Prevalence and risk factors associated with severe acute malnutrition (SAM) in ICDS block of rural Hubli, Karnataka, India

Background: Malnutrition is one of the leading causes of morbidity and mortality in children under the age of five years in developing countries. Despite economic growth of nearly 10% per annum, in India in 2006 the NFHS-3 indicated that 6.4% of children below 60 months of age were suffering from severe acute malnutrition. This study was undertaken to know the prevalence and the risk factors associated with SAM in ICDS block of rural Hubli.Methods: This was a cross sectional observational community based study conducted in the ICDS block of rural Hubli. All children in the age group of 0- 59 months were included in the study. The study is conducted by the department and it is self-funded by the authors, no monetary benefit either from the institute or from the government or its organization.Results: Among 1796 children who were examined in present study, the prevalence of SAM children was 5.79% (104 children). 48% were in the age group of 37 months to 59 months. Male: female ratio was 2:3. 51% of the mothers and 47.1% of fathers were illiterate. 82.7% of the parents had per capita income belonged to class 5 of the modified B.G. Prasad classification. 60% of the SAM children were seen in families who had 3 or 4 children. Maternal anemia, IUGR and PIH were seen in 53.6%, 21.6% and 18% respectively. Low birth weight (<2.5kg) and Birth asphyxia were seen in 80.6% and 11.1%.Conclusions: The risk factors for SAM were illiteracy, low per capita income, high order births, maternal anemia, IUGR, PIH, low birth weight and Birth asphyxia. Due emphasis should be given in improving the knowledge and practices of the parents on appropriate infant and young child feeding practices.

Prevalence of hypomagnesemia in children admitted to pediatric intensive care unit and its correlation with patient outcome

Background: Magnesium deficiency is common in critical illness and is said to be associated with increased need for mechanical ventilation, mortality and prolonged ICU stay. The knowledge of hypomagnesemia is essential as available data is scarce and it could have prognostic and therapeutic implications. This study was undertaken to estimate the prevalence of hypomagnesemia at the time of admission in PICU and its correlation with length of PICU stay, duration on mechanical ventilator and outcome at the end of hospital stay-death or discharge.Methods: This is a prospective observational study including 343 children aged 1month to 12years admitted to PICU. Detailed history taking and clinical examination was done for all enrolled children. At admission, blood was collected for estimation of serum magnesium. Patients were categorized into three groups i.e., hypomagnesemia, normomagnesemia and hypermagnesemia and data was analysed.Results: Out of 343 children, 28% had hypomagnesemia, 7.3% had hypermagnesemia and 64.7% had normomagnesemia. Hypomagnesemia was more common in neurological disorders. No association was found between magnesium and length of mechanical ventilation. PICU stay was significantly longer in hypomagnesemia group (p=0.031). 37.5% patients with hypomagnesemia also had hypocalcemia and 35.4% had hypokalemia. Mortality rate was higher in those with hypomagnesemia (30.2%) compared to those with normomagnesemia (22.1%).Conclusions: Patients with hypomagnesemia had increased duration of PICU stay, other associated electrolyte abnormalities and higher mortality. Hence monitoring of magnesium levels in critically ill patients is indicated.

Functional Endoscopic Sinus Surgery: A Comparative Study of Monitored Anaesthesia Care and General Anaesthesia.

