Clinical profile and outcome of patients with meningoencephalitis in a tertiary care hospital

Background: Encephalitis is an important cause of morbidity, mortality, and permanent neurologic sequelae globally. Causes are diverse and include viral and non-viral infections. In the emergency setting differentiating the bacterial from other causes such as viral, fungal, tubercular, toxic or autoimmune causes is extremely difficult. Although plenty of literature is available on meningitis, the clinic-etiological profile and outcome with meningoencephalitis remains not that well studied, except for in paediatric population. Methods: The present prospective observational study included 75 patients who presented with acute encephalitis syndrome in tertiary care hospital, Bengaluru. All patients were subjected to complete clinical evaluation and appropriate investigations to study the etiology, clinical profile and outcome in them. Results: Among 75 patients, majority of them were <60 years constituting about 73.2%, mean age being 49.14 years with female preponderance. 30 (40%) patients had viral meningoencephalitis where aetiology was confirmed in 15 patients, remaining were presumed to be of viral aetiology. 12 (16%) had tubercular meningitis and 8 (10.6%) had bacterial meningitis followed by cryptococcal meningitis 7 (9.3%). In about 18 (24%) patients, aetiology was not identified and were treated based on syndromic approach. The most common presentation was fever and altered sensorium. Thrombocytopenia was common among viral and bacterial aetiologies and those in unspecified etiological group. Mortality was highest among cryptococcal meningitis (71.4%) followed by tubercular (66.7%) and bacterial meningitis (62.5%). Conclusions: A large number of number of cases where aetiology cannot be identified maybe benefited by a syndromic approach and better diagnostic modalities

Programme and policy perspectives towards a tobacco-free generation in India: findings from a qualitative study

Objective This study explored multistakeholder perspectives on existing adolescent-specific tobacco control policies and programmes, to advance India’s transition towards a tobacco-free generation.Design Qualitative semi-structured interviews.Setting Interviews were conducted with officials involved in tobacco control at the national (India), state (Karnataka), district (Udupi) and village level. Interviews were audio recorded, transcribed verbatim and analysed thematically.Participants Thirty-eight individuals representing national (n=9), state (n=9), district (n=14) and village (n=6) levels, participated.Results The study findings highlighted the need to strengthen and amend the existing Tobacco Control Law (2003) provisions, particularly in the vicinity of schools (Sections 6a and 6b). Increasing the minimum legal age to buy tobacco from 18 to 21 years, developing an ‘application’ for ‘compliance and monitoring indicators’ in Tobacco-Free Educational Institution guidelines were proposed. Policies to address smokeless tobacco use, stricter enforcement including regular monitoring of existing programmes, and robust evaluation of policies was underscored. Engaging adolescents to co-create interventions was advocated, along with integrating national tobacco control programmes into existing school and adolescent health programmes, using both an intersectoral and whole-societal approach to prevent tobacco use, were recommended. Finally, stakeholders mentioned that when drafting and implementing a comprehensive national tobacco control policy, there is a need to adopt a vision striving toward a tobacco-free generation.Conclusion Strengthening and developing tobacco control programmes and policies are warranted which are monitored and evaluated rigorously, and where adolescents should be involved, accordingly

Oyster farming by women self help groups At Wadatar, Sindhudurg district in Maharashtra State

Practical dissemination of bivalve farming technologies in the potential maritime locations of Sindhudurg district was undertaken by ICAR-CMFRI. Initially a demoyster farm was setup in Wadatar, in Sindhudurg District under the UNDP-GEF funded project “Demonstration of bivalve farming at Sindhudurg District in the State of Maharashtra”. The training and demonstration for oyster farming was given to the Self Help Groups-SHG, “Prasidhi” consisting of 10 members. Five hundred strings containing 7,000 numbers of oysters were harvested. Each string consists of 10-15 live oysters. Live oysters were sold at the rate of Rs. 150-200 per dozen. A total profi t of Rs.45,000 was realized. This successful case study can be used as a case manual for group action for bivalve farming technology

