bluuebunny/crossref_metadata_2025 huggingface dataset:
OS SESSENTA ANOS DE “INFLAÇÃO BRASILEIRA” DE IGNÁCIO RANGEL: ENTRE MUDANÇAS E PERMANÊNCIAS
Authors: Rippel Nilmar , Saggiorato Bruno , Clovis Medeiros Marlon
Published: December 2024

O objetivo do artigo é analisar a obra “A inflação brasileira” de Ignácio Rangel, lançada em 1963, e verificar se essa obra possui validade total ou parcial para explicar a inflação brasileira na última década. Para tanto, trouxemos os embates ocorridos à época, além de sua interpretação do fenômeno inflacionário. Assim, foi possível constatar que devido o tempo decorrido desde a publicação, a obra necessita de algumas considerações que não são consideráveis mudanças:  i) a consolidação nos anos 1990 de um pacto de poder liberal e rentista não voltado ao interesse nacional e; ii) Com o Plano Real e posterior financeirização, a inflação perdeu sua função em atuar como mecanismo de defesa da economia. No que concerne a permanência, podemos afirmar que; i) o fenômeno inflacionário não é causa, mas sintoma de anomalias no sistema econômico; ii) o país ainda padece de altíssima concentração de renda e altas taxas de exploração e; iii) aprofundou-se ainda mais o poder de grandes corporações, que não apenas administram como determinam os preços, dado seu alto nível de influência na produção e comercialização de mercadorias. Soma-se a isso, num segundo momento, uma inflação de custos dado os choques de ofertas à nível global.
Comparative Analysis of Microstructure in Ferritic Steel Fabricated by Conventional and Additive Manufacturing Processes
Authors: Nguyen Minh Thuyet
Published: December 2024

Ferritic 439 stainless steels, known as iron–chromium alloys with chromium content between 11% and 30%, have been extensively used worldwide due to their good corrosion resistance, good formability, high-temperature oxidation resistance, and lower cost compared to austenitic stainless steels. Conventional production processes for these steels, such as melting, casting, and rolling, are predominantly employed due to the material's difficult formability and machinability, especially when producing complex shapes. However, additive manufacturing (AM) offers new processing opportunities. AM technology, specifically Selective Laser Melting (SLM), fuses metallic powders using a precisely focused and controlled laser beam, enabling the production of highly complex parts with high precision. In this work, we present a comparison of ferritic 439 stainless steel manufactured using SLM technology with conventionally manufactured one, focusing on their microstructure, phase, and mechanical properties. The results reveal that SLM significantly increases material strength and hardness due to notable differences in microstructure fineness and phase composition. The rapid solidification during the SLM process results in a microstructure for the as-printed ferritic 439 stainless steel that significantly differs from that of conventionally manufactured ferritic 439 stainless steel. This distinctive microstructure in the additively manufactured product is likely responsible for various other differences in material behavior.
Study on Coating of TiO2 Nanotubes on Microporous Ti Surfaces for Biomedical Applications
Authors: Manh Vu Cong , Duc Dang Minh , Khanh Dang Quoc , Bach Dao Hong , Trung Kien Nguyen Duc , Dung Mai Xuan , Phong Truong Quoc , Pham Vuong Hung
Published: December 2024

In this research, smooth commercial Ti grade 2 corroded by ErCl3.6H2O under an electrochemical process with difference electrochemical current ranging from 0.5 – 4A, providing a rougher surface conducive to the adsorption on the Ti surface. A thin layer of TiO2 nanotubes synthesized via the anodization method on microporous Ti surfaces for application in the biomedical field. The results reveal that the smooth titanium surface was completely corroded, resulting in the formation of a microporous structure, with a thin layer of TiO2 successfully formed on the microporous titanium surfaces. The digital optical images obtained using digital microscope (VHX) showed that the micropore depth is around 41.94 - 55.83 µm. On the other hand, the SEM results revealed that the diameter of TiO2 nanotubes ranged from 50 – 80 nm. The EDS and XRD techniques indicated that no impurities were present, and the TiO2 phase was successfully formed. SEM images show positive results regarding the formation of a bone-like CaP mineral layer after 14 days of immersion in simulated body fluid (SBF), indicating suitability for biomedical applications.
Dispassionate hospitality as a Christian value: A pastoral narrative
Authors: Kimpinde Mwansa Claude
Published: December 2024

This article is a reflective narrative on dispassionate hospitality as a Christian value, referencing Mount View Methodist Church (MVMC) and its community as a practical, pastoral example. It aims to challenge bias hospitality in the Christian community, by outlining the implications of an impartial hospitality through the scriptural presentation of hospitality, placed in parallel with the belated Christmas dinner at the MVMC. In light of these insights, I propose a new holistic approach to hospitality as a Christian value perspective through a pastoral narrative framework on inclusiveness.Contribution: This article challenges bias hospitality in the Christian community by outlining the implications of an impartial hospitality in Christian community as a sense of dispassionate and inclusive hospitality, even though there is still some ground work to be done in respect of the radical and hypocritical biases of extremists refusing to align themselves to the current realities of globalisation as a sense of togetherness and inclusiveness in this diverse world.
The founding of Marxist study of religion and its theoretical sources of humanities
Authors: Zeng Chuanhui , Zhang Xiaoxiao
Published: December 2024

