Prevalence and outcome of retinopathy of prematurity in preterm infants, with low birth weight at KMCH, Tamil Nadu, India

Background: Premature infants have avascular or incompletely vascularized retina at birth and ROP evolves over 4-5 weeks after birth. The aim of this study is to know the prevalence of retinopathy of prematurity in preterm infants, with birth weight ? 1500 grams and/or gestational age ?32 weeks in a tertiary care center.Methods: The study was conducted in Kovai Medical Centre and Hospital Coimbatore in 2016. The sample size is 95 babies. All preterm infants admitted with a birth weight of ?1500 grams and/or ? 32 weeks of gestation and baby those at risk of ROP.Results: 95 babies have enrolled during the study period of which 78 babies fulfilled the inclusion criteria and completed this prospective study.12 babies could not complete the follow-up protocol and 5 babies died before full vascularization of the retina. 78 babies who fulfilled the inclusion criteria were screened and 15 babies were found to have ROP. The prevalence of ROP in this study is 19.2%.Conclusions: Among the preventable causes of blindness in children, ROP figures very high on the agenda. Low birth weight and gestational age were found to be the most important risk factors for the development of ROP.

A study of prevalence of culture positive UTI in children: clinical profile, risk factor analysis, and microbiological profile

Background: Urinary infection is one of the common infections occurring in children. Different literature says different definition for UTI. Indian Academy of Pediatrics defines urinary tract infection as the growth of a significant number of organisms of single species in urine culture with the presence of symptoms of UTI. The objective is to study the clinical profile of children with urine culture positive UTI.Methods: The study was conducted in Kovai medical centre and hospital Coimbatore. The sample size is 150 children. The study population includes children with culture-positive UTI who are admitted between October 2015 to September 2016 over a period of 1 year. Child's history was then recorded as answers to the pre-prepared questionnaire in a proforma. Clinical examination was done, and the findings were recorded. Blood sampling was done for all patients and sent to a laboratory to measure total count, differential count, ESR.Results: Previous urinary tract infection was present in 2.7% of children. All children had the same organism grown in urine culture as in previous episode suggesting unresolved or persistent bacteremia. This is comparable with the literature stating unresolved bacteremia as the most common type of recurrent.Conclusions: The study group in which the risk factors were analysed had a female preponderance (may be due to the short urethra, easy ascending infection). In present study population fever and increased frequency are two important symptoms followed by abdominal pain.

Expression studies on NA+/K+-ATPase in gills of Penaeus monodon (Fabricius) acclimated to different salinities.

The decapod crustacean Penaeus monodon survives large fluctuations in salinity through osmoregulation in which Na+/K+-ATPase (NKA) activity in the gills plays a central role. Adult P. monodon specimens were gradually acclimatized to 5, 25 and 35‰ salinities and maintained for 20 days to observe long term alterations in NKA expression. Specific NKA activity assayed in gill tissues was found to be 3 folds higher at 5‰ compared to 25‰ (isosmotic salinity) and 0.48 folds lower at 35‰. The enzyme was immunolocalized in gills using mouse α-5 monoclonal antibody that cross reacts with P. monodon NKA α-subunit. At 5‰ the immunopositive cells were distributed on lamellar tips and basal lamellar epithelium of the secondary gill filaments and their number was visibly higher. At both 25‰ and 35‰ NKA positive cells were observed in the inter-lamellar region but the expression was more pronounced at 25‰. Gill architecture was normal at all salinities. However, the 1.5 fold increase in NKA α-subunit mRNA at 5‰ measured by quantitative RT-PCR (qRT-PCR) using EF1α as reference gene was not statistically significant. The study confirms the osmoregulating ability of P. monodon like other crustaceans at lower salinities. It is likely that significant increase in NKA transcript level happens at an earlier time point. At higher salinities all three methods record only marginal or no change from isosmotic controls confirming the hypothesis that the animal largely osmoconforms in hyperosmotic environment.

A Prevalence Study on Myopia Among School Going Children in a Rural Area of South India.

