Characterization of flue gas desulphurized (FGD) gypsum of a coal-fired plant and its relevant risk of associated potential toxic elements in sodic soil reclamation.

Thermal Power Plant generates FGD gypsum as by-product during coal combustion. This study evaluates the characterization (spectroscopic and elemental), potentially toxic elements (PTEs) distribution, and environmental risk assessment of FGD gypsum for safe and sustainable use in agriculture. The XRD and SEM analysis confirmed the dominance of crystalline CaSO4·2H2O in FGD gypsum. The order of concentrations of PTEs in FGD gypsum was Fe > Al > Mn > Zn > Ni > Co. The residual fraction was the dominant pool, sharing 80-90% of the total PTEs. The heavy metals (HMs) were below the toxic range in the leachates. The Co, Ni, Al, Fe Mn, Zn had low (< 10%) risk assessment code and the ecotoxicity was in the range of 0.0-7.46%. The contamination factor was also low (0.0-0.16) at the normal recommended doses of FGD gypsum application for sodicity reclamation. The enrichment factor was in the order of Al < Mn < Co < Zn < Ni. Mn [enrichment factor (Ef) 1.2-2.0] and Co (Ef 1.7-2.8) showed negligible enrichment of metals, whereas Ni (Ef 4.3-5.2) and Zn (Ef 4.5-5.6) reported moderate accumulation in soil. The application of FGD gypsum @ 10 t ha-1 for sodicity reclamation will develop a geo-accumulation index below the critical values indicating its safe and sustainable use to achieve land degradation neutrality (LDN) and UN's Sustainable Development Goals.

Changes in soil microbial biomass and organic C pools improve the sustainability of perennial grass and legume system under organic nutrient management.

Introduction: The perennial grass-legume cropping system benefits soil because of its high biomass turnover, cover cropping nature, and different foraging behaviors. We investigated the response of soil organic carbon (SOC) pools and their stock to organic and inorganic nutrient management in the Guinea grass and legume (cowpea-Egyptian clover) cropping system. Methods: Depth-wise soil samples were collected after harvesting the Egyptian clover. Based on the ease of oxidation with chromic acid, different pools of SOC oxidizable using the Walkley-Black C method, very labile, labile, less labile, non-labile; and dissolved organic C (DOC), microbial biomass C (MBC), and total organic C (TOC) in soils were analyzed for computing several indices of SOC. Result and discussion: After 10 years of crop cycles, FYM and NPKF nutrient management recorded greater DOC, MBC, SOC stocks, and C sequestration than the NPK. Stocks of all SOC pools and carbon management index (CMI) decreased with soil depth. A significant improvement in CMI, stratification ratio, sensitivity indices, and sustainable yield index was observed under FYM and NPKF. This grass-legume intercropping system maintained a positive carbon balance sequestered at about 0.8Mg C ha-1 after 10 years without any external input. Approximately 44-51% of the applied carbon through manure was stabilized with SOC under this cropping system. The DOC, MBC, and SOC in passive pools were identified for predicting dry fodder yield. This study concludes that the application of organics in the perennial grass-legume inter cropping system can maintain long-term sustainability, enhance the C sequestration, and offset the carbon footprint of the farm enterprises.

Influence of tillage and residue management practices on productivity, sustainability, and soil biological properties of rice-barley cropping systems in indo-gangetic plain of India.

