Iniencephaly is an uncommon and fatal neural tube defect involving the occiput and inion, this occurs together with rachischisis of the cervical and thoracic spine, and retroflexion of the head. We report the ultrasound (US) and magnetic resonance (MR) imaging findings of a case of iniencephaly with clubfeet and arthrogryposis. The diagnosis of iniencephaly is easy to make on ultrasound due to the typical star-gazing fetus. However, the details of the fetal brain and spinal cord may not be adequately delineated on US. We found MR imaging to be superior for depicting central nervous system abnormalities. MR imaging has evolved as an imaging modality and it is complementary to fetal US, yet US remains the screening modality of choice.
Adult ; Arthrogryposis/diagnosis ; Clubfoot/diagnosis ; Female ; Humans ; Magnetic Resonance Imaging ; Neural Tube Defects/*diagnosis ; Pregnancy ; *Prenatal Diagnosis ; Ultrasonography, Prenatal

India contributes substantially to global malaria incidents. Vector dynamics is the significant determinant of malaria risk. Hence, knowledge on the interaction between rainfall, malaria cases and malaria vector density can be very useful for controlling malaria transmission. Kalahandi was screened for malaria cases, Anopheline vector density and their temporal relationship with rainfall. Epidemiological data was obtained from National Vector Borne Disease Control Programme, Odisha, India. Three years vector population study was carried out. Rainfall data was obtained from a database maintained by the Govt. of Odisha and was analysed using Univariate ANOVA and Pearson correlation co-efficient tests using R-prog. Malaria was found to be prevalent throughout the year attaining peak between July to August and another peak in December, amidst which the clinical malaria cases being recorded implied highest incidents in the month of July. The results estimated the seasonality of the population of An. culicifacies, An. fluviatilis and An. annularis over the region and determined the influence of rainfall on the vector population dynamics. Simple linear regression analysis suggested that at one month lag monthly rainfall (P=0.0007) was a significant meteorological factor. Rainfall seemed to be one of the best malaria predictors because of its positive correlation with proliferation of malaria cases in conjunction with An. culicifacies density making malaria a serious health issue in Kalahandi.

The state’s retrospective findings indicate the incidence of malaria deaths, which is more during the onset of first monsoon season. Based upon this fact, our objective was to study the distribution pattern of major Anopheles vectors in two endemic districts viz. Kalahandi and Cuttack of Odisha, India that differ significantly according to malariogenic stratification, under the impact of first monsoon shower. A comparative study of vector abundance, predominance, their habitats, resting site preference, impact of abiotic rhythm (light/dark period) on vector distribution, gonotrophic status as well as sporozoite rate was established in a high and a low endemic district of Odisha, when the degree of malaria transmission elevates to its peak level Anopheles culicifacies was found to be predominant in hyperendemic Kalahandi district while Anopheles subpictus was abundant in hypo-endemic Cuttack district. Both primary vector An. culicifacies and the secondary vector An. subpictus mostly prefer CS (Cattle shed) compared to HD (Human dwelling) in Kalahandi district where as there was slight shifting of resting habitat of An. culicifacies from CS to HD in Cuttack district. Anopheles culicifacies prefers to rest on wall besides objects in Kalahandi while no such site preference was observed in Cuttack district. On the other hand, distribution of An. subpictus was highly influenced by the daily rhythm of light/dark cycle (i.e. day and night) in Cuttack. The gonotrophic condition revealed the high tendency of the predominant vectors towards endophilic resting. The sporozoite rate was 0.66% in Kalahandi and nil in Cuttack district. The proper monitoring of vector prevalence and distribution, at least during the peak transmission period can avert a perpetuated upsurge in malaria.