GB Pant Research Articles

Minimal lactate clearance proclaims pediatric intensive care unit mortality

Background: Lactate clearance among the survived patients is higher and is inversely related to the PRISM III Score. Objectives: We aimed to correlate lactate clearance with pediatric Intensive Care Unit (PICU) mortality. Material and Methods: This was prospective observational hospital-basedstudy conducted atPICU of GB Pant Tertiary Care Hospital, Government Medical College, Srinagar. All the enrolled 315 patients were in between >1 month to 14 years. Serum Lactate levels at PICU admission, 6 hours after PICU admission, Lactate Clearance and Pediatric Risk of Mortality Score (PRISM III) was estimated. Parameters were compared between and survived and expired group. Results: PICU mortality was 19.7%. Mortality rate was significantly high in the smaller age group children. Mean admission lactate level was significantly high (p Conclusions: Six-hour lactate clearance was a significant predictor of PICU mortality like PRISM III score.

Socio-demographic correlates of stunting among children in Port Blair, India

Background: Stunting or low height-for-age is failure to reach linear growth potential, and is a key indicator of chronic under nutrition. The objectives of the study were to assess the status of stunting among children attending outpatient department and to evaluate the demographic profile of such children.Methods: A hospital based cross sectional study conducted over a period 6 months from August 2015 to January 2016 among children within age group of 2 to 12 years attending outpatient department of GB Pant Hospital, Port Blair. Height-for-age z-scores (HFAz) was generated using the WHO Anthro software (version 3.2.2).Results: Overall 444 students’ were included in the study which included 213 male children (48%) and 231 female children (52.0%). Out of this 21.70% children were stunted and 6.3% children were severely stunted. Among the socio demographic factors shunting and severe stunting is seen among lower/upper lower class (82.14%) followed by middle/lower middle class.Conclusions: Collective effort by government, non-government organizations is required to plan long term and short term strategies addressing the risk factors.

Dr Yeshwant Laxman Nene: A Legendary Agricultural Scientist and Pioneer of the Asian Agricultural Heritage

Dr Yeshwant Laxman Nene, Former Deputy Director General of ICRISAT (International Crops Research Institute for the Semi-Arid Tropics) and Chairman Emeritus of the Asian Agri-History Foundation (AAHF) suddenly passed away on 15 January 2018 at his residence in Secunderabad, Telangana state, India. Dr YL Nene was born on 24 November 1936 in Gwalior, Madhya Pradesh, India from where he completed his high school in 1951, and BSc (Agri) degree in 1955. He obtained his Master’s degree in Plant Pathology in 1957 from Government Agriculture College, Kanpur, Uttar Pradesh. He got PhD in Plant Pathology from the University of Illinois, Urbana-Champaign, Illinois, USA in 1960. He then joined as an Assistant Professor in the College of Agriculture, UP Agricultural University (now GB Pant University of Agriculture and Technology – GBPUAT), Pantnagar, Dist. Nainital, Uttar Pradesh (now Dist. Udham Singh Nagar, Uttarakhand) . At Pantnagar he excelled as a plant pathology teacher and a researcher and earned the reputation of being an excellent plant pathology teacher. He solved the mystery of the dreaded khaira disease of paddy in 1965, which was threatening its extinction from the Tarai region of Uttar Pradesh. For his pioneering work on khaira, he was awarded the International Rice Research Prize in 1967 by FAO as part of the International Rice Year (1966) celebrations. His work on viral diseases of warm season (kharif) pulses was recognized internationally. He was promoted to Associate Professor in 1966 and Professor and Head in 1969. He was considered a distinguished faculty member at GBPUAT at Pantnagar and was conferred the honorary degree of Doctor of Science in 1991 in recognition of the “singular contribution to the cause of agricultural research, education and development”. In 1974, Dr Nene joined ICRISAT as the Principal Plant Pathologist in the Pulses Improvement Program. Here again, he excelled in research and his landmark contribution was resolving the problem of “wilt complex” of chickpea. He developed simple disease-resistance screening techniques for laboratory, greenhouse and field conditions as well as multiple-disease field screening systems for major chickpea and pigeonpea diseases, which are widely used internationally. The most outstanding contributions of the Pulses and later Legume Programmes that he led during 1980-89, were the development of high yielding pigeonpeas, wilt-resistant chickpeas, and high-yielding, disease-resistant groundnut varieties. For these contributions, he was internationally recognized as the world leader in grain legumes research. He was also elected Fellow of the American Phytopathological Society (APS) in 1990. Post-ICRISAT (1996-2018), he devoted fulltime to the work of the Asian Agri-History Foundation that he conceptualized and founded in 1994 to unearth and disseminate information on the history of Asian agriculture. As its Founder Chairman, his outstanding achievements have been in the publication of 11 technical Bulletins on Asian agriculture and starting a quarterly journal of Asian Agri-History. He is wellrecognized world over for his leadership in revitalizing agricultural history in Asia especially India. He was a staunch supporter and promoter of Vedic agriculture through Vrikshayurveda of Surapala and strongly believed in its great potential and relevance for Indian agriculture to rectify the damages of the green revolution such as maintenance of soil health, crop growth and productivity, maintenance of biodiversity and protecting environment and human health. Dr Nene through his dedicated work has earned the reputation of a luminary scientist of modern India and has inspired and mentored many young students, scientists and colleagues during his 57 years of professional career. Needless to say that he will be missed by all of them and also by the Indian agriculture for a very long time to come.

