Since the epidemiology of Chlamydia trachomatis infection in apparently healthy population has not been studied in India, a population-based study was conducted in the state of Tamil Nadu, India in order to analyse the prevalence of genital chlamydial infections in the community and to implement control programmes. A representative sample was taken from three randomly selected districts by using the 'probability proportional to size' cluster survey method. Households were the basic units of clusters. Adults aged 15-45 years, pre-identified from the selected households were enrolled during the medical camps conducted for a major study on community prevalence of sexually transmitted diseases in Tamil Nadu. Blood and urine samples collected from the study subjects were tested by enzyme-linked immunosorbent assay (ELISA) for anti-chlamydial IgM antibodies and by the commercial Amplicor polymerase chain reaction (PCR) test for chlamydial DNA. The prevalence of anti-C. trachomatis antibodies determined by IgM-ELISA was 2.4% (95% CI 1.6%-3.2%). The prevalence of genital chlamydial infection determined by PCR was 1.1% (95% CI 0.5%-1.7%). Majority of the detected infections (68.8%) were asymptomatic. This is the first Indian report on the prevalence of genital chlamydial infections in the general population. It is concluded that this study provides evidence for a substantial burden of approximately 10 million asymptomatic genital chlamydial infection cases in the sexually active age groups in the general population of India.

Background:Innovation in the treatment of lower extremity lymphedema has received low priority from the governments and pharmaceutical industry. Advancing lymphedema is irreversible and initiates fibrosis in the dermis, reactive changes in the epidermis and subcutis. Most medical treatments offered for lymphedema are either too demanding with a less than satisfactory response or patients have low concordance due to complex schedules. A priority setting partnership (PSP) was established to decide on the future priorities in lymphedema research.Methods:A table of abstracts following a literature search was published in workshop website. Stake holders were requested to upload their priorities. Their questions were listed, randomized, and sent to lymphologists for ranking. High ranked ten research priorities, obtained through median score, were presented in final prioritization work shop attended by invited stake holders. A free medical camp was organized during workshop to understand patients’ priorities.Results:One hundred research priorities were selected from priorities uploaded to website. Ten priorities were short listed through a peer review process involving 12 lymphologists, for final discussion. They were related to simplification of integrative treatment for lymphedema, cellular changes in lymphedema and mechanisms of its reversal, eliminating bacterial entry lesions to reduce cellulitis episodes, exploring evidence for therapies in traditional medicine, improving patient concordance to compression therapy, epidemiology of lymphatic filariasis (LF), and economic benefit of integrative treatments of lymphedema.Conclusion:A robust research priority setting process, organized as described in James Lind Alliance guidebook, identified seven priority areas to achieve effective morbidity control of lymphedema including LF. All stake holders including Department of Health Research, Government of India, participated in the PSP.

Hantaviruses are etiological agents of hemorrhagic fever with renal syndrome in many parts of Asia and Europe. There has been no documented case of hantavirus disease from India, although serological evidence exists. We investigated the prevalence of hantavirus in the Indian population and tried to identify potential risk groups for hantavirus infections. The presence of hantavirus-specific IgG antibodies was prospectively evaluated in 661 subjects belonging to different groups, i.e. patients with chronic renal disease, warehouse workers and tribal members engaged in rodent trapping. Healthy volunteer blood donors were included as a control group. Thirty-eight seropositive samples were found using a combination of a commercial ELISA followed by an indirect immunofluorescence assay. Western blot using recombinant Hantaan virus nucleocapsid antigen confirmed the presence of anti-hantavirus IgG in 28 (74%) of the 38 sera tested. This study confirms the presence of hantaviruses in India and warrants increasing awareness of the problems of emerging pathogens and the threats they may pose to the public health system.

Pongamia pinnata, Linn., an Indian medicinal plant used in the Ayurvedha and Siddha traditional medicine systems, for treatment of clinical lesions of skin and genitalia, was evaluated for antiviral properties against herpes simplex virus type-1 (HSV-1) and type-2 (HSV-2) by in-vitro studies in Vero cells. A crude aqueous seed extract of P. pinnata completely inhibited the growth of HSV-1 and HSV-2 at concentrations of 1 and 20 mg/ml (w/v), respectively, as shown by complete absence of cytopathic effect.

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Phyllanthus species, especially P. amarus is a medicinal plant with hepatoprotective activity, believed to occur in part by inhibiting hepatitis B virus function. The pathogenesis mechanism of viral hepatitis is closely related to hepatocyte necrosis apoptosis. The aim of our study was to investigate the in vitro effects of extracts from three Phyllanthus species, P. urinaria, P. amarus and P. debilis in regulating cell proliferation and gene expression activities of HepG2 hepatocellular carcinoma cells. All three Phyllanthus species significantly inhibited the proliferation of the HepG2 cells. In addition, the extracts induced apoptosis by inducing caspase-3. Further confirmation of extract-induced apoptosis was obtained by demonstrating that the Bcl-2/Bax ratio decreased in response to treatment with the extracts. We next determined the mechanism by which the Phyllanthus extracts induced apoptosis. Previous studies have demonstrated that TNF-α not only induces apoptotic signals but also causes antiapoptotic and regenerative responses in hepatocytes, the mechanism involving induction of IL-8. Real Time PCR analyses demonstrated that the extracts significantly inhibited cyclooxygenase-2 (COX-2) and interleukin-8 (IL-8) expression, while inducing the expression of tumor necrosis factor-α (TNF-α. Reporter assays using the luciferase constructs containing COX-2 promoter region demonstrated that the extracts inhibited transcription of the gene. Since the extracts inhibited IL-8 expression, while inducing TNF-α, the cells were treated with the extracts in the presence of exogenous TNF-α. While TNF-α only showed a modest effect by itself, it was synergistic with the extracts in inducing apoptosis of the cells. These findings demonstrate that Phyllanthus extracts induce TNF-α production from the hepatocellular carcinoma cells while inhibiting production of potent anti-apoptotic genes IL-8 and COX-2.

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