Development of immunodetection system for botulinum neurotoxin serotype E.

Background & objectives: Botulism, a potentially fatal paralytic illness, is caused by the botulinum neurotoxins (BoNTs) secreted by Clostridium botulinum. It is an obligate anaerobic, Gram-positive, spore-forming bacterium. BoNTs are classified into seven serotypes based on the serological properties. Among these seven serotypes, A, B, E and, rarely, F are responsible for human botulism. The present study was undertaken to develop an enzyme-linked immunosorbent assay (ELISA)-based detection system for the detection of BoNT/E. Methods: The synthetic gene coding the light chain of BoNT serotype E (BoNT/E LC) was constructed using the polymerase chain reaction primer overlapping method, cloned into pQE30UA vector and then transformed into Escherichia coli M15 host cells. Recombinant protein expression was optimized using different concentrations of isopropyl-ß-D-1-thiogalactopyranoside (IPTG), different temperature and the rBoNT/E LC protein was purified in native conditions using affinity column chromatography. The purified recombinant protein was checked by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and further confirmed by western blot and matrix-assisted laser desorption ionization-tandem time-of-flight (MALDI-TOF). Polyclonal antibodies were generated against rBoNT/E LC using Freund's adjuvant in BALB/c mice and rabbit. Sandwich ELISA was optimized for the detection of rBoNT/E LC and native crude BoNT/E, and food matrix interference was tested. The developed antibodies were further evaluated for their specificity/cross-reactivity with BoNT serotypes and other bacterial toxins. Results: BoNT/E LC was successfully cloned, and the maximum expression was achieved in 16 h of post-induction using 0.5 mM IPTG concentration at 25°C. Polyclonal antibodies were generated in BALB/c mice and rabbit and the antibody titre was raised up to 128,000 after the 2nd booster dose. The developed polyclonal antibodies were highly specific and sensitive with a detection limit about 50 ng/ml for rBoNT/E LC and 2.5×10[3] MLD50 of native crude BoNT/E at a dilution of 1:3000 of mouse (capturing) and rabbit (revealing) antibodies. Further, different liquid, semisolid and solid food matrices were tested, and rBoNT/E LC was detected in almost all food samples, but different levels of interference were detected in different food matrices. Interpretation & conclusions: There is no immune detection system available commercially in India to detect botulism. The developed system might be useful for the detection of botulinum toxin in food and clinical samples. Further work is in progress.

Can eye donation rates be increased in hospitals: a pilot study in a tertiary care hospital in North India?

INTRODUCTION: There is a huge need to increase the corneal donation rates worldwide. The tertiary care hospitals can play a pivotal role in this as these hospitals manage a large number of terminally sick patients. Traditionally the thrust of such hospitals is providing specialized medical care and something like eye donation does not get the attention it deserves. In this scenario, can such institutes contribute to increase eye donation rates? METHOD: An intervention involving all the main stakeholders in promoting eye donation, namely nurses, counsellors & the management of the institute, was put into place. The results of this intervention, i.e. the corneas procured by the institute, was measured over a post intervention period of one year. RESULT: The study showed a significant increase in the number of corneas procured by the institute post intervention. DISCUSSION: Hospitals can play a huge role in meeting the demand for corneas by scientifically implementing cornea retrieval programs. The study shows that by using technology & providing a dynamic leadership, hospitals can augment corneal donation rates.

Screening of some weeds for larvicidal activity against Aedes albopictus, a vector of dengue and chikungunya.

