Scenario of mycobacterial and fungal infection in HIV seropositive patients and their co-relation with CD4 count in Western Uttar Pradesh

Background: HIV infection is defined by sero-conversion and the detection of HIV-specific antibodies. Emergence and pandemic spread of acquired immunodeficiency syndrome is due to the exposure to human immunodeficiency virus (HIV). A decrease in CD4 count is at least partially responsible for the profound immunodeficiency that leads to various OIs in HIV- infected persons. When the CD4 count falls below 200cells/µL, there is irreversible breakdown of immune defence mechanism and patient become prey to a variety of human opportunistic pathogens.HIV positive patients must receive infections screening and access medical care before onset of advanced immunosuppression.Methods: In this study, total 230 HIV positive patients were selected during 18 months of study period. CD4 counts were estimated of all HIV positive cases. Positive HIV patients were investigated further to detect mycobacterial and fungal opportunistic infections. They were subjected to routine microscopy such as KOH mount, India ink, Gram’s staining for suspected fungal infection and ZN staining method for suspected mycobacterial infection. For fungal infection, samples were inoculated in two Sabouraud Dextrose Agar followed by different biochemical test and LPCB mount; for mycobacterial infection, samples were cultured on LJ medium followed by biochemical test.Results: In our study, maximum patients presented with complain of fever (90.43%), weight loss (73.91%) followed by loss of appetite (35.65%), breathlessness (33.91%), coughing (28.69%) and chest pain (22.17%). Overall prevalence of OIs (Mycobacterium and fungal) was 93 (40.43%) among 230 HIV positive patients. Among OIs 63(27.39%) patients were detected as having Mycobacterial infection and 41(17.82%) as had opportunistic fungal infections. Maximum OIs were related to patients with CD4 count 0-200 cells/µL followed by 201-400 Cells/µL. Most common OIs, among mycobacterial and opportunistic fungal infection were M. tuberculosis (50 isolates) and Candida spp. (26 isolates) respectively.Conclusions: This study provides important information about the risks of OIs at lower CD4 counts among HIV positive patients. These results highlight the need for early screening of HIV infected patients for opportunistic infections. There is also need to increase awareness in healthcare providers in order to improve decisions regarding prophylaxis for prevention of OIs and appropriate therapeutic intervention

Evaluation of NS1, IgM ELISA and RT-PCR in diagnosis of dengue fever

Background: Dengue fever is a mosquito borne disease caused by flavivirus. Its cases are increasing in India with increasing mortality rate year by year hence, prompt and accurate diagnosis is necessary to prevent morbidity and mortality.Methods: In this study we enrolled 125 clinically suspected cases of dengue. All the collected samples were processed for RT-PCR, NS1 and IgM ELISA. We evaluated NS1 antigen ELISA alone, and combination of NS1 and IgM ELISA against RT-PCR.Results: Among 125 clinically suspected case 67 were positive by RT-PCR and 58 were negative. Sensitivity and Specificity of NS1 ELISA and NS1 with IgM ELISA (in combination) against RT-PCR were 83.58%, 94.82% and 95.55%, 79.31% respectively. (p<0.001).Conclusions: The NS1 ELISA alone was sufficient to detect acute phase of dengue fever, although, combination of NS1 and IgM proved to be most appropriate method for detection of acute as well as late phase of dengue fever

Formulation Development and Evaluation of Floating Microsphere of Famotidine for the Treatment of Peptic Ulcer

The purpose of this research was to prepare a floating drug delivery system of famotidine. The floating microspheres can be prepared for the improvement of absorption and bioavailability of famotidine by retaining the system in the stomach for prolonged period of time. Floating microspheres of famotidine were prepared using different polymers like ethyl cellulose, hydroxy propyl methyl cellulose by solvent diffusion-evaporation method. The microspheres had smooth surfaces with free-flowing and good-packing properties. The yield of the microspheres was up to 73.32±0.14% and ethyl cellulose microspheres entrapped the maximum amount of the drug. Scanning electron microscopy confirmed their hollow structures with sizes in 331.6 nm. The prepared microspheres exhibited prolonged drug release and Percentage buoyancy was found to 73.25±0.23. The formulated batches were evaluated for percentage yield, particle size measurement, flow properties, percent entrapment efficiency, swelling studies. The formulations were subjected to stability studies and In-vitro release and release kinetics data was subjected to different dissolution models. It was concluded that developed floating microspheres of famotidine offers a suitable and practical approach for prolonged release of drug over an extended period of time and thus oral bioavailability, efficacy and patient compliance is improved. Keywords: Famotidine, Solvent diffusion evaporation method, Ethyl cellulose, Hydroxyl propyl methyl cellulos

