Aizawl Adventist Hospital

Chromobacterium violaceum is a Gram-negative bacillus known to be a rare cause of human infection. The organism enters the body through skin injury and usually presents as a localized skin infection that can progress to multiple abscesses and multiorgan failure. To our knowledge, this is the first reported case of skin and soft tissue infection caused by C. violaceum in the northeastern state of India, Mizoram. The organism was isolated from a pus sample obtained from a septic wound located on the foot and thigh of a pediatric patient. Though considered rare, this case report indicates that C. violaceum can be a potential cause of infection.

While recommending a human papillomavirus (HPV) single-dose vaccination schedule in 2022, the World Health Organization highlighted the need for long-term follow-up studies to monitor waning of protection. We report on vaccine efficacy against HPV infections in 1-, 2-, and 3-dose schedules and protection against cervical precancers at a median follow-up of 12 years postvaccination. This randomized multicenter study in India was originally designed to vaccinate unmarried girls aged 10-18 years with either 2 or 3 doses of quadrivalent HPV vaccine. A ministerial decree to halt vaccination in trials resulted in the creation of cohorts receiving different doses, including just a single dose. Cohorts were assessed for incident and persistent infections by genotyping cervical samples collected yearly for 4 consecutive years after participants were married. Cervical screening with an HPV test was initiated at age 25 years for married participants. Age- and site-matched unvaccinated married women were recruited to be compared with vaccinated cohorts. Vaccine efficacy was assessed using proportional incidence ratios. The number of participants in the 1-, 2- (at 0 and 6 months), and 3-dose cohorts was 4949, 4980, and 4348, respectively. Of the recipients, 71%-82% in the different cohorts were eligible to provide samples for genotyping. Vaccine efficacy against persistent HPV 16 and 18 infection was 92.0% (95% confidence interval [CI] = 87.0% to 95.0%) in 3022 recipients of the single dose; and comparable with that observed in the 2-dose arm (94.8%, 95% CI = 90.0% to 97.3%) and the 3-dose arm (95.3%, 95% CI = 90.9% to 97.5%). No high-grade precancer associated with HPV 16 and 18 was detected among vaccinated participants compared with 8 precancers detected among the unvaccinated women. This observational cohort study has established that a single dose of HPV vaccine provides high protective efficacy against persistent HPV 16 and 18 infections and associated neoplasia 15 years postvaccination.

Brachial plexus block is one of the most popular technique to accomplish anaesthesia and post operative pain management for upper limb surgery. Brachial plexus block provides a better alternative to general anaesthesia because of its simple technique, safeties, preserves consciousness during surgery, avoids airway instrumentation, provides rapid recovery, avoids post operative nausea and vomiting and profound post operative analgesia. Lignocaine, bupivacaine and ropivacaine are the amino-amide local anaesthetic drugs used for brachial plexus block. The combination of the two local anaesthetic drugs produces faster onset of block and adequate post operative analgesia instead of using high volume of one drug alone. Hence, the present study was undertaken to compare the onset and duration of sensory and motor block, duration of post operative analgesia and side effects by compounding of two local anaesthetic agents guided by ultrasound to ascertain the better combination of drugs for supraclavicular brachial plexus block in terms of onset, duration and post operative analgesia.

Landslides are the most common hazard in the state of Mizoram. Rapid development and the uncontrolled interaction with the nature are the reason for l and slide in Mizoram. Landslide vulnerability of Mizoram is already high due to lithology, land use and land cover, geomorphology and slope factor. The extensive mining activities along the highways for road construction and building materials also cause one of major landslide along the highways in the state of Mizoram. The present study investigates the Landslide Hazard Zones along the national highway 54 between Phulmawi village and Tlungvel village. The National Highway Number 54 is the most important road connecting Aizawl city and Northern, Southern and Eastern part of the State of Mizoram. Thematic layers such as slope morphometry, geomorphology, Lithology and land use / land cover were created using Remote Sensing and Geographic Information System (GIS) techniques. On the different groups of thematic layers, a weight age rating system dependent on the relative importance of various causative factors is used. In the GIS setting, the classes were given the corresponding rating value as attribute information. An ordinal ranking of 0 to 10 was allocated to each class within a thematic layer. Landslide hazard zonation map generated could be utilized as a reliable database for mitigation measures and planning for secured growth of the village.