Marx and Engels have elaborated the new system of their thought in German Ideology, including some important ideas on religion, from 1845 to 1846. Engels firstly applied the newly founded worldview and methodology to the systematic study of religion in his monograph Peasant War in Germany in 1850. Both events marked the founding of the Marxist Study of Religion. The Marxist humanity theory of religion benefitted from the religious critiques of Neo-Hegelian, Feuerbachian and religious philosophy. The social theoretical sources of Marxism on religion are supposed to be the topics of other articles.Contribution: The general view in Chinese academia has been that the study of religion in the West was founded by Friedrich Max Müller in 1873 when he coined a new terminology ‘Science of Religion’ for his book. Comparatively speaking, the classic Marxist writers had only ‘a view of religion’ and not a view of ‘the study of religion’. The authors argued that there is a systematic study of religion from the very beginning of Marxism. Marx and Engels constructed the humanity theory of the Marxist Study of Religion by adopting and developing religious critique of Neo-Hegelian, Feuerbachian, critical theological thought. The academics in Western countries do not have such kind of views and this resulted in limited contributions in this area.
Biology & control of Anopheles culicifacies Giles 1901
Authors: Sharma V.P. , Dev V.
Published: December 2024

Malaria epidemiology is complex due to multiplicity of disease vectors, sibling species complex and variations in bionomical characteristics, vast varied terrain, various ecological determinants. There are six major mosquito vector taxa in India, viz. Anopheles culicifacies, An. fluviatilis, An. stephensi, An. minimus, An. dirus and An. sundaicus. Among these, An. culicifacies is widely distributed and considered the most important vector throughout the plains and forests of India for generating bulk of malaria cases (>60% annually). Major malaria epidemics are caused by An. culicifaices. It is also the vector of tribal malaria except parts of Odisha and Northeastern States of India. An. culicifacies has been the cause of perennial malaria transmission in forests, and over the years penetrated the deforested areas of Northeast. An. culicifacies participates in malaria transmission either alone or along with An. stephensi or An. fluviatilis. The National Vector Borne Disease Control Programme (NVBDCP) spends about 80 per cent malaria control budget annually in the control of An. culicifacies, yet it remains one of the most formidable challenges in India. With recent advances in molecular biology there has been a significant added knowledge in understanding the biology, ecology, genetics and response to interventions, requiring stratification for cost-effective and sustainable malaria control. Research leading to newer interventions that are evidence-based, community oriented and sustainable would be useful in tackling the emerging challenges in malaria control. Current priority areas of research should include in-depth vector biology and control in problem pockets, preparation of malaria-risk maps for focused and selective interventions, monitoring insecticide resistance, cross-border initiative and data sharing, and coordinated control efforts for achieving transmission reduction, and control of drug-resistant malaria. The present review on An. culicifacies provides updated information on vector biology and control outlining thrust areas of research.
Burden & pattern of illnesses among the tribal communities in central India
Authors: Jain Yogesh , Kataria Raman , Patil Sushil , Kadam Suhas , Kataria Anju , Jain Rachna , Kurbude Ravindra , Shinde Sharayu
Published: December 2024

Tribals are the most marginalised social category in the country and there is little and scattered information on the actual burden and pattern of illnesses they suffer from. This study provides information on burden and pattern of diseases among tribals, and whether these can be linked to their nutritional status, especially in particularly vulnerable tribal groups (PVTG) seen at a community health programme being run in the tribal areas of Chhattisgarh and Madhya Pradesh States of India. This community based programme, known as Jan Swasthya Sahyog (JSS) has been serving people in over 2500 villages in rural central India. It was found that the tribals had significantly higher proportion of all tuberculosis, sputum positive tuberculosis, severe hypertension, illnesses that require major surgery as a primary therapeutic intervention and cancers than non tribals. The proportions of people with rheumatic heart disease, sickle cell disease and epilepsy were not significantly different between different social groups. Nutritional levels of tribals were poor. Tribals in central India suffer a disproportionate burden of both communicable and non communicable diseases amidst worrisome levels of undernutrition. There is a need for universal health coverage with preferential care for the tribals, especially those belonging to the PVTG. Further, the high level of undernutrition demands a more augmented and universal Public Distribution System.
Comparison of haemoglobin estimates using direct & indirect cyanmethaemoglobin methods
Authors: Bansal Priyanka Gupta , Toteja Gurudayal Singh , Bhatia Neena , Gupta Sanjeev , Kaur Manpreet , Adhikari Tulsi , Garg Ashok Kumar
Published: December 2024

Background & objectives:

Estimation of haemoglobin is the most widely used method to assess anaemia. Although direct cyanmethaemoglobin method is the recommended method for estimation of haemoglobin, but it may not be feasible under field conditions. Hence, the present study was undertaken to compare indirect cyanmethaemoglobin method against the conventional direct method for haemoglobin estimation.

Methods:

Haemoglobin levels were estimated for 888 adolescent girls aged 11-18 yr residing in an urban slum in Delhi by both direct and indirect cyanmethaemoglobin methods, and the results were compared.

Results:

The mean haemoglobin levels for 888 whole blood samples estimated by direct and indirect cyanmethaemoglobin method were 116.1 ± 12.7 and 110.5 ± 12.5 g/l, respectively, with a mean difference of 5.67 g/l (95% confidence interval: 5.45 to 5.90, P<0.001); which is equivalent to 0.567 g%. The prevalence of anaemia was reported as 59.6 and 78.2 per cent by direct and indirect methods, respectively. Sensitivity and specificity of indirect cyanmethaemoglobin method were 99.2 and 56.4 per cent, respectively. Using regression analysis, prediction equation was developed for indirect haemoglobin values.