Tuberous sclerosis with visceral leishmaniasis: a case report

<p>Abstract</p> <p>Introduction</p> <p>Visceral leishmaniasis, a tropical infectious disease, is a major public health problem in India. Tuberous sclerosis, a congenital neuro-ectodermosis, is an uncommon disease which requires life long treatment.</p> <p>Case presentation</p> <p>A 15-year-old Indian patient, presented to the outpatient department of our institute with a high-grade fever for two months, splenomegaly and a history of generalized tonic-clonic convulsions since childhood. The clinical and laboratory findings suggested visceral leishmaniasis with tuberous sclerosis. The patient was treated with miltefosine and antiepileptics.</p> <p>Conclusion</p> <p>The patient responded well and in a follow up six months after presentation, she was found free of visceral leishmaniasis and seizures. Diagnosis and treatment of this rare combination of diseases is difficult.</p

Assessing the feasibility of integrating ecosystem-based with engineered water resource governance and management for water security in semi-arid landscapes: A case study in the Banas catchment, Rajasthan, India

Much of the developing world and areas of the developed world suffer water vulnerability. Engineering solutions enable technically efficient extraction and diversion of water towards areas of demand but, without rebalancing resource regeneration, can generate multiple adverse ecological and human consequences. The Banas River, Rajasthan (India), has been extensively developed for water diversion, particularly from the Bisalpur Dam from which water is appropriated by powerful urban constituencies dispossessing local people. Coincidentally, abandonment of traditional management, including groundwater recharge practices, is leading to increasingly receding and contaminated groundwater. This creates linked vulnerabilities for rural communities, irrigation schemes, urban users, dependent ecosystems and the multiple ecosystem services that they provide, compounded by climate change and population growth. This paper addresses vulnerabilities created by fragmented policy measures between rural development, urban and irrigation water supply and downstream consequences for people and wildlife. Perpetuating narrowly technocentric approaches to resource exploitation is likely only to compound emerging problems. Alternatively, restoration or innovation of groundwater recharge practices, particularly in the upper catchment, can represent a proven, ecosystem-based approach to resource regeneration with linked beneficial socio-ecological benefits. Hybridising an ecosystem-based approach with engineered methods can simultaneously increase the security of rural livelihoods, piped urban and irrigation supplies, and the vitality of river ecosystems and their services to beneficiaries. A renewed policy focus on local-scale water recharge practices balancing water extraction technologies is consistent with emerging Rajasthani policies, particularly Jal Swavlamban Abhiyan (‘water self-reliance mission’). Policy reform emphasising recharge can contribute to water security and yield socio-economic outcomes through a systemic understanding of how the water system functions, and by connecting goals and budgets across multiple, currently fragmented policy areas. The underpinning principles of this necessary paradigm shift are proven and have wider geographic relevance, though context-specific research is required to underpin robust policy and practical implementation

Repurposing of Polio Vaccine in Prevention of COVID-19: Thinking towards more options

COVID-19 has created an unprecedented crisis worldwide in every sector. There currently is no approved drug available against this disease. The development of a vaccine is also a complex and long process that is often completed in 10-15 years. Recently, several vaccines for COVID-19 have received emergency approval for use but few experts deem that currently approved COVID-19 vaccines might provide a temporary boost to the immune system but they are dubious for their long-term effect and safety. This article sheds light on polio vaccine as a possibility on COVID-19 prophylaxis because this vaccine was developed through a rigorous process of the various phases of development. The polio vaccine could provide another option to combat COVID-19 and if we have more options, we can fight more effectively against the pandemic. The polio vaccine is utilized globally with a highly satisfactory retort and very good immune responses. By seeing a satisfactory cross-protective immune response, the polio vaccination could be repurposed and offered against COVID-19 for an effective immuno-prophylaxis and protection. This article focusses on the repurposing of vaccines/drugs for COVID-19 and discusses the scientific rationale behind the suggestive use of the polio vaccine against COVID-19 because the polio vaccine is FDA-approved less expensive, readily available, easy to administer, and highly safe

TITRIMETRIC ASSAY OF SOME ANTIHISTAMINE DRUGS WITH PYRIDINIUM FLUORO CHROMATE (PFC) REAGENT

In the present paper, simple, convenient accurate, precise and cost effective &nbsp;titrimetric (Visual volumetric) method has been reported for the estimation of some antihistamine drugs e.g. Cyproheptadine hydrochloride (CPH), Fexofenadine hydrochloride (FFH), Promethazine hydrochloride (PMH) and Pheniramine maleate (PM) in pure form and in their pharmaceutical preparations such as Ciplactin (Tab), Allegra (Tab), Phenergan (Tab and Inj) and Avil (Tab and Inj) with Pyridinium fluoro chromate (PFC) reagent. The principle of this method is based on the fact, that each pharmaceutical drug consists of certain organic functional group which on oxidation&nbsp; by a known excess of potassium iodate in sulphuric acid medium followed by iodometric titration in presence of reagent Pyridinium fluoro chromate (PFC) establishes stoichiometric relationship between drug molecule and an oxidising reagent Pyridinium fluoro chromate (PFC).Different results obtained for each drug during experiment, has been validated by different statistical parameters such as percentage error, standard deviation (SD) and coefficient of variation (CV).Results obtained from these statistical parameters proves the accuracy and precision of adopted method

Status of protection against Hepatitis B infection among healthcare workers (HCW) in a tertiary healthcare center in India: results can’t be ignored!

