Status of insecticide resistance in the dengue vector Aedes aegypti in India: A review.

The study aims to present an overview of the extent of insecticide resistance in the dengue vector Aedes aegypti in India. Published data on insecticide resistance in this species were systematically searched through online databases like PubMed, Google, and Google Scholar. From each study, data were extracted and analyzed to understand the spatial and temporal patterns. Particular emphasis was given to the commonly used insecticides for mosquito control. Forty-three studies met the inclusion criteria, of which 13 had adult bioassay data, 13 larval bioassay data and 17 contained both. Data demonstrated high resistance to DDT and resistance is also widespread against carbamates. There is mounting evidence of increased tolerance to pyrethroids and organophosphorus compounds, viz permethrin, deltamethrin, lambda-cyhalothrin, malathion, and temephos. The emergence of resistance to all the insecticide classes further justifies the need for annual resistance monitoring and to maintain a nationwide database that can provide a reference for formulating effective control strategies.

Highly selective and sensitive 'on-off' fluorescent chemosensor for Fe3+ ions crafted by benzofuran moiety in both experimental and theoretical methods.

A benzofuran glycinamide-based chemosensor, 3-(2-([4-fluorobenzyl]amino)acetamido)benzofuran-2-carboxamide (BGA) was developed and synthesized for the selective and sensitive detection of Fe3+ ions. The photophysical properties of the probe BGA were studied using UV-visible light absorption and fluorescence spectrophotometers. The chemosensor BGA showed a marked 'on-off' fluorescence response towards Fe3+ ions in the presence of other metal ions in DMSO/H2 O solution (9/1, v/v). The very low limits of detection (LOD) were calculated to be 10 nM and 43 nM using UV-visible light absorption and fluorescence spectrophotometers, respectively. Job's plot analysis revealed the formation of a BGA-Fe3+ complex with a 1:1 binding stoichiometry ratio using UV-visible light spectroscopy. The sensing mechanism was also demonstrated using density functional theory calculation.

Evaluation of Soft Tissue Landmark Reliability between Manual and Computerized Plotting Methods.

AIM: The aim of the study is to evaluate the reliability of soft tissue landmark identification between manual and digital plot-tings in both X and Y axes. MATERIALS AND METHODS: A total of 50 pretreatment lateral cephalograms were selected from patients who reported for orthodontic treatment. The digital images of each cephalogram were imported directly into Dolphin software for onscreen digi-talization, while for manual tracing, images were printed using a compatible X-ray printer. After the images were standardized, and 10 commonly used soft tissue landmarks were plotted on each cephalogram by six different professional observers, the values obtained were plotted in X and Y axes. Intraclass correlation coefficient was used to determine the intrarater reliability for repeated landmark plotting obtained by both the methods. RESULTS: The evaluation for reliability of soft tissue landmark plottings in both manual and digital methods after subjecting it to interclass correlation showed a good reliability, which was nearing complete homogeneity in both X and Y axes, except for Y axis of throat point in manual plotting, which showed moderate reliability as a cephalometric variable. Intraclass correlation of soft tissue nasion had a moderate reliability along X axis. Soft tissue pogonion shows moderate reliability in Y axis. Throat point exhibited moderate reliability in X axis. CONCLUSION: The interclass correlation in X and Y axes shows high reliability in both hard tissue and soft tissue except for throat point in Y axis, when plotted manually. The intraclass correlation is more consistent and highly reliable for soft tissue landmarks and the hard tissue landmark identification is also consistent. CLINICAL SIGNIFICANCE: The results obtained for manual and digital methods were almost similar, but the digital landmark plotting has an added advantage in archiving, retrieval, transmission, and can be enhanced during plotting of lateral cephalograms. Hence, the digital method of landmark plotting could be preferred for both daily use and research because of the advantages.

Molecular diagnosis of Pneumocystis jirovecii in patients with malignancy: clinical significance of quantitative polymerase chain reaction.

