Areas Of Northern India Research Articles

ESBL and MBL in Cefepime Resistant Pseudomonas aeruginosa: An Update from a Rural Area in Northern India.

Cefepime, a fourth generation cephalosporin, is widely used for the empirical treatment of serious infections in critically ill hospitalized patients. Pseudomonas aeruginosa (P. aeruginosa), one of the commonest bacteria causing nosocomial infections has a propensity to develop antibiotic resistance quite promptly. We undertook this study to assess the efficacy of cefepime against current clinical isolates of P. aeruginosa and to study existence of different beta-lactamase enzymes among cefepime resistant P. aeruginosa isolates. Total of 618 isolates of P. aeruginosa recovered consecutively from various clinical samples of a tertiary care hospital were analysed. Their Antimicrobial sensitivity profile against piperacilin (100μg), piperacillin/tazobactam (100μg/10μg), ceftazidime (30μg), cefoperazone (75μg), cefepime (30μg), ciprofloxacin (5μg), gentamycin (10μg), amikacin (30μg) and imipenem (10μg) (Himedia) was tested by Kirby-Bauer disc diffusion method (Clinical and Laboratory Standards Institute guidelines). We further looked for ESBL, MBL and ESBL + MBL co producers among the cefepime resistant isolates by two different methods (combined double disc synergy test, imipenem-EDTA combined disc test and vitek2). Among 618 consecutive clinical isolates of P. aeruginosa, we observed resistance to cefepime in 457 (74%) isolates. We observed resistance to ciprofloxacin (n=506, 82%) in maximum number of isolates followed by that to Gentamycin (n=475, 77%), amikacin (n=366, 60%), and cefoperazone (n=350, 56.6%). Among all our cefepime resistant P. aeruginosa isolates only 27(6%) were ESBL producers, 18(4%) MBL producers and 2(0.4%) were ESBL+ MBL co-producers. All the ESBL and MBL isolates were also tested by VITEK 2 advanced expert system (bioMırieux Vitek Systems Inc, Hazelwood, MO, France) which revealed a 100% concordance with the phenotypic method tested. This paper highlights the need to reconsider prescribing empirical antibiotics for Pseudomonas infections in this region and formulate a strong antibiotic policy to curb the menace of spread of multidrug resistant strains.

A cross-sectional survey of hand arm vibration symptoms among angle grinder operators employed in sheet metal work in North India

This study investigates the prevalence of hand arm vibration symptoms and musculoskeletal disorders in the hand and arm of the angle grinder operators of sheet metal industries located in Chandigarh and nearby industrial areas in Northern India. Hand-transmitted vibration was measured in 42 sheet metal industries. A total of 83 workers, who were mainly employed for grinding job, were interviewed and vibration characteristics were measured using tri-axial accelerometer. Hand arm vibration symptoms, musculoskeletal complaints in hands and its correlation with tool weight were investigated. Results shown 84% daily vibration exposure measurements exceeded exposure action value (EAV) and 24% measurements exceeded exposure limit value (ELV). Hand arm vibration symptoms were finger numbness (40%), tingling (29%) and vibration white finger (VWF) (13%). Hand arm vibration symptoms in the workers were not significantly associated with tool weight. However, tool weight was significantly associated with musculoskeletal complaints in wrist, forearm and elbow of the workers. Preventive measures to reduce musculoskeletal complaints are proposed.

Potential source identification for aerosol concentrations over a site in Northwestern India

The collocated measurements of aerosols size distribution (ASD) and aerosol optical thickness (AOT) are analyzed simultaneously using Grimm aerosol spectrometer and MICROTOP II Sunphotometer over Jaipur, capital of Rajasthan in India. The contrast temperature characteristics during winter and summer seasons of year 2011 are investigated in the present study. The total aerosol number concentration (TANC, 0.3–20μm) during winter season was observed higher than in summer time and it was dominated by fine aerosol number concentration (FANC<2μm). Particles smaller than 0.8μm (at aerodynamic size) constitute ~99% of all particles in winter and ~90% of particles in summer season. However, particles greater than 2μm contribute ~3% and ~0.2% in summer and winter seasons respectively. The aerosols optical thickness shows nearly similar AOT values during summer and winter but corresponding low Angstrom Exponent (AE) values during summer than winter, respectively. In this work, Potential Source Contribution Function (PSCF) analysis is applied to identify locations of sources that influenced concentrations of aerosols over study area in two different seasons. PSCF analysis shows that the dust particles from Thar Desert contribute significantly to the coarse aerosol number concentration (CANC). Higher values of the PSCF in north from Jaipur showed the industrial areas in northern India to be the likely sources of fine particles. The variation in size distribution of aerosols during two seasons is clearly reflected in the log normal size distribution curves. The log normal size distribution curves reveals that the particle size less than 0.8μm is the key contributor in winter for higher ANC.

