Hypothyroxinemia in sick term neonates and its risk factors in an extramural neonatal intensive care unit: a prospective cohort study

ABSTRACT Objective: Thyroid functions in the sick newborns may be altered in the first week of life. Transient hypothyroxinemia has been reported in these babies, which could be due to the immaturity of the hypothalamic-pituitary-thyroid axis or to acute illness. We conducted this study to estimate the incidence of hypothyroxinemia and determine its risk factors in sick term newborns. Materials and methods: We analyzed free T4 (FT4) and thyroid-stimulating hormone (TSH) levels in sick term neonates (≤7 days of life) admitted to the neonatal intensive care unit. FT4 and TSH levels were estimated in the first week of life in all the enrolled neonates (N = 98) and then repeated at 14-21 days of life in 46 babies. Risk analysis was conducted using univariate and multivariate logistic regression, and numerical data was compared using the Mann-Whitney U test and t-test. Results: Hypothyroxinemia was seen in 10 (10.2%) of the admitted term babies. Male gender, vaginal delivery, presence of hypoxic ischemic encephalopathy, and need for mechanical ventilation (>24 hours) were identified as risk factors. There was a significant negative linear correlation between FT4 level in the first week of life and duration of hospital stay. Conclusion: Hypothyroxinemia is common in sick term neonates.

Efficacy Of Binary Combination Of Deltamethrin+Mgk-264 On Levels Of Biochemical Changes In The Snail Lymnaea Acuminata

Objective: The objective of the present study is the evaluation of the effect of the sublethal (40% and 60% of 48h LC50) binary combination (1:5 ratios) of molluscicides deltamethrin+MGK-264 on the endogenous levels of protein, amino acid and nucleic acid in different tissues of snail Lymnaea acuminata. Methods: The snails were treated with 1:5 mixtures of sub-lethal concentration of (40% and 60% of 48h LC50) deltamethrin+MGK-264 on the protein, amino acid and nucleic acid levels in gonadal, nervous and foot tissue of L. acuminata. In order to study the effect of withdrawal from treatment, the snails were first exposed to the above concentrations for 96h, after which they were transferred to freshwater. Water was changed every 24h for the next seven days, after which different biochemical parameters were estimated. Results: There was a significant change in the levels of protein (sublethal concentration of 60% of 48h LC50 after 96h) gonadal, nervous and foot tissues are 48.1, 12.1 and 14.5%, respectively, amino acid are 273, 234 and 252%, respectively, DNA are 25.1, 38.9 and 42.1%, respectively and RNA are 12.2, 30.7 and 30.5%, respectively. These changes were time and concentration-dependent. In the withdrawal experiment, the snails were treated for 96h to transfer in freshwater for 7 d, which caused significant recovery in all the biochemical parameters. Conclusion: The present study concluded that the high molluscicidal activity of deltamethrin+MGK-264 simultaneous decrease in the levels of proteins, DNA, RNA and increase in the level of amino acids.

Serological, Isolation and Molecular Studies on Brucellosis in an Organized Farm, Jammu and Kashmir, India

The present study was conducted in an organized farm of Jammu region, Jammu and Kashmir state having history of late-term abortions in cattle and buffaloes to elucidate the role of brucellosis in causing abortions on the farm. The farm had 46 animals (23 adults, 15 heifers and 9 calves). The farm was positive in herd test (milk ring test). Serological tests viz., Rose Bengal plate test (RBPT) and serum agglutination test (SAT) were conducted on 30 serum samples and 11 samples were found positive in both tests. Five vaginal swabs from abortion cases were processed for isolation and 3 isolates of Brucella were obtained which on further characterization by biochemical tests, genus-specific PCR and species-specific PCR were identified as B. abortus biovar 1. As brucellosis is an anthropozoonoses, the high prevalence of brucellosis in livestock of farm demands the surveillance of disease in humans working on the farm and necessitates the control of disease on the farm.

Evaluation of diagnostic efficacy of hepatobiliary scintigraphy as a diagnostic procedure in pediatric practice with special reference to cholestatic jaundice.