Pneumocystis jirovecii pneumonia (PJP) is increasingly seen in association with the use of new and potent immunosuppressive therapies in populations not infected with human immunodeficiency virus. Today, molecular methods are widely used to improve diagnostic yield; however, the relationship between clinical findings and quantitative polymerase chain reaction (qPCR) results is undefined. Our objective was to describe characteristics of PJP in patients with malignancies and determine if qPCR results were correlated with clinical findings. From 2007 to 2012, all patients at the Peter MacCallum Cancer Centre with positive Pneumocystis PCR were identified from a microbiology database. Clinical, radiological, and microbiological records were reviewed. PJP was defined as the presence of positive PCR for Pneumocystis on a respiratory specimen, radiological abnormalities consistent with a pneumonic process, and receipt of targeted PJP treatment. qPCR was performed on all diagnostic specimens, and values were reported according to clinical findings. Forty-five patients fulfilled inclusion criteria: 44.4% had underlying solid organ tumors and 55.6% had hematological malignancies. Nonsmall cell lung carcinoma and lymphoma were the most frequent predispositions. Shortness of breath, cough, and fever were reported in 64.4%, 48.9%, and 42.2% of the patients, respectively. Admission to the intensive care unit and mortality rates were lower than in previous reports. Overall, a relationship between other clinical features and qPCR results was not identified. In the era of routine molecular diagnostics, patients with malignancy and PJP have improved outcomes. However, there was no demonstrable relationship between qPCR results and clinical features or PCR data and outcomes.

The Impact of Preoperative Co-morbidities on Blood Transfusion Requirements Following Reverse Total Shoulder Arthroplasty.

Objectives: Reverse total shoulder arthroplasty (RTSA) continues to increase in popularity as a surgical operation in the United States. As indications for this procedure expand, more attention is needed to evaluate perioperative risk factors and patient characteristics. Postoperative anemia requiring blood transfusion (BT) is a well-documented risk factor for increased in-house mortality although little has been studied on the relationship between RTSA and postoperative BT. The purpose of this study was to identify comorbidities and patient characteristics as risk factors for BT in patient's undergoing RTSA. Methods: Using the Nationwide Inpatient Sample (NIS) database, 59,925 RTSA patients (2016-2019) were analyzed, with 1.96% requiring postoperative BT. Demographics, comorbidities, and preoperative factors were compared between BT and non-BT groups via univariate and multivariate analyses. Results: Overall prevalence of blood transfusion in all patients was 1.96%. Male sex (OR 1.75, p < 0.001), Asian ethnicity (OR 1.96, p = 0.012), age >80 (OR 1.51, p < 0.001), age >90 (OR 2.26, p < 0.001), CKD (OR 1.94, p < 0.001), and Parkinson's disease (OR 2.08, p < 0.001) were associated with increased BT odds. Cirrhosis exhibited the highest impact (OR 5.7, p < 0.001). Conversely, Caucasian ethnicity (OR 0.76, p = 0.023), uncomplicated DM (OR 0.73, p = 0.002), tobacco-related disorders (OR 0.43, p < 0.001), BMI >30 (OR 0.8, p = 0.011), and elective procedures (OR 0.16, p < 0.001) decreased BT odds. Conclusion: These results were useful with identifying several risk factors that predispose to a higher risk of postoperative BT in patients undergoing RTSA including male sex, people of Asian descent, age > 80, CKD, Parkinson's disease, and cirrhosis. These findings provide clinicians with information that may be helpful with preoperative planning and perioperative management of complex patient populations.

Tuning of MgO's base characteristics by blending it with amphoteric ZnO facilitating the selective glucose isomerization to fructose for bioenergy development.

Fructose serves as an important intermediate in the preparation of liquid fuel compounds. Herein, we report its selective production via a chemical catalysis method over ZnO/MgO nanocomposite. The blending of an amphoteric ZnO with MgO reduced the latter's unfavorable moderate/strong basic sites that can influence the side reactions in the sugar interconversion, reducing fructose productivity. Of all the ZnO/MgO combinations, a 1 : 1 ratio of ZnO and MgO showed a 20% reduction in moderate/strong basic sites in MgO with ∼2-2.5 times increase in weak basic sites (overall), which is favorable for the reaction. The analytical characterizations affirmed that MgO settles on the surface of ZnO by blocking the pores. The amphoteric ZnO undertakes the neutralization of the strong basic sites and improves the weak basic sites (cumulative) by the Zn-MgO alloy formation. Therefore, the composite afforded as high as 36% fructose yield and 90% selectivity at 90 °C; especially, the improved selectivity can be accounted for by the effect of both basic and acidic sites. The favorable action of acidic sites in controlling the unwanted side reactions was maximum when an aqueous medium contained 1/5th methanol. However, ZnO's presence regulated the glucose's degradation rate by up to 40% compared to the kinetics of pristine MgO. From the isotopic labelling experiments, the proton transfer pathway (or LdB-AvE mechanism by the formation of 1,2-enediolate) is dominant in the glucose-to-fructose transformation. The composite exhibited a long-lasting ability based on the good recycling efficiency of up to 5 cycles. The insights into the fine-tuning of the physicochemical characteristics of widely available metal oxides would help develop a robust catalyst for sustainable fructose production for biofuel production (via a cascade approach).

