disorders (IDD) are major public health problems in India, including West Bengal. Existing programme to control IDD needs to be continuously monitored through recommended methods and indicators. Thus we undertook the study to assess the prevalence of goiter, status of urinary iodine excretion (UIE) level and to estimate iodine content of salts at the household level in Dakshin Dinajpur district, West Bengal. We conducted a community-based, cross-sectional study in 2004; among 2250 school children, aged 8-10 years. The '30 cluster' sampling methodology and indicators for assessment of IDD, as recommended by the joint WHO/UNICEF/ICCIDD consultation, were used for the study. Goitre was assessed by standard palpation technique, UIE was analyzed by wet digestion method and salt samples were tested by spot iodine testing kit. Of the 2250 children, 419 (18.6%) had goitre (95% CI = 17.0 - 20.2%). Total goitre rate (TGR) was not significantly different in respect of gender, age and religion. Visible goitre rate was 2.5%. Median urinary iodine excretion level was 16 mcg/dL (normal: > or = 10 mcg/dl.) and 16.5% children had value less than 5 mcg/dL. Only 67.4% of the salt samples tested had adequate iodine content of > or = 15 ppm, with significant difference between Hindus and Muslims (chi2 = 12.68, d.f. = 1, p < 0.01). TGR of 18.6% indicate the district is still endemic for IDD, but median urinary iodine within normal range reflects no current iodine deficiency. The district is in the transition phase from iodine-deficient to iodine-sufficient. Measures are to be sustained for successful transition towards elimination.

Large loop excision and cold coagulation for management of cervical intraepithelial neoplasia.

OBJECTIVES: To evaluate the efficacy of large loop excision of the transformation zone (LLETZ) combined with a single application of the cone probe of a Semm Cold Coagulator as a new treatment for women with cervical intraepithelial neoplasia (CIN). METHODS: Retrospective case-record review of 666 women treated with large loop excision and cold coagulation (LLECC) from 1992 to 2000. RESULTS: Of the women who had high-grade CIN at their initial consultation, 4.2% had abnormal cytologic results 6 months after treatment and 0.6% had abnormal cytologic results at 12 months. Of the women who had low-grade CIN at initial presentation, 3.8% had abnormal cytologic results 6 months after treatment and none (0%) at 12 months. Furthermore, there were no reported cases of cervical cancer in this cohort of women during the follow-up period. Short-term bleeding complications (within 24 h of the procedure) occurred in 1% of the women assessed. CONCLUSIONS: Large loop excision combined with cold coagulation is a new and effective treatment for CIN. Randomized controlled trials are required to confirm these findings and determine the long-term safety of the technique.

Some clinico-epidemiological aspect of bronchiolitis among infants and young children--a hospital based study.

A hospital based prospective study was carried out from 1st October 1998 to 30th September 1999 on children with clinical diagnosis of bronchiolitis in OPD and indoor patients of the Department of Paediatric Medicine, Medical College Kolkata. The objective of the study was to find out the proportional case rate and clinico epidemiological features of the disease. The effectiveness of nebulized salbutamol among bronchiolitis children was also looked into. The proportional case rate was found to be 4.65%. Low birth weight (LBW)/premature babies (51.11%) malnutrition (40%), nonimmunization (55.55%) & non breastfeeding practices (48.88%) were significant risk factors for severe bronchiolitis. Response to nebulized salbutamol was remarkably higher (70%) in 6m to 12m age group.

Development of a cellular model to study alternative splicing of type II collagen gene.

To study regulation of alternative splicing of type II collagen (COL2) pre-mRNA, we constructed a mouse COL2 "minigene" containing genomic sequences spanning exon 1 to exon 4 of COL2 downstream of a cytomegalovirus (CMV) promoter. This minigene was introduced into ATDC5 cells, which undergo chondrocytic differentiation when treated with insulin. Alternative splicing of the COL2 minigene was evaluated by comparing the expression of the two mRNAs transcribed from the minigene to the expression of alternatively spliced transcripts from the endogenous COL2 gene. This analysis suggested that regulation of alternative splicing of pre-mRNAs from the minigene and the endogenous COL2 gene are accomplished by similar mechanisms. We conclude that the cloned genomic fragment contains key sequences necessary for alternative splicing of COL2 pre-mRNA. This system provides a useful model to begin the process of identifying cis- and trans-acting factors that carry out alternative splicing of COL2 pre-mRNA during chondrocyte differentiation.