Background: The objective was to assess the diagnostic efficacy of hepatobiliary scintigraphy (Tc99 mebrofenin) in case of cholestatic jaundice in pediatric practice. Method: Study conducted on 45 cases from 0-6 yrs. of age. Out of 45 pt 20 pt excluded from study Hepatobiliary Scintigraphy (Tc99m Mebrofinin) was performed in 25 cases. Injection of Tc99m mebrofinin (1-2 mCi) IV was given to each subject. Dynamic hepatic scan was done upto initial 1 hour study and additional delayed images were taken at 4 & 24 hrs only in case of non-visualization of tracer in the intestine after initial 1 hr. study. Results: In this study hepatobiliary scintigraphy was 100% sensitive, 93.73% specific, 80% positive predictive values, 100% negative predictive value, 6.23% false positive result and virtually no false negative result for biliary atresia. Conclusion: It is concluded that Tc99m mebrofenin hepatobiliary scintigraphy has proven to be reliable noninvasive imaging modality in evaluating cholestatic jaundice in pediatric practice as it carries a high sensitive & specific value, good positive & no negative predictive value, few false positive & virtually no false negative results.

A study of mode of transmission, clinical presentations, WHO and immunological staging among HIV infected children.

Background: The clinical manifestations of HIV infection vary widely among infants, children, and adolescent. So there is a need to study the mode of transmission, clinical presentations, WHO and immunological staging among HIV infected children. Methods: Observational analytic cross sectional study. The children who were HIV positive (confirmed by ELISA for HIV-1 and HIV-2), and attending the OPD of ART Centre and SN Children Hospital, Allahabad during period of one year. The study population consisted of 47 patients, belonging to both sexes and age of 18 months to 19 years. Detailed history was taken and full clinical examination done in all cases. CD4 count was estimated at the time of presentation. Results: Predominant mode of transmission in our study was vertical and it was present in 95% cases. Fever was the most common presenting complaint and was present in 28 (59.57%) cases. The most common clinical sign was pallor in our study, present in 37 cases (78.72%) followed by lymphadenopathy 34 (72.34%). On the basis of WHO clinical staging, most of the patients in our study were found in stage 2 .On the basis of immunological staging, 51% had no evidence of immunosuppression (stage1), 18 (38.3%) had mild to advanced immunosuppression (stage 2 and 3) and 5 (10.63%) patients were severely immunosuppressed (stage 4). Conclusion: In HIV infected children predominant mode of transmission is vertical. Fever and pallor are common clinical manifestations. Most of the patients are found in WHO clinical stage 2 and immunological stage 1.

Supplementary Suckling Technique for Relactation in Infants With Severe Acute Malnutrition.

We report on use of supplementary suckling technique in 62 infants [mean (SD) age 2.5 (1.3) mo] with severe acute malnutrition admitted at our Nutritional rehabilitation Center. It was successful in 34 (55.7%) infants.

A study of habit of fast food eating among school going adolescents and parental advice and its relation with their nutritional status.

Background: A study of habit of fast food eating among school going adolescents and parental advice and its relation with their nutritional status. Methods: Design: an epidemiological analytic observational study. Subjects: 600 adolescents’ 15-19 years of age, studying in 11 and 12 classes and included both boys and girls. A single observer interviewed each student and gathered the information regarding their eating habits. It was recorded on a pre-tested open and closed ended Performa. Nutritional status was assessed by BMI. The adolescents for the purpose of analysis were broadly grouped in two groups. Group I (those having normal BMI ranging 18.5 to 25) and group II (Malnourished i.e. those having BMI <18.5 to >25). Group II adolescents were further divided into group IIa (Underweight, BMI<18.5) and group IIb is (Over weight and obese BMI >25). Results: Adolescents who took both fast food and soft drinks 73.1% were malnourished (group II) as compared to those who did not take both the things 13.7% in group II. Difference was found to be statistically significant (p value <0.01). Out of 73.1% who took both fast food and soft drinks 62.1% and 11.0% were in group IIa (Underweight, BMI <18.5) and group IIb (Over weight and obese BMI >25) subsequently. Incidence of malnutrition was significantly less in 12.4% adolescents’ interfered by their parents as compared to 69.6% of those where parents was not interfering. Difference was found to be statistically significant (P value <0.01). Conclusion: A habit of fast food eating and taking soft drink provokes malnutrition. Interference in eating by parents is beneficial among adolescents.

