Malda Medical College and Hospital

The prevalence pattern of hypertension in developing countries is different from that in the developed countries. In India, a very large, populous and typical developing country, community surveys have documented that between three and six decades, prevalence of hypertension has increased by about 30 times among urban dwellers and by about 10 times among the rural inhabitants. Various factors might have contributed to this rising trend and among others, consequences of urbanization such as change in life style pattern, diet and stress, increased population and shrinking employment have been implicated. In this paper, we study the prevalence of hypertension in an urban community of India using the JNC VII criteria, with the aim of identifying the risk factors and suggesting intervention strategies. A total of 1609 respondents out of 1662 individuals participated in our cross-sectional survey of validated and structured questionnaire followed by blood pressure measurement. Results showed pre-hypertensive levels of blood pressures among 35.8% of the participants in systolic group (120-139mm of Hg) and 47.7% in diastolic group (80-89 mm of Hg). Systolic hypertension (140 mm of Hg) was present in 40.9% and diastolic hypertension (90 mm of Hg) in 29.3% of the participants. Age and sex-specific prevalence of hypertension showed progressive rise of systolic and diastolic hypertension in women when compared to men. Men showed progressive rise in systolic hypertension beyond fifth decade of life. Bivariate analysis showed significant relationship of hypertension with age, sedentary occupation, body mass index (BMI), diet, ischemic heart disease, and smoking. Multivariate analysis revealed age and BMI as risk factors, and non-vegetarian diet as protective factor with respect to hypertension. Prevalence of prehypertensives was high among younger subjects - particularly students and laborers who need special attention. Role of non-vegetarian diet as a protective factor might have been related to fish-eating behavior of the sample population, who also use mustard oil as cooking medium - both of which have significant level of essential polyunsaturated fatty acids. The observed prevalence of hypertension in this study and other studies suggest the need for a comprehensive national policy to control hypertension in India, and, in other similar developing countries.

This review describes the various innovative approaches implemented for naringin extraction as well as the recent developments in the field. Naringin was assessed in terms of its structure, chemical composition, and potential food sources. How naringin works pharmacologically was discussed, including its potential as an anti-diabetic, anti-inflammatory, and hepatoprotective substance. Citrus flavonoids are crucial herbal additives that have a huge spectrum of organic activities. Naringin is a nutritional flavanone glycoside that has been shown to be effective in the treatment of a few chronic disorders associated with ageing. Citrus fruits contain a common flavone glycoside that has specific pharmacological and biological properties. Naringin, a flavone glycoside with a range of intriguing characteristics, is abundant in citrus fruits. Naringin has been shown to have a variety of biological, medicinal, and pharmacological effects. Naringin is hydrolyzed into rhamnose and prunin by the naringinase, which also possesses l-rhamnosidase activity. D-glucosidase subsequently catalyzes the hydrolysis of prunin into glucose and naringenin. Naringin is known for having anti-inflammatory, antioxidant, and tumor-fighting effects. Numerous test animals and cell lines have been used to correlate naringin exposure to asthma, hyperlipidemia, diabetes, cancer, hyperthyroidism, and osteoporosis. This study focused on the many documented actions of naringin in in-vitro and in-vivo experimental and preclinical investigations, as well as its prospective therapeutic advantages, utilizing the information that is presently accessible in the literature. In addition to its pharmacokinetic characteristics, naringin's structure, distribution, different extraction methods, and potential use in the cosmetic, food, pharmaceutical, and animal feed sectors were discussed.