Introduction: Conservation agriculture is a sustainable system of farming that safeguard and conserves natural resources besides enhancing crop production. The biological properties of soil are the most sensitive indicator to assess the short term impact of management practices such as tillage and residue incorporation. Methods: Nine treatments of tillage and residue management practices [Reduced till direct seeded rice-zero till barley (RTDSR-ZTB); RTDSR-ZTB-green gram residue (Gg); Zero till direct seeded rice-zero till barley-zero till green gram (ZTDSR-ZTB-ZTGg); RTDSR-ZTB + rice residue at 4 t ha 1 (RTDSR-ZTBRR4); RTDSR-ZTBRR6; un-puddled transplanted rice (UPTR)-ZTB-Gg; UPTR-ZTBRR4; UPTR-ZTBRR6, and puddled transplanted rice (PTR)-RTB] executed under fixed plot for five years on crop productivity and soil biological properties under rice-barley production system. Results: The shifting in either RTDSR or ZTDSR resulted in yield penalty in rice compared to PTR. The PTR recorded highest pooled grain yield of 3.61 ha-1. The rice grain yield reduced about 10.6% under DSR as compared to PTR. The ZTB along with residue treatments exhibited significantly higher grain yield over ZTB, and the RTDSR-ZTBRR6 registered highest pooled grain yield of barley. The system productivity (12.45 t ha-1) and sustainable yield index (0.87) were highest under UPTR-ZTBRR6. Biological parameters including microbial biomass carbon, soil respiration, microbial enzymes (Alkaline phosphatase, nitrate reductase and peroxidase), fluorescein diacetate hydrolysis, ergosterol, glomalin related soil proteins, microbial population (bacteria, fungi and actinobacteria) were found to be significantly (p < 0.05) effected by different nutrient management practices. Based on the PCA analysis, Fluorescein diacetate hydrolysis, microbial biomass carbon, soil respiration, nitrate reductase and fungi population were the important soil biological parameters indicating soil quality and productivity in present experiment. The results concluded that UPTR-ZTBRR6 was a more suitable practice for maintaining system productivity and soil biological health. Discussion: The understanding of the impact of different tillage and residue management practices on productivity, soil biological properties and soil quality index under rice-barley cropping system will help in determining the combination of best conservation agriculture practices for improved soil quality and sustainable production.

An Observational Study of Genetic Diversity of HIV-1 vpu in Rapid Progressors in India.

BACKGROUND: The genetic diversity in HIV-1 genes affects viral pathogenesis in HIV-1 positive patients. Accessory genes of HIV-1, including vpu, are reported to play a critical role in HIV pathogenesis and disease progression. Vpu has a crucial role in CD4 degradation and virus release. The sequence heterogeneity in the vpu gene may affect disease progression in patients, therefore, the current study was undertaken to identify the role of vpu in patients defined as rapid progressors. OBJECTIVE: The objective of the study was to identify the viral determinants present on vpu that may be important in disease progression in rapid progressors. METHODS: Blood samples were collected from 13 rapid progressors. DNA was isolated from PBMCs and vpu was amplified using nested PCR. Both strands of the gene were sequenced using an automated DNA Sequencer. The characterization and analysis of vpu was done using various bioinformatics tools. RESULTS: The analysis revealed that all sequences had intact ORF and sequence heterogeneity was present across all sequences and distributed all over the gene. The synonymous substitutions, however, were higher than nonsynonymous substitutions. The phylogenetic tree analysis showed an evolutionary relationship with previously published Indian subtype C sequences. Comparatively, the cytoplasmic tail(77 - 86) showed the highest degree of variability in these sequences as determined by Entropy- one tool. CONCLUSION: The study showed that due to the robust nature of the protein, the biological activity of the protein was intact and sequence heterogeneity may promote disease progression in the study population.

Characterization and ecotoxicological risk assessment of sewage sludge from industrial and non-industrial cities.