An Experience of Facility-based Management of Severe Acute Malnutrition in Children Aged Between 6-59 Months Adopting the World Health Organization Recommendations.

Objective: To study the output indicators of a nutritional rehabilitation center to assess its performance. Methods: Data of 182 children aged between 6-59 months with severe acute malnutrition in a nutritional rehabilitation center were analyzed retrospectively. Identification and treatment of severe acute malnutrition was done according to World Health Organization recommendations. Results: The recovery rate, death rate, defaulter rate, mean (SD) weight gain and mean (SD) duration of stay in the nutritional rehabilitation center were 68%, 2.2%, 4.4%, 13.0 (9.0) g/kg/d, 12.7 (6.8) days, respectively. Conclusion: Nutritional rehabilitation centers are effective in management of severe malnutrition.

Nucleated RBC Count as Predictor of Neurological Outcome in Perinatal Asphyxia.

The immediate and short term outcomes of term newborns with perinatal asphyxia were studied in relation to the nucleated red blood cell count at admission. The mean (SD) NRBC/100WBC (white blood cells) was significantly higher in sequelae group than normal [9.8 (98.9) vs. 2.9 (43); P = 0.001].

Influence of Abiotic Factors and Infection of Fasciola gigantica on Oviposition of Vector Snail Lymnaea acuminata.

Aims: The aim of the present study is establish a correlation between the abiotic factors and infection rate of Fasciola gigantica and their effect on the reproduction of vector snail Lymnaea acuminata. Place and Duration of Study: Malacology Laboratory, Department of Zoology, DDU Gorakhpur University, Gorakhpur in between November 2009 - October 2010. Methodology: Fecundity of infected/uninfected snail Lymnaea acuminata was noted in different months of year 2009-2010.Fecundity was dependent on variant abiotic environmental factors and infection rate of Fasciola gigantica larvae in snail body. In infected snail the highest fecundity was observed in winter and lowest in summer. In order to ascertain that such a relationship between fecundity and abiotic factors is not coincident, the nervous tissue of the snail was assayed for the activity of the acetylcholinesterase (AChE) in uninfected and infected snails in each months of the year. It was noted that abiotic factors and infection parameter in snail body influence the influence the fecundity of the snails in each month of year 2009-2010. Results: There was a significant positive rank correlation between total fecundity of uninfected/infected snails and corresponding AChE activity in the nervous tissue of same snails.

Fasciolosis Control: Phytotherapy of Host Snail Lymnaea acuminata by Allicin to Kill Fasciola gigantica Larvae.

Aims: Fasciolosis is a widely distributed disease affecting the lives of herbivorous animals and human. The causative agents are Fasciola hepatica and F. gigantica. Snail Lymnaea acuminata is the intermediate host of Fasciola species. Sporocyst, redia and cercaria are the larval stages found in the snail body. Methodology: The destruction of these larvae in intermediate host is one of the important methods to abolish the incidences of fasciolosis without, killing the snail. Mortality of larvae in in vitro and in vivo condition was observed at 2h, 4h, 6h and 8h, exposure of allicin an active component of Allium sativum. Results: Abiotic factors alter the toxicity of allicin against F. gigantica larvae in different months of year 2011-2012. Highest in vitro toxicity of allicin against redia larva was noted in July (8h LC50 0.001 mg/ml), where as in case of cercaria larva it was in month of June (8h LC50 0.005 mg/ml). Highest toxicity in in vivo treatments against redia and cercaria larvae was observed in February (8h LC50 0.013mg/L and 0.010 mg/L, respectively). The highest temperature, free carbon dioxide, lowest pH and dissolved oxygen were noted in the months of June to August. Conclusion: In vitro and in vivo treatment of allicin against Fasciola larvae is one of the new approaches to control the fasciolosis, without killing the host snail.