BACKGROUND & OBJECTIVES: Screening of crude extracts of plants facilitates the establishment of highly effective extract for mosquito control. This practice should be preferred before in depth study of plant extracts rather than spending much efforts and energy in detailed examinations for practically ineffective extracts. In this study, leaf powders of four weed plants were used for the quick screening of effective plant extract as larvicide against III instar larvae of Aedes albopictus Skuse. At the same time, effect of different seasons on the larvicidal efficacy of plants and selection of proper solvents for further investigation were also studied. METHODS: Leaves of Vernonia cinerea, Prosopis juliflora, Hyptis suaveolens and Malvastrum coromandelianum plants were collected in summer, winter and rainy seasons from Madhya Pradesh region (India). To assess the larvicidal efficacy the suspensions of leaf powders in different solvents (isopropanol, methanol, acetone, dimethylsulfoxide and water) were used for larvicidal bioassay. The mortality counts were made after 24 h and the LC50 and LC90 values were calculated. RESULTS: Results showed that leaf powder of V. cinerea in acetone collected during summer showed highest efficacy with LC50 value of 0.22 g/l and LC90 of 0.96 g/l followed by methanolic solution of P. juliflora with LC50 of 0.44 g/l and LC90 value as 1.85 g/l. Amongst all solvents, leaf powder in acetone; while among seasons, summer collected plant materials were found to be more effective larvicides as compared to others. INTERPRETATION & CONCLUSION: Summer and winter collected leaves of V. cinerea and P. juliflora dissolved in the solvents of medium polarity range showed significant larval toxicity and thus suggests a detailed study on these plants as potential larval control agents.

Solitary rectal ulcer syndrome: clinical, endoscopic, histological and anorectal manometry findings in north Indian patients.

BACKGROUND: Solitary rectal ulcer syndrome (SRUS) is a chronic, benign defecation disorder often related to excessive straining. SRUS is diagnosed on the basis of clinical symptoms, endoscopic and histological findings. METHODS: All patients diagnosed with SRUS by colonoscopy and confirmed by histopathology from October 2012 to August 2014 in the Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, India, were included in the study. Out of 92 patients, thirty-four patients underwent anorectal manometry. Twenty age-matched healthy volunteers were also studied with anorectal manometry to serve as controls. RESULTS: Mean age of the group was 41 ± 19 years with age range of 10-82 years; males were 58 (63%) with male to female ratio of 1.7:1. Bleeding per rectum was present in 83%, constipation in 46.7%, abdominal pain in 27.2%, and diarrhea in 25% of the patients. On endoscopy, ulcerative lesions were seen in 83% patients of whom solitary and multiple lesions were present in 44% and 39%, respectively. Polypoidal lesions were reported in 17.4% whilst rectal polyps and erythematous mucosa were found in 5.4% and 2.2%, respectively. Histological examination revealed fibromuscular obliteration in 100% of patients, surface ulceration in 70.6% and crypt distortion in 20.65% of patients. Anal relaxation and balloon expulsion test was significantly abnormal in SRUS patients compared to healthy controls (53% vs. 20%, p < 0.01). CONCLUSION: Rectal bleeding was the most common symptom and ulcerative lesions the most common endoscopic finding. Fecal evaluation disorder was more prevalent inpatients with SRUS.

Structural and functional analysis of chitinase gene family in wheat (Triticum aestivum).

Chitinases are the hydrolytic enzymes which protect plants against pathogen attack. However, the precise role of chitinases in disease resistance has not been explored in wheat. In the present study, in silico approach, including secondary structure analysis, detailed signature pattern study, cis-acting regulatory elements survey, evolutionary trends and three-dimensional molecular modeling was used for different chitinase classes of wheat (Triticum aestivum). Homology modeling of class I, II, IV and 3 chitinase proteins was performed using the template crystal structure. The model structures were further refined by molecular mechanics methods using different tools, such as Procheck, ProSA and Verify3D. Secondary structure studies revealed greater percentage of residues forming a helix conformation with specific signature pattern, similar to casein kinase II phosphorylation site, amidation site, N-myristoylation (N-MYR) site and protein kinase C phoshorylation site. The expression profile suggested that wheat chitinase gene was highly expressed in cell culture and callus. We found that wheat chitinases showed more functional similarity with rice and barley. The results provide insight into the evolution of the chitinase family, constituting a diverse array of pathogenesis-related proteins. The study also provides insight into the possible binding sites of chitinase proteins and may further enhance our knowledge of fungal resistance mechanism in plants.