Mathematical modeling plays an important role to better understand the disease dynamics and designing strategies to manage quickly spreading infectious diseases in lack of an effective vaccine or specific antivirals. During this period, forecasting is of utmost priority for health care planning and to combat COVID-19 pandemic. In this study, we proposed and extended classical SEIR compartment model refined by contact tracing and hospitalization strategies to explain the COVID-19 outbreak. We calibrated our model with daily COVID-19 data for the five provinces of India namely, Kerala, Karnataka, Andhra Pradesh, Maharashtra, West Bengal and the overall India. To identify the most effective parameters we conduct a sensitivity analysis by using the partial rank correlation coefficients techniques. The value of those sensitive parameters were estimated from the observed data by least square method. We performed sensitivity analysis for R0 to investigate the relative importance of the system parameters. Also, we computed the sensitivity indices for R0 to determine the robustness of the model predictions to parameter values. Our study demonstrates that a critically important strategy can be achieved by reducing the disease transmission coefficient βs and clinical outbreak rate qa to control the COVID-19 outbreaks. Performed short-term predictions for the daily and cumulative confirmed cases of COVID-19 outbreak for all the five provinces of India and the overall India exhibited the steady exponential growth of some states and other states showing decays of daily new cases. Long-term predictions for the Republic of India reveals that the COVID-19 cases will exhibit oscillatory dynamics. Our research thus leaves the option open that COVID-19 might become a seasonal disease. Our model simulation demonstrates that the COVID-19 cases across India at the end of September 2020 obey a power law.

The ongoing novel coronavirus epidemic was announced a pandemic by the World Health Organization on March 11, 2020, and the Government of India declared a nationwide lockdown on March 25, 2020 to prevent community transmission of the coronavirus disease (COVID)-19. Due to the absence of specific antivirals or vaccine, mathematical modeling plays an important role in better understanding the disease dynamics and in designing strategies to control the rapidly spreading infectious disease. In our study, we developed a new compartmental model that explains the transmission dynamics of COVID-19. We calibrated our proposed model with daily COVID-19 data for four Indian states, namely, Jharkhand, Gujarat, Andhra Pradesh, and Chandigarh. We study the qualitative properties of the model, including feasible equilibria and their stability with respect to the basic reproduction number R0. The disease-free equilibrium becomes stable and the endemic equilibrium becomes unstable when the recovery rate of infected individuals increases, but if the disease transmission rate remains higher, then the endemic equilibrium always remains stable. For the estimated model parameters, R0>1 for all four states, which suggests the significant outbreak of COVID-19. Short-time prediction shows the increasing trend of daily and cumulative cases of COVID-19 for the four states of India.

BACKGROUND: Growing smartphone usage among global and Indian college students has resulted in considerable issues of "nomophobia" (NMP) or feelings of discomfort or anxiety experienced by individuals whenever unable to use their smartphones. This significantly impacts their health, work, and study. OBJECTIVE: The objective of this study is to find out the prevalence of NMP among smartphone using medical and engineering undergraduates of West Bengal and to compare the nomophobic behaviors, its predictors, and smartphone usage among them. METHODS: A cross-sectional study was conducted among 303 medical and 305 engineering undergraduates in West Bengal using a validated NMP questionnaire consisting of four factors. Comparison of means of individual questions and factor scores was done. Nomophobic clusters among the two groups were identified using two-stage cluster analysis. Binary logistic regression was used for comparison of predictors of NMP. RESULTS: Engineering students showed a higher proportion of nomophobics (44.6%) than medical students (42.6%). Significant higher means was observed among engineering students for the factor "giving upconvenience" and individual variables like "scared due to running out of battery," "nervous due to disconnection from online identity," "uncomfortable when unable stay up-to-date with social media" and "anxious when unable to check E-mails." A Higher proportion of nomophobics among both groups were females, those owning smartphone beyond 2 years, having monthly mobile bill above Rs. 200 and spending over 4 h daily on smartphone. CONCLUSION: NMP has emerged as a significant cause of concern among both the groups. Standardized measures for identification and appropriate psychobehavioral therapy for those seeking help might alleviate the problem.

