Further evidence of hepatitis B virus genotype I circulation in Northeast India

Hepatitis B virus (HBV) genotypes have known to show a geographical pattern in their distribution and have been used to trace the migration of populations from geographically distant regions. Novel recombinants between HBV genotypes A, G and C referred as genotype I has been recently reported from Eastern India. In our investigation to characterise antiviral resistance mutations, we identified a rare case of HBV genotype I infection in chronic hepatitis B subject. We encountered confounding results of this emerging genotype ‘designated as genotype G’ in three widely used HBV sequence database for genotype determination. The recombinant fragment of genotype G largely occupies the surface gene sequence of the newly identified genotype I and could hence lead to misclassification of genotype I. Additionally, recombination analysis of the generated sequences in Simplot and jpHMM model showed two different patterns of recombination events. In conclusion, the increasing recognition of genotype I in this population suggests that further studies may reveal uncommon genotypes from other geographically distant regions. Our observation of potential genotype I misclassification despite the use of public HBV sequence database and other recombination analysis tools highlights the need for updating and validating public sequence domains of diagnostic importance.     

The state of political priority for safe motherhood in India

Approximately one-quarter of all maternal deaths occur in India, far more than in any other nation on earth. Until 2005, maternal mortality reduction was not a priority in the country. In that year, the cause emerged on the national political agenda in a meaningful way for the first time. An unpredictable confluence of events concerning problem definition, policy alternative generation and politics led to this outcome. By 2005, evidence had accumulated that maternal mortality in India was stagnating and that existing initiatives were not addressing the problem effectively. Also in that year, national government officials and donors came to a consensus on a strategy to address the problem. In addition, a new government with social equity aims came to power in 2004, and in 2005, it began a national initiative to expand healthcare access to the poor in rural areas. The convergence of these developments pushed the issue on to the national agenda. This paper draws on public policy theory to analyse the Indian experience and to develop guidance for safe motherhood policy communities in other high maternal mortality countries seeking to make this cause a political priority.     

Pattern of use of contact lens among college students: A cross-sectional study in coastal Karnataka

The use of contact lens (CL) for the correction of refractive errors, cosmetic use and their usage as a therapeutic modality for corneal pathologies has increased tremendously over the years. The present study was conducted with the aim to find a pattern of CL use amongst college students with a focus on the rationale for CL use and problems related to their use. This study includes 371 college students who were current users of CL at the time of the study. Results showed that 96.8% of the CL users use the ‘daily wear type’ of CL. Most quoted reasons of usage were comfort and convenience (61.2%) with cosmetic benefit (42.9%) as the next most common reply. Common complaints were that of general discomfort (foreign body sensation), dry eyes and watering eyes. Educated use of CLs amongst its users is advised in view of the symptoms and associated complications that may occur.     

Serum homocysteine in Indian adolescents

Objective  To assess serum homocysteine levels and its association with conventional risk factors for cardiovascular disease (CVD) in Indian adolescents. Methods  This was a cross-sectional study conducted in tertiary care hospital in northern India in apparently healthy adolescents aged 10–19 yr. A pre-designed questionnaire was used to assess conventional risk factors. Serum homocysteine levels of ≥ 12μmol/L, serum triglycerides ≥ 150 mg% and serum cholesterol ≥ 200 mg% were taken as hyperhomocysteinemia, hypertriglyceridemia and hypercholesterolemia, respectively. Serum high-density lipoprotein (HDL) ≥ 40 mg% was considered protective for CVD. Results  In 103 subjects, 36.87 % females, mean serum homocysteine level was 11.649 ±0.416μmol/L. Hyperhomocysteinemia was present in 46 (44.6%, 95% CI: 34.965–54.75) subjects. Dietary deficiency of vitamin B12 and folic acid, body mass index (BMI) > 84^th percentile and altered lipid profile were associated with hyperhomocysteinemia on univariate analysis. After multivariate adjustment for BMI and vegetarian diet, low serum HDL (OR: 23.81, 95% CI: 2.86–200; p =0.003) and serum hypertriglyceridemia (OR: 4.17, 95% CI: 1.51–13.51; p = 0.022) had independent association with hyperhomocysteinemia. Conclusion  Since we have also found an association between hyperhomocysteinemia and low serum HDL levels and hypertriglyceridemia, which are conventional risk factors for CVD, interventional strategies are urgently needed among adolescents for prevention of CVD.     