Background: Functional endoscopic sinus surgery is associated with a high rate of success for symptomatic improvement in patients. This operation can be done under general or local anesthesia. In this study we have tried to compare the efficacy of monitored anesthetic care with general anesthesia for Functional endoscopic sinus surgery. Methods: 20 patients each above the age of 18 years, were selected for Monitored anesthesia care (MAC) and for general anesthesia (GA). For MAC, 150mg Tab Ranitidine at BT/6AM, Tab Perinorm 10mg at BT /6AM, Tab Diazepam 5mg at BT /6AM was given as pre medication schedule. Inj Pentacozine 30mg + Inj Promethazine 25mg I/M was given 30–45 mins before the patient was shifted to OT. On the table Inj. Midazolam 1-3 mg was given which has 3–4 Ramsey sedation score .Inj Fantanyl 1mcg/kg weight was given for break-through pain. The GA technique used was Inj. Fantanyl 1 mcg/ kg weight + Inj Midazolam 1-2 mg; Inj Propofol 2mg/kg, Sch 2mg/kg was given, intubated by intermittent positive pressure ventilation (IPPV). Vecuronium 0.1mg/kg + Isoflurane 0.6–1% + N2O 2l/mt +o2 1l/mt was given followed by neostigmine 2.5mg+Glycopyrrolate 0.4mg. Results: There was a 15% increase in heart rate within 12 minutes of sedation in MAC and 20% in GA. The percentage of variation after 15 minutes remained at 15% in case of GA but it reduced to 5% in MAC and remained steady at this rate. 10% of the patients started to respond almost immediately after surgery in the MAC category and 100% of them were conscious within 90mins of surgery, while under general anesthesia, only 80% of them attained consciousness after 120 minutes. It took about 120 minutes for all patients under MAC for ambulation while it took more than 150 minutes for the patients under GA for ambulation. No patient under MAC had any side effects while 60% of the patient under GA ha nausea, vomiting or both. Conclusion: With no complications of extubation and mechanical ventilation, having faster recovery time, with hardly any post operative nausea and vomiting, Monitored anesthetic care is a better choice of anesthesia compared to general anesthesia for elective surgeries like Functional Endoscopic Sinus surgery.

Comparison of acute toxicities and response of standard chemo radiation versus hyper fractionated radiotherapy in head and neck cancers

Background: Head and neck cancers are the most common malignancy among males in India. Carcinoma of buccal mucosa is the most common cancer among head and neck cancers due to high rate of tobacco chewing habit. Aim and objectives: To study the comparison of acute toxicities and response of standard chemo radiation versus hyper fractionated radiotherapy in head and neck cancers. Materials and methods: It was a prospective study of acute toxicity and response in patients diagnosed with head and neck malignancy. Patients with oral cavity site, previously untreated locally advanced III, IV-A and IV -B, age of 20-60 years. Results: Primary tumor site of the patients included in the both CRT arm and HFRT was not significant (P=0.755). Majority of patients included were T3 (44% in CRT arm and 46.7% in HFRT arm) and T2 (24% in CRT arm and 26.7% in HFRT arm) lesions. The tumors with respect to T stage, the difference between two arms was not statistically significant (P = 0.988). Most of the patients presented with N1 (44% of CRT arm and 40% of HFRT arm) and N2 (28% of CRT arm and 26.7% of HFRT arm) stage. With respect to nodal (N) stage at presentation, CRT arm and HFRT arm were comparable (P=0.987). In HFRT arm, 7 (46.7%) patients were presented in stage III Kuppa Prakash, A. Ravi Chandran, M. Vijay Kumar. Comparison of acute toxicities and response of standard chemo radiation versus hyper fractionated radiotherapy in head and neck cancers. IAIM, 2016; 3(9): 228-237. Page 229 and 8 (53.3%) patients were in stage IV. With respect to TNM stage, CRT arm and HFRT arm were comparable (P=0.87). Radiotherapy treatment compared in both CRT Arm and HFRT arms was not statistically significant (P=0.493). In CRT arm Grade 2 toxicity: 13/22 (59%) patients developed skin toxicity, 12/22 (55%) patients developed mucous membrane toxicity, 15/22 (68%) patients developed nausea, 8/22 (36%) patients developed vomiting, 10/22 (45%) salivary gland toxicity. Grade 3 toxicity: 2/22 (9%) patients developed skin toxicity, 10/22 (45%) patients developed mucous membrane toxicity, 5/22 (23%) patients developed nausea, 6/22 (27%) patients developed vomiting. Conclusion: Standard chemo radiation is better than HFRT in Head and Neck (oral cavity) cancers because of less toxicity, less mean overall treatment time, less number of treatment breaks and better response.

Morphometry and Variations of Foramen Vesalius: Significance in Surgical Approach to Mandibular Nerve.