BackgroundAutoinflammatory disorders are the group of inherited inflammatory disorders caused due to the genetic defect in the genes that regulates innate immune systems. These have been clinically characterized based on the duration and occurrence of unprovoked fever, skin rash, and patient’s ancestry. There are several autoinflammatory disorders that are found to be prevalent in a specific population and whose disease genetic epidemiology within the population has been well understood. However, India has a limited number of genetic studies reported for autoinflammatory disorders till date. The whole genome sequencing and analysis of 1029 Indian individuals performed under the IndiGen project persuaded us to perform the genetic epidemiology of the autoinflammatory disorders in India. ResultsWe have systematically annotated the genetic variants of 56 genes implicated in autoinflammatory disorder. These genetic variants were reclassified into five categories (i.e., pathogenic, likely pathogenic, benign, likely benign, and variant of uncertain significance (VUS)) according to the American College of Medical Genetics and Association of Molecular pathology (ACMG-AMP) guidelines. Our analysis revealed 20 pathogenic and likely pathogenic variants with significant differences in the allele frequency compared with the global population. We also found six causal founder variants in the IndiGen dataset belonging to different ancestry. We have performed haplotype prediction analysis for founder mutations haplotype that reveals the admixture of the South Asian population with other populations. The cumulative carrier frequency of the autoinflammatory disorder in India was found to be 3.5% which is much higher than reported. ConclusionWith such frequency in the Indian population, there is a great need for awareness among clinicians as well as the general public regarding the autoinflammatory disorder. To the best of our knowledge, this is the first and most comprehensive population scale genetic epidemiological study being reported from India.

Abstract ObjectiveThe purpose of the study was to develop machine learning models using data from long-term care (LTC) insurance claims and care needs certifications to predict the individualized future care needs of each older adult.MethodsWe collected LTC insurance-related data in the form of claims and care needs certification surveys from a municipality of Kanagawa Prefecture from 2009 to 2018. We used care needs certificate applications for model generation and the validation sample to build gradient boosting decision tree (GBDT) models to classify if 1) the insured’s care needs either remained stable or decreased or 2) the insured’s care needs increased after three years. The predictive model was trained and evaluated via k-fold cross-validation. The performance of the predictive model was observed in its accuracy, precision, recall, F1 score, area under the receiver-operator curve, and confusion matrix.ResultsLong-term care certificate applications and claim data from 2009–2018 were associated with 92,239 insureds with a mean age of 86.1 years old at the time of application, of whom 67% were female. The classifications of increase in care needs after three years were predicted with AUC of 0.80.ConclusionsMachine learning is a valuable tool for predicting care needs increases in Japan’s LTC insurance system, which can be used to develop more targeted and efficient interventions to proactively reduce or prevent further functional deterioration, thereby helping older adults maintain a better quality of life.

We report the electronic and magnetic properties along with the Curie temperature (TC) of the inverse full Heusler alloy (HA) Fe2CoAl obtained by using the first-principles computational method. Our calculations suggests that Fe2CoAl is a magnetic metal when treated within PBE-GGA under the applied compressive pressures. However, the implementation of electron–electron (U) (i.e., GGA+U) with varying compressive pressure (P) drastically changes the profile of the electronic structure. The application of GGA+U along with pressure induces ferromagnetic half-metallicity with an integer value of total magnetic moment ∼4.0 μB per unit cell. The integer value is in accordance with the Slater–Pauling's rule. Here, we demonstrate the variation of semiconducting gap in the spin down channel. The band gap increases from 0.0 eV to 0.72 eV when increasing the pressure from 0 to 30 GPa. Beyond 30 GPa, the electronic band gap decreases, and it is completely diminished at 60 GPa, exhibiting metallic behaviour. The analysis of the computed results shows that the treatment of electron–electron interactions within GGA+U and the application of compressive pressure in Fe2CoAl enables d–d orbital hybridization giving rise to a half-metal ferromagnet. The TC calculated from mean field approximation (MFA) decreases up to 30 GPa and then increases linearly up to 60 GPa.