Vesical preservation in patients with late bladder exstrophy referral: histological insights into functional outcome.

PURPOSE: We evaluated bladder growth after combined bladder and epispadias repair in children 5 years or older, and correlated the histological findings with final surgical outcomes. MATERIALS AND METHODS: We prospectively evaluated 8 late bladder exstrophy referrals from a series of 26 patients treated during a 5-year period. Evaluated outcome measures were bladder capacity (expressed as percentage of expected bladder capacity for age), upper tracts status, continence and histological findings (collagen-to-smooth muscle ratio and type III-to-total collagen ratio). Data were analyzed using nonparametric Spearman rank correlation coefficient and Mann-Whitney U test. RESULTS: Mean age at combined bladder and epispadias repair was 8.9 years. Volitional voiding with a mean ± SD bladder capacity of 90 ± 7.48 ml was achieved in all patients except 1 with a suprapubic fistula. However, mean ± SD bladder capacity was 33.1% ± 7.47% of expected bladder capacity, and was inversely proportional to age at surgery. Mean ± SD compliance and pressure specific bladder volume less than 20 cm H2O were 13.86 ± 4.97 ml/cm H2O and 69.29 ± 18.07 ml, respectively. Two patients had nonobstructive hydroureteronephrosis with bilateral polar scarring. Mean ± SD collagen-to-smooth muscle and type III-to-total collagen ratios were 2.96 ± 1.062 and 0.4 ± 0.106, respectively. The latter showed a significant negative correlation to bladder compliance (p = 0.025). CONCLUSIONS: Successful anatomical closure stimulates bladder growth, even in cases of late referral. However, due to histological alterations, these bladders are poorly distensible and noncompliant. Thus, to have an acceptable functional outcome with preserved upper tracts, augmentation cystoplasty is needed in cases of late referral.

Acute inhalation toxicity of smoke of fentanyl and its 1-substituted analogs in Swiss albino mice.

Fentanyl (N-(1-phenethyl-4-piperidinyl)propionanilide) is a synthetic, potent narcotic analgesic agent. However, it is known to have several side effects, which led to synthesis and evaluation of its new analogs for the management of pain. We have earlier reported the comparative bioassay of fentanyl and its eight 1-substituted analogs (1-8) in mice. Three compounds, viz., N-(1-(2-phenoxyethyl)-4-piperidinyl)propionanilide (2), N-isopropyl-3-(4-(N-phenylpropionamido)piperidin-1-yl)propanamide (5), and N-t-butyl-3-(4-(N-phenylpropionamido)piperidin-1-yl)propanamide (6) were found to be more effective and less toxic compared to fentanyl. The present study reports the comparative acute inhalation toxicity of smoke of fentanyl and its three analogs, viz., 2, 5, and 6 in mice. Animals were exposed to different concentrations of smoke generated by heating the compounds. Exposure was performed in a head only all glass static exposure assembly for 15 min to determine the median lethal concentration (LC50). The breathing pattern and various respiratory parameters of the animals were also monitored online using a polygraph. Out of three compounds tested, analog 5 was found to be most toxic (LC50 = 2820 mg/m3) while 2 was least toxic (LC50 = >8000 mg/m3). All the compounds caused long lasting respiratory depression in a dose-dependent manner, which did not completely resolve even after discontinuation of exposure. Aerodynamic median diameter and geometric standard deviation of smoke particles was determined employing eight-stage Andersen sampler. The particles were found to be within the respirable range. The study, however, concludes that due to possible decomposition of the compounds by heating or its poor absorption by the alveolar surface, the present inhalation technique cannot be employed to generate smoke of fentanyl and its analogs for any medical or surreptitious use.

Correlation of age and hepatitis B virus DNA levels with histological activity in HBeAg negative chronic hepatitis B patients.