Background: Foramen Vesalius a small inconsistent foramen in the base of skull for passage of emissary vein from pterygoid plexus of veins to cavernous sinus. Variations in incidence and morphology are reported in literature. The objective of this study as to estimate its incidence in south Indian population and to evaluate the morphometric variations. Materials and Methods: Twenty-two dry skulls belonging to department of anatomy, Azeezia Institute of Medical Sciences, Kollam was studied with respect to base of the skull foramens. Wherever the foramen Vesalius was noted, the specimens were photographed and incidence, laterality was noted. Maximum, minimum and perimeter were noted. Any difference between male and female skulls and differences in right and left side were studied for statistical significance. P<0.05 was considered as significant. Results: We found foramen Vesalius in 40.9% of 44 sides examined. Six skulls had this foramen bilaterally. Three specimens had foramen Vesalius unilaterally and six specimens had it bilaterally. Average diameter of foramen was 1.35 (±0.56) mm from extra cranial aspect. The average diameter and perimeter of foramen in males were significantly lower than females. The average distance between foramen Vesalius and foramen ovale was significantly more in females than in males. Conclusion: Foramen ovale is an inconsistent and asymmetrical foramen in base of skull near foramen ovale. Forty percent of the skulls studied had foramen Vesalius. There is significant difference measurements of right and left side foramens. Considering these variations in infratemporal fossa decreases complications while approaching mandibular nerve and trigeminal ganglion.

A New Extractive Spectrophotometric Method for the Estimation of Alosetron.

Two simple, accurate, rapid and sensitive Methods (A and B) have been developed for the estimation of Alosetron in its pharmaceutical dosage form. The Method A is based on the formation yellow colored chromogen, due to reaction of Alosetron Hydrochloride with Metanil yellow dye, formation of ion association complexes of the drug with dyes in phosphate buffer of pH 3.6 followed by their extraction in chloroform which exhibits λmax at 410 nm. The Method B is based on the formation of light yellow colored chromogen due to reaction of Alosetron Hydrochloride with Methyl Orange dye, formation of ion association complexes of the drug with dyes in phosphate buffer of pH 3.6 followed by their extraction in chloroform, which exhibits λ max at 422 nm. The absorbance-concentration plot is linear over the range of 5-60 mcg/mL for Method A and 50-120 mcg/mL for Method B. Results of analysis for all the methods were validated statistically and by recovery studies. The proposed methods are precise, accurate, economical and sensitive for the estimation of Alosetron in bulk drug and in its Tablet dosage form.

Genetic Divesity and Molecular Characterization of Mungbean Genotypes (Vigna radiata (L.) Wilczek).

The present investigation was undertaken to examine the genetic divergence in 50 mungbean germplasm lines for 13 characters using Mahalanobis D2 statistics. The genotypes grouped into eight clusters. Cluster VII had maximum intra-cluster distance while inter-cluster distance was highest between clusters V and VII. Cluster means indicated that none of the clusters was superior for all the characters studied. Therefore, hybridization between genotypes belonging to different clusters is suggested for development of superior genotypes. 10 SSR primers were used for molecular study of which only one gave slight difference among 19 mungbean genotypes. The quality and quantity of DNA used for amplification by PCR is the key to reproducible results and success of genotyping. Especially, DNA purity is extremely crucial for obtaining clear and discriminate patterns. DNA extraction from mungbean is difficult due to presence of contaminants such as phenols. Therefore, the present study was under taken to obtain high quality and pure DNA in mungbean. With few modifications four different DNA extraction protocols were tried in the present study to obtain high quality and pure DNA viz., (I) Doyle and Doyle (1987), (ii) Method of Murray and Thompson (1980), (iii) Porebski et al.(1997), and (iv) Lin et al. (2001). Out of the four methods tried for DNA extraction, the method of Lin et al. (2001) was found most efficient, as the DNA obtained through this protocol was relatively pure which gave amplyfying products in the PCR. The genotype used for the standardization was MGG -361. Molecular characterization of 19 randomly chosen mungbean genotypes was attempted with the eight standardized primers. None of the primers showed scorable polymorphism. The primers VR4, VR5 and VR9, exhibited non specific bands, in addition to the monomorphic bands.