BACKGROUND: With myriad geospatial datasets now available for terrain information extraction and particularly streamline demarcation, there arises questions regarding the scale, accuracy and sensitivity of the initial dataset from which these aspects are derived, as they influence all other parameters computed subsequently. In this study, digital elevation models (DEM) derived from Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER V2), Shuttle Radar Topography Mission (SRTM V4, C-Band, 3 arc-second), Cartosat -1 (CartoDEM 1.0) and topographical maps (R.F. 1:250,000 and 1:50,000), have been used to individually extract and analyze the relief, surface, size, shape and texture properties of a mountainous drainage basin. RESULTS: Nestled inside a mountainous setting, the basin is a semi-elongated one with high relief ratio (>90), steep slopes (25°-30°) and high drainage density (>3.5 km/sq km), as computed from the different DEMs. The basin terrain and stream network is extracted from each DEM, whose morphometric attributes are compared with the surveyed stream networks present in the topographical maps, with resampling of finer DEM datasets to coarser resolutions, to reduce scale-implications during the delineation process. Ground truth verifications for altitudinal accuracy have also been done by a GPS survey. CONCLUSIONS: DEMs derived from the 1:50,000 topographical map and ASTER GDEM V2 data are found to be more accurate and consistent in terms of absolute accuracy, than the other generated or available DEM data products, on basis of the morphometric parameters extracted from each. They also exhibit a certain degree of proximity to the surveyed topographical map.

BACKGROUND: Apha-2 agonists are combined with local anesthetics to extend the duration of regional anesthesia. We evaluated the effect of combining dexmedetomidine with levobupivacine with respect to duration of motor and sensory block and duration of analgesia. METHODS: Sixty patients scheduled for elective forearm and hand surgery were divided into two equal groups in a randomized double blind fashion. The patients received brachial plexus block via supraclavicular route with the help of nerve stimulator. In group L (n=30) 35cc of levobupivacaine with 1ml of isotonic saline and in group LD (n=30) 35cc of levobupivacine with 1 ml of (100 microgram) of dexmedetomidine was given. Duration of motor and sensory block and time to first rescue analgesia were recorded. Data analysis was done by SPSS version 16.0 [SPSS Inc ILLINOIS, USA, 2008]. Categorical variables were analyzed using Pearson"s Chi-square test. Normally distributed numerical variables were analyzed using unpaired "t" test. Skewed numerical variables within the group were analyzed using Man-Whitney "U" test. All tests were two tailed. Statistical significance was defined as P<0.05. RESULTS: Sensory and motor block durations were longer in group LD as compared to L (P<0.01). Duration of analgesia was significantly longer in group LD as compared to group L (p<0.05). CONCLUSION: Dexmedetomidine added to levobupivacaine in supraclavicular brachial plexus block prolongs the duration of block and the duration of postoperative analgesia.

<title>Abstract</title> Understanding the dynamics of the COVID-19 pandemic is crucial for improved control and social distancing strategies. To that effect, we have employed the susceptible-exposed-infectious-recovered model, refined by contact tracing and hospitalization data from Indian provinces Kerala, Delhi, Maharashtra, and West Bengal, as well as from overall India. We have performed a sensitivity analysis to identify the most crucial input parameters, and we have calibrated the model to describe the data as best as possible. Short-term predictions reveal an increasing and worrying trend of COVID-19 cases for all four provinces and India as a whole, while long-term predictions also reveal the possibility of oscillatory dynamics. Our research thus leaves the option open that COVID-19 might become a seasonal occurrence. We also simulate and discuss the impact of media on the dynamics of the COVID-19 pandemic.