Interpretation & conclusions:

The present findings revealed that indirect cyanmethaemoglobin method overestimated the prevalence of anaemia as compared to the direct method. However, if a correction factor is applied, indirect method could be successfully used for estimating true haemoglobin level. More studies should be undertaken to establish agreement and correction factor between direct and indirect cyanmethaemoglobin methods.
A Survey of Surgeon Interest in Individually Sized Laparoscopic Instruments
Authors: Aboseif Christine , McEvoy Austin , Fogel Joshua , Fatehi Mary , Gambrill Madison , Onyeike Godwin
Published: December 2024

Objectives:

Allowing surgeons the option of individually sized laparoscopic instruments can potentially improve the ergonomics of laparoscopic surgery. We investigate interest in individually sized laparoscopic instruments among minimally invasive trained surgeons.

Materials and Methods:

Cross-sectional survey of 166 surgeons performing laparoscopic surgery in the disciplines of obstetrics/gynecology, general surgery, and urology. Items investigated surgeon knowledge, attitudes, potential usefulness, and interest regarding dissemination and implementation of individually sized laparoscopic instruments.

Results:

Overall mean knowledge of individually sized laparoscopic instruments ranged from strongly disagree to disagree and did not differ by glove size. Overall mean attitudes, dissemination, and implementation for individually sized laparoscopic instruments were between neutral and agree. Overall mean usefulness for individually sized laparoscopic instruments was neutral. There was a general pattern of small glove size having greater mean values than medium glove size for individually sized laparoscopic instruments for the topics of attitudes, usefulness, dissemination, and implementation.

Conclusion:

We found that those with small glove sizes are interested in individually sized laparoscopic instruments. We recommend that as surgeon demographics continue to diversify, especially with a larger number of women typically with smaller glove sizes becoming surgeons, there is a potential benefit for individually sized laparoscopic instruments. Hospitals, surgical centers, and clinical practices should consider making such individually sized laparoscopic instruments available to surgeons. This can potentially address the ergonomic concerns of surgeons and also improve surgical practice.
Prognostic value of systemic inflammatory markers in elderly patients with tumor-associated venous thromboembolism
Authors: Guo Na , Yan Xinxin , Yi Zhong , Yu Shuihua , Xiu Helu , Gao Yunlei , Ru Songwei , Gong Zuojuan
Published: December 2024

Background:

Elderly tumor patients are more prone to venous thrombotic events than nontumor patients. To investigate the relationship between systemic inflammatory markers and overall survival (OS) in elderly patients with tumorassociated venous thromboembolism (TAVTE). And to evaluate the prognostic value of combined lymphocyte platelettolymphocyte ratio (PLR) with neoplasm metastasis in elderly patients.

Methods:

A prospective study was conducted. A total of 172 elderly patients with TAVTE admitted to the hospital from January 2017 to December 2019 were included in the study, which were followed up for 2 years. Clinical and laboratory data were collected. All-cause mortality within after discharge were followed up. The optimal cutoff values of neutrophiltolymphocyte ratio (NLR), PLR, systemic immuneinflammation index (SII), and monocyte to highdensity lipoprotein ratio (MHR) for predicting efficacy and prognosis were determined according to receiver operating characteristic (ROC) curve and the areas under the ROC curve (AUC). Kaplan-meier curves were used to analyze the survival time. Univariate and multivariate COX logistic regression analyses were used to analyze the independent predictors of OS in elderly patients with TAVTE.

Results:

The cut-off values for NLR, PLR, SII, and MHR were 3.375, 274.63, 399.73 and 0.58, respectively. And the area under the curve (AUC) was 0.639(95%CI: 0.556-0.721), 0.628(95%CI:0.544-0.712), 0.595(95%CI:0.510-0.680) and 0.596(95%CI: 0.510-0.683). Survival analysis showed that OS was longer in the NLR≤3.375 group (181.07 weeks, 95% CI: 150.11 ~ 212.03) than in the NLR >3.375 group (108.95 weeks, 95%CI: 90.38 ~ 127.51) (P = 0.005). The OS of PLR≤274.63 group (160.40 weeks, 95%CI: 138.41 ~ 182.38) was longer than that of PLR >274.63 group (43.85 weeks, 95%CI: 34.08 ~ 53.63) (P < 0.001). The OS of SII≤399.73 group (176.62 weeks, 95%CI:147.26 ~ 205.97) was longer than that of SII>399.73 group (126.55 weeks,95%CI: 105.04 ~ 148.05) (P = 0.012). The OS was longer in the MHR≤0.58 group (156.24 weeks, 95% CI: 127.05-185.43) than in the MHR>0.58 group (108.11 weeks, 95%CI:86.85-129.38) (P = 0.011). Univariate and multivariate Cox analysis showed that tumor metastasis and PLR>274.63 were independent predictors of the lower OS in elderly patients with TAVTE (P < 0.001). According to the tumor metastasis and the cut-off value of PLR, a combined scoring system MPS (Metastasis and PLR System) was designed. The OS of the 0, 1 and 2 score groups was 184.08 weeks (95%CI:158.11-210.05), 82.60 weeks (95%CI:61.57-103.64), and 23.83 weeks (95%CI: 9.575-38.09) (P < 0.001), respectively.