Prevalence of Dental Caries and Gingivitis among children with Intellectual Disability in India.

Introduction: Down syndrome (DS) is one of the most common genetic abnormalities, with highly variable prognosis. Oral diseases such as periodontal disease, malocclusion, mouth breathing, macroglossia, delayed teeth eruption, missing and malformed teeth, microdontia, diastema, and bruxism are common among individuals with DS. Hence, a study was planned to assess the caries experience and periodontal status of subjects with DS. Materials and Methods: A cross-sectional study was conducted among 92 DS patients in two different centers in Chennai and Pondicherry to assess the prevalence of dental caries and gingivitis, using dft/DMFT and Modified Loe and Silness Gingival Index, respectively. The subjects were examined by three trained and calibrated examiners using a pre-tested and pre-validated proforma. Data were entered in a Microsoft Excel spreadsheet and analyzed using SPSS software (version 20). Descriptive statistics were used. A value of P < 0.05 was considered significant. Results: The mean DMFT was low among male (1.47 ± 2.31) when compared to female (2.57 ± 4.57) which was found to be significant statistically. The gingival score was low among male (.85 ± 0.36) when compared to female (1 ± 1.00) which was found to be significant statistically. The mean dft among male and female were (.49 ± 1.37;.43 ± 1.09), respectively, which was found to be not significant statistically. Conclusion: Dental caries and gingival diseases are higher among children with DS. Dental caries was found both in primary dentition and permanent dentition.

A survey of reimbursement practices of private health insurance companies for pharmaceuticals not covered under the Pharmaceutical Benefits Scheme 2008.

OBJECTIVE: To describe the current practices and policy of Australian private health insurance (PHI) companies with respect to cover for pharmaceuticals not subsidised under the Pharmaceutical Benefits Scheme (PBS). DESIGN, SETTING AND PARTICIPANTS: A 2008 review of web-published policy statements for top-level hospital and comprehensive general treatment insurance, and survey of reimbursement practices by way of questionnaire, of 31 Australian-registered, open-membership PHI companies. MAIN OUTCOME MEASURES(S): Description of the level of pharmaceutical cover and important considerations identified by PHI companies for funding non-PBS pharmaceuticals through benefit entitlements or ex-gratia payments. RESULTS: Nine of thirty-one PHI companies (29%) provided responses accounting for ~60% market share of PHI. The majority of smaller PHI firms either declined participation or did not respond. The maximum limits offered for non-PBS pharmaceuticals, under comprehensive general treatment insurance, varied significantly and typically did not adequately cover high-cost pharmaceuticals. Some companies occasionally offered ex-gratia payments (or discretionary payments in excess of the policyholder's entitlement benefits) for high cost-pharmaceuticals. Factors considered important in their decision to approve or reject ex-gratia requests were provided. All results were de-identified. CONCLUSIONS: There is little consistency across PHI companies in the manner in which they handle requests for high-cost pharmaceuticals in excess of the defined benefit limits. Such information and processes are not transparent to consumers.

Smart niosomes of temozolomide for enhancement of brain targeting.

Drug delivery to the brain is challenging because of the low permeability of blood-brain barrier, and therefore, optimum concentration of chemotherapeutics in the target area specifically for glioblastoma, an aggressive brain tumor, opens a new path of research. To achieve the goal, the oral alkylating agent temozolomide was incorporated into niosomes, and the surface was modified with chlorotoxin, a small 36 amino acid peptide discovered from the venom of scorpion Leiurus quinquestriatus. Active targeting using nanosized particles facilitates an increase in the accumulation of drugs in the cerebri by 3.04-folds. Temozolomide-loaded niosomes were prepared using conventional thin-film hydration method and characterized. Niosomes coated with chlorotoxin were produced with the size of 220 ± 1.45 nm with an entrapment efficiency of 79.09 ± 1.56%. Quantitative tissue distribution studies indicate enhanced permeation of the drug into the brain because of surface modification with less deposition in the highly perfused organs.

Chronic postoperative wound infection caused by Myocobacterium fortuitum complex.