Introduction: Myopia or short sightedness is a type of refractive error in which parallel rays coming from infinity are focused in front of retina when accommodation is at rest. It is a vision condition in which close objects are seen clearly, but objects farther away appear blurred. Myopia occurs if the eyeball is too long or cornea has too much curvature. Myopia is a common vision condition affecting nearly 30% of population. It occur more frequently among school children aged between 8 and 12 years. Because the eye continues to grow during childhood, it typically progresses until about age 20. Aims and objectives: This study aimed at finding the prevalence of myopia among the students aged 10-12 years of a school in a rural area of Kollam and the influence of environmental factors, indoor activities like reading, computer games and outdoor activities and genetic factors in development of myopia. Materials and methods: Study population included students of a nearby school. Students of age >10 years were considered, so students of 5th, 6th and 7th standard students were selected. Each of the division was considered as one strata and simple random sample of clusters had been selected from each standard. All the students of the selected division were selected to sample. Thus, a total of 68 students from that school were taken for the study. The study setting was in a rural area in Kollam district of Kerala. Results: Snellen’s chart along with unilateral vision blinders were used for evaluating vision. Details of factors influencing were obtained using a pretested questionnaire in a pilot study. The prevalence of myopia in school children of rural community in Kollam was found to be 51.47% in which a group of hidden myopic of 43.1% were discovered.

Prevalence of Gestational Diabetes Mellitus in a Medical College in South India: A Pilot Study.

Background: The prevalence of diabetes is increasing in India with projected rates of 79.4 million in 2030 — a 15.1% increase from 31.7 million in 2000. The increased prevalence is attributed to the aging population structure, urbanization, the obesity epidemic and physical inactivity. Though prevalence of diabetes is alarmingly high among Indians, there have been very few studies assessing the effect of diabetes on pregnancy outcomes. Diabetes in pregnancy causes maternal and neonatal complications like stillbirth, hydramnios, etc. Among ethnic groups in South Asian countries, Indian women especially south Indians have the highest frequency of gestational diabetes mellitus (GDM) necessitating universal screening. The recognition of glucose intolerance during pregnancy is more relevant as Indian women have 11-fold increased risk of developing GDM compared to other places. Aims and objectives: To find the prevalence of GDM in Kollam and to find the relation of GDM with various risk factors like age, obesity, previous large baby, abortion, previous abnormal glucose tolerance test (GTT), complications in previous pregnancy like hydramnios, bleeding, etc. Study design: A retrospective study of prevalence and possible risk factors associated with gestational diabetes was undertaken on 71 mothers between the age group of 20 and 35 years who were screened. Setting: Details on the medical history, family history of diabetes and obstetric history were collected using a performa. All the study subjects underwent a complete physical examination and biochemical assessment was done. Results and conclusion: This study on prevalence of GDM in Kollam district showed that the prevalence of GDM was 17%. It was found out that the factors such as increased age of pregnant women, overweight and obesity, lack of exercise and diet control, GDM in first-degree relatives, previous abnormal GTT predispose to GDM. Also women with previous large weight babies (macrosomia), previous loss of pregnancy, GDM in previous pregnancy, complications in previous pregnancy like hydramnios, bleeding, etc. have increased chances of getting GDM.

Identification and estimation of phthalate esters in the commonly used deodorants in UAE by using HPTLC method

The study aims to identify and estimate four phthalate esters viz., Dibutyl phthalate [DBP], Diethyl phthalate [DEP], Di [2-ethylhexyl] phthalate [DEHP], Dimehtyl phthalate [DMP] in commonly used deodorants by using High performance Thin Layer Chromatography [HPTLC]. 10 brands of most commonly used deodorants; the volume and frequency of their use were selected based on a questionnaire based survey in UAE. DBP, DEP, DEHP, and DMP were identified in deodorants by comparing the R[f] value with their respective standards by using HPTLC. The estimated phthalate contents were extrapolated to calculate the hazard indices. The results showed that these 4 different phthalates were present in various brands of deodorants. DBP was found to be present in highest concentrations in most of the deodorants. The hazard indices of all four phthalates were found to be less than 1. In our study, the different phthalates [DBP, DEP, DEHP and DMP] contents in 10 brands of commonly used deodorants in UAE were identified and estimated. The Hazard Indices for phthalates estimated [DBP, DEP, DEHP and DMP] in different brands of commonly used deodorants in UAE were found to be below 1 indicates the safety of these products for human use

Detection of stability and degradation of piperacillin and tazobactam in injectables from in-patient wards and pharmacy by RP-HPLC method