Pharmacological effects of Sapindus mukorossi / Efeitos farmacológicos do Sapindus mukorossi

Sapindus mukorossi is an extremely valuable medicinal plant, distributed in tropical and sub-tropical regions of Asia. The aim of present review is to form a short compilation of the phytochemical composition and pharmacological properties of this multipurpose tree. The main phytoconstituents isolated and identified from different parts of this plant are triterpenoidal saponins of oleanane, dammarane and tirucullane type. The structure and chemical names of all the types of triterpenoidal saponins reported in Sapindus mukorossi are included in this review. Many research studies have been conducted to prove the plant's potential as being spermicidal, contraceptive, hepatoprotective, emetic, anti-inflammatory and anti-protozoal. The present review highlights some of the salient pharmacological uses of Sapindus mukorossi.

Sapindus mukorossi é planta medicinal extremamente valiosa distribuída nas regiões tropical e subtropical da Ásia. O propósito da presente revisão é uma compilação curta da composição fitoquímica e das propriedades farmacológicas desta árvore que apresenta múltiplos propósitos. O principal fitoconstituinte isolado e identificado das diferentes partes desta planta são as saponinas triterpenoidais do tipo da oleana, damarana e tiruculana. A estrutura e o nome químico de todos os tipos de saponinas triterpenoidais encontrados no Sapindus mukorossi estão incluídos nesta revisão. Muitas pesquisas tem sido conduzidas para provar o potencial desta planta como espermaticida, contraceptivo, hépato-protetor, emético, anti-inflamatório e anti-protozoário. A presente revisão exalta alguns principais usos farmacológicos do Sapindus mukorossi.

Characterization of the molluscicidal activity of Bauhinia variegata and Mimusops elengi plant extracts against the fasciola vector lymnaea acuminata / Caracterização da atividade moluscicida dos extratos das plantas Bauhinia variegata e Mimusops elengi contra o vetor da Fasciola, Lymnaea acuminata

The molluscicidal activity of Bauhinia variegata leaf and Mimusops elengi bark was studied against vector snail Lymnaea acuminata. The toxicity of both plants was time and concentration-dependent. Among organic extracts, ethanol extracts of both plants were more toxic. Toxicity of B. variegata leaf ethanolic extract (96h LC50- 14.4 mg/L) was more pronounced than M. elengi bark ethanolic extract (96h LC50-15.0 mg/L). The 24h LC50 of column purified fraction of B. variegata and M. elengi bark were 20.3 mg/L and 18.3 mg/L, respectively. Saponin and quercetin were characterized and identified as active molluscicidal component. Co-migration of saponin (Rf 0.48) and quercetin (Rf 0.52) with column purified bark of M. elengi and leaf of B. variegata on thin layer chromatography demonstrate same Rf value i.e. 0.48 and 0.52, respectively. The present study clearly indicates the possibility of using M. elengi and/or B. variegata as potent molluscicide.

A atividade moluscicida das folhas da Bauhinia variegata e da casca do Mimusops elengi foi testada contra o vetor caracol, Limnaea acuminata. A toxicidade de ambas as plantas é dependente do tempo e da concentração. Entre os extratos orgânicos, os extratos de etanol de ambas as plantas foi mais tóxico. A toxicidade do extrato etanólico da folha da B. variegata (96 h LC50 - 14,4 mg/L) foi mais pronunciada do que o extrato etanólico da casca do M. elengi (96h - LC50 - 15,0 mg/L). As frações purificadas em coluna durante 24 h LC50 do B. variegata e da casca do M. elengi foram 20,3 mg/L e 18,3 mg/L, respectivamente. A saponina e a quercentina foram caracterizadas e identificadas como os componentes ativos moluscicidas. A co-migração da saponina (Rf 0,48) e da quercentina (Rf 0,52) com a casca purificada por coluna do M. elengi e as folhas da B. variegata na cromatografia demonstraram o mesmo valor Rf isto é, 0,48 e 0,52 respectivamente. O presente estudo indica claramente a possibilidade de usar M. elengi e/ou B. variegata como moluscicidas potentes.