Mycobacterium fortuitum in a rapidly growing atypical mycobacteia, sometimes associated with nosocomial infections in human. These infections are often difficult to identify; and treat even after indentification. We report here a case of chronic post operative wound infection due to M. fortuitum.

Seeing through their eyes: lived experiences of people with retinitis pigmentosa.

PurposeRetinitis pigmentosa (RP) is the most common retinal degeneration causing blindness. Although their clinical problems are amenable for the clinical diagnosis, their day-to-day problems for having to live with the disease are mostly unexplored. This study aims to explore and understand the issues and impact of people with RP on quality of life (QoL).MethodsA qualitative research methodology to facilitate the understanding of the experiences of people with RP was carried out. Data were collected through audio-recorded semi-structured interviews. Thematic analysis occurred through the process of line-by-line coding, aggregation, and theme development using the NVivo-10 software.ResultsTwenty-three interviews were conducted (mean age=56 years; females, 14). We identified five major QoL themes: (1) struggle to perform important day-to-day tasks; (2) concerns about disease progression, disease outcome and personal safety; (3) facing a lot of emotional and psychological challenges; (4) experiencing a myriad of visual symptoms; and (5) adopting different strategies to cope and manage stressful circumstances. Difficulty in performing important day-to-day tasks was the most prominent QoL issue among these people. Their major concerns were going blind and uncertainties about their future. They face a lot of emotional and psychological challenges to adapt to the physiological stress associated with the progressive vision loss. However, they adopt several coping strategies to manage the stressful circumstances.ConclusionsPeople with RP experience a myriad of QoL issues. Despite all the hardship, they remain optimistic and learn to accept their eye condition and move on in life.

Extra-nodal extension of sentinel lymph node metastasis is a marker of poor prognosis in breast cancer patients: A systematic review and an exploratory meta-analysis.

Invasive breast cancer is the most common malignancy in women. Its most common site of metastasis is represented by the lymph nodes of axilla, and the sentinel lymph node (SLN) is the first station of nodal metastasis. Axillary SLN biopsy accurately predicts axillary lymph node status and has been accepted as standard of care for nodal staging in breast cancer. To date, the morphologic aspects of SLN metastasis have not been considered by the oncologic staging system. Extranodal extension (ENE) of nodal metastasis, defined as extension of neoplastic cells through the nodal capsule into the peri-nodal adipose tissue, has recently emerged as an important prognostic factor in several types of malignancies. It has also been considered as a possible predictor of non-sentinel node tumor burden in SLN-positive breast cancer patients. We sought out to clarify the prognostic role of ENE in SLN-positive breast cancer patients in terms of overall and disease-free survival by conducting a systematic review and meta-analysis. Among 172 screened articles, 5 were eligible for the meta-analysis; they globally include 624 patients (163 ENE+ and 461 ENE-) with a median follow-up of 58 months. ENE was associated with a higher risk of both mortality (RR = 2.51; 95% CI: 1.66-3.79, p < 0.0001, I(2) = 0%) and recurrence of disease (RR = 2.07, 95% CI: 1.38-3.10, p < 0.0001, I(2) = 0%). These findings recommend the consideration of ENE from the gross sampling to the histopathological evaluation, in perspectives to be validated and included in the oncologic staging.

Pneumocystis jirovecii pneumonia associated with gemcitabine chemotherapy: experience at an Australian center and recommendations for targeted prophylaxis.

Pneumocystis jirovecii pneumonia (PJP) is seen increasingly in non-human immunodeficiency virus (HIV) infected immunocompromised populations, but few cases have previously been reported in association with gemcitabine therapy. We identified all patients administered gemcitabine between March 2009 and December 2012 at the Peter MacCallum Cancer Centre. Cases of PJP were identified using accepted definitions. Overall, 288 gemcitabine-treated patients were identified. Nine cases of PJP were detected, corresponding to an overall rate of 3.1% (95% confidence interval [CI] 1.5-5.7%). PJP was diagnosed during gemcitabine therapy in seven patients, a median of 67 (range 31-109) days from commencement. Among patients with lymphoma, 4/22 developed PJP, corresponding to a rate of 18.2% (95% CI 6.1-38.2%). Fewer infections were associated with breast, lung and gastrointestinal malignancies (1/24 [4.2%], 3/118 [2.5%] and 1/61 [1.6%], respectively). A risk-based tool incorporating concomitant steroid therapy can be applied to target high-risk populations who would benefit from PJP prophylaxis during gemcitabine therapy.