Esophageal tuberculosis: Uncommon of common.

Background and AimEsophageal involvement in tuberculosis (TB) is rare and is usually secondary. Data on esophageal TB are scarce. We aimed to analyze clinical and endoscopic features and outcomes of treatment in esophageal TB.MethodsWe retrospectively identified patients with esophageal TB from January 2014 to December 2016 at GB Pant Hospital. Well‐defined granuloma with or without caseation and/or acid‐fast bacilli on staining either from esophageal biopsy or the adjacent mediastinal lymph node fine‐needle aspiration cytology (FNAC) specimen, along with clinical features and response to antitubercular therapy (ATT), were collectively considered to diagnose definite TB. Treatment received and response to therapy were documented and analyzed.ResultsA total of 19 patients had definite esophageal TB, and the median age of patients was 39 years (14–65 years) and 10 (52.6%) patients were female. The most common presenting symptom was dysphagia (n = 16, 84%) followed by odynophagia (n = 8, 42%). On endoscopy, the mid‐esophagus was the most common site of involvement, and findings included ulcers (n = 17), elevated lesions (n = 9), and fistulae (n = 4) in patients. The mediastinal lymphadenopathy was present in all patients, with parenchymal lesions seen in three patients. The endoscopic mucosal biopsies were diagnostic in 11 patients, and in the remaining 8 patients, endoscopic ultrasound‐guided FNAC from the mediastinal lymph nodes was diagnostic. A total of 18 patients completely responded to ATT, and 1 patient had partial response with persistent fistulae requiring additional treatment.ConclusionEsophagus involvement is rare in TB; endoscopic mucosal biopsy and EUS‐guided FNAC is diagnostic, and the response to ATT is excellent.

Impact of crop intensification and establishment techniques on weed dynamics under different cropping systems

The field experiments were conducted during 2015–16 and 2016–17 at Norman E. Borlaug Crop Research Center, Pantnagar GB Pant University of Agriculture & Technology, Pantnagar, U.S. Nagar (Uttarakhand) India, to study the crop intensification and establishment techniques influence on weed dynamics under irrigated rice-wheat system. In Kharif season, density of total weeds as well as grasses, broad-leaved weeds and sedges was observed lowest in rice-wheat cropping system. Transplanted rice-vegatable pea-groundnut cropping sequence proved superior over those cropping systems where upland direct-seeded rice was included as one of the crop with respect to control of Kharif season weeds. In Rabi season, maize (B) (cob + fodder) + cowpea (B) + Sesbania (F)-2:1:2-vegetable pea (B) + toria (F)-3:1-groundnut (B) + mentha (F)-3:1(BBF 105 x 30 cm)] proved to be the most prominent cropping system for controlling broad-leaved weeds and sedges. All the cropping systems proved superior for the control of grassy weeds (Phalaris minor and Avena fatua) in which there was inclusion of either legumes or oilseed crops in place of wheat. During summer season, soybean (B) + rice (DSR) (F)-2:1-wheat (B) + mentha (F) (3:1)-continue (NBS 60 x 30 cm) cropping system was found better for the control of complex weed flora

Evaluation of various management modules against insectpest complex of blackgram and greengram

