MOST OF THE HELICOBACTER PYLORI ISOLATES ARE RESISTANT TO LEVOFLOXACIN IN NORTH INDIA

Objective: Helicobacter pylori related gastro-duodenal diseases can be cured by proper treatment therapy. In India, the commercially available classic treatment therapy (proton pump inhibitor, amoxicillin, and clarithromycin) for bacterial eradication is available. However, antibiotic resistance to the commonly used triple regimen is increasing very rapidly. Considering that treatment including levofloxacin may be an alternative to the classic regimen. Therefore, we aimed to verify H. pylori isolates susceptibility to levofloxacin in India.Methods: H. pylori were cultured from 56 patients suffering from different gastro-duodenal diseases. Minimum Inhibitory concentration to levofloxacin was determined by agar dilution method.Results: The clinical diagnosis of 56 patients who were H. pylori culture positive were Gastro Esophageal Reflux Disease (GERD) (n=23), Non-erosive reflux Disease (NERD) (n=22), Non Ulcer Dyspepsia (NUD) (n=3), Antral Gastritis (n=2), Duodenal ulcer (n=1) and others (n=5). Of the 56 H. pylori isolates, the prevalence of levofloxacin resistance was found in 41 H. pylori isolates (73.2%). Conclusion: We found that three-fourth of the isolated H. pylori strains of North India showed resistance to levofloxacin which is used for H. pylori treatment in other countries. Therefore, the conventional triple therapy comprising amoxicillin and clarithromycin is more appropriate for anti H. pylori management in India.Â

Antenatal parameters to predict mortality and major morbidity in very low birth weight preterm neonates

Objectives: The objective of this study was to determine effect of maternal factors and abnormal antenatal color Doppler of umbilical artery on mortality and major morbidity in very low birth weight (VLBW) neonates. Materials and Methods: This prospective study was conducted in the Department of Pediatrics, of a teaching institution of central India. All consecutive intramural live-born preterm neonates, delivered with BW of 1000–<1500 g, were included in the study. All preterm neonates received standardized neonatal care as per the unit protocol. A total of 400 intramural live-born VLBW, preterm neonates (diagnosed as per WHO criteria) were included in the study; out of which, 103 had absent or reversed end-diastolic blood flow and 117 had forward enddiastolic blood flow and in the remaining 180 babies, color Doppler could not be done. All the VLBW neonates were followed up till the time of discharge or death. The mortality and major morbidity (one or more of the following: intraventricular hemorrhage (IVH) and necrotizing enterocolitis (NEC) during hospital stay were assessed in all the babies. Results: A total of 400 preterm neonates were enrolled in study, out of which, 109 died (27.25%). The causes of neonatal mortality included septicemia (44.9%), birth asphyxia (18.34%), hyaline membrane disease (30.6%), pulmonary hemorrhage (11.34%), prematurity (10.09%), aspirationpneumonia (8.25%), IVH (1.83%), and NEC (1.83%). Abnormal antenatal Doppler 15.1 (8.7–25.5) (p=0.0001) was an important factor for the major morbidities. Among maternal risk factors, premature rupture of membrane (p=0.015), meconium-stained liquor (p=0.01), fetal distress (p=0.001), and the absence of antenatal steroid (p=0.0001) significantly predict the mortality. Conclusion: Among maternal factors, premature rupture of membrane, meconium-stained liquor, and abnormal antenatal color Doppler are the important predictors of early mortality and major morbidities such as respiratory distress syndrome, IVH, NEC in VLBW neonate

THERAPEUTIC POTENTIAL OF LICHEN PARMELIA PERLATA AGAINST DUAL DRUG-RESISTANT HELICOBACTER PYLORI ISOLATES

Objective: H. pylori have acquired resistance to the commonly used antibiotics due to their use in many anaerobic and parasitic infections leading to treatment failure of various gastroduodenal diseases associated with H. pylori infection. Our aim was to test the efficacy of Parmelia perlata which is traditionally used for the treatment of dysentery, diarrhea, and dyspepsia against antibiotic resistant gastric pathogen H. pylori.Methods: The antimicrobial activity of an ethanolic and methanolic extract of P. perlata against drug-resistant H. pylori isolates from North India in vitro was carried out by determining the Minimum inhibition concentration (MIC) using disk diffusion method and microdilution method.Results: Two H. pylori isolates were included in this study. One was resistant to both metronidazole (MIC of 64 µg/ml) and clarithromycin (MIC of 4 µg/ml) and another one was resistant to metronidazole only having a MIC of 64 µg/ml. Methanolic and ethanolic extract of P. perlata showed its effectiveness in inhibiting drug resistant H. pylori isolates with maximum inhibition at 500 × 103 µg/ml concentration of P. perlata.Conclusion: Prevalence of metronidazole resistant ranges between 50–90% in developing countries including India with the emergence of dual-drug resistance was reported in many studies. This study suggests that P. perlata used commonly as a spice in food has a potential for the treatment of drug-resistant H. pylori infection in a safe and effective manner.Â

