Long-term impact of legume-inclusive diversification and nutrient management practices on phosphorus dynamics in alkaline Fluvisol.

An insight into the dynamics of soil phosphorus (P) pools with long-term cropping/management practices would help in designing efficient and sustainable management module(s). The study aimed to investigate the long-term impact of diversified rice-based rotations and variable nutrient management practices on the dynamic composition of P pools and their influence on systems' base-crop productivity in an alkaline soil of Indo-Gangetic plain (Fluvisol). Treatments consisted of four rotations [rice-wheat (R-W), rice-wheat-mungbean (R-W-Mb), rice-wheat-rice-chickpea (R-W-R-C), rice-chickpea (R-C)] each with three nutrient treatments [control (CT), integrated nutrient management (INM), sole-chemical fertilizers (CF)]. Notably, R-C exhibited higher levels of bioavailable-P (soluble-P, Ca2-P, labile-Po), particularly in subsurface soil depth (0.2-0.4 m) compared to other rotations. Likewise, the inclusion of chickpea every alternate year (R-W-R-C) resulted in higher Ca2-P (40%), labile-Pi (15%), labile-Po (11%), and moderately labile Po (8%) compared to R-W rotation demonstrating an increased significance of chickpea in maintaining a favorable soil P regime in alkaline soil. Both R-C and R-W-R-C reduced the surface-to-subsurface depth ratio (SSBR) of soluble-P and Ca2-P while increasing the ratio for microbial biomass P. Even with a suboptimal fertilizer-P rate, INM significantly increased soluble-P (4-33%), labile-Po (13-17%), microbial biomass P (10-26%), moderately labile-Po (4-17%) compared to CF and exhibited higher SSBR values. Correlation analysis demonstrated the substantial influence of very-labile carbon, microbial and phosphatase activities on P availability. The treatment-induced changes in labile-P pools significantly influenced rice (base-crop) yields. In conclusion, chickpea-inclusive diversification and INM could be a sustainable approach to enhance P bioavailability and crop productivity in tropical rice soils.

Addendum to the consensus opinion from the International Deep Endometriosis Analysis (IDEA) group: sonographic evaluation of the parametrium.

Preoperative sonographic staging in patients with suspected parametrial endometriosis is essential to plan the surgical intervention and to anticipate the need for a multidisciplinary approach, and hence optimize surgical outcome. The results of a recent metanalysis suggest that defining more accurately the ultrasonographic criteria of parametrial involvement in endometriosis is needed. The aim of this addendum to the IDEA-consensus is to highlight the sonographic characteristics of the parametrium and identify ultrasound techniques to diagnose deep endometriosis in this area. This article is protected by copyright. All rights reserved.

Long-term impact of pulses and organic amendments inclusion in cropping system on soil physical and chemical properties.

Mono-cropping of maize-wheat, mechanical disintegration of soils, and continuous chemical fertilization have deteriorated soil health in the Indo-Gangetic Plains. We studied the long-term impact of pulse-based cropping systems with integrated nutrient management on soil physical and chemical properties and yield sustainability. We evaluated four different cropping systems: (1) maize-wheat (M-W), (2) maize-wheat-mungbean (M-W-Mb), (3) maize-wheat-maize-chickpea (M-W-M-C), (4) pigeonpea-wheat (P-W) each with three degrees of soil fertilization techniques: (1) unfertilized control (CT), (2) inorganic fertilization (RDF), and (3) integrated nutrient management (INM). The field experiment was undertaken in a split-plot design with three replications each year with a fixed layout. P-W and M-W-Mb systems enhanced soil properties such as volume expansion by 9-25% and porosity by 7-9% (p < 0.05) more than M-W, respectively. P-W and M-W-Mb increased soil organic carbon by 25-42% and 12-50% over M-W (RDF). P-W system enhanced water holding capacity and gravimetric moisture content by 10 and 11% (p < 0.05) than M-W. Pulse-based systems (P-W and M-W-Mb) had higher available nitrogen (8-11%), phosphorus (42-73%), and potassium (8-12%) over M-W (p < 0.05). M-W-Mb increased 26% maize yield and 21% wheat yield over M-W (p < 0.05) at the thirteenth crop cycle. P-W system had a higher sustainable yield index (p < 0.05) of wheat over the M-W. Thus, pulse inclusion in the cropping system in combination with INM can enhance physical and chemical properties vis-à-vis sustainable yield index over the cereal-cereal system.