The present study highlights the occurrence and the temporal variations of physicochemical properties, and heavy metals in the sludge from sewage treatment plants (STPs) located in industrial (two sites) and non-industrial (one site) cities of Haryana, India. The sludge was acidic (5.59) to neutral (7.21) with a mean EC of 7.4 dS m-1. Prominent heavy metals present in the sewage sludge from industrial sites were Cd, Ni, and Cr with maximum values of 2.83, 1449.0, and 3918.5 mg kg-1, respectively. The contamination and enrichment factor better explained the buildup of Ni, Cr, and Cu in the sewage sludge from industrial sites. The pH, total carbon, phosphorus, and other water-soluble anions, viz. SO42-, Cl-, HCO3-, and PO43-, were the most important attributes of sludge controlling the binding and removal of the metals with particulate matters during the phase separation in STPs. These attributes explained about 90% of the variation in Cd, Ni, Cr, Cu, Mn, and Zn content of the sludge from different STPs. Sludge from the non-industrial site had a low potential ecological risk index of 74.0 compared to a very high-risk index of 2186.5 associated with the industrial sites. This study concludes that besides the concentration of the heavy metals, the enrichment factor coupled with geo-accumulation or ecological risk index can effectively categorize the sludge. However, these indices need to be linked with bioaccumulation, bioaccessibility, and biomass quality under different agroecologies for guiding the safer use of sewage sludge in agriculture.

Irrigation water quality, gypsum, and city waste compost addition affect P dynamics in saline-sodic soils.

The amendments used for sodicity reclamation also profoundly influence P dynamics and leaching losses. This study characterized the effect of irrigation water quality on P dynamics and leaching from saline-sodic soil during reclamation utilizing gypsum alone or in combination with manure and city compost. Changes in properties of unleached and leached soils were fitted with labile P pools using redundancy analysis. The relation between leachate properties and P loss was explained by means of monitoring leachate properties up to ten pore volumes. During incubation, the water-extractable P (PH2O) concentration was greater than Olsen's P (PNaHCO3) in all treatments. The PNaHCO3 decreased in proportion to the amount of gypsum applied. Applying the organics with gypsum increased the PNaHCO3, PH2O, and organic P concentration compared to gypsum alone. The labile P pools in soil were positively correlated with HCO3- content (r = 0.39-0.77; P < 0.05) of leached and unleached soils. Adding gypsum and compost caused a 10-14% decrease in cumulative P leaching. The cumulative P leaching were greater with rainwater compared to saline water of SAR (sodium adsorption ratio) 5 and 15. The CO32-, HCO3-, pH, and SO42-content of the leachate explained about 71% variability in total P leaching (adj. R2 = 0.71; P < 0.001). This study concludes that low electrolyte water had a greater risk of P leaching and associated environmental pollution. Leaching of the saline-sodic soil amended with gypsum and city waste compost with low SAR saline water can reduce P leaching compared to good quality rainwater.

The food-energy-water-carbon nexus of the rice-wheat production system in the western Indo-Gangetic Plain of India: An impact of irrigation system, conservational tillage and residue management.

The conventional rice-wheat system in the western Indo-Gangetic plain of India is energy and water intensive with high carbon footprint. The transition towards resource-efficient eco-friendly production technologies with lower footprint is required for inclusive ecological sustenance. A five-year (2016-17 to 2020-21) field experiment was conducted in RWS with hypothesis that pressurized irrigation systems [drip (DRIP) and mini-sprinkler (MSIS)] in conservation tillage [reduced (RT)/zero (ZT)] and crop residue management [incorporation (RI)/mulch (RM)] might result in higher resource use efficiency with lesser carbon footprint compared to conventional system. Experiment consisted five treatments namely (1) puddled transplanted rice followed by conventionally tilled wheat (PTR/CTW), (2) DRIP irrigated reduced till direct seeded rice (RTDSR) followed by zero-till wheat with 100 % rice residue mulching (ZTW + RM) (DRIP-RTDSR/ZTW + RM), (3) surface irrigated RTDSR followed by ZTW + RM (SIS-RTDSR/ZTW + RM), (4) MSIS irrigated RTDSR followed by ZTW + RM (MSIS-RTDSR/ZTW + RM), and (5) MSIS irrigated RTDSR with 1/3rd wheat residue incorporation followed by ZTW + RM (MSIS-RTDSR + RI/ZTW + RM). The pressurized irrigation system in RWS established under conservational tillage and residue management (DRIP-RTDSR/ZTW + RM and MSIS-DSR + RI/ZTW + RM) produced at par system productivity compared to PTR/CTW. Substantial nitrogen (79-114 ka ha-1) and irrigation water (536-680 mm) savings under pressurized irrigation systems resulted in 41-64 % higher partial factor productivity of nitrogen with 48-61 % lower water footprint. These systems had lower energy consumption attaining 15-21 % higher net energy, 44-61 % higher energy use efficiency, and 31-38 % lower specific energy. Efficient utilization of farm inputs caused lower greenhouse gas emission (39-44 %) and enhanced carbon sequestration (35-62 %) resulting 63-76 % lower carbon footprint over PTR/CTW. The information generated here might useful in developing policies for resource and climate-smart food production system aiming livelihood security and ecological sustainability in the region. Further, trials are needed for wider adaptability under different climate, soil and agronomic practices to develop site-specific climate smart practices.