An evaluation of bed management in a rural hospital adjacent to Indo-Nepal border in West Bengal.

Bed management is one of the important activities for efficient hospital management. The present study on evaluation of bed management in a rural hospital revealed that the total bed capacity could not be utilised. The turnover rate, turnover interval, bed occupancy rate and average length of stay were closely corroborating.

Identification of twenty-two candidate markers for human osteogenic sarcoma.

Since osteogenic sarcoma (OGS) predominantly affects children, its etiology and progression may be determined more by genetic than environmental factors. A few genes have been associated with OGS, however, their value in the diagnosis and/or prognosis of the disease remains poor. Evidently, more markers need to be identified for improving management of patients with OGS. To identify potential genetic markers for OGS, we have extended preferential amplification of coding sequences (PACS) to screen multiple samples simultaneously. The extended method is termed multi-PACS. Multi-PACS was applied between a normal osteoblast and four OGS-derived cell lines to identify differentially expressed coding sequence tags (dCST) that identified 145 dCSTs. Subsequently, differential mRNA expression was validated for a chosen subset of 22 dCSTs. These chosen dCSTs include among others cyclins D and E, two cyclin dependent kinases, two other kinases, transcription factors E2F4, E2F5, and p130, a DNA repair gene, a gene for the signalosome subunit, and potential guanine nucleotide binding factors. We infer that these genes could be so easily identified because PACS preferentially identifies coding instead of non-coding sequences. We also infer that these genes identify signaling pathways pertinent to OGS. mRNA expression profile of these 22 genes/dCSTs generated distinct expression signature of the OGS-derived cell lines suggesting that further work on clinical samples with these dCSTs will yield valuable information for OGS. We conclude that these 22 genes/dCSTs are candidate markers for OGS.

A method for accurate detection of translocation junctions in Ewing family of tumors.

The Ewing family of tumors (ET) generally contain translocations involving the EWS gene and the FLI or ERG genes. Identification of the translocation confirms the diagnosis of ET. Currently, diagnosis of the translocation is made by several methods. In general, these methods require different primer sets for amplifying different translocations and subsequent efforts to identify the amplified product. The need to employ different sets of primers to amplify different translocation junctions presents some limitations. We have developed a method based on PCR with consensus primers followed by direct automated sequencing of the amplified product. With this method we have correctly determined known as well as unknown ET-associated EWS-FLI and EWS-ERG translocations in appropriate specimens. Use of our consensus primers eliminates the need for separate PCRs to amplify EWS-FLI and EWS-ERG translocation junctions, and because direct sequencing is used for confirming the identity of the amplification product, the accuracy of detection becomes 100%. The method might also accurately diagnose ET-associated translocations other than EWS-FLI and EWS-ERG translocations.

Rural people and fine needle aspiration cytology (FNAC)--some findings in North Bengal Medical College, Darjeeling, West Bengal.

A hospital based interdepartmental collaborative study was carried out from 1st July to 30th September, 2000 on 269 rural people residing in six districts of the northern part of West Bengal and attending the Pathology Department in North Bengal Medical College for Fine Needle Aspiration Cytology (FNAC) after being referred from different clinical departments. The objectives of the study were to study some aspects of the outcomes of FNAC among rural people and to suggest for its wider application in rural community through Community Health Centre/Rural Hospital/Block Primary Health Centre. The results shows that Hindus (80.3%) are attending more in number than Muslims (14.13%), Christians (4.83%) and Buddhist (0.74%); 53.54% of the population are in 11-40 years age group. In benign conditions 76.95% are coming from up to 100 kms. of N.B.M.C; people in lower per capita income group of up to Rs.400/- per month are attending twice in number than those in the income groups of Rs.401/- and more per month. In malignancy however people do not think of distance or expenses due to seriousness of the diseases. In 14.5% cases FNAC remains inconclusive whereas in 85.5% cases it provides definite diagnoses.

An integrated approach to assess structure-to-function relationships in the skeleton.