Xenographic transplantation of monkey pancreatic islets into rats.

Islets of Langerhans were isolated from the monkey pancreatic by collagenase digestion method. Freshly isolated monkey pancreatic islets were transplanted under the renal capsule of normal rats. Treated group of rats received Cyclosporine A injections and the control group of rats did not receive any drug. In Cyclosporine A treated rats the monkey islets were not destroyed. They maintained their normal structural integrity with occasional neutrophils surrounding the islets. In the untreated rats dense infiltration of neutrophils destroyed the islets in three days. On the seventh day dense infiltration of lymphocytes was seen. Granulomas composed of epitheloid cells and occasional multinucleated Langerhans type giant cells were seen on the fourteenth day.

IRF-1 transcriptionally upregulates PUMA, which mediates the mitochondrial apoptotic pathway in IRF-1-induced apoptosis in cancer cells.

Interferon regulatory factor-1 (IRF-1) is a transcription factor that acts as a tumor suppressor and causes apoptosis in cancer cells. We evaluated IRF-1-induced apoptosis in gastric cancer cell lines. We established stable clones in AGS cells that have a tetracycline-inducible IRF-1 expression system. We used these clones and recombinant adenovirus expressing IRF-1 to explore the mechanism of IRF-1-induced apoptosis in gastric cancer. Expression of IRF-1 causes apoptosis in gastric cancer cell lines as shown by phosphatidylserine exposure and cleavage of caspase-8, caspase-3, and Bid with the mitochondrial release of cytochrome c. However, inhibition of caspase-8 and Bid did not inhibit apoptosis and did not decrease cleaved caspase-9 or mitochondrial release of cytochrome c. We then show that IRF-1 upregulates PUMA (p53 upregulated modulator of apoptosis), which is known to activate apoptosis by the intrinsic pathway; this can be p53-independent. IRF-1 binds to distinct sites in the promoter of PUMA and activates PUMA transcription. Moreover, molecular markers of mitochondrial apoptosis are eliminated in PUMA knockout and knockdown cells and phosphatidylserine exposure is decreased dramatically. Finally, we show that IFN-gamma induces IRF-1-mediated upregulation of PUMA in cancer cells. We conclude that IRF-1 can induce apoptosis by the intrinsic pathway independent of the extrinsic pathway by upregulation of PUMA.

Langerhans cell histiocytosis of the mandible in a six-year-old child.

Histiocytosis is a term applied to a group of rare disorders of the reticuloendothelial system. Eosinophilic granuloma, the most benign and localized of the three Langerhans cell histiocytosis entities, may be solitary or multiple. Eosinophilic granuloma can affect almost any bone, but commonly involves the mandible when the jaws are affected. Conventional treatment of LCH is with surgery, radiotherapy, chemotherapy and steroid injections, alone or in combination. Spontaneous regression of localized disease has also been reported. We report a six and a half-year-old patient with Langerhans cell histiocytosis--solitary eosinophilic granuloma of the mandible that initially regressed but rapidly recurred even after radical treatment and had a fatal outcome.

The prevalence of tuberculosis infection among Year 8 schoolchildren in inner Sydney in 1992.

OBJECTIVE: To determine the prevalence of tuberculosis (TB) infection in Year 8 schoolchildren (aged 12-14 years) in Sydney. DESIGN: Cross-sectional survey. SETTING: 22 inner city Sydney secondary schools. PARTICIPANTS: 2290 Year 8 school children enrolled in 1992. OUTCOME MEASURES: Distribution of Mantoux test reaction size and proportion of children who were Mantoux positive (i.e., having Mantoux reaction > or = 15 mm with previous Bacille Calmette-Guérin vaccination; > or = 10 mm without). RESULTS: Of the 2290 children, 1836 (81%) were screened and 1801 Mantoux reactions were read. Ten per cent of children were Mantoux positive--27% of foreign-born children and 2% of Australian-born children (relative risk 16.7, 95% confidence interval 10.6-26.4). Two children were found to have active TB disease. CONCLUSION: There is a high prevalence of primary (non-contagious) TB infection in children aged 12-14 years in inner Sydney, mostly confined to children born overseas. Thus there is a large pool of infected children at risk of developing active (contagious) adult-type TB disease in the future. This public health problem should be addressed by identification and treatment of those infected.