The influence of ethylene glycol (EG)/glycerol(GL)–water mixed media on clouding action of an amphiphilic drug, amitriptyline hydrochloride was studied in presence and absence of inorganic salts in selected compositions of EG–WR and GL–WR mixed media.

X-ray repair cross complementary group gene is one of the most studied candidate gene involved in different types of cancers. Studies have shown that X-ray repair cross complementary genes are significantly associated with increased risk of breast cancer in females. Moreover, studies have revealed that X-ray repair cross complementary gene polymorphism significantly varies between and within different ethnic groups globally. The present case–control study was aimed to investigate the association of X-ray repair cross complementary 1A (Arg194Trp) and X-ray repair cross complementary 3 (Thr241Met) polymorphism with the risk of breast cancer in females from northeastern region of India. The present case–control study includes histopathologically confirmed and newly diagnosed 464 cases with breast cancer and 534 apparently healthy neighborhood community controls. Information on sociodemographic factors and putative risk factors were collected from each study participant by conducting face-to-face interviews. Genotyping of X-ray repair cross complementary 1A (Arg194Trp) and X-ray repair cross complementary 3 (Thr241Met) was carried out by polymerase chain reaction-restriction fragment length polymorphism. For statistical analysis, both univariate and multivariate logistic regression analyses were performed. We also performed stratified analysis to find out the association of X-ray repair cross complementary genes with the risk of breast cancer stratified based on menstrual status. This study revealed that tryptophan allele (R/W-W/W genotype) in X-ray repair cross complementary 1A (Arg194Trp) gene significantly increased the risk of breast cancer (adjusted odds ratio = 1.44, 95% confidence interval = 1.06-1.97, P < .05 for R/W-W/W genotype). Moreover, it was found that tryptophan allele (W/W genotype) at codon 194 of X-ray repair cross complementary 1A (Arg194Trp) gene significantly increased the risk of breast cancer in premenopausal females (crude odds ratio = 1.66, 95% confidence interval = 1.11-2.46, P < .05 for R/W-W/W genotype). The present study did not reveal any significant association of X-ray repair cross complementary 3 (Thr241Met) polymorphism with the risk of breast cancer. The present study has explored that X-ray repair cross complementary 1A (Arg194Trp) gene polymorphism is significantly associated with the increased risk of breast cancer in premenopausal females from northeastern region of India which may be beneficial for prognostic purposes.

The association of TP53 codon 72 polymorphism with cancer susceptibility remains uncertain and varies with ethnicity. Northeast India represents a geographically, culturally, and ethnically isolated population. The area reports high rate of tobacco usage in a variety of ways of consumption, compared with the rest of Indian population. A total of 411 cancer patients (161 lung, 134 gastric, and 116 oral) and 282 normal controls from the ethnic population were analyzed for p53 codon 72 polymorphism by polymerase chain reaction-restriction fragment length polymorphism. No significant difference in genotypic distribution of p53 between cases and controls was observed. Results suggested betel quid chewing as a major risk factor for all the three cancers (odds ratio [OR]=3.54, confidence interval [CI]=2.01-6.25, p<0.001; OR=1.74, CI=1.04-2.92, p=0.03; and OR=1.85, CI=1.02-3.33, p=0.04 for lung, gastric, and oral cancers, respectively). Tobacco smoking was associated with risk of lung and oral cancers (OR=1.88, CI=1.11-3.19, p=0.01 and OR=1.68, CI=1.00-2.81, p=0.04). Interactions between p53 genotypes and risk factors were analyzed to look for gene-environment interactions. Interaction of smoking and p53 genotype was significant only for oral cancer. Interactions of betel quid with p53 genotypes in lung cancer showed significant increase for all the three genotypes, indicating a major role of betel quid (OR=5.90, CI=1.67-20.81, p=0.006; OR=5.44, CI=1.67-17.75, p=0.005; and OR=5.84, CI=1.70-19.97, p=0.005 for Arg/Arg, Arg/Pro, and Pro/Pro, respectively). In conclusion, high incidence of these cancers in northeast India might be an outcome of risk habits; further, tissue- and carcinogen-specific risk modification by p53 gene is probable.