Phytoplankton species diversity indices in Anjanapura reservoir, Western Ghat region, India.

A qualitative study on species composition and diversity of phytoplankton flora was carried out in the Anjanapura reservoir. Water samples were collected monthly at four sites from November 2005 to October 2007 for plankton analysis. A total of 152 phytoplankton species belonging to 59 genera were recorded. The species belonging to genera Crucigenia, Pediastrum, Scenedesmus, Tetraedron, Cyclotella, Gyrosigma, Melosira, Navicula, Fragillaria, pinnularia, Synedra, Closterium, Cosmarium, Euastrum, Staurastrum, Gleocapsa, Merismopedia, Microcystis,Oscillatoria, Euglena and Phacus were found dominant. Phytoplankton density was recorded in the range of 222-1467 Org l-1 for chlorococcales, 267-1467 Org l-1 for diatoms, 44-889 Org l-1 for desmids, 44-889 Org l-1 for blue-greens and 22-1667 Org l-1 for euglenoids. Seasonal density Shannon-Weiner diversity index (1.60-1.88) indicate that reservoir exhibited rich phytoplankton and Nygaard tropic status indices for myxophycean(1.0-1.50), chlorophycean(1.62-2.16), diatoms(0.10-0.14), euglenophycean(0.18-0.19) and compound quotient(3.25-4.66) showed that reservoir was moderately polluted. From the observed data, it could be concluded that the presence of more diverse group of phytoplankton indicate the productivity of the reservoir.

Accessory neurovascular foramina on the lingual surface of mandible: Incidence, topography, and clinical implications.

Context: It was suggested that the accessory neurovascular foramina of the mandible might be of significance in relation to the effectiveness of local anesthesia following the routine inferior alveolar nerve block. Aims: To investigate the incidence of neurovascular foramina over the lingual surface of the mandible in South Indian population. Settings and Design: The study was conducted at the department of anatomy. Materials and Methods: The study included 67 human adult dry mandibles, the exact ages and sexes of which were not known. The location and number of neurovascular foramina were topographically analyzed. Statistical Analysis Used: Descriptive statistics. Results: The foramina were observed in 64 mandibles (95.5%) and were often multiple in most of the cases. They were located between the two medial incisors in 8 mandibles (1.9%), between the medial and lateral incisor in 34 mandibles (50.7%; 25-bilateral; 7-right; 2-left), between the lateral incisor and canine in 7 mandibles (10.4%; 2-bilateral; 3-right; 2-left), between the canine and first premolar in 6 cases (8.9%; 3 on each side). Foramina were also present around the genial tubercle in 56 mandibles (83.6%). Among them, 52 mandibles showed a single foramen just above the genial tubercle, 34 mandibles had foramina below the tubercles, 13 mandibles had foramina on the right side of genial tubercle and 17 were having on the left side. Conclusion: Since the anatomical details of these foramina are important to various fields of dentistry and oncology, the present investigation was undertaken. The clinical significance and implications are emphasized.

Temporal-scale spectral variability analysis of water quality parameters to realize seasonal behaviour of a tropical river system - River cauvery, India.

This paper describes the Time series analysis of river water quality with emphasis on variation in parameters as evidenced by statistical approach and mathematical models. The extensive study enabled to differentiate and realize the behaviour of river and catchment’s changes induced by human activities. The Time series analysis evaluation indicated trivial variation and movement in the water quality as reflected by the changes in the catchment characteristics. Although the observed trends showed an insignificant human contribution to basin hydrology and river water chemistry, noticeable human activities and unsustainable practices steadily contributed to change in water quality from the existing long term spectral signatures to short term spectral signatures. It is inferred that short term spectral signature exhibited on temporal scale by a monitoring program of this kind reflects an insalubrious river system and long term gradual changes in spectrum is an indication of healthy system. Monitoring and analyses of these decisive changes in water quality parameters over a period could be a powerful tool for assessing general river water quality and management plan.

Short rib polydactyly syndrome - type 2 (Majewski).