Seasonal electrocution fatalities in free-range rhesus macaques (Macaca mulatta) of Shivalik hills area in northern India.

The arboreal nature of rhesus macaques makes them vulnerable to electrocution from high-voltage industrial supply as well as low-tension domestic wires. The data on pattern of electrocution injuries and electrocution mortalities in free-ranging rhesus macaques are rarely reported. From January 2011 to 2013, the cases of accidental electrocution injuries were recorded in difference to sex, age group, season, body region distribution, contact details, and extent of injuries in free-ranging rhesus macaques (Macaca mulatta) of Shivalik hill areas. electrocution injuries were highest in juveniles (52.05%), followed by adults (30.13%) and old (10.95%) rhesus macaques. Of the 73 cases recorded, 23 (31.50%) succumbed to death following severe electrocution and associated injuries. The intensity and body region distribution of electrocution injuries was recorded. High-voltage current is the most common factor for fatal injuries. Strategies to avoid such electrocutions include burying all lines and transformers, shielding and insulating all high-tension lines, installing bridges that monkeys, and other arboreal species can use to move around.

Gender Preferences, Inequalities and Female Infanticide in Rural Area of Northern India

Gender Preferences, Inequalities and Female Infanticide in Rural Area of Northern India

Modeling strategies to increase population immunity and prevent poliovirus transmission in 2 high-risk areas in northern India.

India presented many challenges to the global effort to eliminate the transmission of wild polioviruses (WPVs) and poliomyelitis, with the last case of WPV type 2 in the world reported in northern India in 1999 and WPV types 1 and 3 circulating until early 2011. We used a differential equation-based model to characterize the dynamics of poliovirus transmission and various opportunities to increase and maintain high population immunity to poliovirus transmission for 2 high-risk areas in northern India. We explored options that India probably considered before 2011, to demonstrate the impact of strategies to accelerate WPV elimination and sustain high population immunity. We also characterized the impact of current and potential future vaccination strategies and explored the potential trade-offs associated with the various strategies. National immunization policy choices impact population immunity, which leads to different numbers of expected paralytic cases and risks of circulating vaccine-derived poliovirus outbreaks. Assuming that India maintains high vaccination intensity everywhere, we do not anticipate issues with outbreaks of circulating vaccine-derived poliovirus type 2 infection following globally coordinated cessation of type 2-containting oral poliovirus vaccine use. We find a relatively modest potential role for inactivated poliovirus vaccine. National policy makers should consider the impacts of their vaccine choices on population immunity to poliovirus transmission.

Edible mushrooms of the Northwestern Himalaya, India: a study of indigenous knowledge, distribution and diversity

In the present study, the diversity, edibility, indigenous knowledge and distribution of wild edible mushrooms in the Northwestern Himalaya are discussed. The information provided herein was derived from a study carried out in the states of Uttarakhand and Himachal Pradesh during the period of 2000-2013. A total of 23 species of mushrooms considered as edible or used for trade were recorded. Twenty-one of these are basidiomycetes and two are ascomycetes. Certain species of Amanita, Agaricus, Astraeus, Hericium, Macrolepiota, Morchella, Pleurotus and Termitomyces are very commonly collected and consumed by the local people, whereas species of Auricularia, Cantharellus, Sparassis, Lactarius, Ramaria and Russula are less commonly collected and consumed. Cordyceps sinensis and several species of Morchella are collected specifically for trade purposes in the spring season in high elevation areas of the Himalaya. Among the edible wild mushrooms collected are a number of species involved in ectomycorrhizal symbiotic relationships with banj (oak), other broadleaf trees and several types of conifers. The results of the present study can be used to promote the domestication of those wild edible mushrooms not yet cultivated in India. These results also indicate the need to avoid over exploitation of these mushrooms and a reason to establish a ‘state germplasm bank’ to allow studies of tissue culture. The latter could serve as the basis of further scientific study into various ways of enhancing the livelihood of particular areas of northern India through increased mushroom domestication as well as assessing the possible bioactivity of mushrooms against certain human diseases.