An investigation was carried out for the evaluation of various IPM modules against pest complex of greengram and blackgram, at GB Pant University of Agriculture and Technology, Pantnagar. Five IPM modules were applied under field conditions, consisting of seed treatment with imidacloprid 600FS @ 5ml/kg + Trichoderma 4 g/kg, NSKE 5% or neem based formulation 30–40 DAS and yellow sticking traps @ 100/ha as common practices, whereas the chemical application (Novaluron 1 ml/l, Triazophos 0.04%, Indoxacarb 15.8 EC 250 ml/ha and Acephate 500 g/ha) at 45–50 days after sowing varied in all modules. Higher effectiveness was observed in module 1 (seed treatment with imidacloprid 600FS @ 5ml/kg + Trichoderma 4 g/kg, NSKE 5% or neem based formulation 30–40 DAS, Novaluron 1 ml/l (4550 days after sowing), yellow sticking traps @ 100/ha) against whitefly, jassid, Raptotoris and Maruca sp. Module1 proved superior in reducing population of all tested, sucking insect-pests webbing and pod damage by Maruca sp., resulting in higher grain yield of 1317.17 and 1281.26 kg/ha in greengram and blackgram, respectively. Highest cost benefit ratio of 1: 7.21 and 1: 7.48 were also recorded in greengram and blackgram, respectively under IPM module 1.

Determination of lethal dose for gamma rays induced mutagenesis in different cultivars of dahlia

High aesthetic and economic importance of dahlia stimulates breeders for the development of new cultivars. To determine the lethal dose (LD50) of gamma rays in different cultivars of dahlia, an experiment was conducted at MFC, GB Pant University of Agriculture and Technology, Pantnagar. Rooted cuttings of three dahlia cultivars viz., Jyotsana, Agni and Glory of India were exposed to acute (60Co) gamma ray irradiation at 0.0 (Control), 1.0, 1.5, 2.0, 2.5 and 3.0kR to determine the lethal doselevel. Probit analysis for extrapolated LD50 in different cultivars of dahlia for mortality was 2.07, 1.91, and 1.87 kR for Jyotsana, Agni and Glory of India, respectively indicating the higher sensitivity for cultivar Glory of India. There was direct correlation between dose of gamma irradiation and mortality of cuttings. Maximum mortality (47.00%) was observed at 3.0 kR while, minimum (10.00%) was observed at 1.0 kR dose of gamma rays treatment. Different cultivars also exhibited significant differences for mortality percentage by gamma rays irradiation. The LD50 values for maximum survival percentage of cuttings can be fixed at 2.07, 1.91 and 1.87 kR of gamma rays irradiation for cvs. Jyotsana, Agni and Glory of India, respectively.

Assessment of serum lipid profile and liver function parameters in children with epilepsy on phenytoin or valproic acid monotherapy for 6 months and beyond

Objectives: The highest incidence of epilepsy in children coupled with the need of long-term antiepileptic treatment could lead to development of metabolic complications at an early age. Phenytoin and valproic acid are commonly used antiepileptic drugs in children. This study aimed to assess the serum lipid profile and liver function tests in children with epilepsy on phenytoin or valproic acid monotherapy for 6 months and beyond. Materials and Methods: This prospective descriptive study recruited children from the pediatric outpatient department of a tertiary care GB Pant Children Hospital, Srinagar, Kashmir, India from August 2009 to September 2011. All consecutive children diagnosed with epilepsy as per International League Against Epilepsy definition aged 3–18 years on phenytoin or valproic acid monotherapy for 6 months or beyond were enrolled. After baseline clinical and anthropometric evaluation (including body mass index [BMI]), the fasting blood samples were analyzed for serum lipid profile and liver enzyme changes. Results: Total of 75 children were enrolled. There were 25 patients each in phenytoin, valproic acid, and control group. We observed statistically significant high mean total cholesterol and alkaline phosphatase levels in group receiving phenytoin when compared with valproic acid or control group. Conclusion: The lipid and liver enzyme abnormalities may be observed in children on phenytoin or valproic acid therapy, which warrants careful screening and monitoring.