BACKGROUND: To control the double burden of communicable and non-communicable diseases (NCDs), in the developing world, understanding the patterns of morbidity and healthcare-seeking is critical. The objective of this cross-sectional study was to determine the distribution, predictors and inter-relationship of perceived morbidity and related healthcare-seeking behavior in a poor-resource setting. METHODS: Between October 2013 and July 2014, 43999 consenting subjects were recruited from 10107 households in Malda district of West Bengal state in India, through multistage random sampling, using probability proportional-to-size. Information on socio-demographics, behaviors, recent ailments, perceived severity and healthcare-seeking were analyzed in SAS-9.3.2. RESULTS: Recent illnesses were reported by 55.91% (n=24,600) participants. Among diagnosed ailments (n=23,626), 50.92% (n=12,031) were NCDs. Respiratory (17.28%, n=7605)), gastrointestinal (13.48%, n=5929) and musculoskeletal (6.25%, n=2749) problems were predominant. Non-qualified practitioners treated 53.16% (n=13,074) episodes. Older children/adolescents [adjusted odds ratio for private healthcare providers (AORPri)=0.76, 95% confidence interval=0.71-0.83) and for Govt. healthcare provider (AORGovt)=0.80(0.68-0.95)], females [AORGovt=0.80(0.73-0.88)], Muslims [AORPri=0.85(0.69-0.76) and AORGovt=0.92(0.87-0.96)], backward castes [AORGovt=0.93(0.91-0.96)] and rural residents [AORPri=0.82(0.75-0.89) and AORGovt=0.72(0.64-0.81)] had lower odds of visiting qualified practitioners. Apparently less severe NCDs [acid-peptic disorders: AORPri=0.41(0.37-0.46) & AORGovt=0.41(0.37-0.46), osteoarthritis: AORPri=0.72(0.59-0.68) & AORGovt=0.58(0.43-0.78)], gastrointestinal [AORPri=0.28(0.24-0.33) & AORGovt=0.69(0.58-0.81)], respiratory [AORPri=0.35(0.32-0.39) & AORGovt=0.46(0.41-0.52)] and skin infections [AORPri=0.65(0.55-0.77)] were also less often treated by qualified practitioners. Better education [AORPri=1.91(1.65-2.22) for ≥graduation], sanitation [AORPri=1.58(1.42-1.75)] and access to safe water [AORPri=1.33(1.05-1.67)] were associated with healthcare-seeking from qualified private practitioners. Longstanding NCDs [chronic obstructive pulmonary diseases: AORPri=1.80(1.46-2.23), hypertension: AORPri=1.94(1.60-2.36), diabetes: AORPri=4.94(3.55-6.87)] and serious infections [typhoid: AORPri=2.86(2.04-4.03)] were also more commonly treated by qualified private practitioners. Potential limitations included temporal ambiguity, reverse causation, generalizability issues and misclassification. CONCLUSION: In this poor-resource setting with high morbidity, ailments and their perceived severity were important predictors for healthcare-seeking. Interventions to improve awareness and healthcare-seeking among under-privileged and vulnerable population with efforts to improve the knowledge and practice of non-qualified practitioners probably required urgently.

A coplanar waveguide (CPW)-fed flexible elliptical antenna with triple band notched characteristics is presented in this article. The designed antenna consists of an elliptical patch and slots incorporated CPW feed line to cover the bandwidth requirements for ultra-wideband (UWB) applications. The designed UWB antenna has a fractional bandwidth of about 166.19% (1.20-13 GHz) with a center frequency of 7.1 GHz in simulation and about 170.10% (1.05-13 GHz) with a center frequency of 7.025 GHz in measurement. The overall dimension of the proposed flexible antenna is 45 × 35 × 0.6 mm3. The triple notched bands are realized by designing with circular shaped split-ring-resonators (SRRs) and defected ground structure (DGS). According to the measurement, first notched band (2.0−2.70 GHz) is generated for rejecting 2.4 GHz WLAN by introducing a single circular ST-SRR on the radiating patch. The second notch (3.45-3.80 GHz) is obtained by embedding another circular ST-SRR on the patch to mitigate the interference of 3.5 GHz Wi-MAX system. Finally, due to presence of DGS, third notch (5.15-6.20 GHz) is produced which suppresses the interference from 5.5 GHz Wi-MAX and 5.2/5.8 GHz WLAN systems. The proposed antenna offers excellent performance in different flexible conditions that confirm its applicability on curved surfaces for UWB systems.