Fatigue Life Modelling of Steel Suspension Coil Springs Based on Wavelet Vibration Features Using Neuro-Fuzzy Methods.

This study proposed wavelet-based approaches to characterise random vibration road excitations for durability prediction of coil springs. Conventional strain-life approaches require long computational time, while the accuracy of the vibration fatigue methods is unsatisfactory. It is therefore a necessity to establish an accurate fatigue life prediction model based on vibrational features. Wavelet-based methods were applied to determine the low-frequency energy and multifractality of road excitations. Strain-life models were applied for fatigue life evaluation from strain histories. ANFIS modelling was subsequently adopted to associate the vibration features with the fatigue life of coil springs. Results showed that the proposed wavelet-based methods were effective to determine the signal energy and multifractality of vibration signals. The established vibration-based models showed good fatigue life conservativity with a data survivability of more than 90%. The highest Pearson coefficient of 0.955 associated with the lowest RMSE of 0.660 was obtained by the Morrow-based model. It is suggested that the low-frequency energy and multifractality of the vibration signals can be used as fatigue-related features in life predictions of coil springs under random loading. Finally, the proposed model is an acceptable fatigue life prediction method based on vibration features, and it can reduce the dependency on strain data measurement.

Vibration-Based Fatigue Analysis of Octet-Truss Lattice Infill Blades for Utilization in Turbine Rotors.

Vibration fatigue characteristics are critical for rotating machinery components such as turbine rotor blades. Lattice structures are gaining popularity in engineering applications due to their unique ability to reduce weight and improve the mechanical properties. This study is an experimental investigation of octet-truss lattice structure utilization in turbine rotor blades for weight reduction and to improve vibration fatigue characteristics. One completely solid and three lattice infilled blades with variable strut thickness were manufactured via additive manufacturing. Both free and forced experimental vibration analyses were performed on the blades to investigate their modal and vibration fatigue characteristics. The blades were subjected to random vibration using a vibration shaker. The response was measured using a triaxial accelerometer in terms of vibration acceleration time histories in the X, Y, and Z directions. Results indicate a weight reduction of up to 24.91% and enhancement in the first natural frequency of up to 5.29% were achieved using lattice infilled blades. The fatigue life of the blades was investigated using three frequency domain approaches, namely, Lalanne, Dirlik and narrow band. The fatigue life results indicate that the 0.25 mm lattice blade exhibits the highest fatigue life, while the solid blade exhibits the lowest fatigue life of all four blades. The fatigue life of the 0.25 mm lattice blade was 1822-, 1802-, and 1819- fold higher compared to that of the solid blade, using the Lalanne, Dirlik, and narrow-band approaches, respectively. These results can serve as the first step towards the utilization of lattice structures in turbine blades, with thermal analysis as the next step. Therefore, apart from being light weight, the octet-truss lattice infilled blades exhibited superior vibration fatigue characteristics to vibration loads, thereby making them a potential replacement for solid blades in turbine rotors.

Strengths and limitations of diagnostic tools for endometriosis and relevance in diagnostic test accuracy research.

Endometriosis is a chronic systemic disease that can cause pain, infertility and reduced quality of life. Diagnosing endometriosis remains challenging, which yields diagnostic delays for patients. Research on diagnostic test accuracy in endometriosis can be difficult due to verification bias, as not all patients with endometriosis undergo definitive diagnostic testing. The purpose of this State-of-the-Art Review is to provide a comprehensive update on the strengths and limitations of the diagnostic modalities used in endometriosis and discuss the relevance of diagnostic test accuracy research pertaining to each. We performed a comprehensive literature review of the following methods: clinical assessment including history and physical examination, biomarkers, diagnostic imaging, surgical diagnosis and histopathology. Our review suggests that, although non-invasive diagnostic methods, such as clinical assessment, ultrasound and magnetic resonance imaging, do not yet qualify formally as replacement tests for surgery in diagnosing all subtypes of endometriosis, they are likely to be appropriate for advanced stages of endometriosis. We also demonstrate in our review that all methods have strengths and limitations, leading to our conclusion that there should not be a single gold-standard diagnostic method for endometriosis, but rather, multiple accepted diagnostic methods appropriate for different circumstances. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.

An exposed Cardiovascular Implantable Electronic Device (CIED) complicated with infection: A case report of unconventional experience with 'Sealed CIED'.