Platelet indices in diabetics and influence of glycemic control – a hospital based study in North-East India

Introduction: Platelets from patients with type 1 and type 2 diabetes exhibit enhanced platelet aggregation activity early in the disease course that may precede the development of cardiovascular diseases. Both atherosclerosis and thrombosis appear to contribute significantly to the increased cardiovascular risk of diabetic patients. Platelet indices include mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (P-LCR). This study was undertaken with the aim to find out the differences in platelet indices between diabetics and non-diabetics and also between patients with controlled and uncontrolled diabetes mellitus in a tertiary health care centre in North East India. Methods: This is a cross sectional study conducted in Agartala Government Medical College and GB Pant Hospital (AGMC & GBP Hospital). 100 cases and 100 controls were selected from the Diabetes clinic of Medicine out patient department (OPD) and Medicine wards. Platelet indices and HbA1C levels of these cases and controls were measured. Platelet indices were measured by a 3-part differential hematology auto-analyzer and HbA1C by High Performance Liquid Chromatography (HPLC) method. Blood glucose levels were estimated by oxidase-peroxidase method. Results: Platelet indices were found to be significantly higher among diabetics compared to non-diabetics and also they were found higher among patients with poor glycemic control with HbA1C>7% in comparison to patients with good glycemic control with HbA1C<7% (P value <0.05). Conclusions: Platelet indices are significantly increased in diabetics and the extent of increment is more in diabetics with poor glycemic control.

APOLIPOPROTEIN B / A1 RATIO AS RISK PREDICTOR OF ANGIOGRAPHICALLY PROVEN ATHEROSCLEROSIS

30Jun 2016 APOLIPOPROTEIN B / A1 RATIO AS RISK PREDICTOR OF ANGIOGRAPHICALLY PROVEN ATHEROSCLEROSIS Anita Devi , Ritu Singh and Sanjay Tyagi. Senior Resident, Deptt of Biochemistry, Lady Hardinge Medical College, New Delhi. Professor, Deptt of Biochemistry, Lady Hardinge Medical College. Director Professor & HOD, Deptt of Cardiology, GB Pant Hospital, New Delhi.

Assessment of Knowledge and Practice of Mothers of Children under Five regarding Zinc Therapy in Childhood Diarrhea

ABSTRACT Aim Zinc is now considered as an important treatment intervention along with low-osmolarity oral rehydration salts in diarrhea. But awareness about the use of zinc remains low. The present study was conducted with an objective of assessing knowledge and practice of mothers of under-5 children about zinc supplementation in diarrhea. Materials and methods A hospital-based cross-sectional study was carried out in the Paediatric Outpatient Department Agartala Government Medical College and GB Pant Hospital, Agartala, Tripura, India, with a sample size of 700 mothers of under-5 children over 2 months. Convenience sampling technique was employed and the data were collected in a structured, interview schedule. Descriptive statistics and tests like chi-square test were used for analysis. Results Only 1.9% of all the respondents (13 out of 700) had heard about zinc therapy in diarrhea. Out of them, 11 mothers had actually used zinc in practice and 7 could tell the duration of therapy. None of them were aware of what benefit is conferred by zinc in an episode of diarrhea. An association between knowledge levels and educational status and occupation of mothers was found to be statistically significant. Conclusion The study reaffirmed the abysmally low level of awareness about zinc supplementation among mothers. Therefore, health education can be used as a tool to promote knowledge and practice of zinc supplementation in diarrhea to reduce mortality and morbidity. How to cite this article Dhar DK, Majumder N, Paul D. Assessment of Knowledge and Practice of Mothers of Children under Five regarding Zinc Therapy in Childhood Diarrhea. Int J Adv Integ Med Sci 2016;1(4):169-172.

Study of TNF-α Polymorphism (308G/A) and the Role of NF-κB as an Novel Marker of Severity of Atherosclerosis: A Pilot Study in Indian Population