Conclusion:

Our findings suggest that the systemic inflammatory markers (NLR, PLR, SII, MHR) may have predictive value for all-cause mortality in elderly patients with TAVTE. PLR combined with tumor metastasis may be an effective index to predict the prognosis of elderly patients with TAVTE.
Porokeratotic Eccrine Ostial Dermal Duct Nevus: A Case Report of a Young Male With Disordered Keratinization
Authors: Agarwal Mansi , Sharma Shruti , Palanisamy Madhumitha , Singh Paridhi
Published: December 2024

Porokeratotic eccrine ostial and dermal ductal nevus (PEODDN) is a rare benign nevoid disorder of keratinization. It is considered as an epidermal nevus variant and is classified as an eccrine hamartoma, characterized by parakeratotic features. Here, we report a case of a young adolescent male with unilateral PEODDN.
Immunohistochemical Study of Nerve Growth Factor Expression in Hansen’s Disease
Authors: Lubna Fatma , Abbas Aijaz , Adil Mohammad , Akhtar Kafil
Published: December 2024

Aim:

To study the immunoexpression of nerve growth factor (NGF) in Hansen’s disease to assess the diagnostic and prognostic significance.

Objective:

NGF is a neurotrophin and an important growth factor for the tissue remodeling process. Higher expression of NGF is observed in the lepromatous forms when compared to tuberculoid forms.

Materials and Methods:

The present prospective study was carried out in the Departments of Pathology and Dermatology at Aligarh Muslim University, Aligarh, Uttar Pradesh, India, in 50 patients of Hansen’s disease.

Results:

The study included 50 cases of Hansen’s disease. The majority of the cases were of borderline lepromatous, 15 (30.0%), followed by 12 (24.0%) cases each of borderline tuberculoid and tuberculoid leprosy. Higher staining intensity of NGF and a higher percentage of positive cells were observed in lepromatous leprosy (LL) cases as compared to tuberculoid leprosy (TT) cases. The highest number of cases with a high immunoreactivity score (IRS) was of LL, whereas TT cases showed a low IRS.

Conclusion:

The immunoexpression of NGF was more intense on the lepromatous side of the spectrum compared to the tuberculoid side, indicating the severity of the disease with less potential for cure.
Efficacy of metformin in improving glycaemic control & perinatal outcome in gestational diabetes mellitus
Authors: Singh Neeta , Madhu Malti , Vanamail Perumal , Malik Nisha , Kumar Sunesh
Published: December 2024

Background & objectives:

Gestational diabetes mellitus (GDM) can cause adverse perinatal outcome if not treated. Although insulin therapy has been the main treatment modality over decades but considering its cost and parenteral mode of administration, it does not seem to be appropriate, especially in low-resource settings. The objective of this study was to evaluate the role of metformin in GDM and know its efficacy as well as adverse effect on foetus and mother.

Methods:

All pregnant women with GDM who were not controlled on medical nutrition therapy and required metformin therapy were included in the study. Careful monitoring of blood sugar was done. Development of any maternal or foetal complications and adverse effect were recorded.

Results:

A total of 2797 pregnant women were screened, of whom 233 (8.3%) were found to have GDM. Of the 64 women with GDM (28.7%) who required metformin therapy, majority (93.8%) achieved blood sugar control, whereas three (4.7%) women failed. Caesarean section rate was 54 per cent, and 15.6 per cent neonates were large for gestational age. Only two (3.1%) women had gastrointestinal side effects which were minor and got resolved with time. No case of hypoglycaemia or perinatal mortality was reported.

Interpretation & conclusions:

Our findings indicate that metformin may be used as a safe and effective oral hypoglycaemic agent in GDM, especially in low-resource settings where cost, storage and compliance are logistic issues. However, long-term follow up studies are needed to solve issues related to its safety in pregnancy.
HIV-malaria interactions in North-East India
Authors: Mohapatra Pradhyumn K. , Pachuau Elsa , Kumar Chandra , Borkakoty Biswajit , Zomawia Eric , Singh Achouba , Walia Kamini , Arora Rashmi , Mahanta Jagdish , Subbarao Sarala K.
Published: December 2024

Background & objectives:

The interactions between HIV and malaria co-infection have been shown to influence each other in their clinical outcomes in Sub-Saharan Africa. This study was carried out in the two States of north east India endemic for both HIV and malaria infections, to study the interactions between the two diseases in the HIV-infected population.

Methods:

In this prospective study, a total of 333 HIV-infected individuals were followed up for a period of 6-18 months in Mizoram and Manipur during 2010-2011. The study assessed the changes in viral load and also the therapeutic efficacy of artesunate plus sulphadoxine-pyrimethamine (AS+SP) combination therapy in HIV-infected and HIV-uninfected individuals with Plasmodium falciparum malaria.

Results:

Viral load in HIV-infected malaria patients on day zero (D0) ranged from 1110 to 147,000 copies/ml. The log transformation of the geometric means of HIV viral loads revealed no significant difference on different days of follow up. There was 100 per cent adequate clinical and parasitological response (ACPR) after treating with artemisinin based combination therapy (ACT) both in HIV-infected and HIV-uninfected P. falciparum-positive individuals. Similarly, chloroquine showed 100 per cent ACPR in P. vivax HIV-infected individuals.