BACKGROUND: The relationship between age and serum HBV DNA levels with histological activity in chronic hepatitis B inactive carriers is still unclear. We evaluated the correlation between age and hepatitis B viral DNA levels with Metavir score in inactive chronic HBV carriers. METHODS: 50 patients (30 males and 20 females) were enrolled in the study after informed consent. Their blood samples were taken for routine investigations and specific tests for the study. Serum HBV DNA levels were quantified by real-time PCR. Metavir score was used for histologic grading. RESULTS: A1F0, A1F1, A1F2, A2F2 and A2F3 metavir scores were found in 41 (82%), 4 (8%), 1 (2%), 3 (6%), and 1 (2%) patients, respectively. There was significant correlation between age > 40 years and Metavir scores (p < 0.001). However there was no significant correlation between HBV DNA level with Metavir score (p = 0.074). CONCLUSION: Inactive carriers of 40 years of age or more should undergo liver biopsy to look for presence of significant histological findings despite having low HBV DNA level and normal SGPT level.

Microscopic colitis in children with chronic diarrhea.

OBJECTIVE: The aim of the present study was to study microscopic colitis (MC) in children with special reference to its role in chronic diarrhea and changes in mucosal biopsies. METHODS: A total of 100 consecutive children ages 3 to 12 years, with nonbloody diarrhea (passage of ≥3 loose stools per day) of >12 weeks' duration were screened and 26 were enrolled in the study in which no specific etiology could be found and colonoscopy did not reveal any mucosal abnormality. Colonic biopsies were evaluated for the presence of lymphocytic colitis or collagenous colitis and those with the characteristic changes were defined to have MC (group A). Colonic biopsies from patients with MC were compared with biopsies from patients with chronic diarrhea but no evidence of MC (group B). One hundred children ages 3 to 12 years with bleeding per rectum were screened and colonic biopsies from 45 patients (group C) who had colonic mucosal changes but no vascular or polyp lesion were compared with patients with MC. RESULTS: Of the 26 patients with chronic diarrhea, MC was found in 5 (3 lymphocytic colitis and 2 collagenous colitis). Significantly higher polymorphonuclear infiltration was seen in group A as compared with group B (13.8 [5.4-20.6] vs 7.2 [0-19.6]; P = 0.03) or group C (13.8 [5.4-20.6] vs 4 [0-13.4]; P = 0.007). Intraepithelial lymphocytes (12 [4-32] vs 4 [0-24]; P = 0.008) and basement membrane thickening (3.5 [2.9-10.6] vs 2.5 [1.6-5.86]; P = 0.008) were also significantly higher in group A as compared with group C. CONCLUSIONS: MC was found to be present in children with nonbloody chronic diarrhea in children. Further multicentric studies may provide adequate data on its prevalence.

Intrarenal resistance index (RI) as a predictor of early renal impairment in patients with liver cirrhosis.

BACKGROUND: Despite its functional nature, hepatorenal syndrome (HRS) is associated with a poor prognosis and the only effective treatment is liver transplantation. It is very important to diagnose renal impairment in cirrhosis patients at an early stage before overt HRS develops. In patients with cirrhosis the early renal impairment or renovascular vasoconstriction can be predicted by renal arterial resistance index (RI). Our study aimed to compare RI in healthy controls versus patients with liver cirrhosis with and without ascites and assess its value for predicting subsequent renal status. METHODS: Patients were divided into 2 groups with 50 patients in each group. Group 1 contained patients with cirrhosis without ascites and group 2 contained cirrhosis patients with ascites. All patients were subjected to detailed clinical examination, laboratory investigations and abdominal doppler ultrasound with renal RI measurements. Patients were followed for 6 months. RESULTS: RI was significantly higher in cirrhotic patients as compared to healthy controls (0.62 vs. 0.52, p< 0.01). In patients with cirrhosis, RI was significantly greater in patients with ascites than those without ascites (0.70 vs. 0.62, p < 0.01). RI >0.70 was significant independent predictor of subsequent HRS development (p = 0.006) CONCLUSIONS: Intrarenal RI measurement can be used as a predictor of HRS and may be further validated for regular monitoring of cirrhotic patients at risk of developing renal impairment.