Self-Vision Testing and Intervention Seeking Behavior among School Children: A Pilot Study

Purpose: Refractive error is the most common cause of visual impairment among school children. Worldwide, school vision testing is one major area of thrust to address vision screening among school children, and is carried out by a diverse group of professionals and non-professionals, with variable success rates. In a pilot study we aimed to determine how efficiently and reliably students could self-examine their vision and how many actually seek intervention for refraction and eventually wear glasses.Methods: The pilot study was done in 25 schools in a rural area of northern India. The methodology of self-assisted vision examination (SAVE) was directly demonstrated to school children. School children self-examined their visual acuity, and sensitivity, specificity and positive and negative predictive values were calculated after secondary screening by professionals. Students requiring refraction were given referral slips. Frequency of uptake of glasses for those referred for refractive services was assessed in a follow-up visit.Results: A total of 7411 students in 6th to 12th standard were enrolled in the pilot study. Sensitivity and specificity of the SAVE strategy were 96.22% (95% confidence interval [CI] 94.52–97.43%) and 90.23% (95% CI 87.79–92.23%), respectively. The positive predictive value was 90.83% (95% CI 88.55–92.71%) and negative predictive value was 95.95% (95% CI 94.13–97.24%). At the time of follow-up 66% of students had undergone refraction and 81% of these were wearing glasses.Conclusion: SAVE provides a simple, acceptable and valid alternate strategy for school vision screening. However, factors influencing procurement of glasses and their use will require further study.

Sitala Worship: The Continuing Story of Vulnerability, Protection and Fortune in the Social Fabric of the Savaras of West Bengal

This paper discusses religious narratives about the annual deity of the Savaras of South Bengal, which can be conceptualised as myths, legends and memorates according to the folklore of ‘Sitalamangal’. In almost every part of India, there is a goddess, known by a variety of local names, concerned with smallpox. Throughout most areas of Northern India, from Gujarat in the west to Bengal in the east, a goddess associated to smallpox is found to whom some variant of the name ‘Sitala’ is attached. This goddess is primarily associated with smallpox, yet she is occasionally given other roles and powers, including those as the protector of children and the giver of good fortune.

A global health project: creating sustainable solutions to address anemia at Munsel-ling school in rural northern India

Anemia is a major public health concern in India, especially with- in the rural population. Six years ago, a group of medical students from the University of British Columbia began a collaboration with a boarding school in the Spiti Valley area of Northern India. The team found a high prevalence of anemia within the school population and devised a set of sustainable proj- ects to improve student health, includ- ing health education, greenhouses, water and sanitation, and iron supplementation. Health screens were also integrated ev- ery year to track changes in the popula- tion's health over time. To date, these in- terventions have significantly decreased the students' levels of anemia over the five-year period. However, the most effec - tive intervention appears to be direct iron supplementation, yet the sustainability of this practice remains challenging. Global Health Initiative (GHI) program, the Spiti Project. This project estab- lished a partnership with the Munsel-ling Boarding School in the village of Rangrik and its affiliated local Non-Government Organization (NGO), Rinchen Zangpo Society for Spiti Development. The school is privately run and is currently respon- sible for the education of approximately 700 children from surrounding commu- nities, housing three quarters of the stu- dents for the entire school year. Since its inauguration, the Spiti Project has also collaborated with the Vancouver-based Trans-Himalayan Aid Society (TRAS) and several other NGOs for funding. In 2006, the first UBC Spiti Valley team

Missing Female Fetus: A Micro Level Investigation of Sex Determination in a Periurban Area of Northern India

A micro-level investigation of 983 pregnant women (aged 15–49 years) regarding sex determination and associated factors was carried out in a periurban region of Northern India. Among the women surveyed, 183 chose to use sex determination. The highest percentage of sex determination was among 30–39-year-old women, and general caste and family size were two risk factors associated with sex determination. Correcting imbalances in sex ratios at birth is a complex issue without easy answers, especially in patriarchal societies. Apart from raising awareness among decisionmakers, property rights in favor of women and strict vigilance and record of registration of ultrasound machines are necessary.