New RP-HPLC method for the detection of degradants and quantification piperacillin and tazobactam in injectables stored in inpatient wards and pharmacy has been developed on C[8] column [250 x 4.6, 5 micron] using methanol and water [55:45% v/v] as mobile phase and Diode array detection at 215 nm. Linearity regression coefficients were more than 0.999 and % RSD for intra- and inter-assay precision and accuracy were less than 2. Selectivity of the method for all possible degradants and analytes were established by mild acidic and alkaline stress degradation using 0.001M HCl and 0.001M NaOH. Method was applied on various samples of injectables collected from inpatients wards and pharmacy. Results revealed that few minor degradants were observed in samples collected from refrigerator and 9 degradants were found in samples collected from trays of inpatient ward. Formed degradants were identical with acid/base hydrolytic products of stress studies. This RP-HPLC method is highly reliable in hospitals and clinical analysis of Piperacillin and Tazobactam in Injectables to preserve potency, to prevent resistance and to ensure efficacy. This study educates the paramedical staff in handling and storage of Piperacillin and Tazobactam in injectables in wards and pharmacy stores

Ethnomedicinal plants used to cure diarrhoea and dysentery in Pachalur hills of Dindigul district in Tamil Nadu, Southern India.

The people residing in Pachalur hills in Dindigul district of Tamil Nadu mostly depend on the vegetation around them for the prevention as well as the treatment of diseases and ailments. Information on ethnomedicinal uses of plants, their doses and mode of administration have been collected from the local traditional medicine practitioners (Vaithiyar) as well experienced men and women. The paper deals with 54 ethnomedicinal plants of 52 genera belonging to 31 families used by the villagers for diarrhoea and dysentery in Pachalur hills. Most of these plants are commonly available in natural sources and some were obtained from local dealers. Isolation of active principles, pharmacological investigations, and the potent anti–microbial activity should be studied on these medicinally important species. Attention should also be made on proper exploitation and utilization of these medicinal plants.

Influence of relative humidity in Vibrio cholerae infection: A time series model.

Background & objectives : Spread of cholera in West Bengal is known to be related to its ecosystem which favours Vibrio cholerae. Incidence of cholera has not been correlated with temperature, relative humidity and rainfall, which may act as favourable factors. The aim of this study was to investigate the relational impact of climate changes on cholera. Methods : Monthly V. cholerae infection data for of the past 13 years (1996-2008), average relative humidity (RH), temperature and rainfall in Kolkata were considered for the time series analysis of Seasonal Auto-Regressive Integrated Moving Average (SARIMA) model to investigate relational impact of climatic association of V. cholerae infection and General Linear Model (GLM) for point estimation. Results : The SARIMA (1,0,0)(0,1,1) model revealed that monthly average RH was consistently linear related to V. cholerae infection during monsoon season as well as temperature and rainfall were non-stationary, AR(1), SMA(1) and SI(1) (P<0.001) were highly significant with seasonal difference. The GLM has identified that consistent (<10%) range of RH (86.78 ± 4.13, CV=5.0, P <0.001) with moderate to highest (>7 cm) rainfall (10.1 ± 5.1, CV=50.1, P <0.001) and wide (>5-10°C) range of temperature (29.00 ± 1.64, CV=5.6, P <0.001) collectively acted as an ideal climatic condition for V. cholerae infection. Increase of RH to 21 per cent influenced an unusual V. cholerae infection in December 2008 compared to previous years. Interpretation & conclusions : V. cholerae infection was associated higher RH (>80%) with 29°C temperature with intermittent average (10 cm) rainfall. This model also identified periodicity and seasonal patterns of cholera in Kolkata. Heavy rainfall indirectly influenced the V. cholerae infection, whereas no correlation was found with high temperature.

Morphological variation, histology, histochemistry and nutrient contents of Frankia root nodules in Casuarina equisetifolia.