Short rib polydactyly syndromes (SRPS) are a group of inherited autosomal recessive skeletal dysplasias. It is characterized by the triad of micromelia, polydactyly and short horizontal ribs with or without visceral involvement. We report a case of SRPS-2 in a fresh stillborn and discuss the differential diagnosis.

Antimicrobial efficacy of secondary metabolites from Glomerella cingulata

Fungi are known to produce a vast array of secondary metabolites that are gaining importance for their biotechnological applications. Early reports suggest that G. cingulata has the capability to transform many compounds by various enzymatic actions. Therefore, the focus of this study was to determine the antibacterial and antifungal activity of crude ethyl acetate extract of G. cingulata using agar cup bioassay method. Crude extract of G. cingulata exhibited remarkable antifungal activity against Rhizopus oryzae, Chrysoporium tropicum and Beauveria bassiana but no antifungal activity was found against Alternaria tenuissima and Aspergillus niger at any concentrations. The crude extract presented no antibacterial activity against Gram positive and Gram negative bacteria at any concentration.

Fungos são conhecidos produtores de uma vasta coleção de metabólitos secundários que vem mostrando importância crescente na sua aplicação biotecnológica. Publicações anteriores sugerem que G. cingulata tem a capacidade de transformar vários componentes por diferentes ações enzimáticas. Logo, o foco deste estudo foi determinar a atividade antibacteriana e antifúngica do extrato bruto de G. cingulata obtido por acetato de etila utilizando-se um método envolvendo bloco de agar. O extrato bruto de G. cingulata demonstrou marcante atividade antifungica contra Rhizopus oryzae, Chrysoporium tropicum e Beauveria bassiana entretanto, não foi possível detectar, em nenhuma concentração, atividade antifungica contra Alternaria tenuissima e Aspergillus niger. O mesmo extrato não apresentou atividade antibacteriana, em nenhuma concentração, contra bactérias Gram negativa e positiva.

Groundwater quality--assessment on Anekal Taluk, Bangalore Urban district, India.

Water as a resource, basic amenity and universal solvent is shared by population. The physicochemical and biological quality study of Anekal Taluk has been taken up to evaluate its suitability for potable purposes. 1026 water samples were collected from bore well, hand pumps of 272 villages covering in Anekal Taluk. The quality of groundwater has been made through the analysis of pH, colour, electrical conductivity, turbidity, total dissolved solids, alkalinity, chlorides, total hardness, calcium, fluoride, nitrate, sulphate, iron and E. coli. The quality of groundwater assessed in the study area is discussed in detail.

Multidisciplinary approach in the long-term management of intrahepatic stones: Indian experience.

BACKGROUND: Intrahepatic stones, though common in East Asia, are uncommon in India. There is paucity of data from India regarding the treatment and long-term outcome of patients with intrahepatic stones. METHODS: We retrospectively analyzed medical records of 35 patients with intrahepatic stones who had been treated surgically. Endoscopic biliary drainage had been used in patients who presented with acute cholangitis. Intraoperative stone clearance was confirmed by choledochoscopy and intraoperative cholangiography. Outcome of surgery, frequency and subsequent management of recurrent intrahepatic stones, and factors associated with stone recurrence and cholangitis were analyzed. RESULTS: Twenty-one (60%) patients had bilobar disease. Eight patients underwent hepatectomy and 16 hepatico-jejunostomy with access loop; 12 of these were jejuno-duodenal anastomoses. Postoperative morbidity was observed in 10 patients (29%). Recurrence of stones occurred in 12 patients (34%) and cholangitis in 9 patients (26%). Presence of bilobar disease and associated biliary strictures were associated with recurrent cholangitis (p< 0.05). Two patients (6%) required re-operation for recurrent cholangitis. Complete removal of recurrent stones using conventional endoscope was possible through jejuno-duodenostomy in all 5 cases who had this type of access loop construction. CONCLUSION: Surgical treatment for intrahepatic stones depends on the site of involvement. Construction of a jejuno-duodenal access loop in patients with bilobar disease and intrahepatic strictures is helpful in facilitating postoperative stone clearance. A multidisciplinary approach is beneficial especially when the disease is bilobar and recurrent in type.