Knowledge, attitude, and practices about the seasonal influenza vaccination among healthcare workers in Srinagar, India

Please cite this paper as: Bali NK et al. (2012) Knowledge, attitude, and practices about the seasonal influenza vaccination among healthcare workers in Srinagar, India. Influenza and Other Respiratory Viruses 7(4), 540–545. Background Healthcare workers (HCWs) universally have a poor uptake of influenza vaccination. However, no data are available from India. Objective To explore knowledge, attitudes, and practices associated with influenza vaccination in HCWs in a temperate climate area in northern India. Patients and Methods A self‐administered questionnaire was offered to all HCWs in three major hospitals of Srinagar and information sought on motivations, perceptions, preferences and practices regarding influenza vaccination. Results Of the 1750 questionnaires received, 1421 (81%) were returned. Only 62 (4·4%) HCWs had ever received influenza vaccination even as 1348 (95%) believed that influenza poses adverse potential consequences for themselves or their contacts; 1144 (81%) were aware of a vaccine against influenza and 830 (58%) of its local availability. Reasons cited by 1359 participants for not being vaccinated included ignorance about vaccine availability (435; 32%), skepticism about efficacy (248; 18%), busy schedule (166; 12%), fear of side effects (70; 4%), and a perception of not being‐at‐risk (82; 6%). Sixty‐one percent (865) believed that vaccine programs are motivated by profit. Eighty‐eight percent opined for mandatory vaccination for HCWs caring for the high‐risk patients, as a part of ‘employee health program’. Most of the participants intended to get vaccinated in the current year even as 684 (48%) held that vaccines could cause unknown illness and 444 (31%) believed their adverse effects to be underreported. Conclusion Influenza vaccination coverage among HCWs is dismally low in Srinagar; poor knowledge of vaccine availability and misperceptions about vaccine effectiveness, fear of adverse effects and obliviousness to being‐at‐risk being important barriers. Multifaceted, adaptable measures need to be invoked urgently to increase the coverage.

Genetic yield potential of rice (Oryza sativa) through water saving and high-yielding SRI technology

In this investigation 20 rice genotypes were evaluated for yield and other traits under SRI and conventional system to identify suitable cultivars for SRI. In general, genotypes flowered earlier but matured late in SRI than conventional method. A majority of the genotypes attained more biological yield and grain yield/plant in conventional over SRI method. However, four genotypes namely; IR 64 (24.31%) HKRH 1094 (15.21%), Pusa 1121 (12.54%), and HKR 46 (11.78%) yielded higher in SRI over conventional. IR 64 is a widely adapted cultivar grown over a number of countries including India, whereas HKR 46 has been released for and cultivated in Haryana state. Pusa Basmati 1121 was released for commercial cultivation in 2003 for Haryana state but it’s occupying about 60% of the total basmati area in northern India and contributed foreign exchange to the tune of INR 5000/crores annually (www.icar.org.in 2009). These genotypes identified superior for grain and biological yield could be tested over macro-environments of space and time and recommended for cultivation in SRI production system.

Estimation of radiological risk due to concentration of ^{238}U, ^{226}Ra, ^{232}Th and ^{40}K in soils of different geological origins in northern India

Radioactivity of nuclides ^{238}U, ^{226}Ra, ^{232}Th and ^{40}K was measured in soil by \gamma-ray spectrometry using a HPGe detector. A criterion was set in order to analyse soil samples from plain, semi-hilly and hilly areas in northern India. More than three \gamma-ray energy peaks were used for the determination of ^{226}Ra and ^{232}Th activity concentrations to obtain more accurate results. Some of these peaks have interfering energies, which was caused by the limited resolution of the detector, but they were resolved theoretically and used in the analysis because of their significance in reducing the random error to its minimum level. Relationships between the measured radionuclides have been discussed elaborately. Radionuclides ^{238}U and ^{226}Ra were found in disequilibrium with ratio of specific activities (^{238}U/^{226}Ra) less than unity for most of the samples. In some cases this disequilibrium may be significant enough to modify the \gamma -ray dose factors.