PURPOSE: This paper aims to investigate the prevalence by geographical locations and socio-demographic correlates of menstrual hygienic practices among young currently married Indian women. METHODS: The study is based on secondary data, collected from the latest round of the National Family Health Survey (NFHS-4), conducted in 2015-16. A total of 94,034 young currently married women aged 15-24 years were utilised in this study. The prevalence of menstrual hygienic practices was portrayed across regions, states, and districts of India. Bivariate and multivariate analyses were carried out to assess the factors associated with menstrual hygienic practices. RESULTS: Nearly half of the women (49.3%) practice hygienic methods to contain menstrual bloodstains. The prevalence of menstrual hygiene practices is lower in low-income states of central and eastern India. Multivariate analyses reveal that education of women and wealth status are found to be the most important positive factors of menstrual hygienic practices. Women's autonomy and exposure to mass media also have a positive impact on the use of menstrual hygiene practice. In contrast, women residing in rural areas, belonging in scheduled tribes and unemployed women are less likely to use hygienic methods during their menstruation. CONCLUSION: The findings of this study suggest increasing opportunities for female education, providing economic incentives, enhancing women's autonomy could help to increase hygienic practices of women during menstruation period. Furthermore, interventions should target socio-economically disadvantaged women to raise the use of sanitary napkins.

BACKGROUND: Depression is a major public health threat that can affect anyone including health professionals and nursing students. OBJECTIVES AND METHODS: This analytical, cross-sectional study was conducted among 180 students of a nursing college to find out the burden of depression on them and possible contributing factors using the Beck Depression Inventory. RESULTS: 63.9% of the students were found to be depressed, the majority being mild in grade. First-year students were found to be significantly more affected (P=0.008). Binary logistic regression showed that familial disharmony, disinterest in the course and insecurity about future placement were statistically significant factors behind the development of depression. CONCLUSION: It is imperative that the psychological condition of nursing students be viewed as an important aspect to be considered, particularly within the Indian population and others in which there is a paucity of data.

Surface-enhanced Raman scattering (SERS) of hypoxanthine (HX) molecule on silver colloid confirms that the molecule in the surface adsorbed state exists as [keto–N9 H9] form at acidic and normal pH but as [enol–O6 H1, N9 H9] form at alkaline pH. It is substantiated by the appearance of an intense carbonyl stretching mode at 1690 cm−1, a medium-intense in-plane CO bending mode at 655 cm−1 and disappearance of the C6–O6 H1 stretching mode in SER spectra in acidic and normal pH. Strongly intense Raman band at 1166 cm−1 assigned as C6–O6 H1 stretching mode confirms [enol–O6 H1, N9 H9] form in alkaline pH. The presence of Ag–N and Ag–O stretching modes in SER spectra further infer two modes of orientation of the HX molecule on the silver surface. At acidic pH (pH 2) the HX molecule is adsorbed on the metal surface through the N3 atom with the molecular plane lying almost perpendicular on the silver substrate, while at alkaline pH the molecule is oriented nearly parallel to the silver surface via nonbonding electrons of N1, N3, N7 and O6. Copyright © 2000 John Wiley & Sons, Ltd.

Abstract We present herein a new class of singularity-free interior solutions to describe realistic anisotropic compact stellar objects with spherically symmetric matter distribution. A specific form of anisotropy is assumed to obtain the exact solution for the field equation. Smooth matching of interior solutions thus obtained with the Schwarzschild exterior metric over the bounding surface of a compact star, together with the condition that the radial pressure vanishes at the boundary, is used to obtain the mathematical form for the model parameters. The pulsar 4U1608-52 with its current estimated data (mass $$=1.57 ~M\odot $$ <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow> <mml:mo>=</mml:mo> <mml:mn>1.57</mml:mn> <mml:mspace/> <mml:mi>M</mml:mi> <mml:mo>⊙</mml:mo> </mml:mrow> </mml:math> and radius $$=9.8 \pm 0.8$$ <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow> <mml:mo>=</mml:mo> <mml:mn>9.8</mml:mn> <mml:mo>±</mml:mo> <mml:mn>0.8</mml:mn> </mml:mrow> </mml:math> km; Özel et al. in ApJ 820:28, 2016) is used to study the model graphically.