Interpretation & conclusion:

The study showed no significant increase in HIV viral load in malaria cases. All HIV-infected and HIV-uninfected P. falciparum malaria-positive cases responded to the treatment with 100 per cent ACPR.
Unreliability of three commercial Coxiella burnetii phase II IgM ELISA kits for the seroscreening of acute Q fever in human cases
Authors: Stephen Selvaraj , Ambroise Stanley , Pradeep Jothimani , Gunasekaran Dhandapany , Sangeetha Balakrishnan , Sarangapani Kengamuthu
Published: December 2024

Background & objectives:

Seroprevalence of Q fever (QF) caused by Coxiella burnetii has been reported from different parts of India. Usually serological/molecular tests are employed for detection of infection. The present study was undertaken to verify the validity of three different QF phase II IgM ELISA kits for acute QF diagnosis by comparing with the gold standard indirect fluorescent antibody assay (IFA).

Methods:

Fifty eight serum samples collected from 42 patients (26 patients provided acute sample only and 16 both acute and convalescent samples) which were examined by all three commercial kits, were cross-checked with QF Phase II IgM IFA for confirmation.

Results:

Eleven patients were positive for C. burnetii antibodies by IFA in acute and/or convalescent serum samples. Taking IFA as a reference, percentages of sensitivity, specificity, positive predictive value and negative predictive value for Virion-Serion/Vircell/NovaTec were 36.36, 61.29, 25.00, 73.08; 81.82, 35.48, 31.03, 84.62 and 100, 25.81, 32.35, 100 per cent, respectively.

Interpretation & conclusions:

The three different ELISA kits exhibited poor agreement amongst them and unacceptable level of false positivity. IFA remains to be the only option for diagnosing acute QF. Discrepancy between the clinical findings and IFA/ELISA results needs confirmation by C. burnetii DNA detection in real-time polymerase chain reaction.
Family planning in India
Authors: Muttreja Poonam , Singh Sanghamitra
Published: December 2024

Given the magnitude of the family planning programme in India, there is a need to strengthen the coordination of all its aspects, focusing on planning, programmes, monitoring, training and procurement. The quality of care in family planning must be a major focus area to ensure the success of family planning programmes. Despite serious efforts and progress, India has yet to achieve its family planning goals. Furthermore, there is a need for greater male participation both as enablers and beneficiaries and also address the sexual and reproductive needs of the youth. It is imperative for the government to ensure the prioritization of family planning in the national development agenda. Family planning is crucial for the achievement of the sustainable development goals, and subsequent efforts need to be made to improve access and strengthen quality of family planning services.
Molecular characterization of Plasmodium falciparum in Arunachal Pradesh from Northeast India based on merozoite surface protein 1 & glutamate-rich protein
Authors: Sarmah Nilanju Pran , Sarma Kishore , Bhattacharyya Dibya Ranjan , Sultan Ali , Bansal Devendra , Singh Neeru , Bharti Praveen K. , Kaur Hargobinder , Sehgal Rakesh , Mohapatra Pradyumna Kishore , Mahanta Jagadish
Published: December 2024

Background & objectives:

Northeast (NE) India is one of the high endemic regions for malaria with a preponderance of Plasmodium falciparum, resulting in high morbidity and mortality. The P. falciparum parasite of this region showed high polymorphism in drug-resistant molecular biomarkers. However, there is a paucity of information related to merozoite surface protein 1 (msp-1) and glutamate-rich protein (glurp) which have been extensively studied in various parts of the world. The present study was, therefore, aimed at investigating the genetic diversity of P. falciparum based on msp-1 and glurp in Arunachal Pradesh, a State in NE India.

Methods:

Two hundred and forty nine patients with fever were screened for malaria, of whom 75 were positive for P. falciparum. Blood samples were collected from each microscopically confirmed patient. The DNA was extracted; nested polymerase chain reaction and sequencing were performed to study the genetic diversity of msp-1 (block 2) and glurp.

Results:

The block 2 of msp-1 gene was found to be highly polymorphic, and overall allelic distribution showed that RO33 was the dominant allele (63%), followed by MAD20 (29%) and K1 (8%) alleles. However, an extensive diversity (9 alleles and 4 genotypes) and 6-10 repeat regions exclusively of R2 type were observed in glurp.

Interpretation & conclusions:

The P. falciparum population of NE India was diverse which might be responsible for higher plasticity leading to the survival of the parasite and in turn to the higher endemicity of falciparum malaria of this region.
Influence of single photon emission computed tomography (SPECT) reconstruction algorithm on diagnostic accuracy of parathyroid scintigraphy
Authors: Gedik Gonca Kara , Sari Oktay
Published: December 2024

Background & objectives:

Preoperative localization of parathyroid lesions is essential for improving the results in patients with primary hyperparathyroidism. The purpose of this study was to evaluate retrospectively the value of technetium-99m (Tc-99m) methoxyisobutylisonitrile (MIBI) single photon emission computed tomography (SPECT) and to compare the diagnostic accuracy of iterative reconstruction (IR) and filtered backprojection (FBP) reconstruction algorithms about localization of parathyroid lesions.

Methods:

Forty four patients with primary hyperparathyroidism, in whom histopathological correlation could be performed, were included in the study. Dual-phase Tc-99m parathyroid scintigraphy was performed 20 and 120 min after injection of 740 MBq Tc-99m MIBI in all patients. Tomographic images were acquired 120 min after the administration of radiopharmaceutical. The SPECT data were evaluated using an IR as well as a FBP algorithm. In 23 of 44 patients, SPECT acquisitions were performed in 64×64 matrix; in the remaining 21 patients, tomographic data were collected in 128×128 matrix. The imaging results were compared with pathological findings and sensitivities of both reconstruction algorithms, and planar views were calculated.