Background: Biallelic polymorphism of A/G variation at position 308 in the promoter region of TNF-α gene is an important genetic factor causing high TNF-α transcription which could influence the clinical outcome of atherosclerosis. Studies have also implicated the role of NF-κB in atherogenesis by regulating genes involved in the inflammatory response and insulin sensitivity. Material and Method: 50 cases of angiographically significant atherosclerosis (>50% obstruction in coronary arteries) and 50 age, sex, BMI matched patients with insignificant atherosclerosis (>50% obstruction) on angiography were selected from GB Pant Hospital. Polymorphism was studied by amplifying DNA using PCR and amplified segments were digested by restriction enzyme Nco-I and followed by RFLP. Serum NF-κB, TNF-α levels were estimated by sandwich ELISA. Results: The mean serum NF-κB and TNF-α levels were significantly (p=0.04, 0.000 respectively) raised in cases as compared to controls. Upon binomial logistic regression analysis, NF-κB emerged as the best predictor of severity of atherosclerosis (Odds ratio=27) among other markers. Our results showed no intergenotypic variation of 308-G/A polymorphism of the TNF-α gene between cases and controls. Conclusion: Our study establishes NF-κB as an emerging biomarker of severity of atherosclerosis in Indian population. No intergenotypic variation between cases and controls indicates that significantly high levels of TNF-α in the cases is attributed to cause other than polymorphism in Indian population. High prevalence of chronic low grade inflammation in population could be postulated as the possible cause.

Promotion of Successful Hand Hygiene practices in the Intensive Care Units of a Tertiary Care Hospital

BackgroundControl of nosocomial infections is a major health concern in a hospital setting and hand hygiene is considered as the most important tool in nosocomial infection control. MethodsThis prospective study about the practice of hand washing by 106 HCWs (Health Care Workers) working in Intensive Care Unit (ICU) before and after patient contact in a tertiary care hospital was conducted to find out the hand washing compliance rate in ICU of GB Pant Institute of Postgraduate Medical Education and Research and the factors associated with noncompliance and to find out the impact of a task-orientated hand hygiene education and intervention program. Results462 opportunities of hand hygiene were observed in the ICUs over 30h. Adherence was found to be 52%. A positive intention to comply with hand hygiene was found among 94% of the respondents. Most respondents (78.2%) believed that they could improve compliance with hand hygiene on their own. Intervention included education on hand hygiene indications and technique, hand hygiene performance feedback, and discussion of the previous assessment of HCWs’ beliefs toward hand hygiene. After intensive promotion of hand hygiene, observation sessions were performed on 98 nursing staff, which provided 425 opportunities of hand hygiene, and hand hygiene adherence was increased to 63% as an impact of measures taken. ConclusionsThe study revealed that hand hygiene compliance can be effectively increased among HCWs by regular reminders and surveys. Training programs on hand hygiene should be systematically planned, regularly conducted, and evaluated for staff nurses so as to keep them motivated.

An Analysis of the Origins, Subjects, and Awards Received for Presentations at the Annual IASG Conferences (2009-2013).

s presented at scientific meetings are important for making ongoing research more widely known and may also reflect the quality of the parent institution's standard of patient care. We analyzed the abstracts presented at the annual meetings of IASG for the past 5years for (i) medium of presentation (oral/poster/videos), (ii) subjects discussed, (iii) institution of origin, (iv) whether a prospective/ retrospective study or a case report, (v) changing trends, and (vi) awards received. Of the 1340 abstracts analyzed, there were 18.5% oral, 74.9% posters, and 6.5% videos presented from 205 in 2009 to 388 in 2012. The main organs discussed were the liver (19.3%) pancreas (18.8%), and biliary system (14.4%). Sixty percent was from the private sector with Sir Ganga Ram, SGRH (95) and the Apollo Hospital, New Delhi (60), being the most prolific. From public institutes, the abstracts were predominantly from PGIMER, Chandigarh (39) and GB Pant Hospital (37). Thirty-three percent was from DNB and 25% from M.Ch GI Surgery centres and 42% was from others (most of these were as posters). There were 1016 (75.8%) prospective/retrospective studies and 324 (24.2%) case reports. Presentations, especially those related to liver transplantation, showed an increase. The main awards were won by SGRH (8); AIIMS, New Delhi (7); and JIPMER, Puducherry (6). Over the last 5years, abstracts presented at the IASG have increased in number especially those dealing with the hepato-pancreatico-biliary system and liver transplantation. Most presentations were from "academic" departments, and similar analyses may inform us where we are heading and stimulate healthy competition.