BACKGROUND: Eclampsia is a very serious complication of pregnancy which is responsible for high maternal and perinatal mortality. Worldwide, it accounts for 50,000 maternal deaths annually. In spite of several global and regional interventions and initiatives from governments and other concerned agencies, maternal mortality is still very high in India, with eclampsia as a major cause. This study was conducted to determine the mode of deaths and incidence of maternal mortality associated with eclampsia and to assess how socio-demographic and clinical characteristics of the women influence the deaths. MATERIALS AND METHODS: This is a retrospective study of 111 eclampsia related maternal deaths over a period of 5 years from January 2008 to December 2012. Data pertaining to their age, parity, booking status, gestational age at delivery, and time interval from admission to death were also obtained from the records for analysis. RESULTS: Eclampsia accounted for 43.35% of total maternal deaths, with case fatality of 4.960%. The commonest mode of death in eclampsia is pulmonary oedema. Death due to eclampsia commonly occurs in younger age group of 19-24 years and in primi gravid. Eclampsia related deaths were mostly seen in illiterate and unbooked cases. Maternal deaths were also very common in lower socio economic status. CONCLUSION: Eclampsia still remains the major cause of maternal mortality in this region resulting from unsupervised pregnancies and deliveries. There is a need to educate and encourage the general public for antenatal care and hospital delivery by which we can defeat this powerful enemy.

BACKGROUND: Caesarean section delivery is a major life-saving obstetric surgical intervention for mothers and babies from pregnancy and childbirth related complications. This paper attempts to investigate the geographical variations and correlating factors of caesarean section delivery in India, particularly focusing on the states of Bihar and Tamil Nadu, accounting for one of the lowest and highest prevalence states of caesarean section delivery respectively. METHODS: This study is based on secondary data, collected from the fourth round of the National Family Health Survey (NFHS-4), 2015-16. We utilized 190,898 women aged 15-49 years who had a living child during the past 5 years preceding the survey. In this study, caesarean section delivery was the outcome variable. A variety of demographic, socio-economic, and pregnancy- and delivery-related variables were considered as explanatory variables. Descriptive statistics, bivariate percentage distribution, Pearson's Chi-square test, and multivariate binary logistic regression models were employed to draw the inferences from data. RESULTS: Of participants, about 19% of women had undergone caesarean section delivery in the country. The state-wise distribution shows that Telangana (60%) followed by Andhra Pradesh (42%) and Tamil Nadu (36%) represented the topmost states in caesarean delivery, while Bihar (7%), Madhya Pradesh (10%), and Jharkhand (11%) placed at the bottom end. Multivariate logistic models show that the likelihood of caesarean delivery was higher among older women (35-49 years), women with higher levels of education, Muslims, women belonging to the upper quintiles of the household wealth, and those who received antenatal care (ANC), experienced pregnancy loss and delivery complications. Moreover, the odds of caesarean section delivery were remarkably greater for the private health sector than the public health sector in both focused states: Bihar (odds ratio [OR] = 12.84; 95% confidence interval [CI]: 10.90, 15.13) and Tamil Nadu (OR = 2.90; 95% CI: 2.54, 3.31). CONCLUSION: Findings of this study suggest that improvement in female education, providing economic incentives, and spreading awareness through mass media could raise the caesarean section delivery among women whose vaginal delivery could be unsafe for them as well as for their babies. Moreover, providing adequate ANC and well-equipped public healthcare services would facilitate caesarean delivery among needy women.