Results:

Using planar MIBI scans, abnormal parathyroid glands were correctly localized in 75 per cent of the cases. Sensitivity increased to 77 per cent using SPECT with FBP and to 84 per cent with IR. When the sensitivities were calculated according to the acquisition matrix, these were 95 per cent (20/21) and 85 per cent (18/21) for IR and FBP, respectively in patients in whom 128×128 matrix was used. The sensitivities were lower in patients who were imaged with 64×64 matrix; these were calculated as 74 per cent (17/23) and 70 per cent (16/23) with IR and FBP, respectively.

Interpretation & conclusions:

Our findings showed that compared to planar scintigraphy, Tc-99m MIBI SPECT was more sensitive diagnostic modality in the detection of abnormal parathyroid tissues. Image quality and sensitivity may be improved further when larger matrices with IR are used instead of FBP algorithm.
Haematological profile of patients with mixed-phenotype acute leukaemia from a tertiary care centre of north India
Authors: Sharma Manupriya , Sachdeva Man Updesh Singh , Bose Parveen , Varma Neelam , Varma Subhash , Marwaha R.K. , Malhotra Pankaj
Published: December 2024

Background & objectives:

Mixed-phenotype acute leukaemia (MPAL) is a rare neoplasm with no definite treatment protocols and a distinctly poor outcome. Advancement in polychromatic flow cytometry has made its identification easier. This prospective study was designed to identify cases of MPAL and study their clinical presentation and haematological profile in a tertiary care hospital in north India.

Methods:

Ethylenediaminetetraacetic acid (EDTA)-anticoagulated bone marrow aspirate samples of patients diagnosed as acute leukaemia (AL) on the basis of morphology were utilized for immunophenotyping. A comprehensive panel of fluorochrome-labelled monoclonal antibodies targeting myeloid, B-cell, T-cell and immaturity markers was utilized. The patients diagnosed to have MPAL, on the basis of the World Health Organization 2008 classification, were selected for further analyses.

Results:

There were 15 (2.99%) patients with MPAL of the total 501 cases of AL. Seven were children, all males and mean age of 5.08±3.88 yr. Eight were adults, male:female=6:2 and mean age of 21.43±5.74 yr. Eight were diagnosed as B/myeloid and seven were T/myeloid. No association was observed between age and immunophenotype of MPAL. On morphology, 11 were diagnosed as AML and four as ALL, and no specific morphology of blasts was predictive of a MPAL.

Interpretation & conclusions:

MPAL appeared to be a rare neoplasm (2.99% of AL cases). A comprehensive primary panel of monoclonal antibodies should be used to identify this neoplasm known to have a poor outcome.
Seroprevalence of transplacentally acquired measles antibodies in HIV-exposed versus HIV-unexposed infants at six months of age
Authors: Jain Sneha , Seth Anju , Khare Shashi , Chandra Jagdish
Published: December 2024

Background & objectives:

Measles infection is reported to be more severe, prolonged and associated with a higher complication rate in children with HIV infection. Reports indicate that infants born to HIV-infected women [HIV exposed infants (HEI)] may be more vulnerable to measles. The World Health Organization recommends measles vaccination starting at six months of age in these infants who may be HIV-infected themselves. However, in India, they are given measles vaccination at nine months of age like all other infants. In this study, the seroprevalence of transplacentally acquired measles antibodies was compared in HEI and unexposed infants (HUnI) at six months of age and the proportion of HEI undergoing seroconversion after immunization with measles vaccine was assessed.

Methods:

In this prospective longitudinal study, measles IgG antibodies were estimated in serum of 49 HEI and 50 HUnI aged 6-7 months. Measles vaccine was then administered to HEI. Assessment for measles IgG antibodies was repeated 8-12 wk post-immunization.

Results:

Measles IgG antibodies were detected in two of 49 (4.1%) HEI and 16 of 50 (32%) HUnI. HEI were 11 times more likely to lack measles antibodies as compared to HUnI (odds ratio=11.05, 95% confidence interval=2.989-40.908). Post-vaccination, seroprevalence of measles antibodies increased to 38.5 per cent (P< 0.001) in HEI compared to 4 per cent at baseline.

Interpretation & conclusions:

Most HEI lacked measles antibodies at six months age and were, therefore, more vulnerable to measles than HUnI. Seroconversion in response to a single dose of measles vaccine administered at six months age was low in these infants, signifying the need of additional dose(s) of measles/measles-containing vaccine.
Seroprevalence & changing trends of transfusion-transmitted infections amongst blood donors in a Regional Blood Transfusion Centre in north India
Authors: Rawat Akanksha , Diwaker Preeti , Gogoi Priyanka , Singh Bharat
Published: December 2024

Background & objectives:

Transfusion-transmitted infections (TTIs) are the major problem associated with blood transfusion. Accurate estimates of risk of TTIs are essential for monitoring the safety of blood supply. The present study was undertaken to determine the percentage of voluntary donors (VDs) and replacement donors (RDs) and also, to estimate and compare the seroprevalence and changing trends of TTIs amongst VDs and RDs in a regional blood transfusion centre in north India.

Methods:

This retrospective study was based on the records of all voluntary and replacement donations which were collected from January 2008 to December 2014 in a Regional Blood Transfusion Centre placed in a tertiary care hospital in Delhi, India.

Results:

Of the total 220,482 donations, 163,540 (74.17%) were voluntary and 56,942 (25.83%) were replacement donation. The overall seroprevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis and malaria were 0.32, 1.61, 0.73, 1.62 and 0.06 per cent, respectively. Furthermore, the TTIs were more frequently encountered in RDs in comparison to VDs.

