Agents In India Research Articles

Clinical characteristics, outcomes and prognostic factors in KRAS mutant lung cancers: experience from a tertiary care cancer center in India.

Kirsten rat sarcoma viral oncogene homologue (KRAS) mutations in lung cancers, long considered untargetable, have had a recent rise in interest due to promising data of agents targeting KRAS p.G12C. As Indian data are scarce, we sought to identify baseline clinical characteristics, prognostic factors and outcomes of lung cancer patients with KRAS mutations at our hospital. Patients with KRAS mutant lung cancers treated at our institute from 2016 to 2022 were analysed. 133 patients with KRAS mutant lung cancers were identified. Median age was 57 (interquartile range 28-78) years, and 58 (43.6%) were smokers. 17 (12.7%) had brain metastases. The commonest variant was p.G12C, seen in 53 (39.8%) patients. Six (4.5%) had programmed death ligand 1 (PDL-1) expression >50% by Ventana SP263 PDL-1 assay, and 13 (9.7%) had epidermal growth factor mutation. Of 92 patients with available treatment details, the majority received intravenous chemotherapy, nine (9.8%) received tyrosine kinase inhibitors and four (4.4%) received immunotherapy (pembrolizumab). Median progression-free survival (PFS) with first-line therapy was 6 (95% confidence interval (CI) 2.8-9.2) months and median overall survival (OS) was 12 (CI 9.2-14.8) months. The incidence of brain metastases was higher in patients with G12C mutations (p = 0.025). Brain metastases (HR: 3.57, p < 0.001), Eastern Cooperative Oncology Group performance status (PS) ≥ 2 (HR: 2.13, p = 0.002) and G12C mutation (HR: 1.84, p = 0.011) were associated with inferior PFS, while brain metastases (HR: 4.6, p < 0.001), PS ≥ 2 (HR: 2.33, p = 0.001) and G12C mutation (HR: 1.93, p = 0.01) were associated with inferior OS. This is the largest dataset of KRAS mutant lung cancers from India. Brain metastases were higher in patients with G12C mutations and associated with poorer PFS and OS. G12C mutation and PS ≥ 2 were also associated with inferior PFS and OS. Experience with targeted therapy for KRAS mutations remains an area of future exploration due to the unavailability of these agents in India.

Profile of poisoning cases in a tertiary care centre in rural South India

BACKGROUND: Poisoning is the fourth most common cause of mortality in rural India. The commonest agents in India appear to be pesticides, sedatives, chemicals, alcohol, animal plant toxins and household toxins. Our hospital receives an average of 20 to 25 poisoning cases every month.&#x0D; AIMS: To profile all cases of poisoning those are reported to casualty department at Dr. Chandramma Dayananda Sagar Institute of Medical Education and Research (CDSIMER); to study the types and frequency of poisoning cases admitted to the centre; to study the socio demographic associations of the poisoning cases.&#x0D; MATERIALS AND METHODS: Present study is a hospital record-based retrospective observational study of acute poisoning cases registered in the medicolegal register in the casualty of CDSIMER, which is a tertiary care centre situated in rural area near Harohalli, Ramanagara District, India.&#x0D; RESULTS: Males constituted 58% of the cases and 33.52% of the cases were in the age group of 21–30 years. 81.4% of the cases were able to reach hospital between 1 to 8 hours. 56% of the cases recovered and were discharged within 3 days. In 22 cases the duration of admission was more than 2 weeks as they went into complications. Organo phosphorus group of insecticide was the most common type of poison consumed constituting to 40.8% of the cases followed by Snake bite. Attempt to suicide (60.35%) was more common than accidental poisoning.&#x0D; CONCLUSION: Insecticides mainly Organophosphorus compound are the most common group of poisons which causes morbidity and mortality in rural Indian population especially in young adults between 21 to 40 years. Owing to the presence of forests in the region, Snake bite becomes the second largest type of poisoning. Suicide frequently prevails in the rural areas; financial problem is the leading cause for farmers to commit suicide.