Manual on Edible Oyster and Green Mussel Farming कालवं आणि काकई संवर्धन तंत्र प्रशिक्षण पुस्तिका

Manual on Edible Oyster and Green Mussel Farming कालवं आणि काकई संवर्धन तंत्र प्रशिक्षण पुस्तिका (Marathi Version

Exposure to tobacco imagery in popular films and the risk of ever smoking among children in southern India

Background Exposure to smoking in films is a recognised cause of smoking uptake among children. In India, in an attempt to protect children, films containing smoking are required to include tobacco control messaging including audiovisual disclaimers, on-screen health warnings when tobacco imagery is displayed and antitobacco € health spots' before and during the film. We report a study of the association between ever smoking and exposure to tobacco imagery in locally popular films among children in Udupi district of Karnataka state in southern India. Methods A cross-sectional questionnaire survey of all students in grades 6-8 in schools in the Udupi district ascertained smoking status and potential confounders of smoking uptake, and whether children had seen any of 27 locally popular films we had coded and found to contain imagery of actual or implied tobacco use. Ever-smoking status was defined as any reported smoking of cigarettes, beedis or other tobacco products currently or at any time in the past. Independent effects on ever-smoking status were estimated using multiple logistic regression. Results Of 46 706 students enrolled in grades 6-8 in 914 participating schools, 39 282 (84.1%) provided questionnaire responses sufficiently complete for analysis. Ever smoking was reported by 914 (2.3%) participants and in a mutually adjusted model was significantly related to age, male sex, living in a home where smoking is allowed, having parents or siblings who smoke, low paternal education, low levels of family wealth, low self-esteem, rebelliousness and poor school performance. After allowing for these effects, the odds of ever smoking were not increased among students who had seen any of the listed films containing tobacco imagery when included in the analysis as a binary exposure (OR 0.9, 95% CI 0.4 to 2.0), and decreased in relation to level of exposure graded into tertiles of tobacco intervals seen. Conclusions In this cross-sectional study, children in southern India who had seen films containing tobacco imagery are no more likely to smoke than those who had not, indicating that the tobacco control messaging mandated by Indian law may be attenuating the effect of tobacco imagery in films on smoking uptake

Prospective cohort study of exposure to tobacco imagery in popular films and smoking uptake among children in southern India

Background Exposure to tobacco imagery in films causes young people to start smoking. Popular Indian films contain high levels of tobacco imagery, but those that do are required by law to display onscreen health warnings when smoking imagery occurs and to include other health promotion messaging before and during the film. We report a prospective cohort study of incident smoking in relation to exposure to film tobacco imagery and anti-tobacco messaging in a cohort of children in southern India. Methods We carried out a one-year longitudinal follow up questionnaire survey in 2018 of a cohort of 39,282 students in grades 6, 7 and 8 (aged between 10 and 15 years) in schools in the Udupi district of Karnataka State in India who participated in a 2017 cross-sectional study of exposure to smoking in films and ever smoking status. Results We obtained usable linked data in 2018 from 33,725 of the 39,282 (86%) participants with data from 2017. Incident smoking was reported by 382 (1.1%) participants. After adjusting for age, sex and common confounders significantly associated with incident smoking there was no significant independent effect of exposure to film smoking, either as a binary (Odds Ratio 1.6, 95% Confidence Interval (CI) 0.5 to 4.9) or as a graded variable, on smoking uptake. An exploratory analysis indicated that the presence of on-screen health warnings that complied fully with Indian law was associated with a significantly lower odds of smoking uptake (Odds Ratio 0.8 (0.6 to 1.0, p = 0.031) relative to the same exposure sustained in absence of compliant warnings. Conclusion Exposure to tobacco imagery in Indian films was not associated with a significantly increased risk of incident smoking in South Indian children. While it is possible that this finding is a false negative, it is also possible that the effect of film exposure has been attenuated by the presence of on-screen health warnings or other Indian tobacco-free film rules. Our findings therefore support the wider implementation of similar tobacco-free film measures in other countries

