No time to waste for wasted children in Bihar: time to reset

Background: Severe acute malnutrition (SAM) with severe wasting remains a major killer of children. In Bihar, 48% of children are stunted, 21 % are wasted, and 7% are severely wasted. Even during the first six months of life, 31% are wasted. The objective of this study was to study wasting trends and contributing factors responsible for changes in Bihar among children 0-5 years. Methods: This cross-sectional study was done using a data of NFHS-5 survey in Bihar (N=35,834) conducted in all 38 districts of the state from July, 2019 to February, 2020. The Bihar NFHS-5 report and factsheets, including NFHS-4 data, were downloaded and converted to excel to enable data visualization and trend analysis. The outcome variable Wasting was measured using NFHS-5 relevant questionnaires given under nutrition category. We analyzed trends between NFHS-5 and NFHS-4 Bihar data for severe wasting/wasting, determinants, and coverage of interventions.Results: The prevalence of severe wasting has increased from 7% to 8.8%, while wasting increased from 20.8% to 22.9% (NFHS-5). The severe wasting and wasting has reversed or worsened in 27 districts. There is a mixed picture of infant feeding- early initiation of breastfeeding worsening and some improvements in exclusive breastfeeding and timely introduction of complementary feeding. Consistent improvement across districts for underlying determinants, but slight, in women抯 education, teenage pregnancy, and marriage before 18 years. Conclusions: Need to invest in improving maternal determinants-age at marriage, education, ANC coverage, and teenage pregnancy. It is imperative to focus on preventing, identifying, and treating wasting.

Detection of butachlor in viscera by thin layer chromatography.

Butachlor, a selective systemic herbicide, was isolated, analyzed and detected in viscera obtained from medi-colegal autopsy. Butachlor was extracted by using solvent extraction methods and then identified by Thin Layer Chromatography (TLC). For chromatographic separation, various solvent systems were used. Bromophenol blue was used as chromogenic reagent on developed TLC plates which successfully increased the sensitivity without dispensing with the simplicity of the method. For the study, a total of 15 solvent systems in different ratios were chosen. Of these, the best two solvent systems, namely, Benzene:Diethyl ether (8.5:1.5) and Hexane: Acetone (9:1) were chosen for statistical analysis, which included the calculation of mean Rf value and value of standard deviation and coefficient of variance.

Collection, preservation and forwarding of biolgical samples for toxicological analysis in medicolegal autopsy cases : A review.

Collection of proper autopsy specimen is an essential step in the process of toxicology case work¹. Improper collection of these specimens can greatly alter or negate chemical and toxicological analysis. This article is an update about the standard methods of biological specimen collection procedures for toxicological analysis which will be helpful for the forensic pathologist and forensic scientists.

Determination of malathion in blood and urine using thin-layer chromatography.

Malathion is a broad-spectrum Organophosphorus insecticide generally used to control a variety of insects. Routinely it is analysed by Gas Liquid Chromatography & High Performance Liquid Chromatography. Now an attempt has been made to develop a new method for analysis of Malathion in biological samples using Thin Layer Chromatography (TLC) technique, which is inexpensive, accurate and non-destructive. Malathion was extracted from blood and urine using solvent extraction methods and then identified on the TLC plates. For chromatographic separation, various binary and tertiary solvent systems were used to demonstrate in the laboratory. For detection on developed plates, palladium chloride reagent was used which successfully increased the sensitivity without dispensing with the simplicity of the method. For the analysis, a total of 20 solvent systems were chosen. Out of these 20 solvent systems, the three best solvent systems namely Cyclohexane: Chloroform (60:40), Hexane: Acetone (80:20) and Acetone: Hexane: Toluene (40:40:20) were chosen for statistical analysis which included the calculation of mean Rf value, value of standard deviation and coefficient of variance. The method developed is simple, inexpensive, accurate and non-destructive that allows for sensitive and reproducible analysis of Malathion.

Foramen magnum tumors: a series of 30 cases.