Efficacy of super bioavailable itraconazole in the management of dermatophytosis in India

Itraconazole (ITZ) is a commonly prescribed oral antifungal agent in India and has a low minimum inhibitory concentration when compared to other oral antifungals. However, clinicians have reported inconsistent clinical responses despite its high skin levels, which may be due to variations in pelletization parameters, which affect its bioavailability and serum levels. Conventional ITZ has a maximum bioavailability of 55%; however, this is unpredictable and inconsistent. In contrast, the novel ITZ formulation, super bioavailable ITZ (ITZ-SB), has targeted drug release in the small intestine, resulting in predictable serum levels with minimal interindividual variability. This makes it a potentially useful drug in treating recalcitrant dermatophytosis. This expert opinion highlights the benefits of novel ITZ-SB with the incorporation of SUBA® technology. The SUBA® technology improves the bioavailability of poorly soluble drugs by ‘solid dispersion’ in polymer to increase drug absorbency. This technology also has potential to reduce variability in absorption and adverse effects. Benefits of this technology include more predictable clinical response and lower drug quantities necessary to achieve therapeutic blood levels, making it a promising treatment option for recalcitrant dermatophytosis. Fixtral SB, which uses this technology, is a novel weapon in the arsenal of treatments for superficial mycoses.

Digital marketing adoption by small travel agencies: a comprehensive PLS-SEM model using reflective and higher-order formative constructs

PurposeThis study examines the vital factors that influence digital marketing adoption among small travel agencies (brick-and-mortar) and the impact of digital marketing adoption on organizational performance modeled as a formative-formative HOC.Design/methodology/approachThis empirical study builds on diffusion of innovation (DOI) theory and technology-organization-environment (TOE) framework to identify the factors of digital marketing adoption by small travel agencies. Data were collected from 226 small travel agents in India using purposive and snowball sampling. Partial least square-structural equation modelling (PLS-SEM) is used to analyze the reflectively and formatively measured constructs.FindingsThe findings reveal significant constructs of digital marketing adoption by small travel agencies. The study also establishes the positive impact of digital marketing adoption on organizational performance. Trust partially mediates the impact of technological factors (relative advantage, security concerns) and organizational factor (knowledge) on digital marketing adoption.Research limitations/implicationsThe study provides methodological contribution to the literature by applying confirmatory composite analysis (CCA) approach in PLS-SEM. The study contributes to the literature by integrating DOI theory and TOE framework. The study enriches the literature on trust as it recognizes the crucial role of trust as a mediating construct.Practical implicationsThe study provides useful implications to marketing practitioners of small travel agencies. The study shows strong predictive capacity and can be generalized throughout diverse samples.Originality/valueThe study adds value to the literature as it explores the digital marketing adoption among the under researched small travel agencies by integrating DOI-TOE theory. The study uniquely proposes and validates organizational performance as a formative-formative higher-order construct.

Identification of terms and conditions of clearing and forwarding agents in India.

Identification of terms and conditions of clearing and forwarding agents in India.

Cavitating Consolidation with Acute Febrile Respiratory Illness &amp; ‘Sister Cavities’ Without Typical Constitutional Symptoms in Pulmonary Tuberculosis: A Rare But Possible!