New Dimensions in Catalysis Research with Hard X‐Ray Tomography

The structure and function of solid catalysts are inseparably linked at length scales from nm to cm and beyond. Hard X-ray tomography offers unique potential for spatially-resolved characterization by combining flexible spatial resolution with a range of chemical contrasts. However, the full capabilities of hard X-ray tomography have not been widely explored in the catalysis community. This review highlights modern advances in hard X-ray tomography using synchrotron radiation. Case studies from model to technical scale illustrate the bright future of X-ray tomography in catalysis research

Contesting restrictive mobility norms among female mentors implementing a sport based programme for young girls in a Mumbai slum.

BACKGROUND: Harmful gender norms are known structural barriers to many public health and development interventions involving adolescent girls. In India, restrictions on girls' liberty to move freely in public spaces contribute to school dropout and early marriage, and negatively affect girls' health and wellbeing, from adolescence into adulthood. We report on mechanisms of change among female mentors 18 to 24 years old who contested discriminatory norms while implementing a sports-based programme for adolescent girls in a Mumbai slum. METHODS: We adopted a prospective qualitative research design. Our analysis is based on case studies derived from two rounds of face to face, in -depth interviews with 10 young women recruited to serve as mentors for the project's young female athletes. We combined both thematic and narrative analysis. RESULTS: The programme created opportunities for collective action, increasing mentors' ability to think and relate in a collectivized manner, and challenged the traditional female identity constructed for young women, which centres on domestic duties. The mentors themselves negotiated freedoms both in and outside their homes, which required careful and strategic bargaining. They changed the nature of key day-to-day social interactions with parents and brothers, as well as with neighbours, parents of their groups of athletes and men on the streets. They formed a new reference group for each other in terms of what was possible and acceptable. Demonstrating greater negotiation skills within the family helped win parents' trust in the mentor's ability to be safe in public spaces. Parents became active supporters by not giving into social sanctions of neighbours and relatives thus co-producing a new identity for their daughters as respectable young women doing 'good work'. They effectively side stepped reputational risk with their presence in public spaces becoming de-sexualised. CONCLUSIONS: Mentors contested mobility restrictions by taking risks as a group first, with collective agency an important step towards greater individual agency. This research provides important insights into addressing embedded social norms that perpetuate gender discriminatory practices and the social patterning of health inequalities

ANTIBIOGRAM PROFILING OF HELICOBACTER PYLORI STRAINS AND THE EFFICACY OF BRASSICA CAPITATA AGAINST RESISTANT STRAINS ISOLATED FROM THE PATIENTS SUFFERING FROM GASTRODUODENAL DISEASES IN GUWAHATI, ASSAM

  Objective: Helicobacter pylori resistance toward commonly used antibiotics is increasing leading to the treatment failure; hence, our aim is to determine the antibiogram susceptibility pattern of H. pylori strains isolated from Guwahati, Assam (Northeast India) and also to test the efficacy of the Brassica capitata against the multi and dual drug-resistant strains of North and Northeast India.Methods: Minimum inhibitory concentration of different antibiotics was determined by agar dilution method. Disc diffusion method was used to check the efficacy of B. capitata against clarithromycin (CLR), metronidazole (MTZ), and levofloxacin (LEV)-resistant H. pylori strains.Results: All the H. pylori strains were 100% sensitive to CLR, tetracycline, amoxicillin, and furazolidone. 72.8% of the strains were sensitive toward MTZ and 54.5% were sensitive toward LEV. B. capitata showed good efficacy against the resistant strains of H. pylori of North and Northeast India.Conclusion: Most of the H. pylori strains from Northeast India were sensitive toward the commonly used antibiotics for the treatment regime. B. capitata is effective against H. pylori infection, suggesting its potential as an alternative therapy, and opens the way for further studies on identification of novel antimicrobial targets of B. capitata

MORINDA COREIA HAS AN ANTI-HELICOBACTER PYLORI EFFECT AGAINST THE MULTIDRUG-RESISTANT CLINICAL ISOLATE OF NORTH-EAST INDIA