Interpretation & conclusions:

The increase in public awareness regarding voluntary blood donation, meticulous donor screening, counselling and use of highly sensitive tests can help in reducing the risk of TTIs.
Role of inducers in detection of bla PDC-mediated oxyimino-cephalosporin resistance in Pseudomonas aeruginosa
Authors: Ingti Birson , Krishnatreya Deepika B. , Maurya Anand Prakash , Dhar (Chanda) Debadatta , Chakravarty Atanu , Bhattacharjee Amitabha
Published: December 2024

Background & objectives:

Pseudomonas aeruginosa possessing chromosomally inducible bla
PDC along with other intrinsic mechanism causes infection with high mortality rate. It is difficult to detect inducible AmpC enzymes in this organism and is usually overlooked by routine testing that may lead to therapeutic failure. Therefore, three different inducers were evaluated in the present study to assess their ability of induction of bla
PDC in P. aeruginosa.

Methods:

A total of 189 consecutive Pseudomonas isolates recovered from different clinical specimens (November 2011-April 2013) were selected for the study. Isolates were screened with cefoxitin for AmpC β-lactamases and confirmed by modified three-dimensional extract test (M3DET). Inductions were checked using three inducers, namely, clavulanic acid, cefoxitin and imipenem along with ceftazidime. Molecular screening of AmpC β-lactamase genes was performed by PCR assay. Antimicrobial susceptibility and minimum inhibitory concentrations (MICs) were determined, and repetitive extragenic palindromic-PCR of all bla
PDC harbouring isolates was performed.

Results:

Inducible phenotype was observed in 42 (24.3%) of 97 (56%) isolates confirmed by M3DET. Among these, 22 isolates harboured chromosomal bla
PDC gene, and cocarriage of both chromosomal and plasmid-mediated bla
AmpC genes was observed in seven isolates. Cefoxitin-ceftazidime-based test gave good sensitivity and specificity for detecting inducible AmpC enzymes. Isolates harbouring bla
PDC showed high MIC against all tested cephalosporins and monobactam. DNA fingerprinting of these isolates showed 22 different clones of P. aeruginosa.

Interpretation & conclusions:

P. aeruginosa harbouring inducible (chromosomal) and plasmid-mediated AmpC β-lactamase is a matter of concern as it may limit therapeutic option. Using cefoxitin-ceftazidime-based test is simple and may be used for detecting inducible AmpC β-lactamase amongst P. aeruginosa.
Prevalence of Vibrio cholerae O1 serogroup in Assam, India
Authors: Sharma Ajanta , Dutta Bornali Sarmah , Rasul Elmy Samsun , Barkataki Dipa , Saikia Anjanamoyee , Hazarika Naba Kumar
Published: December 2024

Background & objectives:

Although cholera remains to be an important public health problem, studies on reliable population-based estimates of laboratory confirmed cholera in endemic areas are limited worldwide. The aim of this hospital-based study was to evaluate the prevalence of Vibrio cholerae serogroup in Assam, India, during 2003-2013.

Methods:

Stool samples/rectal swabs were collected from acute watery diarrhoea (AWD) cases during 2003-2013 and processed by standard microbiological procedures. Antibiotic sensitivity test was done following the Clinical and Laboratory Standards Institute guidelines. Year-wise epidemiological trend of cholera was analyzed.

Results:

Cholera contributed to 3.93 per cent of AWD cases. In Assam, cholera was found to be more prevalent in the rural areas (6.7%) followed by the tea gardens (5.06%), urban slum (1.9%) and urban areas (1.4%). Highest proportion of cholera (13.7%) was observed in 0-10 yr age group. Of them, 11.5 per cent belonged to 0-5 yr age group. V. cholerae O1 El Tor serotype Ogawa was the predominant isolate. Multiple drug-resistant isolates of V. cholerae O1 Ogawa were reported in the study.

Interpretation & conclusions:

Emergence of resistance amongst V. cholerae towards many antibiotics is a matter of concern. Hence, continuous surveillance for diarrhoeal disorders is necessary to control the future outbreaks of cholera in this region.
Retrospective analysis of clinical information in Crimean-Congo haemorrhagic fever patients
Authors: Mourya Devendra T. , Viswanathan Rajlakshmi , Jadhav Santosh Kumar , Yadav Pragya D. , Basu Atanu , Chadha Mandeep S.
Published: December 2024

Background & objectives:

Differential diagnosis of Crimean-Congo haemorrhagic fever (CCHF) from other acute febrile illnesses with haemorrhagic manifestation is challenging in India. Nosocomial infection is a significant mode of transmission due to exposure of healthcare workers to blood and body fluids of infected patients. Being a risk group 4 virus, laboratory confirmation of infection is not widely available. In such a situation, early identification of potential CCHF patients would be useful in limiting the spread of the disease. The objective of this study was to retrospectively analyse clinical and laboratory findings of CCHF patients that might be useful in early detection of a CCHF case in limited resource settings.

Methods:

Retrospective analysis of clinical and laboratory data of patients suspected to have CCHF referred for diagnosis from Gujarat and Rajasthan States of India (2014-2015) was done. Samples were tested using CCHF-specific real time reverse transcription (RT)-PCR and IgM ELISA.