Community acquired pneumonia is the most common cause for lung parenchymal infiltrates in chest radiograph in scenarios with acute febrile respiratory illness. Tuberculosis in India accounts for the highest number of cases and deaths in the world. In spite of an efficient National tuberculosis control program for five decades, Tuberculosis is still the number one cause of death due to infectious agents in India and one third of total global deaths occurs in India due to this disease. Tuberculosis may present with consolidation, cavitation, coin lesion, parenchymal infiltrates and hilar mass like lesions. Acute febrile respiratory illness without typical constitutional symptoms is not frequently described in pulmonary tuberculosis. In this case report, a 69-year male, presented with acute febrile respiratory illness of short duration. He was having high grade fever, cough, shortness of breath &amp; haemoptysis of less than two weeks duration. His symptoms were progressive and empirically treated as lower respiratory tract infection or community acquired pneumonia with oral and intravenous antibiotics by general physicians and family physicians. Family physician referred to our center for worsened general health with increased shortness of breath with episodes of minimal haemoptysis. Chest x-ray documented right lower lobe consolidation which has progressed to central cavitations and thick pericavitary rim of consolidation mimicking lung abscess. Clinically he was having crepitations in the right inframammary and infrascapular area with egophony heard. HRCT thorax showed consolidation with cavitation in the superior segment of the right lower lobe and adjacent small cavity in the posterior segment presenting as a ‘Sister cavity’ accompanying a large parent cavity. He was unable to produce sputum and we have processed induced sputum examination which has documented acid-fast bacilli in smear and MTB genome with rifampicin sensitivity in cartridge based nucleic acid amplification test. Initially, microbiologists refused for smear preparation due to salivary nature and poor-quality sputum. We have insisted for microbiology workup due to high chances of yield due to cavitary lung disease and noted positive yield. Treatment initiated with anti-tuberculosis (ATT). We have recorded near complete radiological resolution, bacteriological cure after eight months of ATT with good compliance. Acute febrile respiratory illness and absence of typical constitutional symptoms is not uncommon. Although cavitating consolidation is commonly described in community acquired pneumonia, presence of ‘sister cavity’ is a radiological clue to think and proceed to workup towards active pulmonary tuberculosis. Induced sputum has a very significant impact on diagnostic yield. Pulmonary tuberculosis should be suspected early in cases with cavitating consolidations to have a successful treatment outcome.

Progressive Primary Pulmonary Tuberculosis in Current Times: Are we really heading Towards ‘End of TB’ or Still, Many Miles to go for ‘Dream Come True’?

Tuberculosis is a more prevalent disease and the leading cause of death from an infectious agent in India. Tuberculosis in India accounts for the highest number of cases and deaths annually in the world. In spite of an efficient National tuberculosis control program for five decades, Tuberculosis is still the number one cause of death due to infectious agents in India and one third of total global deaths occurs in India due to this disease. Burden of drug sensitive and drug resistant cases is highest in the south east Asian region with maximum cases in India and China. India has launched a National strategic plan to end TB in 2017 with a target to eliminate TB by 2025. Main theme of the national strategic plan is ‘TB Free India’ with the vision of zero TB disease, zero deaths due to TB and decreasing poverty due to TB. Tuberculosis is an ancient disease and history traced before the evolution of mankind on this planet. Tuberculosis primarily affects the lung and is classified pathologically as primary, post-primary and progressive primary tuberculosis. In this case report, a 62-year male, presented with constitutional symptoms for six-month duration with partial response to medical treatment. He was having low grade fever, cough, shortness of breath, weight loss and anorexia for 6 months. His symptoms were progressive and empirically treated as enteric or typhoid fever for four to five occasions with oral and intravenous antibiotics with steroids with general physicians and family physicians. Additionally, he received empirical treatment as jaundice, viral fever, bronchitis, asthma, and generalised debilitating disease. Relatives brought to our center worsened general health with increased shortness of breath. Clinically he was having bilateral crepitations with decreased breath sounds right lower axillary and infrascapular area. Chest x-ray showed right pleural effusion with miliary opacities bilateral lung field. HRCT thorax showed typical miliary opacities with conglomerated pattern and pleural effusion on the right side of thorax. Pleural fluid analysis revealed exudative effusion with raised ADA level. He was unable to produce sputum, we have done bronchoscopy and BAL evaluation confirmed pulmonary tuberculosis and sensitivity pattern. BAL cytology documented acid-fast bacilli in smear and MTB genome with rifampicin sensitivity in cartridge based nucleic acid amplification test. Treatment initiated with anti-tuberculosis (ATT). We have recorded near complete radiological resolution, bacteriological cure after eight months of ATT with good compliance. More awareness is required regarding symptoms, diagnosis and treatment of tuberculosis to family physicians and general practitioners as the majority of the rural population receives treatment from these health professionals.