The rate of infected Cardiovascular Implantable Electronic Device is alarming and causes substantial socio-economic burden. A common approach involves immediate extraction of the infected device. Here, we report an unorthodox approach to this problem by 'sealing' the generator inside a sterile container as a temporary permanent pacemaker while waiting for implantation of another device. We report a 66 years old emaciated lady with underlying Sick Sinus Syndrome, who had an implanted single chamber pacemaker and presented with partial protrusion of her device. She underwent sub-pectoral implantation of the new device but subsequently re-presented with pocket site infection after a month. A decision was made to extract the infected generator from the sub-pectoral pocket and it was sealed inside a sterile container as 'bridging therapy' while awaiting arrival of a leadless pacemaker for implantation together with total extraction of the old infected device. Our clinical vignette demonstrated the difficulties we encountered and influenced on our decision for this unconventional approach despite limited supporting evidence.

Paraquat poisoning in Andaman and Nicobar Islands - Government must intervene.

Paraquat poisoning is a grave public health problem in the Andaman and Nicobar islands of India. To evaluate various aspects of paraquat poisoning that influence the outcome, a retrospective study was planned. In this case series study, the information about all cases of acute paraquat poisoning who were admitted to GB Pant Hospital, Port-Blair, in a 12-year period (January 2007-December 2018) were evaluated. A total of 29 referred patients were evaluated with the majority from the early productive age of 16-30 years (68.97%). The case fatality rate was 100%. Most of the incidents took place in South Andaman district (68.97%) and during the rainy season (55.17%). Initially, they presented with local symptoms like mouth and throat pain with ulceration (48.27%), vomiting (44.82%), breathlessness (34.48%), epigastric and abdominal pain (31.03%), hematemesis (27.58%), and oliguria (20.68%). Later on, major organ dysfunctions like a respiratory failure (65.51%), acute kidney injury (62.08%), acute liver failure (55.17%), cardiac dysfunction (31.03%), and multiorgan failure (58.62%) ensued. Patients who were referred early had a significantly longer hospital stay. Few received advanced care, like, methyl prednisolone (24.12%), cyclophosphamide (10.34%), Mesna/NAC (06.89%), charcoal tablets (10.34%), mechanical ventilation (06.89%), and hemodialysis (10.34%). Apart from hemodialysis in acute kidney injury patients and steroid pulse, no other modalities showed improved hospital survival duration. Primary prevention especially government laws, public awareness, and education of health professionals regarding the seriousness of this problem are the keys to get rid of this incurable poisoning in these islands. The government should prioritize preventive works in the south Andaman district and during the rainy season to avoid catastrophe each year and if possible should ban it. Methyl prednisolone therapy and hemodialysis might be advocated to have a better outcome.

Distribution of pathogenic Leptospira in environmental water and soils of selected recreational forests in Perak, Malaysia.

Leptospirosis is an emerging zoonotic disease endemic in tropical regions. Aiming at assessing the potential infection risks via recreational exposure, the molecular prevalence of pathogenic Leptospira in 14 amenity forests in five selected districts of the state of Perak was determined. Water and soil samples along streams and waterfalls were subjected to culture of leptospires and the pathogenic Leptospira spp. was detected by lipL32-based polymerase chain reaction (PCR). Twenty out of 154 samples (13%) that tested positive for leptospires were mostly soils and still water recorded with tolerable temperatures (22.2- 26.5°C) and pHs (5.73-6.70). The localised prevalence was highly varied among eight positive forests (6.7-41.7%), particularly higher in Kampar and Kinta districts which are the more populated urban areas. The importance of public health surveillance should not be underrated given the high prevalence of Leptospira spp. in forests in close proximity to indigenous settlements, even where the places are clean. Overall, this study discovered a wide distribution of pathogenic Leptospira spp. in recreational areas.

Highlighting the compound risk of COVID-19 and environmental pollutants using geospatial technology.