Results:

Among the 69 patients referred, 21 were laboratory confirmed CCHF cases of whom nine had a history of occupational exposure. No clustering of cases was noted. Platelet count cut-off for detection of positive cases by receiver operating characteristic curve was 21.5×10[9]/l with sensitivity 82.4 per cent and specificity 82.1 per cent. Melaena was a significant clinical presentation in confirmed positive CCHF patients.

Interpretation & conclusions:

The study findings suggest that in endemic areas thrombocytopenia and melaena may be early indicators of CCHF. Further studies are needed to confirm these findings.
Inhibition of coxsackievirus infection in cardiomyocytes by small dsRNA targeting its cognate coxsackievirus adenovirus receptor
Authors: Sharma Mirnalini , Mishra Baijayantimala , Saikia Uma Nahar , Bahl Ajay , Ratho R. K.
Published: December 2024

Background & objectives:

Coxsackievirus B (CVB), a member of human Enterovirus group, is the most common cause of viral myocarditis. Coxsackievirus adenovirus receptor (CAR) is identified as a key determinant for the entry of CVB in the target cells. Thus, blockade of receptor by RNA interference (RNAi) may inhibit the entry and pathogenesis of CVB in cardiac cells. The present study was aimed to determine the effect of CAR small dsRNA (siRNA) on coxsackieviral load and CAR expression in coxsackievirus-infected cardiomyocytes.

Methods:

Transfection efficiency in rat cardiomyocytes (H9c2) was determined by the fluorescent microscopy and flow cytometry. CAR siRNA dose was optimized based on cell viability and relative CAR messenger RNA (mRNA) expression. Cardiomyocytes were transfected with CAR siRNA followed by infection with 100 multiplicity of infection of CVB, which were harvested after 24, 48 and 72 h post-infection (p.i.). RNA was extracted for relative CAR mRNA expression. Cells were freeze-thawed thrice for estimating coxsackieviral load.

Results:

The efficiency of transfection was optimized to be >80 per cent and CAR siRNA dose of 60 pmol was standardized. The knockdown of CAR by siRNA decreased its expression twice the expression in normal cardiomyocytes after 24 h p.i. of CVB. The treatment with CAR siRNA resulted in significant two log reduction of CVB load in cardiomyocytes infected with CVB at 24 h p.i. and retained till 72 h p.i.

Interpretation & conclusions:

The inhibition of CAR by siRNA was found to be effective against CVB in cardiomyocytes. However, this treatment strategy has to be evaluated in vivo to develop a new treatment strategy for patients suffering with viral myocarditis.
Acute effects on cardiovascular oscillations during controlled slow yogic breathing
Authors: Bhagat Om Lata , Kharya Chhaya , Jaryal Ashok , Deepak Kishore Kumar
Published: December 2024

Background & objectives:

Breathing exercises are believed to modulate the cardiovascular oscillations in the body. To assess the validity of the assumption and understand the underlying mechanism, the key autonomic regulatory parameters such as heart rate variability (HRV), blood pressure variability (BPV) and baroreflex sensitivity (BRS) were recorded during controlled slow yogic breathing. Alternate nostril breathing (ANB) was selected as the yogic manoeuvre.

Methods:

Twelve healthy volunteers (age 30±3.8 yr) participated in the study. ANB was performed at a breathing frequency of 5 breaths per minute (bpm). In each participant, the electrocardiogram, respiratory movements, beat-to-beat BP and end-tidal carbon dioxide were recorded for five minutes each: before, during and after ANB. The records were analyzed for HRV, BPV and BRS.

Results:

During ANB, HRV analysis showed significant increase in the standard deviation of all NN intervals, low-frequency (LF) component, LF/HF (low frequency/high frequency) ratio and significant decrease in the HF component. BPV analysis showed a significant increase in total power in systolic BPV (SBPV), diastolic BPV (DBPV) and mean BPV. BRS analysis showed a significant increase in the total number of sequences in SBPV and DBPV and significant augmentation of α-LF and reduction in α-HF. The power spectrum showed a dominant peak in HRV at 0.08 Hz (LF component) similar to the respiratory frequency. The acute short-term change in circulatory control system declined immediately after the cessation of slow yogic breathing (ANB) and remained elevated in post-ANB stage as compared to the pre-ANB.

Interpretation & conclusions:

Significant increase in cardiovascular oscillations and baroreflex recruitments during-ANB suggested a dynamic interaction between respiratory and cardiovascular system. Enhanced phasic relationship with some delay indicated the complexity of the system. It indicated that respiratory and cardiovascular oscillations were coupled through multiple regulatory mechanisms, such as mechanical coupling, baroreflex and central cardiovascular control.
Improving accuracy of breast cancer biomarker testing in India
Authors: Shet Tanuja
Published: December 2024

There is a global mandate even in countries with low resources to improve the accuracy of testing biomarkers in breast cancer viz. oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2neu) given their critical impact in the management of patients. The steps taken include compulsory participation in an external quality assurance (EQA) programme, centralized testing, and regular performance audits for laboratories. This review addresses the status of ER/PR and HER2neu testing in India and possible reasons for the delay in development of guidelines and mandate for testing in the country. The chief cause of erroneous ER and PR testing in India continues to be easily correctable issues such as fixation and antigen retrieval, while for HER2neu testing, it is the use of low-cost non-validated antibodies and interpretative errors. These deficiencies can however, be rectified by (i) distributing the accountability and responsibility to surgeons and oncologist, (ii) certification of centres for testing in oncology, and (iii) initiation of a national EQA system (EQAS) programme that will help with economical solutions and identifying the centres of excellence and instill a system for reprimand of poorly performing laboratories.