Economic Evaluation of Different Brands of Commonly Prescribed Drugs Used in the Management of Angina Pectoris in Indian Market

Introduction: Coronary artery disease (CAD) is one of the most common causes of cardiovascular mortality and morbidity in developing countries like India. Initial management includes use of many anti- anginal drugs. If angina pectoris not managed adequately results in significant morbidity and mortality too due to the complications. Anti-anginal drugs are used for lifelong. Therefore, analysis of the price of different drugs used in ischemic heart disease will help to improve patient compliance. Objective: (1) To assess the cost variation of different drugs available as antianginal agents in India. (2) To assess the cost ratio and percentage price variation of different formulations. Method: The maximum and minimum price of each brand of the drugs given in Indian rupees (INR) was noted by using ‘Drug Today’ (Oct 2022 – Jan 2023, volume II). The cost range, cost ratio, and the percentage cost variation for individual drug brands were calculated. The cost of tablets/capsule was calculated, and the cost ratio and percentage cost variation of various brands was compared. Results: After calculation of cost ratio and percentage cost variation for each brand of anti-anginal drugs, tab Diltiazem (60 mg) had a maximum percentage cost variation of 459.76% and a cost ratio of 5.59 while tab GTN (6.4 mg) had a minimum percentage cost variation of 76.19% and cost ratio of 1.76. Conclusions: There is a wide variation in the price of different brands ofanti-anginal drugs available in India. The clinicians prescribing these drugsshould be aware of these variations to reduce the financial burden of drugtherapy and improve compliance.

Effects of perceived stress, mindfulness, self-efficacy and social support on psychological wellbeing of life insurance agents during the COVID-19 pandemic

The Conservation of Resources theory has been set in motion to understand the psychological wellbeing at work-place-focused foothold of the realm in light of the JD-R theory. Life insurance agents experience multifarious stressors and challenges that negatively impact their psychological wellbeing. The current pandemic situation of the COVID-19 outbreak has directed significance to workplace health promotion as a novel postulation addressed in this study. This research is the first to empirically test and investigate the predicting effects of perceived stress, mindfulness, social support, and self-efficacy on psychological well-being among 794 Life Insurance Agents in India. This non-experimental research method incorporates the reflective model analysed through Smart PLS-3. A power analysis is executed by drawing evidence from India recruited through random sampling. Results show mindfulness as the strongest and most effective predictor of positive psychological well-being. This study underpins the significance of mindfulness-based interventions in unprecedented times during the COVID-19 pandemic where the mindful selling of the right policies surges and assists the agents to build a long-term relationship with the customers. Future studies should try to test these interventions with multi-centred research that can further enhance the robustness of research findings.