Potential risk factors of smokeless tobacco consumption among adolescents in South India

Introduction: Although most of the disease burden is due to tobacco smoking, smokeless tobacco (SLT) use contributed to an estimated 76,000 deaths in 2017. We have studied the potential risk factors for SLT use among adolescents in South India. Methods: A cross-sectional questionnaire survey of all students in grades 6 to 8 in schools in the Udupi district of Karnataka State ascertained SLT use status and potential determinants of SLT uptake. Ever SLT use was defined as any reported consumption of any SLT products, currently or at any time in the past. Independent effects on ever-SLT use status were estimated using multiple logistic regression. Results: Of 46,706 students from 914 participating schools, 39,282 (84.1%) provided questionnaire responses sufficiently complete for analysis. Ever SLT use was reported by 775 (2.0%) participants and in a mutually adjusted model was significantly related to age, male sex, family use or friend’s use of SLT, low socio-economic status, high rebelliousness and low self-esteem. After controlling for these effects, the odds of ever-SLT use were significantly higher among students who had least awareness of the harmful effects of tobacco use [OR 3.7 95% CI (2.9,4.7)] and significantly lower among those not exposed to tobacco advertising [OR 0.7 95% CI (0.5,0.8). Conclusions: The prevalence of SLT use among children in Karnataka is relatively low as compared to other studies in India. The significant potential risk factors of SLT use include low awareness of the harmful effects of tobacco and tobacco control policies and exposure to tobacco advertising

Massively parallel fitness profiling reveals multiple novel enzymes in Pseudomonas putida lysine metabolism

P. putida lysine metabolism can produce multiple commodity chemicals, conferring great biotechnological value. Despite much research, the connection of lysine catabolism to central metabolism in P. putida remained undefined. Here, we used random barcode transposon sequencing to fill the gaps of lysine metabolism in P. putida. We describe a route of 2-oxoadipate (2OA) catabolism, which utilizes DUF1338-containing protein P. putida 5260 (PP_5260) in bacteria. Despite its prevalence in many domains of life, DUF1338-containing proteins have had no known biochemical function. We demonstrate that PP_5260 is a metalloenzyme which catalyzes an unusual route of decarboxylation of 2OA to d-2-hydroxyglutarate (d-2HG). Our screen also identified a recently described novel glutarate metabolic pathway. We validate previous results and expand the understanding of glutarate hydroxylase CsiD by showing that can it use either 2OA or 2KG as a cosubstrate. Our work demonstrated that biological novelty can be rapidly identified using unbiased experimental genetics and that RB-TnSeq can be used to rapidly validate previous results.Despite intensive study for 50 years, the biochemical and genetic links between lysine metabolism and central metabolism in Pseudomonas putida remain unresolved. To establish these biochemical links, we leveraged random barcode transposon sequencing (RB-TnSeq), a genome-wide assay measuring the fitness of thousands of genes in parallel, to identify multiple novel enzymes in both l- and d-lysine metabolism. We first describe three pathway enzymes that catabolize l-2-aminoadipate (l-2AA) to 2-ketoglutarate (2KG), connecting d-lysine to the TCA cycle. One of these enzymes, P. putida 5260 (PP_5260), contains a DUF1338 domain, representing a family with no previously described biological function. Our work also identified the recently described coenzyme A (CoA)-independent route of l-lysine degradation that results in metabolization to succinate. We expanded on previous findings by demonstrating that glutarate hydroxylase CsiD is promiscuous in its 2-oxoacid selectivity. Proteomics of selected pathway enzymes revealed that expression of catabolic genes is highly sensitive to the presence of particular pathway metabolites, implying intensive local and global regulation. This work demonstrated the utility of RB-TnSeq for discovering novel metabolic pathways in even well-studied bacteria, as well as its utility a powerful tool for validating previous research