The new COVID-19 coronavirus disease has emerged as a global threat and not just to human health but also the global economy. Due to the pandemic, most countries affected have therefore imposed periods of full or partial lockdowns to restrict community transmission. This has had the welcome but unexpected side effect that existing levels of atmospheric pollutants, particularly in cities, have temporarily declined. As found by several authors, air quality can inherently exacerbate the risks linked to respiratory diseases, including COVID-19. In this study, we explore patterns of air pollution for ten of the most affected countries in the world, in the context of the 2020 development of the COVID-19 pandemic. We find that the concentrations of some of the principal atmospheric pollutants were temporarily reduced during the extensive lockdowns in the spring. Secondly, we show that the seasonality of the atmospheric pollutants is not significantly affected by these temporary changes, indicating that observed variations in COVID-19 conditions are likely to be linked to air quality. On this background, we confirm that air pollution may be a good predictor for the local and national severity of COVID-19 infections.

Diversity of native larvivorous fish fauna during pre- and post-tsunami in Car Nicobar, Andaman & Nicobar Islands, India.

BACKGROUND & OBJECTIVES: Malaria is a serious public health problem in Car Nicobar Island, Andaman & Nicobar Islands, India. Using larvivorous fishes has proved to be the cheapest method for vector management approach, with long suppression of mosquito population. This study aims to scale-up the diversity of larvivorous fishes and their potential larvivoracity to evolve an appropriate biological intervention strategy against the immature stages of malaria vectors. METHODS: During 2003 (pre-tsunami) and 2014-2016 (post-tsunami), an ecological descriptive survey was carried out in the water bodies around Car Nicobar Island. Fishes were captured using fishing nets and cast nets; and placed in plastic jars and preserved in formalin solution. Fishes were identified and classified according to the available keys. Their abundance and data on the current conservation status was recorded and analyzed. Their potential larvivoracity was graded according to their feeding intensity. RESULTS: Pre-tsunami, a total of 27 larvivorous fish species belonging to 11 orders, 23 families and 23 genera were identified. Order Perciformes and the family Cyprinidae were the most ascendant group constituting 51.9 and 11.1%, respectively. While, 80.8% of species were preferred to inhabit the freshwater region, only 37% of species were surface feeders (SF). According to the conservation, assessment and management plan (CAMP, 1998), 44.4% species were at lower risk least concern (LRlc), while 55.6% species were at least concerned (LC) as per the IUCN, 2017 categorization. However, after the tsunami, 17 fish species had gone extinct and 10 fish species were found to remain alive in the local water bodies. INTERPRETATION & CONCLUSION: Post-tsunami, the larvivoracity analysis indicated that Ophiocara aporos, Ophiocara procephala, Valamugil seheli, Channa punctata, Kuhlia rupestris, Khulia mugil, and Terapon jarbua possess high-level larvivorous potentiality in nature and are recommended for vector control in the study area. These fish species were facing several anthropogenic threats, such as human interference, loss of habitat, trade, overexploitation, and fishing. Therefore, it is important to protect the water bodies from external impact and implement the conservation strategies. Further, periodic fish fauna surveys, identification of breeding sites, scale-up of the larvivorous potentiality at the field level, creating public awareness through health education on establishment of larvivorous fish ponds and planning for mass rearing of the native fish species should be adopted as part of vector management approach in the endemic malarious region of Car Nicobar Island.

Distribution of pathogenic Leptospira in environmental water and soils of selected recreational forests in Perak, Malaysia

@#Leptospirosis is an emerging zoonotic disease endemic in tropical regions. Aiming at assessing the potential infection risks via recreational exposure, the molecular prevalence of pathogenic Leptospira in 14 amenity forests in five selected districts of the state of Perak was determined. Water and soil samples along streams and waterfalls were subjected to culture of leptospires and the pathogenic Leptospira spp. was detected by lipL32-based polymerase chain reaction (PCR). Twenty out of 154 samples (13%) that tested positive for leptospires were mostly soils and still water recorded with tolerable temperatures (22.226.5°C) and pHs (5.73-6.70). The localised prevalence was highly varied among eight positive forests (6.7-41.7%), particularly higher in Kampar and Kinta districts which are the more populated urban areas. The importance of public health surveillance should not be underrated given the high prevalence of Leptospira spp. in forests in close proximity to indigenous settlements, even where the places are clean. Overall, this study discovered a wide distribution of pathogenic Leptospira spp. in recreational areas.

Crop variety management for climate adaptation supported by citizen science.