P290 Public health treatment due to rise in Candida auris candidemia infection

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PMIntroductionIsolation of Candida spp. from a blood sample in patients is known as candidemia. Candida albicans is the most common causative agent of candidemia globally while C. tropicalis is the most common causative agent in India. Candida parapsilosis complex, C. glabrata, and C. krusei are the other three common causative agents of candidemia. Candida auris was described in 2009 and is a public health treatment. It is multidrug-resistant and causes localized hospital outbreaks.ObjectiveTo determine the fungal profile of candidemia in a tertiary care hospital.MethodsInstitute ethics approval was taken. All patients admitted to the Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India from January 2020 to January 2021, whose blood culture samples yielded yeast were included in the study. The patient's demographic details were recorded. Yeast isolates were identified by Matrix-Assisted Laser Desorption/Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) as per the manufacture's instruction. The antifungal susceptibility testing (AFST) was performed by microbroth dilution method for fluconazole, voriconazole, amphotericin B, and caspofungin as per Clinical and Laboratory Standards Institute (CLSI) M27 and interpreted by CLSI M59 and M60 document. AFST of C. auris was interpreted as per Centers for Disease Control and Prevention (CDC) criteria. Results were expressed in percentages.ResultsA total of 248 blood culture samples yielded yeast cells during the study period. Approximately 63% of samples were obtained from male patients, while ∼37% were obtained from female patients. Most of the patients were between 41 to 60 years or under 10 years of age. A total of 52/240 (15.8%) were diabetic, and 30 (15.2%) were positive for severe acute respiratory syndrome coronavirus 2 (Sars-CoV-2). Candida tropicalis (34.7%) was the most common causative agent. It was followed by C. parapsilosis complex (20.2%). Candida auris (16.5%), C. albicans (13.3%), C. glabrata (6.5%), and other C. spp. (8.9%). Candida krusei is no longer observed as one of the top five agents of candidemia and it is replaced by C. auris. The rise of candidemia due to C. auris is a cause of concern, and its prevalence is observed more than that of C. albicans in our tertiary care hospital. The antifungal resistant pattern of the top four candidemia isolates is depicted in Figure 1. The antifungal resistance was maximum in C. auris isolates, followed by C. parapsilosis complex isolates. A total of 12.2% of C. auris isolates were resistant to amphotericin B, and azoles and 4.9% of C. auris isolates were multidrug-resistant.Conclusion Candida tropicalis was the most common causative agent of candidemia. But the increased prevalence of C. auris over C. albicans is a cause of concern as 4.9% of C. auris isolates were multidrug-resistant.

Toxicological Aspect of Somala Dhatu Visha (Arsenic) and Its Recent Advances – A Review

Human health is mainly depends on our surrounding environment. Arsenic is present in air, water, soil and food hence affecting many people across the world. Arsenic toxicity is now global health problem. The main source of arsenic toxicity is contaminated drinking water. In Ayurved Samhita Somala (Arsenic) is described as Sthawar Dhatu Visha. Acharya Sushruta first described Somala as Dhatu Visha. In Rasashastra Somala(Arsenic) is classified under Sadharana Rasa. Instead of highly toxic in nature Arsenic in proper dose act as medicine. It is use in many Ayurvedic medicinal preparations. Different compounds of Arsenic are used as insecticides, weedkiller, rodenticide, in flypaper, for sheep deep, as fruit spray, in medicine, as depilatory, colouring agent, and in industries. Arsenic trioxide is now used to treat acutepromyelocytic leukaemia. Arsenic is mainly use to treat syphilis since ancient time. Arsenic is often used as a part of extremely diluted homeopathic remedies. Its improper medical use leads to accidental poisoning hence it should be take in proper doses. Arsenic is easily available and cheap hence it is use as homicidal agent in India. Inorganic Arsenic is carcinogenic to humans. Most of population get indirectly exposed to Arsenic as it is accumulates in rice plants in large quantity and in drinking water. This study is design to elaborate toxicological properties of Arsenic, its various sources of poisoning so that everyone should aware of its lethal effect on human being and its recent advances.

Trends for in-office usage of pharmacological sedation agents in India: A narrative review.