BACKGROUND AND AIMS: Foramen magnum tumors, especially those located ventrally, are surgically challenging. We studied clinical and surgical details of extramedullary tumors located in the region of the foramen magnum. MATERIAL AND METHODS: A series of 30 cases of extramedullary tumors at the foramen magnum, operated over a period of 8 years is presented. RESULTS: There were 10 neurofibromas, 8 meningiomas, 6 chordomas, 2 tuberculomas and 4 miscellaneous tumors. The clinical profile consisted of sensory symptoms in all the patients, quadriparesis in 24, lower cranial nerve affection in 8 and sphincter disturbances in 6 patients. The surgical approaches consisted of an extreme lateral approach in 10, a posterior or posterolateral approach in 18 and a per-oral route in 2 cases. Total excision of the tumor was performed in 24 and a subtotal excision of the tumor was done in 6 cases. Two patients died, one due to meningitis and the other due to chest infection. Eight other patients had complications like CSF leak, meningitis, pseudomeningocele, laryngeal edema, and transient worsening of neurological deficits. CONCLUSIONS: Foramen magnum tumors have long been regarded as difficult lesions both in terms of diagnosis and management. However, with the availability of MR imaging, newer surgical techniques and skull basal exposures, the excision of these lesions is becoming easier and safer.

Lymphocutaneous sporotrichosis treated with three different modalities.

Three cases of lymphocutaneous sporotrichosis were treated with three different modalities and oral saturated solution of potassium iodide was found to be best modality.

Painful bruising syndrome.

Painful bruising syndrome is a distinctive but rare clinical entity. A case of this condition in a psychiatrically normal teenage girl is reported.

Does pentoxifylline find a place in the armementarium of leprologists in type II reaction?

Alternative therapeutic interventions in Type II lepra reaction are being considered following serious problems associated with the use of steroids and thalidomide. Pentoxifylline (PTX) has been used in Type II reaction with varying degrees of success. The results of a study on the use of this drug in a dose of 1200 mg per day for a period of 2 months in patients with ENL reaction are discussed. Five patients, one of whom was HIV positive--all with severe Type II reaction, were regularly evaluated for regression of inflammatory symptoms and clinical involution of ENL lesions while on PTX therapy and thereafter. It was found that PTX led to a total elimination of systemic symptoms within a week. ENL lesions regressed in two weeks. However, in one patient, lesions recurred after one month of therapy. It appears that PTX is well tolerated and could be used as an additional drug in the armamentarium of leprologists in the management of Type II reaction, especially in HIV co-infection, where long-term steroids are contraindicated. However, further studies to compare the effects of PTX with currently, widely used drugs for the treatment of ENL reaction are necessary.

Ecologic perspective of dermatologic problems in North Eastern India.

In the nations of the developing world, the incidence of skin diseases is especially affected by geography. Epidemiological studies of skin diseases are important in the study of disease pattern, changes in disease pattern and for planning dermatology service and research for a country. This report records the pattern of skin diseases encountered in the North-East region of India. The incidence of non-infectious dermatoses was slightly higher than that of infectious dermatoses in this part of the country.

Acquired (digital) fibrokeratoma.

Acquired digital fibrokeratoma is a rarely reported disorder, especially in the Indian literature. We report our findings on one such case, occurring at an unusual site.

Changing trends in sexually transmitted diseases in North Eastern India.

A retrospective data analysis was carried out to find the trends in frequency and distribution of different STDs in North Eastern (NE) India during 1995-1999. The commonest STD was chancroid (25.7%) followed by condylomata acuminata (CA), nongonococcal urethritis (NGU), lymphogranuloma venereum (LGV), syphilis, gonorrhoea (GONO), herpes genitalis (HG), mixed infection (MI) and balanoposthitis (BP). Interestingly no case of donovanosis (Dono) was seen. HIV infection accounted for 9.62% of the total STD patients. A comparison of the present data with that reported a decade back (1986-1990) revealed a sharp decline in the incidence of syphilis, chancroid, GONO, whereas a conspicuous upward trend in CA and NGU. Factors responsible for these variations are analysed briefly.

Effect of environmental deprivation on anxiety in rats.