Crop adaptation to climate change requires accelerated crop variety introduction accompanied by recommendations to help farmers match the best variety with their field contexts. Existing approaches to generate these recommendations lack scalability and predictivity in marginal production environments. We tested if crowdsourced citizen science can address this challenge, producing empirical data across geographic space that, in aggregate, can characterize varietal climatic responses. We present the results of 12,409 farmer-managed experimental plots of common bean (Phaseolus vulgaris L.) in Nicaragua, durum wheat (Triticum durum Desf.) in Ethiopia, and bread wheat (Triticum aestivum L.) in India. Farmers collaborated as citizen scientists, each ranking the performance of three varieties randomly assigned from a larger set. We show that the approach can register known specific effects of climate variation on varietal performance. The prediction of variety performance from seasonal climatic variables was generalizable across growing seasons. We show that these analyses can improve variety recommendations in four aspects: reduction of climate bias, incorporation of seasonal climate forecasts, risk analysis, and geographic extrapolation. Variety recommendations derived from the citizen science trials led to important differences with previous recommendations.

Nuclear morphometry and texture analysis on cytological smears of thyroid neoplasms: a study of 50 cases.

BACKGROUND: Fine needle aspiration cytology (FNAC) is a reliable and reproducible diagnostic technique for thyroid lesions with certain limitations. Computed morphometric methods have been introduced with a view to improve the diagnostic yield of thyroid aspirates. However, a review of the existing literature revealed conflicting reports regarding morphometric parameters in thyroid neoplasms. MATERIALS AND METHODS: This study included 50 cases of thyroid lesions (20 cases of colloid goitre, 15 of follicular adenoma, 5 of follicular carcinoma and 10 papillary carcinomas). Digital images of cytologic smears of these cases were captured using a dedicated photomicrography system and nuclear profiles traced manually. With self-designed image analysis software, nuclear morphometric measurements, including texture analysis, were performed. Discriminant analysis was performed including the morphometric parameters and percentage of correctly classified nuclei noted. RESULTS: Nuclear morphometry parameters showed that papillary thyroid carcinoma had the highest perimeter, area, radius and elongation factor compared to other thyroid lesions. Discriminant analysis revealed that altogether 77.9% of cells could be correctly classified to their lesion category based on the nuclear morphometric and textural parameters. Of the neoplastic cases, 84.5% of cells of follicular neoplasms and 72.5% of papillary carcinoma were classified to the respective category. CONCLUSION: Nuclear morphometry, including texture analysis, can assist in the cytologic diagnosis of thyroid lesions, considering the high degree of accuracy of classification. Further studies and methodological refinements can achieve higher accuracy.

Placebo Controlled Introduction of Prophylactic Supplementation of Probiotics to Decrease the Incidence of Necrotizing Enterocolitis at Dhulikhel Hospital in Nepal.

Background Although recent reports suggest that the use of probiotics may enhance intestinal functions in premature infants, the mechanisms are unclear, and open questions remain regarding the safety and its efficacy. Objective The objective of this study is to evaluate the efficacy of probiotics on prevention of necrotizing enterocolitis in preterm infants in Nepal. Method We conducted a randomized, double blind, placebo controlled study of 72 hospitalized preterm infants. They were randomly allocated to receive probiotics (lactobacillus rhamnosus 35) at a dose of 0.8 mg in infants >1500 gms and 0.4 mg in infants <1500 gms in 2 ml of expressed breast milk two times daily or the same amount of expressed breast milk as placebo (without probiotics). Result Seventy-two patients were studied. The probiotics group (n=37) and placebo group (n=35) showed similar clinical characteristics. The incidence of necrotizing enterocolitis was found less frequently in the probiotic group (6/37, 16.2%) compared to the control group (10/35, 28.6%), this difference was not significant (p=0.16). This is 12.35% reduction in the incidence of necrotizing enterocolitis. Among the risk factors for necrotizing enterocolitis, pregnancy risk factors and perinatal risk factors were not significant. However neonatal risk factors were more frequent in the probiotic group (59.3%, n=32) than in the placebo group (40.7%, n=22), the difference was significant (p=0.02). Conclusion In the western world probiotics have been shown to be preventive in regard to necrotizing enterocolitis incidence. The present randomized trial showed a trend towards necrotizing enterocolitis minimal reduction in Nepal too. Further studies in a larger cohort are warranted to prove this effect for preterm infants.

Chelonitoxism in Andaman and Nicobar Island: A report on mass poisoning including a death of an adult.