Background and Aims:Conscious sedation plays a significant role in in-office pharmacological behavior management for short-term procedures in children and apprehensive adults. The advantage conscious sedation provides is by improving quality of care provided by decreasing pain and anxiety while maintaining a patent airway and adequate spontaneous ventilation.Methodology:Present review was conducted to evaluate recent trends regarding use of in-office pharmacological sedation agents in India. A rigorous search was conducted through five electronic databases namely PubMed, Scopus, Web of Science, Cochrane Database, and CTRI (Clinical Trial Registry – India). The search period was defined to be last 5 years, that is, from 1st January 2014 to 31st July 2019. Terminologies “Conscious Sedation,” “In-office Sedation,” “Midazolam,” “Nitrous Oxide,” “India” were included in the search. The Boolean Operation “OR” and “AND” were applied to combine the terminologies.Results:A total of 20 studies were identified following strict inclusion and exclusion criteria. The included studies were evaluated for study design, speciality involved, number of individuals and their age groups, drugs compared along with route and dosage, procedures undertaken, place of study and results. Dental fraternity (13) had more number of trials conducted as compared to medical fraternity (7) in the stimulated period, with South Indian region having maximum trials registered or published.Conclusion:Midazolam was observed to the drug of choice for in-office sedation procedures in Indian Scenario. The limitation of study is that the published clinical studies are limited to a few states of India.

Maximizing treatment benefits in type 2 diabetes by affordable oral anti diabetes agents in India

Diabetes mellitus (DM) is a global epidemic with number of cases rising exponentially with each decade. What makes it more concerning is its association with numerous complications like cardiovascular diseases, end-stage renal disease, neuropathy, and retinopathy. In India, the management of this disease mainly involves out‑of‑pocket expense and contributes to catastrophic health expenditure and distress financing. Thus, the need of the hour is to make oral anti diabetes agents (OADs) affordable and accessible so that maximum number of patients can avail treatment benefits in diabetes care. This review article focuses on the currently available low cost OADs such as sulfonylureas, metformin, thiazolidinediones, alpha glucosidase inhibitors, dipeptidyl-peptidase 4 (DPP4) inhibitors and sodium-glucose co-transporter-2 (SGLT2) inhibitors explaining their efficacy and safety from recent clinical evidence and those going off patent and becoming much affordable in their generic form. This information will help family physicians make rational choices for their type 2 DM (T2DM) patients.

The effectiveness of NEPA in the prevention of chemotherapy-induced nausea vomiting among chemo naive patients in an Indian setting

BackgroundChemotherapy induced nausea- vomiting (CINV) is considered as the most common, feared and most troublesome side effect of chemotherapy. NEPA (NEtupitant 300 mg + PAlonosetron 0.50 mg) is the first commercially available oral fixed-dose combination (FDC) of two active antiemetic agents in India. The present study was planned to evaluate the effectiveness of NEPA in the real world setting of India.MethodsThis was a multicentric retrospective study conducted in two centers in India. The data of all chemonaive patients, who were prescribed NEPA was analyzed. Effectiveness i.e. complete response and complete protection in controlling overall, acute and delayed phase was analyzed.ResultsA total of 329 patients were enrolled in the study. 260 received highly emetogenic chemotherapy (HEC) regimen and 69 received moderately emetogenic chemotherapy (MEC) regimen. Among all the enrolled patients, complete response in acute, delayed and overall phase was 93, 85.71 and 85.41% respectively; and completed protection was 88.44, 81.76 and 80.54% respectively. Those who received HEC regimen, the completed response and complete protection in overall phase was 84.61 and 79.61% respectively and those who received MEC regimen the completed response and complete control in overall phase was 84.05 and 84.05% respectively.ConclusionA single oral dose of NEPA targeting dual pathways showed effective control of nausea-vomiting in patients on the HEC and MEC regimens and had good control over nausea-vomiting in acute, delayed and overall phase of nausea-vomiting.