Seasonal incidence of major insect-pests of soybean and their correlation with abiotic factors

Population dynamics of insect-pests of soybean and there correlation with abiotic factors were studied at Norman E Borlaug Crop Research Centre, GB Pant University of Agriculture and Technology, Pantnagar. Observations on the incidence of various insect-pests viz. Spodoptera litura, Spilarctia obliqua, Thysanoplusia orichalcea, Obereopsis brevis, Bemisia tabaci and Melanagromyza sojae were recorded at weekly intervals. On the basis of observations and correlation study of insect incidence in relation to weather parameters, it was found that stem fly having 100% infestation showed significant negative correlation with minimum temperature and its maximum damage (100% infestation, 33.84% tunneling) was highly significant and negatively correlated with the evaporation. S. obliqua incidence was significantly positively correlated with wind velocity. But all the weather parameters were nonsignificantly related to incidence of S. litura, T. orichalcea, O. brevis and B. tabaci. Thus, low temperature and evaporation have negative correlation with incidence of stem fly, whereas, wind velocity was found positively correlated in the case of S. obliqua incidence.

Performance of wheat in relation to INM under Rice-Wheat cropping system

An investigation to study the effect of different planting methods in rice and nutrient management practices in rice and wheat on productivity of cropping system was conducted at GB Pant University of Agriculture and Technology, Pantnagar during the years 2006–07 and 2007–08. Rice cultivation by transplanting method gave higher grain yield in paddy whereas the higher wheat yield was recorded when it was grown after direct seeded rice. FeSO4 fertilization in rice along with recommended NPK and sesbania green manuring also proved as the yield enhancing practice for rice, however in the same combination of nutrient sources when FeSO4 was replaced by MnSO4 in wheat, some increase was found in wheat yield; but not statistically significant over all the other treatments. Growing ofwheatafter direct seeded rice along with MnSO4 application and sesbania residual green manuring in combination with recommended NPK was found a better nutrient management practice in wheat under rice-wheat cropping system.

Isolation of Mycobacterium tuberculosis from sputum of tribal, non-tribal pulmonary tuberculosis patients of Andaman & Nicobar islands by conventional culture method and assessment of first line anti-tuberculosis drug susceptibility patterns

BackgroundDrug resistance surveys have not yet conducted in these Islands and as such no data exists on drug resistance currently. Aimsthe present study was initiated with the objective of isolation and assessment of Drug resistance patterns of Mycobacterium tuberculosis isolates from sputum specimens collected from different categories of Tribal, Non-Tribal pulmonary tuberculosis patients treated under DOTS and Non-DOTS program by conventional culture and Proportion sensitivity (PST) method to detect patients with Multidrug resistant strains. MethodsThe investigation was hospital based laboratory surveillance study carried out for a period of 3 years at the selected hospitals of Andaman district (TB ward GB Pant Hospital at Port Blair, CHC Bamboflat at Port Blair and CHC Rangat at Rangat) and Nicobar district (CHC Nancowry at Nancowry groups of Islands), among the new cases and re-treatment cases of tuberculosis patient under DOTS program and Non-DOTS patients attended selected hospitals of Andaman & Nicobar districts chosen for the study. Results83 culture positive isolates obtained (74 identified as M. tuberculosis) from the sputum specimen of 162 cases of tuberculosis patient by conventional culture method. 60 M. tuberculosis isolates subjected to drug susceptibility test using PST method, 7 patients (11.67%) found to be Multidrug resistant tuberculosis (MDR-TB), resistant patterns were S + H + R + E = 1(Cat II-DOTS),H + r = 3(Cat-I DOTS = 1, Cat II-DOTS-1,Non-DOTS = 1), Rifampicin resistant alone = 2 (Non-DOTS = 1, Cat II-DOTS = 1) and R + E = 1(Cat I-DOTS). ConclusionsLaboratory finding suggested that nine MDR-TB strains detected in DOTS and Non-DOTS among 60 M. tuberculosis isolates were selected for drug susceptibility testing but two isolates detected as MDR-TB from patients was already on Second line drugs treatment were not included in the MDR-TB detection criteria. Hence 7 patients (11.67%) declared to be Multidrug resistant tuberculosis (MDR-TB). 2 MDR-TB strains with resistant patterns H + r = 1(Cat II-DOTS), Rifampicin resistant alone = 1(Non-DOTS) detected from 12 isolates of Tribal patients from Nicobar district and 5 MDR-TB strains with resistant patterns S + H + R + E = 1 (Cat II-DOTS), H + r = 2(Cat I-DOTS = 1,Non-DOTS = 1), Rifampicin resistant alone = 1 (Cat II-DOTS) and R + E = 1(Cat I-DOTS) detected from 48 isolates of Non-Tribal patients from Andaman district. To assess the MDR-TB burden in the islands, systematic drug resistant surveillance study needs to be conducted.