Deep learning model for predicting tunnel damages and track serviceability under seismic environment.

Jammu and Kashmir in the northwestern part of the Himalayan region is frequently triggered with moderate to large magnitude earthquakes due to an active tectonic regime. In this study, a mathematical formulation-based Seismic Tunnel Damage Prediction (STDP) model is proposed using the deep learning (DL) approach. The pertinency of the DL model is validated using tunnel damage data from historical earthquakes such as the 1999 Chi-Chi earthquake, the 2004 Mid-Niigata earthquake, and the 2008 Wenchuan earthquake. Peak ground acceleration (PGA), source to site distance (SSD), overburden depth (OD), lining thickness (t), tunnel diameter (Ф), and geological strength index (GSI) were employed as inputs to train the Feedforward Neural Network (FNN) for damage state prediction. The performance evaluation results provided a clear indication for further use in a variety of risk assessment domains. When compared to models based on historical data, the proposed STDP model produces consistent results, demonstrating the robustness of the methodology used in this work. All models perform well during validation based on fitness metrics. The "STD multiple graphs" is also proposed which provide information on damage indexing, damage pattern, and crack predictive specifications. This can be used as a ready toolbox to check the vulnerability in post-seismic scenarios. The seismic design guidelines for tunnelling projects are also proposed, which discuss the damage pattern and suggest mitigation measures. The proposed STDP model, STD multiple graphs, and seismic design guidance are applicable to any earthquake-prone tunnelling project anywhere in the world.

The Implementation of a Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) Program at a Level 1 New England Trauma Center: Feasibility and Early Outcomes.

OBJECTIVES: We evaluated the feasibility of implementing a Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) program at our urban level 1 trauma center and evaluated early outcomes. DESIGN: A multidisciplinary committee including physicians (trauma surgery, emergency medicine, vascular surgery, and interventional radiology) and nurses created clinical practice guidelines for the placement of REBOA at our institution. All trauma surgeons and critical care board certified emergency medicine physicians were trained in placement and nurses received management training. A formal review process was implemented to identify areas for improvement. Finally, we instituted refresher training to maintain REBOA competency. Trauma patients with noncompressible torso hemorrhage from blunt or penetrating injuries who were partial or nonresponders to blood product resuscitation were included. Pregnant patients, children, or patients with significant hemothorax or suspected aortic or cardiac injury were excluded. RESULTS: Over seven months, eight catheters were successfully placed, all on the first attempt, including six in Zone 3 and two in Zone 1. All Zone 3 catheters were placed for pelvic fracture-related bleeding which were subsequently embolized. The Zone 1 catheters were placed immediately preoperatively for intraabdominal bleeding. Upon committee review, one critique was made regarding zone selection. One patient developed an arteriovenous fistula after placement which resolved without intervention. There were no other complications and all patients survived to discharge. CONCLUSIONS: An REBOA program is feasible and safe following a comprehensive multidisciplinary effort. The efforts described here can be utilized by similar trauma programs for adaptation of this endovascular approach to bleeding control.

Exploring the diversity of virulence genes in the Magnaporthe population infecting millets and rice in India.

Blast pathogen, Magnaporthe spp., that infects ancient millet crops such pearl millet, finger millet, foxtail millet, barnyard millet, and rice was isolated from different locations of blast hotspots in India using single spore isolation technique and 136 pure isolates were established. Numerous growth characteristics were captured via morphogenesis analysis. Among the 10 investigated virulent genes, we could amplify MPS1 (TTK Protein Kinase) and Mlc (Myosin Regulatory Light Chain edc4) in majority of tested isolates, regardless of the crop and region where they were collected, indicating that these may be crucial for their virulence. Additionally, among the four avirulence (Avr) genes studied, Avr-Pizt had the highest frequency of occurrence, followed by Avr-Pia. It is noteworthy to mention that Avr-Pik was present in the least number of isolates (9) and was completely absent from the blast isolates from finger millet, foxtail millet, and barnyard millet. A comparison at the molecular level between virulent and avirulent isolates indicated observably large variation both across (44%) and within (56%) them. The 136 Magnaporthe spp isolates were divided into four groups using molecular markers. Regardless of their geographic distribution, host plants, or tissues affected, the data indicate that the prevalence of numerous pathotypes and virulence factors at the field level, which may lead to a high degree of pathogenic variation. This research could be used for the strategic deployment of resistant genes to develop blast disease-resistant cultivars in rice, pearl millet, finger millet, foxtail millet, and barnyard millet.