Environmental deprivation (ED) induced a significant increase in open-field ambulation, rears, self-groomings, faecal pellets and decrease in activity in centre in Charles Foster albino rats of 30, 45 and 60 days age groups. In elevated plus maze, significant attenuation of open arm time/entries and augmentation of enclosed arm time/entries were noted in ED rats of all the three age groups. Similarly ED rats also showed significant decrease in time spent on open arms, entries, head dips and stretched attend postures in comparison to age matched rats reared under normal environmental conditions. The results indicate that imposition of environmental deprivation in rats' life consistently resulted in significant anxiogenic behaviour on all the tests. However, the anxiogenic effect of ED was less marked when it was imposed at 60th day of life in rats.

Cerebellar medulloblastoma in a 65 year old Indian male.

A case of cerebellar medulloblastoma in a 65 year old male is reported. Cerebellar medulloblastoma is classically seen during childhood, and less than 25% of these tumours are found in adults below 40 years of age. Rarely, cases are reported above the age of 40 years. So far only three cases have been reported in patients aged above 64 years and none of these case reports are from India.

Anxiolytic activity of Indian Abies pindrow Royle leaves in rodents: an experimental study.

Putative anxiolytic activity of ethanolic extract of Indian A. pindrow Royle leaf was investigated in rats using various experimental paradigms of anxiety viz. open field exploratory behaviour, elevated plus maze (EPM) and elevated zero maze (EZM) tests. Pilot studies indicated that single dose administration of extract had little to no acute behavioural effects, hence the extract was administered orally at different dose levels once daily for three consecutive days, while lorazepam (LR) (0.5 mg/kg, i.p.) was administered acutely. Ethanolic extract of A. pindrow (AP) leaves (50 and 100 mg/kg, p.o.) showed significant anxiolytic effects on all the paradigms of anxiety. The results indicate that AP and LR induced a significant increase in open field ambulation and slight increase in rearings and activity in center, whereas grooming and faecal droppings remain unchanged. In EPM, significant augmentation of open arm entries, and time spent on open arms was noted in AP treated rats. In EZM test, significant increase in time spent on open arms and entries in open arms was observed, whereas slight increase in head dips and stretched attend postures was also observed. The AP extract showed consistent and significant anxiolytic activity in all the tests. The effects induced by ethanolic extract of AP were less marked than those of lorazepam were.

Hyperglycaemia in pregnancy: effects on the offspring behaviour with special reference to anxiety paradigms.

Maternal hyperglycemic effect was studied on the offspring behaviour. Offspring were obtained from diabetic rats by mating a normal father with a diabetic mother (NFDM), diabetic father with normal mother (DFNM) and diabetic father with diabetic mother (DFDM). Rats were rendered diabetic by injecting streptozotocin (STZ, 50 mg/kg i.p.) in citrate buffer. Offspring were subjected to various anxiety parameters including open field exploratory behaviour, elevated plus maze and zero maze behaviours, and the social interaction tests at the age of 8 weeks. The results indicate that offspring of NFDM and DFDM showed anxiogenic activity on the elevated plus maze zero maze and the social interaction test. Offspring of NFDM and DFDM exhibited hyper and emotional activity in the open field behaviour test. The behavioural alterations observed in the offspring were comparable to the behavioural alterations noted in STZ diabetic rat as reported earlier. Further offspring of NFDM and DFDM exhibited mild hyperglycaemia. No significant behavioural alterations in the offspring of DFNM were observed. It may be concluded, that exposure of offspring to diabetic environment in their foetal life can lead to anxiogenic/emotional behaviours in adult life.

Anxiolytic activity of Indian Hypericum perforatum Linn: an experimental study.