Maternal mortality in Andaman and Nicobar group of islands: 10 years retrospective study

Context:Maternal mortality ratio (MMR) is an indicator of effectiveness of health care facilities for women of child bearing age group. Andaman and Nicobar (A&N) group of islands are unique as they are situated 1200 km from the mainland India. Healthcare delivery for the these islands is exclusively provided and controlled by only one authority, Directorate of Health Services, A&N Islands. GB Pant Hospital, Port Blair is the only referral hospital with round the clock specialists and surgical services.Aims:To estimate the MMR in A&N islands from 2001 to 2010, and study the causes of maternal mortality.Settings and Design:Retrospective.Materials and Methods:Data for the estimation of MMR were collected from office of Registrar of Births and Deaths, Hospital and Peripheral Health Centres. Case records of maternal deaths in GB Pant Hospital were reviewed to study the causes of death.Statistical analysis used:Proportions and Ratios.Results:Ten years average MMR for the entire island was 85.42. Analysis of 30 maternal deaths in GB Pant Hospital showed that 63.3% were due to direct obstetric causes (eclampsia 30%, hemorrhage 23.33%, sepsis 6.66%, and 3.33% amniotic fluid embolism). Of the indirect causes, anemia was the commonest (16.66%).Conclusions:The MMR of A&N islands is much lower than the national average of 250. Direct obstetric causes accounted for more than half of maternal deaths 63.33%.

A study of autonomic functions in the patients of episodic migraine

Background: Autonomic disturbances are common in the patients of migraine, predominantly sympathetic hypofunction was observed while parasympathetic system also showed abnormal behavioral response. There is no comprehensive study regarding these aspects in migraineurs in India. Aims & Objective: To study the state of autonomic nervous system in the patients of episodic migraine during interictal period. Materials and Methods: This case control study done employing a sample of 54 migraine cases selected from the outpatient department, GB Pant hospital Delhi. Selection of patients was based on the clinical diagnosis by neurologists and each case fulfilling the International headache society criteria 2004 irrespective of aura status. The control pool was formed by 30 normal healthy participants from Maulana Azad Medical College. All participants were aged between 20 to 40 years. Informed consent was taken from all the participants and the ethical clearance was obtained from the college. Sympathetic function tests: handgrip test, cold pressor Test, sympathetic skin response and parasympathetic function tests: resting heart rate, standing to lying Ratio, 30: 15 ratio, Valsalva Ratio and tachycardia Ratio. Assessment of the autonomic system was carried out during headache free interval. Results: Of the sympathetic tests, the sympathetic skin response showed a significant statistical difference between cases and controls while remaining parameters showed no statistical significance. Of the parasympathetic tests, none of them revealed any statistical significance between cases and controls. Conclusion: In contrast to many western studies which showed sympathetic hypofunction, we observed sympathetic hyperfunction during the interictal period, while parasympathetic system was normal. Key Words: Migrain

Neurovirology: Neurotropic Viruses and the Brain

Sunit K Singh speaks to Hannah Branch, Commissioning Editor Sunit K Singh obtained a Bachelor's degree from GB Pant University of Agriculture and Technology (India) followed by his Master's degree from the Central Institute of Fisheries Education (India). Upon the completion of his Master's degree, Singh moved to the University of Wuerzburg (Germany) to complete his PhD degree in the field of Molecular Infection Biology. Subsequently, he undertook his postdoctoral training at Yale University School of Medicine (CT, USA) and at the University of California Davis Medical Center (CA, USA). Singh has also been visiting faculty at the Albert Einstein College of Medicine (NY, USA), Department of Pathology and Immunology, University of Geneva (Switzerland) and the Institute of Parasitology (Czech Republic). At present, he is a permanent member of faculty in the Section of Infectious Diseases and Immunobiology Centre for Cellular and Molecular Biology (CCMB; India) and is leading a research group in the area of neurovirology there. Singh has been an author of a number of papers published in peer-reviewed journals, and has been honored with several awards, including the Skinner Memorial Award, Young Scientist Award, Travel Grant Award and the NIH-Fogarty Fellowship. In addition, he is a valued editorial board member of several journals, including Future Microbiology.