Mainstreaming Local Food Species for Nutritional and Livelihood Security: Insights From Traditional Food Systems of Adi Community of Arunachal Pradesh, India.

This study brings out the critical role of lesser-known local plant species in the food, nutrition and livelihood security of Adi community in Arunachal Pradesh, India. Considering women as a major custodian in knowledge and practices on foods, a total of 90 Adi women and 60 key knowledgeable community members (thus a total of 150 participants) were selected from East Siang and Upper Siang districts of Arunachal Pradesh. Data were collected using combination of methods including recipe contest, focus group discussion, personal interviews and laboratory analyses. The results indicated that Adi women were able to identify 39 bioculturally important species from a range of locally available plant species. Used alone or with other foods, these plants remain central to the Adi people's cultural identity and livelihood security. In addition to improving food and nutritional security, these species accessed from different land use systems, are also sold on the local markets to generate decent incomes. Of the species identified by Adi women, 28 were culturally shared and used frequently in food and ethnomedicine. Laboratory analyses of the selected 22 species revealed exceptionally high levels of minerals and other nutrients, such as proteins and anti-oxidants, supporting their traditional use for health benefits. Our study results provide valuable insights to the researchers to explore the vast hidden potential of these and other similar species for improving nutritional well-being of local communities in marginal areas. Adequate policy support is needed to enable Adi and other such marginalized communities to cope with challenges being posed to traditional food systems.

Seroprevalence of anti-SARS-CoV-2 antibodies in Indore, Madhya Pradesh: A community-based cross-sectional study, August 2020.

BACKGROUND: In India, laboratory diagnosis of SARS - CoV-2 infection has been mostly based on real-time reverse transcriptase-polymerase chain reaction (RT-PCR). Studies have shown that Viral titres peak within the first week of symptoms but may decline later hampering RT-PCR-based diagnostic strategies. Exact estimate is difficult under high-risk screening strategy with evidences of having large number of asymptomatic cases. This has prompted a call for adoption of antibody testing as potential source of data. MATERIALS AND METHODS: A cross-sectional study with a sample size of 7000 was conducted for 15 days including all the 85 wards under Indore Municipal Corporation. Stratified Random Sampling was used to collect the samples. Trained teams collected basic sociodemographic information and serum samples which were tested for the presence of specific antibodies to COVID-19 using ICMR-Kavach IgG ELISA kits. The data collected was compiled and analysed using appropriate statistical software. RESULTS: Overall weighted seroprevalence of the study population was found to be 7.75%. The prevalence in males and females was comparable (7.91% vs 7.57%). Highest seropositivity (10.04%) was seen among individuals aged more than 60 years. Total number of infections in the population were estimated to be 2,03,160. Overall Case Infection Ratio was found to be 27.43. CONCLUSION: The current seroprevalence study provides information on proportion of the population exposed, but the correlation between presence and absence of antibodies is not a marker of total or partial immunity. It must also be noted that more than 90 percent of the population is still susceptible for COVID-19 infection. Hence, non-pharmaceutical interventions like respiratory hygiene, physical distancing, hand sanitization, usage of personal protective equipment such as masks and implementation of public health measures need to be continued.