Added value of the measles-rubella supplementary immunization activity in reaching unvaccinated and under-vaccinated children, a cross-sectional study in five Indian districts, 2018-20.

INTRODUCTION: Supplementary immunization activities (SIAs) aim to interrupt measles transmission by reaching susceptible children, including children who have not received the recommended two routine doses of MCV before the SIA. However, both strategies may miss the same children if vaccine doses are highly correlated. How well SIAs reach children missed by routine immunization is a key metric in assessing the added value of SIAs. METHODS: Children aged 9 months to younger than 5 years were enrolled in cross-sectional household serosurveys conducted in five districts in India following the 2017-2019 measles-rubella (MR) SIA. History of measles containing vaccine (MCV) through routine services or SIA was obtained from documents and verbal recall. Receipt of a first or second MCV dose during the SIA was categorized as "added value" of the SIA in reaching un- and under-vaccinated children. RESULTS: A total of 1,675 children were enrolled in these post-SIA surveys. The percentage of children receiving a 1st or 2nd dose through the SIA ranged from 12.8% in Thiruvananthapuram District to 48.6% in Dibrugarh District. Although the number of zero-dose children prior to the SIA was small in most sites, the proportion reached by the SIA ranged from 45.8% in Thiruvananthapuram District to 94.9% in Dibrugarh District. Fewer than 7% of children remained measles zero-dose after the MR SIA (range: 1.1-6.4%) compared to up to 28% before the SIA (range: 7.3-28.1%). DISCUSSION: We demonstrated the MR SIA provided considerable added value in terms of measles vaccination coverage, although there was variability across districts due to differences in routine and SIA coverage, and which children were reached by the SIA. Metrics evaluating the added value of an SIA can help to inform the design of vaccination strategies to better reach zero-dose or undervaccinated children.

What is in N A M E?

An interesting and rare case of name syndrome is reported here. A young patient presented with stroke (left side hemiperesis due to cardiac embolic stroke) and cutaneous lesions. Further investigations revealed that left atrial myxoma was the cause of cardioembolic stroke. Skin lesions were also present which included, nevi, ephelides and neurofibroma hence diagnosis of "NAME SYNDROME" was made.

Role of GeneXpertMTB/RIF in the diagnosis of cutaneous tuberculosis.

BACKGROUND: cutaneous involevemtn is an important extrapulmonary manifestation of tuberculosis. It is a paucibacillary condition and has diverse clinical presentations. Sufficient data is not available regarding role of GeneXpertMTB/RIF in cutanoues tuberculosis. METHODS: in this study, BacT/Alert3D and response to antitubercular therapy were taken as gold standard and performance of GeneXpertMTB/RIF was evaluated against it in clinically and histopathologically suspected cases of cutaneous tuberculosis. RESULTS: forty seven patients were included in the study of which commonest presentation was scrofuloderma (42.6%) followed by lupus vulgaris (40.4%). Granulomatous inflammation on histopathology was seen in 75.5% patients on skin biopsy. Sic patients had extracutaneous focus of tuberculosis. In 14 (29.79%), culture of skin biopsy was positive for M. tuberculosis and all showed complete response to ATT in 6 months. GeneXpertMTB/RIF detected M. tuberculsois in 4 samples. CONCLUSION: GeneXpertMTB/RIF is not a reliable tool for diagnosis of cutaneous tuberculosis. Clinic-histopathological correlation along with response to ATT is needed for confirmation of diagnosis of cutaneous tuberculosis.