Chelonitoxism is a type of seafood poisoning which usually occurs due to consumption of certain marine turtle flesh. As the pharmacology or chemistry of the toxin is still unknown, antidote or treatment to chelonitoxism is unavailable. The symptoms can vary from common gastro-intestinal symptoms to neurological manifestations and even death. This case report of community poisoning following consumption of turtle meat includes the death of an adult male (56 yrs.) being reported for the first time in the Great Nicobar Island, Andaman and Nicobar (A&N) Islands, India in August 2012. The patient encountered common gastrointestinal symptoms after one day of ingestion of green turtle flesh and later, he developed neurological symptoms and did not respond to symptomatic treatment and expired after four days after the consumption. However, out of 30 villagers who took the same food, six others developed symptoms and recovered within a period of 3-7 days while two pets (a dog and a cat) died within 24 hours as they were fed with the same food. In spite of several existing wildlife protection acts, catching a turtle and making them a source of food-celebration is quite common in coastal areas of the Indian Ocean and the Bay of Bengal which includes A&N Islands. A proper monitoring and follow-up of the food-borne diseases along with a wide range of explorative health education protocol should be implemented especially for the people who are not reachable via media to avoid such incidents in future.

Characterization of rice (Oryza sativa L.) genotypes on the basis of morpho-physiological and biochemical traits grown under aerobic situation in rainfed ecosystem .

The objective of the present study was to examine the effect of aerobic situation on yield, physiological and biochemical traits of advanced breeding lines of rice. Experiment was conducted with two set of rice genotypes under two water regimes (aerobic and irrigated), during three consecutive wet seasons 2010-2012. Significant decrease in yield was observed in rice genotypes grown under aerobic situation as compared to the irrigated ones. Promising rice genotypes having the ability to maintain high plant biomass, harvest index, early vegetative vigour, improved physiological and biochemical traits in terms of relative water content (RWC), leaf area index (LAI), total soluble sugar, starch, protien and proline content help to sustain higher grain yield under aerobic situation. The yield gap between aerobic and irrigated rice ranged between 24% to 68%. Grain yield showed positive correlation with harvest index (0.434), test weight (0.647), plant biomass (0.411) and effective tiller numbers (0.473), whereas spikelet sterility was negative associated (-0.380). The current study suggested that promising genotypes viz., IR77298-14-1-2-130-2, IR84899-B-182-3-1-1-2, IR84887-B-157-38-1-1-3 and IR 84899-B-179-1-1-1-2 for aerobic situation, showing yield advantage due to better performance of physiological and biochemical traits, might be adopted in large area of rainfed ecosystem as well as in irrigated areas where water scarcity was a major problem.

Leptospirosis among the self-supporting convicts of Andaman Island during the 1920s--the first report on pulmonary haemorrhage in leptospirosis?

Several researchers had carried out investigations on the possibility of existence of Weil's disease in Andaman Islands during early 20 th century. The first report of a series of confirmed cases of leptospirosis that occurred during 1929 was published in 1931.There were several reports during 1995 to 2009 that described detailed account of leptospirosis including various clinical syndromes. The possibility of pulmonary involvement in leptospirosis being a manifestation historically overlooked rather than newly emerged during the past two decades is examined in this review in the context of Andaman Islands. Two case series of leptospirosis, one occurred in 1929 and the other in 1996-1997 were reviewed with special emphasis on pulmonary involvement and haemorrhagic manifestations. The similarities and differences in the clinical profile of patients of the two case series were analysed. The review shows that respiratory system involvement and pulmonary haemorrhage as evidenced by presence of haemoptysis as a complication of leptospirosis was occurring during 1920s in Andaman Islands. The incidence of pulmonary involvement, however, rose from 9.4 per cent during 1929 to 52 per cent in 1996-1997. The case fatality ratio in patients with pulmonary involvement, which was 50 per cent during 1929 and 42.9 per cent during 1996-1997, was higher than that in cases without pulmonary involvement.Fever, conjunctival congestion, jaundice, vomiting, diarrhoea, hepatomagaly, haemoptysis, haematemesis and subconjunctival haemorrhage were common in both series. The case series in Andaman Islands in 1929 was probably the first report of pulmonary haemorrhage as a manifestation of leptospirosis. The increase in the incidence of pulmonary involvement in leptospirosis in the recent past is probably due to the increase in the density and diversity of its animal vectors,the broadening of the range of circulating serovars and the interactions between the vector and the agent. An increased virulence of Leptospira through gene acquisition and loss on an evolutionary time scale and the resulting change in the gene content, gene order and gene expression cannot be ruled out.