Deficit saline water irrigation under reduced tillage and residue mulch improves soil health in sorghum-wheat cropping system in semi-arid region.

Judicious application of saline water except for critical growth stages, could be the only practical solution to meet the crop water demand in arid and semi-arid regions, due to limited access to freshwater, especially during dry winter months. A field experiment was conducted to study the effect of tillage [conventional (CT), reduced (RT), and zero (ZT)], rice straw mulch and deficit saline-water irrigation in wheat (100, 80 and 60% of wheat water requirement, CWR) followed by rainfed sorghum on soil properties and the yields of the cropping system. Yields of both the crops were comparable between RT and CT, but the wheat yield was reduced in ZT. The RT, mulching and deficit saline irrigation in wheat season (60% CWR) increased the sorghum fodder yield. Olsen's P (8.7-20.6%) and NH4OAc-K (2.5-7.5%) increased in RT and ZT, respectively, over CT under both the crops. Deficit irrigation reduced soil salinity (ECe) by 0.73-1.19 dS m-1 after each crop cycle, while soil microbial biomass C (MBC) and N (MBN), dehydrogenase, urease and alkaline phosphatase reduced with an increase in ECe. The α-glucosidase, MBC, ECe, KMnO4oxidizable N, and urease were identified as major contributors in developing the soil health index. Deficit irrigation (60% CWR) and rice straw mulching under ZT and RT showed higher values of soil health index. Overall, deficit saline-water irrigation under reduced tillage and straw mulching had the greatest potential in maintaining soil health, saving fresh irrigation water without affecting the productivity of the sorghum-wheat system in the semi-arid regions of India. Results also demonstrated that salt affected areas of arid and semiarid countries can replicate the protocol for indexing and screening of soil health indicators to assess the sustainability of a cropping system. This integrated management based on the nature of the available resources also provided a practical approach to achieve the target of land degradation neutrality and land restoration.

Comparative genetic variability in HIV-1 subtype C p24 Gene in early age groups of infants.

It is important to study the molecular properties of vertically transmitted viruses in early infancy to understand disease progression. P24 having an important role in virus assembly and maturation was selected to explore the genotypic characteristics. Blood samples, obtained from 82 HIV-1 positive infants, were categorized into acute (≤ 6 months) and early (> 6-18 months) age groups. Of the 82 samples, 79 gave amplification results for p24, which were then sequenced and analysed. Amino acid heterogeneity analysis showed that substitutions were more frequent. Several substitution mutations were present in some of the sequences of both the age groups in the functional motifs of the gene namely Beta hairpin, CyPA binding loop, residues L136 and L190, linker region and major homology region. In the acute age group, an insertion of Asparagine residue (N5NL6) was observed in the ß hairpin region in one of the sequences. This insertion was accompanied with analogous substitutions of N5Q, Q7L and G8R. In the early age group, a deletion of two residues; VK181-182, was observed at the C-terminal end in one of the sequences. These mutations may impair the structure of the protein leading to defective virus assembly. Protein variation effect analyzer software showed that deleterious mutations were more in the acute than the early age group. Variability analysis revealed that the amino acid heterogeneity was comparatively higher in the acute than the early age group. Variability in the virus was decreasing with the increasing age of the infants indicating that the virus is gradually evolving under positive selection pressure. HLA class 1 binding peptide analysis showed that the epitopes TPQDLNTML and RMYSPVSIL may be helpful in designing epitope based vaccine.

Synchronous Breast Cancer and Gallbladder Diseases-A Chromosomal Analysis: A Pilot Study at a Tertiary Care Centre.