The putative anxiolytic activity of 50% ethanolic extract of Indian Hypericum perforatum (IHp) was investigated in rats using various experimental paradigms of anxiety viz. open field exploratory behaviour (OFB), elevated plus maze (EPM), elevated zero maze (EZM), novelty induced suppressed feeding latency (FL) and social interaction (SI) tests. Pilot studies indicated that single dose administration of IHp had little to no acute behavioural effects, hence the extract of IHp was administered orally at different dose levels once daily for three consecutive days, while lorazepam (LR) (0.5 mg/kg, i.p.) was administered acutely. IHp extract (100 and 200 mg/kg, p.o.) showed significant anxiolytic effects on all the paradigms of anxiety. The results indicate that IHp and LR induced a significant increase in open field ambulation and slight increase in rearings and activity in centre, whereas grooming and fecal droppings remain unchanged. In EPM, significant augmentation of open arm entries, open arm/closed arm entries ratio and time spent on open arms was noted in IHp treated rats. In EZM test, significant increase in time spent on open arms and entries in open arms were observed, whereas slight increase in head dips and stretched attend postures were also observed. IHp and LR significantly attenuated the novelty induced increase in feeding latency. IHp treated rats also showed significant increase in social interaction in the novel environment. The IHp extracts showed consistent and significant anxiolytic activity in all the tests. The effects induced by 50% ethanolic extract of IHp were less marked than those of lorazepam were.

Antidepressant activity of Indian Hypericum perforatum Linn in rodents.

A standardised 50% aqueous ethanolic extract of Indian Hypericum perforatum (IHp) was investigated for its antidepressant activity on various experimental paradigms of depression, viz. behavioural despair (BD), learned helplessness (LH), tail suspension (TS) and reserpine-induced hypothermia (RIH) tests in rats and mice. Pilot studies indicated that single dose administration of IHp had very little or no acute behavioural effects, hence the IHp was administered orally at two dose levels (100 and 200 mg/kg, p.o.) once daily for three consecutive days, while imipramine (15 mg/kg, i.p.), a clinically used antidepressant agent, was administered acutely to rats (CF strain, 150 +/- 10 g) and mice (Wistar strain, 23 +/- 2 g) of either sex as the standard drug. Controls animals were treated similarly with equal volume of vehicle (0.3% carboxymethyl cellulose). Indian Hypericum perforatum extract showed significant antidepressant activity on all the paradigms of depression used. Thus IHp and imipramine treatments significantly reduced the immobility time in BD and TS tests. Significant reduction in escape failures was also observed in LH test. In RIH test IHp and imipramine inhibited reserpine induced hypothermia in a dose dependent manner. The observed antidepressant activity of IHp was qualitatively comparable to that induced by imipramine.

Effect of phenobarbitone administration to pregnant rats on anxiety in offsprings.

Adults Charles-Foster rats were prenatally treated to phenobarbitone (10 mg/kg, i.p.) from day 13 to 21 of gestation, this being the critical period of neural development. Pregnant control rats were similarly treated with equal volume of vehicle. Adult rat offsprings at 8-9 weeks of age were subjected to open-field exploratory behaviour, elevated plus-maze and elevated zero-maze tests. The rat offsprings displayed significantly increased ambulation and rearings in an open-field arena when compared to control offsprings whereas self-grooming and faecal droppings remain unchanged. On elevated plus-maze test these prenatally treated rat offsprings spent significantly less time on open arms and more time and more number of entries in enclosed arms as compared to controls. Prenatally exposed rats also showed significant less time on open arms, less number of head dips and stretched attend postures on elevated zero-maze test indicating increased anxiogenic behavioural pattern in these animals. The results suggest that prenatal exposure to phenobarbitone leaves a lasting effect on the anxiety state of the offsprings.

Superoxide dismutase, catalase and glutathione peroxidase activities in the brain of streptozotocin induced diabetic rats.

Brain antioxidant enzymes, superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX) levels were studied in the brains of early diabetic (72 hr) and long term diabetic (one month) rats. Diabetes was induced by injecting streptozotocin (50 mg/kg, i.p.) in citrate buffer. One group of diabetic rats was treated with insulin (1U/day/animal). The results indicate that early diabetic rats exhibit increased SOD and CAT activities with no alteration in the GPX activity. On the contrary, increased CAT decreased GPX activities with no alteration in the SOD activity, was noted in the long-term Diabetic rats. Insulin treatment reversed these alterations in both the groups. It can be concluded that, in diabetic condition antioxidant enzyme levels are elevated and insulin treatment attenuated these changes. Hence, diabetes mellitus, if left untreated, may initiate degenerative processes and other CNS complications due to accumulation of oxidative free radicals.