Induction of ovulation of ovulatory size non-ovulatory follicles and initiation of ovarian cyclicity in summer anoestrous buffalo heifers (Bubalus bubalis) using melatonin implants.

This study was conducted on summer anoestrous buffalo heifers to monitor the efficacy of melatonin for induction of ovulation and ovarian cyclicity. During pre-treatment period of 24 days, the ovarian dynamics of five cycling and 10 summer anoestrous heifers was monitored on each alternate day using a transrectal ultrasound scanner. Thereafter, during treatment period, these 10 anoestrous heifers along with additional seven anoestrous heifers were randomly allocated into non-implanted (n = 5) and implanted (n = 12, one melatonin implant/50 kg, 18 mg melatonin/implant) group. Non-implanted heifers were monitored on each alternate day till the confirmation of second-ovulation in implanted heifers. Pre-treatment period revealed the presence of dominant follicles in anoestrous heifers which attained the diameter comparable with ovulatory follicles of cycling heifers but failed to ovulate and regressed. Between 6 and 36 days (15.3 +/- 2.9 days) post-treatment, all the implanted heifers (p < 0.05) exhibited ovulation of dominant follicles; however none of the non-implanted heifers ovulated during the corresponding period. The first-interovulatory period in implanted heifers ranged between 8 and 28 days (18.0 +/- 1.8 days). The implanted heifers with short (

Assessment of daily intake of trace elements by Kakrapar adult population through ingestion pathway.

Concentration of trace elements such as Fe, Cu, Ni, and Zn were measured in cereals, pulses, vegetables, fish, meat, milk, egg, and water samples collected around Kakrapar, Gujarat, India. A wide variation of the trace element concentration was observed among all the dietary matrices. The concentration of Fe is comparatively more in all the dietary matrices. The concentrations of these elements are translated into intake rates through ingestion pathways. Daily intake (milligrams/day) of Fe, Cu, Ni, and Zn by adult population of Kakrapar, Gujarat were 16.5 +/- 6.2, 3.3 +/- 1.2, 1.8 +/- 1.0, and 3.6 +/- 1.3, respectively. Dietary sources of Fe, Cu, and Ni by Kakrapar adult population are comparable with RDA. In case of Zn, the daily dietary intake is comparatively lower than that of RDA.

Ethionamide induced blue vision (cyanopsia): Case report.

Ethionamide is part of a group of drugs used in the treatment of drug resistant TB. With the advent of increasing drug resistance in pulmonary TB cases, use of Ethionamide, a second line anti tubercular drug is increasing. Vision changes are rare with ethionamide. Cyanopsia i.e., bluish tinted vision of surroundings with ethionamide is not known in literature. Here, we report a case of DRTB patient who developed cyanopsia soon after introducing ethionamide. Although reversible, ethionamide may sometimes need withdrawal because of significant distress caused to patient.

Direct and seasonal legacy effects of the 2018 heat wave and drought on European ecosystem productivity.

In summer 2018, central and northern Europe were stricken by extreme drought and heat (DH2018). The DH2018 differed from previous events in being preceded by extreme spring warming and brightening, but moderate rainfall deficits, yet registering the fastest transition between wet winter conditions and extreme summer drought. Using 11 vegetation models, we show that spring conditions promoted increased vegetation growth, which, in turn, contributed to fast soil moisture depletion, amplifying the summer drought. We find regional asymmetries in summer ecosystem carbon fluxes: increased (reduced) sink in the northern (southern) areas affected by drought. These asymmetries can be explained by distinct legacy effects of spring growth and of water-use efficiency dynamics mediated by vegetation composition, rather than by distinct ecosystem responses to summer heat/drought. The asymmetries in carbon and water exchanges during spring and summer 2018 suggest that future land-management strategies could influence patterns of summer heat waves and droughts under long-term warming.