Background and Aims: the Aim of the study was to find the level of protection among the healthcare workers (nurses, doctors, housekeeping staff and general duty assistants) by doing Anti-HBsAb titer and vaccinate those who were not properly immunized against HBV infection. Materials and Methods: The study was approved by the Institutional review board of the Hospital. The study group included doctors, nurses, technical staff and lab attendants. Anti-HBs antibody titer was done on Vitros 3600 (OCD, USA). Tests were performed according to manufacturer&rsquo;s instruction. Vaccine provided was Engerix B (GSK Glaxo, Belgium). Vaccination was provided to all employees had titer below 10 miu/ml. Results: 489 of 794(61.5%) HCW had no history of previous vaccination and only 293 (36.9%) subjects had complete vaccination. Only 60.8 % (482/794) of the total subjects had titer above 10 miu/ml and were protected against Hepatitis B. Around 80.6% (246/305) of those who were fully vaccinated and 40.8% (237/489) of those who were not vaccinated previously had protective anti-HBs titers(&gt;10 miu/ml). Majority (86.8%, 271/312) who had titer below 10 miu/ml were unvaccinated. Two of eight employees who had history of needle stick injury in past were found non-immune to Hepatitis-B infection. Conclusion: Despite being involved in the procedures with high chances of infections through needle stick or other exposures, only one third of health care workers were vaccinated against hepatitis B. We recommend that all the HCWs should be vaccinated for Hepatitis B and their anti-HBs levels determined at regular intervals

Evaluation of modified Dubois model for estimating surface soil moisture using dual polarization RISAT-1 C-band SAR data

The present study focuses on the soil moisture estimation using dual polarimetric RISAT-1, C-band SAR data in HH and HV polarization. The semi empirical approach derived by Dubois and the same modified and proposed as modified Dubois model (MDM) is worked for winter wheat crop from initial vegetative to maturity stage. Surface roughness model derived roughness is replaced with ‘s’ parameter for retrieval of dielectric constant which is further used in Topp’s model to derive soil moisture. Model derived soil moisture and ground measured soil moisture demonstrates pragmatic correlation after performing linear regression. The behaviour of inversion model varies at different crop stages depending on the soil exposure and crop cover. Normalized difference vegetation index from moderate resolution imaging spectroradiometer has also been evaluated to monitor crop status. Performance of MDM is promising for early and maturity stages of crop for soil moisture estimation

Surface soil moisture estimation in bare agricultural soil using modified Dubois model for Sentinel-1 C-band SAR data

Surface soil moisture has vital role in water energy balance, climate change and agriculture mainly for crop water requirements and irrigation scheduling. Microwave remote sensing with its unique characteristics of high penetration and sensitivity towards dielectric constant, has enabled the researchers to explore various techniques for soil moisture estimation. With the launch of Sentinel-1 (A&B) Synthetic Aperture Radar (SAR) satellites, the hindrance in accessing high spatial and temporal resolution data is eliminated. The current study focuses on surface soil moisture estimation for bare agricultural fields in the semi-arid region. Field soil moisture up to 5 cm depth using HydraGo Probe sensor and surface roughness synchronizing with satellite pass dates were collected from total 102 locations spanning four dates. Volumetric and sensor-based soil moisture are well correlated with R2 = 0.85. The Modified Dubois Model (MDM) was applied to obtain the relative permittivity of the soil for the backscattering coefficient (σ◦) for VV polarization, which is used as one of the inputs in universal Topp’s model for soil moisture calculation. Model derived soil moisture is well correlated with ground-based soil moisture for the entire range of the soil moisture (0.02-0.18 m3m-3) with R2 = 0.85 and RMSE=0.005. The entire soil moisture was categorized in three soil moisture ranges to evaluate the sensitivity. The highest correlation was observed for 0.06-0.1 m3m-3 with R2 = 0.73 and RMSE=0.003 followed by 0.015-0.6 m3m-3 with R2 = 0.81 and RMSE=0.001 and 0.11-0.18 m3m-3 with R2 = 0.48 and RMSE=0.019 which is significantly low. Performance accuracy of MDM is encouraging for bare soil moisture estimation for even the lower range of surface soil moisture