In general, the disciplines of biomechanics, morphology, densitometry, biochemistry, cell biology and molecular biology have advanced independently of one another. In spite of this fragmentation, there have been incremental increases in our understanding of the organization, mechanical properties, growth, remodeling and repair of the tissues comprising the skeleton. As a practical application, this increased knowledge has greatly improved our capabilities for early diagnosis of bone loss and has proven similarly useful in determining the efficacy of interventions to prevent osteoporosis. This approach, however, has been much less successful in countering several other important musculoskeletal disorders, including arthritis. In the immediate future, a major emphasis will be placed on tissue regeneration (engineering) to restore lost mechanical function to a compromised skeleton. To accomplish this goal, it will be necessary to employ much more sophisticated approaches toward evaluating the structure-to-function relationships, ones which will include integration of the respective contributions of gene expression, cell number and activity, matrix composition and architecture to achieve adequate tissue function.

Differential mRNA fingerprinting by preferential amplification of coding sequences.

The need for rapid identification of differentially expressed genes will persist even after the complete human genomic sequence becomes available. The most popular method for identifying differentially expressed genes acquires expressed sequence tags (ESTs) from the extreme 3' non-coding end of mRNAs. Such ESTs have limitations for downstream applications. We have developed a method, termed preferential amplification of coding sequences (PACS), that was applied to identify differentially expressed coding sequence tags (dCSTs) between osteoblasts and osteosarcoma cells. PACS was achieved by PCR with a set of primers to anchor at sequences complementary to AUG sequences in mRNAs and another set of primers to anchor at a PCR-amplifiable distance from AUG sequences. An initial screen identified 103 candidate dCSTs after screening approximately 15% of the expressed genes between the two cell types. Of these sequences, 27 represent CSTs of known genes and two are from 3'-ESTs of known mRNAs. Thus, PACS identified CSTs approximately 13.5 times more often than it identified 3' ESTs, attesting to the objective of the method. Since many of the dCSTs represent known genes, their identity and potential relevance to osteosarcoma could be immediately hypothesized. Differential expression of many of the dCSTs was further demonstrated by northern blotting or RT-PCR. Since PACS is not dependent on the existence of a poly A tail on an mRNA, it should have application to identify dCSTs for both prokaryotic and eukaryotic organisms. Additionally, PACS should aid in the identification of cell-specific or tissue-specific genes and bidirectional acquisition of cDNA sequence enabling rapid retrieval of full-length cDNA sequence of novel genes.

Human papillomavirus type 16 integrations in cervical tumors frequently occur in common fragile sites.

The development of cervical cancer is highly associated with human papillomavirus (HPV) infection. HPV integration into the genome of infected cervical cells is temporally associated with the acquisition of the malignant phenotype. A relationship between the sites of HPV integration in cervical cancer and the position of the common fragile sites (CFSs) has been observed at the cytogenetic level. To explore this relationship at the molecular level, we used a PCR-based method to rapidly isolate cellular sequences flanking the sites of HPV16 integrations in primary cervical tumors. Human bacterial artificial chromosome clones were isolated based on these flanking sequences and used as probes for fluorescence in situ hybridization on metaphases derived from cells cultured in the presence of aphidicolin. Our data demonstrate that HPV16 integrations in cervical tumors frequently occur within CFSs at the molecular level. In addition, we have determined the precise molecular locations of the CFSs FRA6C and FRA17B.

Identification of differentially expressed genes by mutually subtracted RNA fingerprinting.

A mutually subtracted RNA fingerprinting (SuRF) method has been developed that allows efficient identification of differentially expressed sequence tags between two samples. Mutual subtractions of two RNA samples are achieved by first synthesizing cDNAs using oligo(dT) coupled with magnetic beads which are then reciprocally hybridized to starting RNA samples to remove common mRNAs between them. The second step involves differential fingerprinting of the subtracted RNA samples by polymerase chain reaction with specially designed degenerate primers. SuRF was applied to identify alteration in gene expression pertinent to osteogenic sarcoma which was achieved by employing the method between FOB (an immortalized fetal osteoblast) and MG63 (an osteosarcoma) cell lines. An estimated 10% of the total expressed genes in these two cell types were screened by the method. This analysis identified 96 differentially expressed sequences, none of which was identified repeatedly. A subset of these sequences was subsequently confirmed to have differential expression between the two cell types. Removal of common mRNAs prior to differential display should diminish redundant identification of abundant genes and increase the chance of identifying rare differentially expressed genes.