SARS Covid-19- Call of Threat: Attributes and Current Approach

COVID -19 disease (Coronavirus) is a contemporary strain of coronavirus species which has initially appeared in Wuhan city, China. Over the few months it has spread to various regions of the world. It is observed that COVID-19 is able to get transmitted from human to human contact, by means of droplets sustained in the air as aerosols, fomites etc. WHO (World Health Organization) has declared the current outbreak to be a public health emergency globally. Asthe disease is life threatening, there is a crucial need for effective drugs. Optimistic nurture remains the backbone of the therapy. Despite the COVID-19 patients having benign or mild courses, up to 5% -10% can have serious;probably life alarming courses, there is a crucial need for effective drugs. There have been several clinical trials persisting, various immune regulating and antiviral agents for assessments of COVID-19 in those investigations and some of them would be reported in later couple of days. Although the critical need to find an efficient antiviral medication for COVID-19 through randomized controlled investigation, certain agents are being utilized all over the world, established on either envisioned evidence, in vitro or experimental studies. Presently, the research investigation on SARS COVID-2 is in the initial stages. Based on ongoing published information, this review article consistently summarizes the pathological analysis, clinical symptoms, prevention and treatment of COVID-19. Generally, maximum used therapeutic agents in India and all over the world includes hydroxychloroquine, chloroquine, remdesivir, favipiravir, lopinavir and Nitazoxanide. This review reports about Ivermectin to have an activity against SARS-COVID-19 in vitro, which is permitted for some other treatments of human diseases. It is assumed that this review willencourage the nation to recognize and handle COVID-19 and contribute for prospective studies.

Super Bioavailable Itraconazole and Its Place and Relevance in Recalcitrant Dermatophytosis: Revisiting Skin Levels of Itraconazole and Minimum Inhibitory Concentration Data.

Itraconazole, is the most commonly prescribed oral antifungal agent in India, and has a low minimum inhibitory concentration as compared to other oral antifungals, and in conjunction with the markedly high skin levels, the drug should have a predictably good clinical response which is not the consistent experience of clinicians. Probably the variation in pelletization parameters might affect the bioavailability of the drug and consequently affect the serum levels. The maximum bioavailability of conventional itraconazole is 55 percent, which is neither consistent nor predictable. However, the novel itraconazole (Super bioavailable Itraconazole) with targeted drug release in the small intestine has predictable serum levels with minimum interindividual variability, which could make it a potentially useful drug in recalcitrant dermatophytosis.

Antibiofilm and synergistic antibacterial effect of Garlic (Allium sativum) against Methicillin resistant Staphylococcus aureus (MRSA)

Background: Methicillin resistant Staphylococcus aureus (MRSA) is one of main bacterial pathogens that is associated with difficult to treat nosocomial and community infections with high mortality. Shiga toxin producing E. Coli (STEC) infections result in bloody diarrhea, vomiting and mild fever. Biofilm formation has been linked with pathogenicity and virulence of these bacterial pathogens. Garlic (Allium sativum) has been traditionally used as an antibacterial agent in India and South East Asia. We have demonstrated that garlic exhibits antibiofilm and antibacterial activity against drug resistant STEC clinical isolates. In addition, organosulphide compounds of garlic have been reported to exhibit antibacterial activity against MRSA. In view of these observations, our laboratory wanted to investigate if crude garlic extract has any antibiofilm activity against MRSA. Further, we wanted to test if for synergistic effect of garlic when used in combination with antibiotics. Methods and materials: The study was performed with three MRSA isolates. Standard disc diffusion, serial dilution and kill curve assays were performed to access the antibacterial and synergistic activity of garlic against MRSA. In vitro microtiter plate assay was performed to quantify the formation of biofilm in the presence and absence of garlic crude extract. In addition, the effect of garlic on biofilm formation was also evaluated using scanning electron microscopy (SEM). Results: The results indicated that crude garlic extract exhibited significant dose dependent antibacterial activity against MRSA and the activity was much better in terms of clarity of zones of inhibition compared to pure organosulphide compounds found in garlic. It was interesting to note that sub-MIC concentrations of garlic were able to sensitize MRSA to methicillin. Garlic at sub-MIC concentrations reduced MRSA biofilm formation by more than 60%. We conclude that crude garlic extract has more antibacterial activity than its active ingredients. This is the first study to report its antibiofilm property against MRSA to best of our knowledge. Conclusion: Garlic organosulphide compounds have the potential to be used in combination with standard antibiotics to treat drug resistant bacterial infections. Garlic organosulphide compounds based novel antibiotic and antibiofilm drugs can be developed to tackle the problem of antibacterial drug resistance.