Out of a total of 50 study-eligible patients, 15 patients were found to have synchronous breast cancer and gallbladder diseases. Fourteen such patients had breast cancer and cholelithiasis while 1 patient had breast cancer with gallbladder cancer. Amongst these 15 patients, 7 patients tested positive for chromosomal aberrations on karyotyping. Aberrations in these patients were seen on chromosomes 13 and 17 with 2 patients having deletion 13q, 2 having deletion 17q, and 2 having deletions on 17p while one patient had multiple deletions on chromosomes 13q and 17p. The patient with multiple aberrations on 13q and 17p had a grade III infiltrating ductal carcinoma (NOS) of the breast with adenocarcinoma of the gallbladder. On the basis of our study and its analysis, we conclude that synchronous breast and gallbladder lesions are common amongst females and the occurrence of one should warn the clinician to search for the other. Also, chromosomal aberrations are common amongst patients with synchronous diseases and since these abnormalities are in the germ line cells, genetic counselling should be offered to the first- and second-degree female relatives.

Typical & atypical enteropathogenic Escherichia coli in diarrhoea & their role as carrier in children under five.

BACKGROUND & OBJECTIVES: Multidrug-resistant enteropathogenic Escherichia coli (EPEC) is responsible for a large number of cases of infantile diarrhoea in developing countries, causing failure in treatment with consequent health burden and resulting in a large number of deaths every year. This study was undertaken to determine the proportion of typical and atypical EPEC in under five children with diarrhoea and controls, their function as a carriage and to identify virulent genes associated with them. METHODS: During the study period, 120 stool samples including 80 from controls children were collected and analyzed for the presence of EPEC using standard bacteriological methods. Isolates were subjected to antimicrobial testing by disc diffusion method. Isolates confirmed as E. coli by phenotypic method were further tested for the presence of attaching and effacing (eae) and bundle-forming pilus (bfpA) genes by real-time SYBR Green-based polymerase chain reaction. RESULTS: All isolates were tested for the presence of EPEC. The frequency of typical EPEC was 20 and 16.25 per cent whereas the frequency of atypical EPEC strains was 5 and 23.75 per cent in patients and controls, respectively (PbfpA was seen in 45 and 18.75 per cent isolates of diarrhoeal patients and controls, respectively. INTERPRETATION & CONCLUSIONS: Our results showed that typical EPEC was a common cause of diarrhoea, but at the same time, atypical EPEC was emerging as colonizers in the intestine of children with and without diarrhoea in and around Delhi. Children can be considered asymptomatic carriers of these pathogens and can transmit them to other susceptible children. Adequate steps need to be taken to stop these strains from developing and spreading further.

Comparative genetic variability in HIV-1 subtype C nef gene in early age groups of infants.

Targeting properties of vertically transmitted viruses in early infancy is important to understand disease progression. To investigate genotypic characteristics of transmitted viruses, blood samples were obtained from infants aged 6 weeks-18 months, categorized in two age groups, acute (<6 months) and early (>6-18 months). Nef having an important role in pathogenesis was selected to explore the viral characteristics. A total of 57 PCR positive samples, amplified by nef gene were sequenced. Analysis showed that 50 sequences belonged to subtype C. In one sequence of acute age group, a long insertion of 10 residues (AAERMRRAEP) in variable region and a 13 residues deletion (ATNNADCAWLEAQ) around proteolytic cleavage region of gene in another sequence was observed. Insertions were also observed in sequences of early age group, however, they ranged from two to eight residues only. In one sequence of early age group, 3/4 arginines at positions 19, 21, 22 of arginine cluster were mutated to glutamine, alanine, and glutamine, respectively. Entropy analysis of two age groups revealed presence of several residues with statistically significant differences in their variability. Among these, 15 (R18,R23,R24; A66,L68,Q71; E74,E77,E78; V87,M92; R119, P144, E167, and C176) belonged to functional motifs, out of which, 12 were in acute age group, suggesting that variability was greater in this group. Prediction of HLA binding peptide motif revealed that epitope LTFGWCFKL was present in >80% study sequences. This epitope was also present in maximum number of HLA types circulating in India and vaccine candidate sequences, suggesting that it may be helpful in designing an epitope-based vaccine.

Report of novel H105R, D29N, V27A mutations in the methyltransferase region of the HEV genome in patients with acute liver failure.