Perception of the Indian pharmaceutical firms towards stronger product patent regime: a case study of North West region

India, being a signatory member of WTO, adopted product patents laws in 1995. Prior to that Indian pharmaceutical industry was being governed by the Indian Patent Act of 1970, which allowed only process patent laws. What are the effects of stronger patent laws on the Indian pharmaceutical firms? What is the perception of the Indian pharmaceutical firms towards stronger product patent regime? Whether they treat it as an opportunity or they perceive it as a threat. These are some of the issues the present paper tries to answer. With a sample of 100 firms, the study tries to cover the major areas in Northern India which has a combination of excise free zone and non-excise free zone. The overall reliability of the questionnaire has been .798. Statistical tools like chi-square tests and ANOVA are used to test the hypothesis. The results of the study highlight an improvement in the perception of Indian firms. They are ready for the challenges offered by the post-TRIPS era and are accepting the new opportunities offered by it.

Pandemic and seasonal influenza viruses among patients with acute respiratory illness in Kashmir (India)

Please cite this paper as: Koul PA., et al. (2011) Pandemic and seasonal influenza viruses among patients with acute respiratory illness in Kashmir (India). Influenza and Other Respiratory Viruses 5(6), e521–e527. Background With the emergence of pandemic influenza A (2009A/H1N1) virus in India, we sought to determine the prevalence and clinical presentations of seasonal and pandemic influenza viruses among acute respiratory illness (ARI) patients from Srinagar, a temperate climate area in northern India, during the peak winter season. Methods Combined throat and nasal swabs, obtained from 194 (108 male) presenting with ARI from January to March 2010 (Week 53‐week 10), were tested by RT‐PCR for influenza A and B, including 2009A/H1N1 viruses. HA1 gene of selected 2009A/H1N1‐positive samples was sequenced, and phylogenetic analysis was carried out. Results Twenty‐one (10·8%, age 15–80 years, median age 40 years) patients tested positive for influenza viruses: 13 (62%) for 2009A/H1N1 virus, 6 (28·5%) for seasonal influenza A (H3N2), and 2 (9·5%) for influenza B. Twelve of the 13 patients with 2009A/H1N1 presented with febrile ARI, and eight had associated comorbidities. All of the patients recovered. Phylogenetic analysis of HA gene (n = 8) revealed that all strains from Srinagar clustered in 2009A/H1N1 clade seven along with the other 2009A/H1N1 strains from India. Amino acid substitutions in the HA protein defining clade seven (P83S, S203T, and I321V) were found in almost all isolates from Srinagar. Conclusions Both seasonal and 2009A/H1N1 viruses appear to be associated with ARI in Srinagar. The 2009A/H1N1 in Srinagar is genetically similar to globally circulating clade 7 strains, with unique signature sequences in the HA gene. Further investigations into ascertain the role of these mutations in possible alteration of the virulence and transmissibility of the virus are needed.

Measurement of Radioactivity of &amp;lt;sup&amp;gt;238&amp;lt;/sup&amp;gt;U, &amp;lt;sup&amp;gt;226&amp;lt;/sup&amp;gt;Ra, &amp;lt;sup&amp;gt;232&amp;lt;/sup&amp;gt;Th and &amp;lt;sup&amp;gt;40&amp;lt;/sup&amp;gt;K in Soil of Different Geological Origins in Northern India

Radioactivity of the nuclides 238U, 226Ra, 232Th and 40K was measured in soil by γ-ray spectrometry using HPGe detector. A criterion was set in order to analyse soil samples from plain, semi-hilly and hilly areas in northern India. More than three γ-ray energy peaks were used for the determination of 226Ra and 232Th activity concentrations to obtain more accurate results. Some of these peaks have interfering energies, which was caused by the limited resolution of the detector, but they were resolved theoretically and used in the analysis because of their significance in reducing the random error to its minimum level. Relationships between the measured radionuclides have been discussed elaborately. Radionuclides 238U and 226Ra were found in disequilibrium with ratio of specific activities 238U/, 226Ra) less than unity for most of the samples. In some cases this disequilibrium may be significant enough to modify the γ-ray dose factors.