Double Fetus In Fetu.

Fetus in fetu (FIF) is an extremely rare cause of infantile abdominal mass where a rudimentary, malformed monozygotic-diamniotic twin grows inside the other twin. We describe a male infant with double or twin fetuses in fetu. The diagnosis was made on a computerized tomography (CT) scan of the abdomen and confirmed on surgery. Surgical excision was done and the baby did well post operatively.

Bait formulations of molluscicides and their effects on biochemical changes in the ovotestis of snail Lymnaea acuminata (Mollusca; Gastropoda:Lymnaeidae) / Formulações de iscas de moluscicidas e seus efeitos sobre as alterações bioquímicas no ovoteste do caramujo Lymnaea acuminata (Mollusca;Gastropoda:Lymnaeidae)

The effect of sub-lethal feeding of bait formulations containing molluscicidal component of Ferula asafoetida (ferulic acid, umbelliferone), Syzygium aromaticum (eugenol) and Carum carvi (limonene) on biochemical changes in the ovotestis of snail Lymnaea acuminata were studied. Bait formulations feeding to L. acuminata were studied in clear glass aquaria having diameter of 30 cm. Baits were prepared from different binary combinations of attractant amino acid (valine, aspartic acid, lysine and alanine 10 mM) in 100 mL of 2 percent agar solution + sub-lethal (20 percent and 60 percent of 24h LC50) doses of different molluscicides (ferulic acid, umbelliferone, eugenol and limonene). These baits caused maximum significant reduction in free amino acid, protein, DNA, RNA levels i.e. 41.37, 23.56, 48.36 and 14.29 percent of control in the ovotestis of the snail, respectively. Discontinuation of feeding after treatment of 60 percent of 96h LC50 of molluscicide containing bait for next 72h caused a significant recovery in free amino acid, protein, DNA and RNA levels in the ovotestis of L. acuminata.

Foi estudado o efeito subletal das iscas usadas para alimentação contendo componentes moluscicidas de Ferula asafoetida (ácido ferúlico, umbeliferone), Syzygium aromaticum (eugenol) e Carum carvi (limonene) nas alterações bioquímicas do ovoteste do caramujo Lymnaea acuminata. A formulação das iscas usadas para alimentar L. acuminata foi estudada em aquários de vidros transparentes de diâmetro de 30 cm. As iscas foram preparadas por combinações diferentes binárias de aminoácidos (valina, ácido aspártico, lisina e alanina 10 mM) em 100 mL de solução de agar a 2 por cento + doses subletais (20 por cento e 60 por cento durante 24 horas LC50) de diferentes moluscicidas (ácido ferúlico, umbeliferone, eugenol e limonene). Estas iscas causaram redução significante máxima em aminoácidos livres, proteínas, níveis de DNA e RNA isto é 41,37 por cento, 23,56 por cento, 48,36 por cento e 14,29 por cento de controle no ovoteste do caramujo, respectivamente. Discontinuação da alimentação depois do tratamento de 60 por cento de 96 horas de LC50 do moluscicida contendo a isca para as subsequentes 72 horas causou significante recuperação dos níveis de aminoácidos livres, proteína, DNA e RNA no ovoteste da L. acuminata.

Intravenous Adrenaline for Shock in Neonates.

Dopamine and dobutamine have been widely used to treat shock with variable success in newborns. In this retrospective data analysis, we report on the use of adrenaline in 20 neonates with birth asphyxia and shock that was refractory to dopamine and dobutamine. We concluded that adrenaline is a safe and effective drug that can be used as an add-on therapy to dopamine and/or dobutamine in newborns with shock secondary to birth asphyxia.