BACKGROUND: The Hepatitis E virus (HEV) has been responsible for major outbreaks in the developing countries affecting millions of people and acute sporadic hepatitis worldwide. The HEV methyltransferase is important for capping the 5'-end of the viral pregenomic RNA which is critical for viral infection. OBJECTIVES: We aimed to assess the substitutional profile in the HEV methyltransferase region in patients with acute liver failure (ALF) and acute viral hepatitis (AVH) from North Indian population and associate the substitutions with the poor outcome of the disease. STUDY DESIGN: HEV RNA was detected and partial region encoding the Methyltransferase domain in the HEV genome was amplified by Reverse Transcriptase(RT-PCR). Viral load of HEV was quantified utilizing Real time PCR.32 representative samples consisting of 16 AVH and 16 ALF were directly sequenced and amino acid changes were compared using Fischer's exact (two-tailed) test. RESULTS: Novel mutations Valine27Alanine (V27A), Aspartate29Asparagine (D29N) and Histidine105Arginine (H105R) mutation corresponding to 107T>C, 115G>A and 341 A>G substitutions respectively were significantly (p<0.0001) obtained in 16/16(100%) ALF patients compared to none (0/16) of the AVH patients. HEV viral load and disease severity parameters corresponding to the samples with D29N and V27A mutations were significantly higher compared to the isolates lacking these mutations while the H105R mutation was associated with decreased viremia. CONCLUSION: The D29N and V27A mutations had significant association with the poor outcome in ALF patients suggesting key role in enhancing HEV replication while the association of H105R mutation with decreased viremia creates interest on its antiviral aspects.

Chlamydia and ocular adnexal lymphomas: An Indian experience.

CHLAMYDIA AND OCULAR ADNEXAL LYMPHOMAS: AN INDIAN EXPERIENCE: Ocular adnexal lymphomas (OALs) are a heterogeneous group of malignancies, majority being extranodal mucosa-associated lymphoid tissue (MALT) type. Different geographical regions have reported association of Chlamydia with OALs (MALT type). In India, role of Chlamydia in OALs remains unexplored. The aim of this study was to detect Chlamydia and to correlate with clinicopathological features of OALs in India. The clinicopathological features of 41 OAL cases were studied prospectively. Chlamydia DNA was detected by genus specific PCR amplifying major outer membrane protein (MOMP) gene followed by DNA sequencing. Chlamydia immunoexpression was evaluated by immunofluorescence and immunohistochemistry. The results were correlated with clinicopathological features including follow-up and survival. Chlamydia genome was detected in 3/41 (7.3%) OAL cases by PCR. Direct sequencing revealed C. trachomatis in 3 positive cases. Immunofluorescence and immunohistochemistry showed Chlamydia antigen in 5/41 and 1/41 cases respectively. Immunofluorescence demonstrated higher sensitivity than immunohistochemistry. A significant association was observed between Chlamydia positivity and orbital location (P=0.05). Follow-up revealed relapse in 2 Chlamydia positive cases (P=0.056). Our results demonstrate for the first time presence of C. trachomatis genome in 7.3% OAL cases in India. As no other reports are documented, more detailed studies from different regions within India are needed to explore status of Chlamydia in OALs.

Giant Cutaneous Horn Overlying A Verruca at an Uncommon Site: Medical Marvel vs Superstitious Dilemma.

Cutaneous horn has been a matter of discussion to mankind since time immemorial and a subject of fascination for the layman. There have been instances where certain groups saw it with angst and disgust, with a person having a large cutaneous horn on an exposed area getting a dismal look. We present a case of a 64-year-old man with a giant cutaneous horn over his left gluteal region. Cutaneous horns more commonly present in the sun-exposed areas. In our case it has presented in an uncommon site. The patient had delayed and denied medical treatment due to his superstitious beliefs, after having sought advice from faith healers leading to progression of the disease. This case has been presented for its giant size (rare variety), its location being over the gluteal region (photo-protected site) and its benign histopathology suggestive of wart in spite of the giant size.