Multilocus sequence analysis of a ‘Candidatus Phytoplasma australasia’-related strain associated with peanut little leaf disease in India

Severe little leaf and excessive shoot proliferation symptoms typical of the peanut little leaf (PnLL) disease were observed in different peanut (Arachis hypogaea) fields, variety K-6, at Kadiriand Gooty regions, of Andhra Pradesh, India, during the monsoon season of 2018–19. Disease incidence was 2–3%. The phytoplasma etiology of the recorded disease was confirmed by amplifying ~1.25 kb DNA products of 16S rRNA gene from symptomatic plants using nested polymerase chain reaction with phytoplasma specific primers, P1/P7 and R16F2n/R16R2, respectively. A further confirmation of the phytoplasma etiology was obtained by amplification of 840 bp, 1094 bp and 465 bp DNA fragments using phytoplasma specific primers targeting secA, tuf and SAP11 genes, respectively. Sequence and phylogenetic analyses of the amplified 16S rRNA, secA, tuf and SAP11 genes revealed that the detected phytoplasma is a member of the peanut witches’-broom phytoplasma group or 16SrII group (‘Candidatus Phytoplasma australasia’). Also, on the basis of computer-simulated RFLP (= in silico RFLP) analysis of amplified 16S rRNA gene, the detected phytoplasma was assigned to subgroup D (16SrII-D). Parthenium hysterophorus plants showing witches’ broom and Cleome viscosa plants with little leaf symptoms, both collected in the mentioned peanut fields were also infected by similar strain of phytoplasma which proved to be identical with each of the molecular marker employed to the peanut-infecting agent in India. This is the first report on the association of ‘Ca. P. australasia’ (16SrII-D subgroup phytoplasma) with PnLL disease in India.

Canine Myiasis and its Causal Agents in India

Myiasis, the invasion of tissues of live humans and vertebrate animals with dipteran larvae is common throughout the tropical regions of the world. It is a real welfare problem of worldwide distribution and a matter of great concern among medical and veterinary fields. The reports indicate that dogs are the most common canine species affected by myiasis. The present study was conducted to ascertain prevalence of myiasis among pet dogs and to identify myiasis-causing flies in India. The study resulted in the identification of three species of myiasis causing flies among pet dogs. The Old World Screw-worm fly- Chrysomya bezziana was reported to be the predominant fly species followed by Musca domestica and Sarcophaga ruficornis. The overall infestation rate was high in rainy season followed by summer, spring, autumn and least in winter. Incidence of myiasis was found to be higher among adult males than the females. The most frequently infested body regions were the face, neck and perianal region among males and face, neck and vulvar lips among females. Most infestations were found in the wounds at front body parts of the adult males, suggesting the common occurrence of myiasis in consequence of competitive fighting.

Motivation among travel agents in India: The moderating role of employee’s expertise and marital status

This study contributes to the literature by offering insights over the relationship between job satisfaction and work stress with employees’ motivation among travel agencies in India. The paper aims to determine the impact of job satisfaction and work stress on employees’ motivation level with a specific focus on the moderating impact of employees’ expertise and marital status in the context of travel agencies in Southern India. A survey was conducted over employees of travel agencies in Southern India by adopting scales from the extant studies, and data were analyzed using structural equation modeling through Smart PLS. The outcome of the study reveals that job satisfaction has a strong significant effect on employees’ motivation, unlike work stress and employees’ expertise has a partial significant moderating effect on the relationship between work stress and motivation. The study stressed much about the combined effects of the mediators. The present study has tested the new composite scale to measure the overall motivational level, unlike the previous studies. The survey was conducted between November 2019 and December 2019 and entails 164 respondents, the majority of the subjects are millennials between 18 and 35 years, with 43.3% having master’s degree, all were found to be pre-qualified for the investigation.