Root nodules were collected from the existing plantation of Casuarina equisetifolia from three different agroclimatic zones of Tamil Nadu, India. Morphological variation, histology, histochemistry and nutrient contents of the nodules were studied. The nodules were found to be simple, dichotomously branched and coralloid. The stele in simple and branched nodules reached up to the tip of the nodules. Structure of Frankia nodules was described using histochemical methods to elucidate the nature of micro-symbiont within the nodules. The nodule consisted of a distinct periderm enclosing the cortex. The cortex showed patches of infected cells interspersed among the uninfected ones. Inside the cortex was a stele bound by an endodermis, which contained high amount of tannin. The micro-symbiont was observed in the nodule tisues in hyphal form and spore packed sporocorp was also seen in the cortex. The histochemical tests revealed the presence of proteins, insoluble polysaccharides and polyphenols.

Histopathological changes in experimental cholera with a non toxigenic non- O1 non-O139 Vibrio cholerae strain isolated from Kolkata, India.

This study was conducted to understand the pathophysiological changes in experimental rabbit ileal loop model using the Vibrio cholerae strain non-O1non-O139, isolated as sole pathogen from clinically diagnosed cholera patients in Kolkata. Significant amount of haemorrhagic fluid accumulation was observed in all the test loops of rabbit model where the strain of V.cholerae was inoculated as compared to control loops. Microscopic examination of the accumulated fluid showed the presence of erythrocytes and pus cells. Histology revealed structural alteration of the villous epithelium with inflammatory cells infiltration in all the layers of the gut mucosa including the nerve plexus region. Preliminary observation with a haemagglutinin protease extracted from the non-O1 non-O139 strain, was also studied in different concentrations in the same animal model which showed similar type of macroscopic and microscopic response in the ileal loops as seen with the original strain. The results highlight that along with other pathways, inflammatory cells and the enteric neurons have an important role in the pathophysiology of diarrhoea and the isolated protease may be the probable virulence factor in initiating the disease process in this non-O1non-O139 strain induced cholera.

In vitro antioxidant studies of Annona squamosa Linn. leaves.

The free radical scavenging potential of the leaves of A. squamosa was studied by using different antioxidant models of screening. The ethanolic extract at 1000 microg/ml showed maximum scavenging of the radical cation, 2,2-azinobis- (3-ethylbenzothiazoline-6-sulphonate) (ABTS) observed upto 99.07% followed by the scavenging of the stable radical 1,1-diphenyl, 2-picryl hydrazyl (DPPH) (89.77 %) and nitric oxide radical (73.64%) at the same concentration. However, the extract showed only moderate scavenging activity of superroxide radicals and antilipid peroxidation potential, which was performed using rat- brain homogenate. The findings justify the therapeutic applications of the plant in the indigenous system of medicine, augmenting its therapeutic value.

Cluster-analysis & patterns of dissemination of multidrug resistance among clinical strains of Vibrio cholerae in Calcutta, India.

BACKGROUND & OBJECTIVES: Antimicrobial resistance among Vibrio cholerae has been monitored for several years in Calcutta. To investigate the changing trends in multidrug resistance (MDR) among different serogroups of V. cholerae and to perform software assisted cluster analysis the current study was undertaken. METHODS: Strains isolated from patients with cholera and "cholera-like" diarrhoea admitted in the Infectious Diseases Hospital, Calcutta were analysed. Eight hundred and forty V. cholerae strains isolated from 1992 through 1997 were tested for susceptibility to 11 antibiotics. Cluster analysis was done using SPSS software. RESULTS: Most of the strains exhibited MDR with fluctuating trends as the resistance profile diverged each year. A total of 119 different resistance profiles exhibited by V. cholerae O1, O139 and non-O1, non-O139 serogroups were analysed by cluster combination method. During 1993 and 1994, 53 per cent of V. cholerae O139 and 82 per cent of V. cholerae O1 serogroups, respectively, exhibited maximal number of new resistance patterns. The frequency of new resistance patterns among V. cholerae non-O1, non-O139 was constantly high (33-47%) during 1995 to 1997. INTERPRETATION & CONCLUSIONS: With a few exceptions, preponderance of the resistance profiles was generally not confined to any serogroup. The cluster analysis depicted dissemination of some of the resistance patterns commonly found among V. cholerae non-O1, non-O139 belonging to different serogroups to the O139 serogroup in the succeeding years. In this study we have shown that the V. cholerae strains are resistant to several antibiotics with constant change in the MDR profiles. It is imperative to define the susceptibility pattern of the strains to determine the effective drug of choice for the treatment of cholera.