SWOT Analysis of Total Sanitation Campaign in Yavatmal District of Maharashtra

Aims:

To study the strengths, weaknesses, opportunities, and threats of the Total Sanitation Campaign (TSC) in the Yavatmal district of Maharashtra.

Methodology:

Data was collected in December 2006 through interviews with stakeholders, house-to-house surveys, focus group discussions, and transect walks. Information in each category was finalized in a meeting after brainstorming and discussion with the TSC cell members.

Results:

The strengths of the campaign were innovations in Information Education and Communication, motivation through incentives, competitive spirit, active participation and partnerships, involvement of women, and universal coverage. The main weaknesses of the program were the absence of Rural Sanitary Marts/Production Centers, poor maintenance of Women Sanitary Complexes, lack of facilities for monitoring/ follow-up and a temporary focus of the campaign approach. There is an opportunity to tap additional resources, learn from other experiences, and institute back-up agencies to support and guide the community in the post-TSC phase. A change in administration and local leadership and loss of priority and interest needed to sustain the momentum while scaling up the interventions are possible threats for the program.     

Prospective Comparison of Eubacterial PCR and Measurement of Procalcitonin Levels with Blood Culture for Diagnosing Septicemia in Intensive Care Unit Patients

Rapid identification of infection has a major impact on the clinical course, management, and outcome of critically ill intensive care unit (ICU) patients. We compared the results of PCR and procalcitonin with blood culture for ICU patients suspected of having septicemia. Ninety patients (60 patients meeting the criteria for sepsis and 30 patients not meeting the criteria for sepsis) were evaluated. Compared with blood culture as the gold standard, the sensitivity, specificity, and positive and negative predictive values for PCR were 100%, 43.33%, 46.87%, and 100%, respectively, and for procalcitonin were 100%, 61.66%, 56.6%, and 100%, respectively. The average times required to produce a final result were as follows: PCR, 10 h; blood culture, 33 h; procalcitonin, 45 min. Both PCR and procalcitonin may be useful as rapid tests for detecting septicemia but compared with blood cultures lacked specificity.A rapid and reliable system to detect bacteria in the bloodstream would be clinically useful as it could guide early appropriate antibiotic treatment and result in improved patient survival (14). The gold standard for the diagnosis of infection is the isolation and identification of organisms by culture (27). This process usually requires 24 h or more. A large proportion of patients suspected of having septicemia have negative blood cultures (3) due to either previous antibiotic treatment, samples of small volume, transient bacteremias, or sepsis of nonbacterial origin (8, 30). Given the slowness and low sensitivity of blood culture, there is a need for more-rapid and more-sensitive techniques. PCR, which amplifies characteristic genes of microorganisms, is one such technique. In clinical conditions with diverse etiological agents in sterile sites, e.g., blood in sepsis, a broad-range bacterial PCR which uses a primer pair aimed at highly conserved DNA coding regions on bacterial rRNA can be used (8, 10, 11, 20). This is described as eubacterial PCR as well as broad-range bacterial PCR as it detects an rRNA gene component present in all bacteria. PCR cannot differentiate DNA sequences from viable and nonviable bacteria. The value of this test may be enhanced if it is coupled with a host response biomarker indicative of infection and systemic inflammation. Procalcitonin is one such marker and is gaining increasing importance in identification of sepsis (1, 15, 16). Procalcitonin levels are undetectable in healthy individuals but increase in patients with bacterial sepsis and correlate well with the severity of the illness (5, 19, 29).The aim of this study was to compare the results for eubacterial PCR and procalcitonin with blood culture in intensive care unit (ICU) patients suspected of having septicemia.     

Enhanced tumour growth after DNA vaccination against human papilloma virus E7 oncoprotein: evidence for tumour-induced immune deviation

We have examined the induction of anti-tumour immunity in a murine model using a gene vaccine approach to deliver a well defined tumour antigen. The vaccines expressed the human papilloma virus type 16 (HPV 16) E7 oncoprotein, and protection was measured against HPV 16-expressing C3R tumour cell line in vivo. In control mice injected with saline, C3R cells initially formed tumours but then regressed completely. As expected, animals injected with a peptide that represents the D(b)-presented CTL epitope from E7 (RAHYNIVTF) were completely protected from tumour growth. Contrary to expectation, however, we consistently saw enhanced tumour growth, delayed regression, or tumour outgrowth in mice vaccinated with two different E7-expressing DNA vaccines. We found no evidence for loss of D(b) or K(b) class I MHC molecules from C3R cells recovered from outgrown tumours, and fluorescent MHC/peptide tetramer staining revealed E7 gene vaccination did not delete RAHYNIVTF-specific CD8(+) T cells. However, we did observe an effect on cytokine production. Splenocytes from E7 gene vaccinated animals responded to re-stimulation in vitro with C3R cells by producing IL-4 but background levels of IFN-gamma. We also observed that cytokine production and E7 peptide-specific CTL were only detectable in vaccinated animals after C3R challenge, but not after DNA priming alone. We conclude that 'prime-boosting' is necessary to observe tumour-specific T cell responses with the gene vaccine approach, but that boosting with tumour cells causes skewing of the primed cells in a T2 direction that is incompatible with protective anti-tumour immunity.     