Partial shading is the most unexpected scenario encountered by the arrays that degrade the performance causing power reduction, non-convex characteristics curves, losses, hotspot, module damage, and system failure. The adoption of various reconfiguration techniques has recently provided relief to the PV array to reduce power losses during partial shading. However, these techniques exhibit vulnerabilities such as reliable operation, ease of implementation and, higher cost and complexity due to the requirement of abundant manpower, labour, complex algorithms, dynamic operation, switches and sensors that cause additional power losses. Hence, this paper presents a low cost and less complex reconfiguration technique for PV arrays to effectively increase the power generation during partial shading scenarios. The proposed reconfiguration does not require any manpower, labour, algorithms or additional devices to reduce the losses in arrays during shading. The efficacy of the technique is tested using two array sizes under various shading scenarios using MATLAB modelling and real-time field experiments. Also, for better analysis, the performance of the proposed technique is compared with conventional configurations and Sudoku reconfiguration. The investigation proclaimed that the proposed reconfiguration technique has an average power enhancement of 20&#x0025; higher than any other conventional configurations.

By using computational methodologies based on time dependent density functional theory (TDDFT) we study the opto-electronic properties of three types of triphenylamine (TPA)-based dyes, namely TPA-TBT-1, TPA-DBT-1, and TPA-BT-1, and these are proposed as potential candidates for photovoltaic applications. Energy band modulation has been performed by functionalizing these dyes with different electron donating and electron withdrawing groups. Photoelectron spectra and photovoltaic properties of the dyes have been investigated by a combination of DFT and TDDFT approaches. Based on the optimized molecular geometry, relative position of the frontier energy levels, and the absorption maximum of the dyes we propose some dyes offering good photovoltaic performance. At the same time, these results provide a direction for optimizing the composition of dye-metal surface nanodevices for fabricating dye-sensitized solar cells (DSSCs).

Tuberculosis is characterized by severe immunosuppression of the host macrophages, resulting in the loss of the host protective immune responses. During Mycobacterium tuberculosis infection, the pathogen modulates C-C Chemokine Receptor 5 (CCR5) to enhance IL-10 production, indicating the possible involvement of CCR5 in regulation of the host immune response. Here, we found that Mycobacterium infection significantly increased CCR5 expression in macrophages there by facilitating the activation of its downstream signaling. These events culminated in up-regulation of the immunosuppressive cytokine IL-10 production, which was further associated with the down-regulation of macrophage MHC-II expression along with the up-regulation of CCR5 expression via engagement of STAT-3 in a positive feedback loop. Treatment of macrophages with CCR5 specific siRNA abrogated the IL-10 production and restored MHCII expression. While, in vivo CCR5 silencing was also effective for the restoration of host immune responses against tuberculosis. This study demonstrated that CCR5 played a very critical role for the immune subversion mechanism employed by the pathogen.

BACKGROUND: Antibiotic-resistant Acinetobacter nosocomial infection is a leading problem. It acts as an opportunistic pathogen to cause a wide spectrum of infection including nosocomial pneumonia, meningitis, endocarditis, skin and soft tissue infections, urinary tract infection, conjunctivitis, burn wound infection and bacteremia. Multidrug-resistant Acinetobacter infection creates a great problem in hospital setting. MATERIALS AND METHODS: The clinical specimens obtained from ICU and different surgical and medical wards were investigated using standard microbiological techniques to know the distribution of and their resistant profile. Antimicrobial resistance was studied using the modified Kirby Bauer disk diffusion technique following the CLSI protocol. RESULTS: Major infections found in different medical wards, surgical wards and ICU were due to Acinetobacter baumannii (74.02%), A. lowfii (14.2%), A. haemolyticus (7.79%), A. junii (3.8%) among Acinetobacter spices. Acinetobacter showed increased resistant against majority of commercially available drugs imipenem (5.2%), meropenem (9.75%), piperacillin-tazobactum (18.2%), netilmicin (16.24%), amikacin (14.29%), ceftazidime (74.1%), gentamicin (70.13%), ofloxacin (42.21%). CONCLUSION: A. baumannii was found to be associated with UTI, RTI, septicemia, bacteremia, and meningitis and wound infection. A. baumannii displayed higher resistance to more number of antibiotics than other nosocomial pathogens from ICU.