Extent and speed of spread of HIV infection in India through the commercial sex networks: a perspective

India has the world's highest number of HIV/AIDS infections for any country outside Africa. Eighty-five per cent of HIV transmission in India occurs through heterosexual contact. One billion population, a large number of female sex workers, high prevalence of sexually transmitted infection (STIs) and low condom use make a potent combination for explosive growth of the epidemic. Taking available estimates of the number of female sex workers (FSWs), their work patterns, prevalence of HIV and STIs and condom use among them in 1999 as the base, and adopting reasonable infectivity rates, this paper attempts to present a model to estimate the spread of HIV infection in commercial sex networks until 2005. HIV infections in commercial sex networks are estimated to increase from the 1999 level of approximately 2.49 million to about 3.93 million by 2005 in a favourable scenario, and to 6.87 million in a worse scenario. Spread of HIV is influenced in the short term by condom use and prevalence of STIs, and these are the only factors that can be manipulated to limit the spread of the infection.     

中印制药产业竞争力比较研究

目的:为我国制药产业提高国际竞争力提供参考。方法:提炼决定制药产业国际竞争力的主要因素,对中印制药产业的国际竞争力分别进行SWOT(优势、劣势、机会、威胁)分析。结果:印度制药产业在国际新药注册、质量认证和人才战略等方面远远领先于我国。结论:我国制药产业可以借鉴印度制药产业的成功经验,确定适合自己的发展战略。     

A novel 33.3 kb deletion (- -KOL) in the alpha-globin gene cluster: a brief report on deletional alpha-thalassaemia in the heterogeneous eastern Indian population

We have detected, in three unrelated eastern Indian individuals, a hitherto unreported alpha zero deletion, - -KOL, in the heterozygous state, encompassing the embryonic zeta2-globin and the duplicated alpha-globin genes extending from c. 1150 bp upstream of the zeta2 globin gene to c. 960 bp downstream of the theta1 gene. Other deletions present in 120 unrelated, eastern Indian, putative alpha-thalassaemia patients are -3.7 kb (16.25%), -4.2 kb (5%) and - -SEA (3.33%).     

Unexpected detection of simian SA11-human reassortant strains of rotavirus G3P[8] genotype from diarrhea epidemic among tribal children of Western India

This investigation is in continuation with the earlier studies on diarrhea epidemic due to rotavirus, that occurred at Jawhar western India, among tribal children during Dec 2000-Jan 2001 published by National Institute of Virology, Pune. Three rotavirus strains were isolated in cell culture from fecal specimens of affected children. Monoclonal antibody ELISA and RT-PCR typed the isolates as G3P [8]. Two isolates agglutinated guinea pig erythrocytes thereby indicating their animal origin. Antiserum against simian G3, SA11 neutralized both the isolates largely than antiserum against human G3 (YO). Nucleotide sequencing of VP7 gene, nested PCR product of three isolates, and two original fecal specimens showed 100% identity with both simian G3, SA11 prototype and ROSVP7, SA11 strains whereas, lower identity (82%) with human G3 (YO) strain. Partial sequence analysis of the VP4 gene of fecal specimen FS-006964 & isolate I-006964 showed 99% identity with G1P[8] strain, while 80% identity with simian G3P[2], SA11 strain. Thus, the strains appeared to be reassortants between human and simian origin. Serological studies further supported the identity of the causative agent as simian G3, SA11 like strains. Neutralizing antibody titers at very low level against simian G3, SA11 as well as human G3 (YO) strains among the population at Jawhar suggested an overall lack of immunity against the virus. Seroconversion against simian G3, SA11 was shown by six out of seven child patients. Thus, simian G3, SA11 like strains are claimed for the first time as etiological agents of diarrhea in humans.     

The State of Medical Informatics in India: A Roadmap for Optimal Organization

In India, the healthcare delivery systems are based on manual record keeping despite a good telecommunication infrastructure. Unfortunately, Indian policy makers are yet to realize the importance of medical informatics (including tele-health, which comprises e-Health and Telemedicine) in delivering healthcare. In the medical curriculum also, nowhere is this treated as a subject or even as a tool for learning. The final aim of most of the medical and paramedical students should be to become good users, and if possible, also experts for advancing medical knowledge base through medical informatics. In view of the fast changing world of medical informatics, it is essential to formulate a flexible syllabus rather than a rigid one for incorporating into the regular curriculum of medical and paramedical education. Only after that one may expect all members of the healthcare delivery systems to adopt and apply medical informatics optimally as a routine tool for their services.