Objective: Antimicrobial resistance is a growing problem in Helicobacter pylori eradication which is a microaerophilic bacterium causing various gastroduodenal diseases. The present study has been designed to test the efficacy of Morinda coreia against the metronidazole clarithromycin and levofloxacin-resistant H. pylori strains isolated from the biopsy taken from the patient suffering from gastric erosion in Guwahati, Assam.Method: The antimicrobial activity of n-hexane and chloroform extract of M. coreia was tested against multidrug-resistant H. pylori isolate of Guwahati, Assam, by agar well method and microdilution method.Result: In the present study, the H. pylori strain resistant for metronidazole (minimal inhibitory concentration [MIC] >64 μg/mL), clarithromycin at (MIC >0.5 μg/mL), and levofloxacin at (MIC >1 μg/mL) was tested against the n-hexane and chloroform extract of M. coreia. Both the extracts of M. coreia showed good efficacy against the multidrug-resistant strain of H. pylori shown inhibition at 1.2 μg/mL with n-hexane extract and 2 μg/mL with chloroform extract of M. coreia. Conclusion: The prevalence of metronidazole-resistant ranges between 50% and 90% in the developing countries, including India, clarithromycin ranges from 0% to 15% in India, and levofloxacin ranges between 50% and 70% in India, so there is a need of alternative therapy for the eradication of this bacterium from the stomach. Hence, this study suggests that M. coreia, which has been used traditionally as a folk medicine for the treatment of many gastric diseases, has also shown good efficacy against the multidrug-resistant H. pylori strain of North-east India

Socio-demographic and Clinico-pathological Profile of Cervical Cancer Patients at a Tertiary Care Centre in New Delhi: A Five-Year Retrospective analysis

Background: Cervical cancer remains a major public health challenge in low and middle-income countries including India. However, if detected early, it is preventable and curable. Objective: The present study aimed to ascertain the sociodemographic and clinical profile of cervical cancer patients visiting a tertiary cancer center. Methodology: A retrospective study was carried out at the Delhi State Cancer Institute, New Delhi. The study population included 136 women who were diagnosed with cervical cancer. A pretested data extraction sheet was used as the study tool for collecting information from the inpatient records. Descriptive analysis and chi-square test were performed and the level of significance was set at p<0.05. Results: A total of 136 cervical cancer patients with mean age of 46 ± 9.85 and mean BMI of 23.78 ± 5.03, were studied retrospectively. About 36.8% of patients were aged between 40-49 years and 57.4% were illiterate. While 40.4% of the patients belonged to FIGO stage II, 27.2% had FIGO stage III cancer. Majority (63.2%) of patients were diagnosed with squamous cell carcinoma (SCC), while the rest were adenocarcinoma (25%) and adenosquamous (11.8%). Clinical stage of cancer was found to be significantly associated with educational status (p=0.03) and dietary practices (p=.007). Conclusion: Our study found higher percentage of women with stage II and III cervical lesions and reaffirms the importance of education and healthy diet in early detection and prevention of cervical cancer. Therefore, it is suggested that accelerated population awareness and screening, incorporating digital innovations including vaccination programs are mandatory

Practice-based insights in developing and implementing a sport-based programme for girls

Parivartan Plus is a structured sports mentoring programme for girls, implemented in a Mumbai slum where social expectations around gender-appropriate behaviour and good parenting restricts girls’ mobility and visibility in public spaces. This article presents practice-based learning from developing and implementing programme theory to empower girls in achieving changes in their everyday social interactions at home and beyond. Gender and social norms theory were combined with local practical wisdom to turn main implementation challenges into opportunities. The article reflects on the strategies that gave visibility to, and achieved community endorsement for, the erosion of restrictive gender norms while ensuring community safety

Elimination of visceral leishmaniasis in the Indian subcontinent: a comparison of predictions from three transmission models.

We present three transmission models of visceral leishmaniasis (VL) in the Indian subcontinent (ISC) with structural differences regarding the disease stage that provides the main contribution to transmission, including models with a prominent role of asymptomatic infection, and fit them to recent case data from 8 endemic districts in Bihar, India. Following a geographical cross-validation of the models, we compare their predictions for achieving the WHO VL elimination targets with ongoing treatment and vector control strategies. All the transmission models suggest that the WHO elimination target (<1 new VL case per 10,000 capita per year at sub-district level) is likely to be met in Bihar, India, before or close to 2020 in sub-districts with a pre-control incidence of 10 VL cases per 10,000 people per year or less, when current intervention levels (60% coverage of indoor residual spraying (IRS) of insecticide and a delay of 40days from onset of symptoms to treatment (OT)) are maintained, given the accuracy and generalizability of the existing data regarding incidence and IRS coverage. In settings with a pre-control endemicity level of 5/10,000, increasing the effective IRS coverage from 60 to 80% is predicted to lead to elimination of VL 1-3 years earlier (depending on the particular model), and decreasing OT from 40 to 20days to bring elimination forward by approximately 1year. However, in all instances the models suggest that L. donovani transmission will continue after 2020 and thus that surveillance and control measures need to remain in place until the longer-term aim of breaking transmission is achieved