Evaluation of the antioxidant activity of non-transformed and transformed pineapple: A comparative study

Pineapple has several beneficial properties including antioxidant activity. We investigated the antioxidant effect of different extracts of non-transformed (S) and transformed pineapple (with the magainin gene construct, [TS], for disease resistance). They were examined using 1,1-diphenyl-2-picryl hydrazyl (DPPH) radical scavenging, oxygen radical absorbance capacity (ORAC) and lipid peroxidation assays besides phenolic and flavonoid contents. HPLC analysis was carried out to identify the possible components responsible for the differences observed. The present study indicates that the ORAC values of extracts range from 9.5 to 26.4, similar to or higher than those for some fruits and vegetables. The HPLC analysis shows that the main compounds present are ascorbic acid, quercetin, flavone-3-ols, flavones, cinnamic acids. The TS core Et. extract exhibited slightly higher concentration of ascorbic acid and considerably higher concentration of flavon-3-ols. Our study, in general, indicates that the transformation event has caused only marginal difference in antioxidant activity. Moreover the TS samples showed more antioxidant activity in some aspects and also exhibit more flavonoid content. It appears that plant cell transformation has only caused minor and favourable changes in the overall chemical composition. Thus the TS pineapple variety may have potential applications in human health like its non-transformed counterpart.     

Derivation and characterization of four new human embryonic stem cell lines: the Danish experience

In September 2003, legislation approved in Denmark legalized work on surplus human embryos from IVF for clinical purposes to establish human embryonic stem (ES) cell cultures. The aim of this study was to establish such stem cell lines. Fresh surplus embryos were donated after informed consent from the donors. Embryos were cultured into blastocysts and using the immunosurgery procedure, inner cell masses were isolated and cultured on irradiated human foreskin fibroblasts in KnockOut D-MEM supplemented with KnockOut Serum Replacement, bFGF, and LIF. Within a period of 12 months, 198 embryos were donated. Four isolated inner cell masses developed into putative ES cell lines, CLS1, CLS2, CLS3, CLS4, which have now been continuously cultured for eight months, corresponding to 30 passages. These cells expressed markers for undifferentiated human ES cells: stage-specific embryonic antigen-4, tumour-related antigen (TRA)-1-60, TRA-1-81, OCT4, NANOG, SOX2, and FGF4. The cells expressed high levels of telomerase activity, had a normal karyotype, and have been successfully cryopreserved and thawed. Finally, the cells displayed the potential to differentiate in vitro into cell types originating from all three germ layers. It is thought that the cell lines described in this study are the first human ES cells established in Denmark.     

Impact of COVID-19 Lockdown on Non-Alcoholic Fatty Liver Disease and Insulin Resistance in Adults: A before and after Pandemic Lockdown Longitudinal Study

Background: Non-alcoholic fatty liver disease is a chronic disease caused by the accumulation of fat in the liver related to overweight and obesity, insulin resistance, hyperglycemia, and high levels of triglycerides and leads to an increased cardiovascular risk. It is considered a global pandemic, coinciding with the pandemic in 2020 caused by the “coronavirus disease 2019” (COVID-19). Due to COVID-19, the population was placed under lockdown. The aim of our study was to evaluate how these unhealthy lifestyle modifications influenced the appearance of metabolic alterations and the increase in non-alcoholic fatty liver disease. Methods: A prospective study was carried out on 6236 workers in a Spanish population between March 2019 and March 2021. Results: Differences in the mean values of anthropometric and clinical parameters before and after lockdown were revealed. There was a statistically significant worsening in non-alcoholic fatty liver disease (NAFLD) and in the insulin resistance scales, with increased body weight, BMI, cholesterol levels with higher LDL levels, and glucose and a reduction in HDL levels. Conclusions: Lockdown caused a worsening of cardiovascular risk factors due to an increase in liver fat estimation scales and an increased risk of presenting with NAFLD and changes in insulin resistance.