Screening resistance of Dalbergia sissoo clones against Ganoderma lucidum root rot disease in field conditions

Summary Ganoderma lucidum is a serious root rot pathogen of trees and is known to cause large scale mortality in Dalbergia sissoo. Clones prepared from selected plus trees of D. sissoo have been established in a clonal seed orchard and a seed production area in northern India where 5-year-old plants of various clones were attacked by G. lucidum to varying degrees. Regular assessment was carried out for further 5 years to screen disease progress in the field and to identify clones of greater and lesser resistance. Data for height, clear bole and girth were collected to select trees with better growth form and disease resistance. Five highly resistant and five susceptible clones were categorized on the basis of total score for growth form characters and disease development.

Presence, characterization, and genotype profiles of Mycobacterium avium subspecies paratuberculosis from unpasteurized individual and pooled milk, commercial pasteurized milk, and milk products in India by culture, PCR, and PCR-REA methods

Mycobacterium avium subspecies paratuberculosis (MAP) causes Johne's disease in ruminants, a chronic enteritis evocative of human inflammatory bowel disease. In industrialized countries MAP has been cultured from pasteurized milk, compounding the increasing concern that MAP may be zoonotic. The purpose of this study was to evaluate commercially available unpasteurized and pasteurized milk and its products for the presence of viable MAP or MAP DNA from an area of northern India with a population of 150 million people. We studied 43 samples (16 unpasteurized, 27 pasteurized) purchased in Mathura, Agra, or New Delhi, for the presence of MAP by culture or by PCR for IS900 MAP DNA. Positives results were confirmed as MAP by restriction endonuclease analysis and/or DNA sequencing. Colonies appeared in 1.5-20 months post-inoculation. Of the unpasteurized samples, 44% (7/16) were MAP culture-positive and 6% (1/16) were positive for IS900 MAP DNA. Of the pasteurized samples, 67% (18/27) were MAP culture-positive and 33% (9/27) were IS900-positive. Subsequently, 100% (25/25) of the cultured colonies were IS900 and IS1311 MAP DNA-positive. This is the first report from a developing country of MAP cultured from both pasteurized and unpasteurized milk and milk products. Thus we corroborate the presence of viable MAP in the food chain reported from industrialized countries. With the increasing concern that MAP may be zoonotic, these findings have major implications for healthcare in India. The decreased sensitivity in detecting MAP DNA by PCR directly from milk should be ascribed to our employing only one set of PCR primers.

Persistence of severe iodine-deficiency disorders despite universal salt iodization in an iodine-deficient area in northern India

The aim of the present study was to determine the impact of universal salt iodization (USI) on the prevalence of iodine deficiency in the population of an area previously known to have severe iodine deficiency in India. In a cross-sectional survey, a total of 2860 subjects residing in fifty-three villages of four sub-districts of Gonda District were examined for goitre and urinary iodine concentration. Free thyroxine and thyroid-stimulating hormone levels were also measured. Salt samples from households were collected for estimation of iodine content. A reduction in goitre prevalence was observed from 69 % reported in 1982 to 27.7 % assessed in 2007. However, 34 % of villages still had very high endemicity of goitre (goitre prevalence >30 %). Twenty-three per cent of households consumed a negligible amount (<5 ppm) and 56 % of households consumed an insufficient amount (5-15 ppm) of iodine from salt. Although there was an overall improvement in iodine nutrition as revealed by decreased goitre prevalence and increased median urinary iodine levels, there were several pockets of severe deficiency that require a more targeted approach. Poor coverage, the use of unpackaged crystal salt with inadequate iodine and the washing of salt before use by 90 % of rural households are the major causes of persisting iodine-deficiency disorders. This demonstrates lapses in USI implementation, lack of monitoring and the need to identify hot spots. We advocate strengthening the USI programme with a mass education component, the supply of adequately iodized salt and the implementation of complementary strategies for vulnerable groups, particularly neonates and lactating mothers.