Effectiveness of Training for Teachers in Early Identification of Skin Disorders Among Primary School Attending Children - A Quasi-Experimental Study Protocol

Skin diseases are the leading cause of morbidity in children. As children spend most of their time in schools, training teachers on the detection of skin changes and timely referral will prevent or reduce the complications. Hence, we propose a quasi-experimental study to evaluate the effectiveness of training for teachers in the early identification of skin disorders among primary school children in a rural area of southern India. The teachers of government and government-aided schools in the field practice area of Model Rural Health Research Unit, Tirunelveli, will be the intervention group. The same schools in the nearby village will be the control group. The investigators and the National Institute of Epidemiology, ICMR, Chennai will develop and validate the training manual. Using the manual, the principal investiga-tor will train the teachers on identifying and referring skin changes and provide a training manual, model register and referral slip to each teacher. The investigators will review the schools quarterly and collect the number of children identified and referred from both groups before and after the intervention. Thus, the trained teachers will be a resource to achieve the objectives of the school health program, comple-menting the health services.

Cytotoxicity based screening for radioprotective properties of methanolic extract of Tragia involucrata L. on cultured human peripheral lymphocytes exposed to gamma radiation

Radioprotective drugs of plant origin with bioactives are a boon against ionizing radiation injuries. Tragia involucrata L. (Indian stinging nettle), has medicinal properties and is traditionally used to treat various ailments. Here, we evaluated the radioprotective efficacy of the methanolic whole plant extract of T. involucrata against the damaging effects of gamma radiation. Cultured lymphocytes were treated with methanolic extract for one hour and irradiated with (1-4 Gy) gamma radiation. This pretreatment of lymphocytes with methanolic extract significantly increased the cell viability at 10 μg/mL and reduced the damage to the treated cells compared to the radiation control. In addition, a significant decrease in comet parameters (Comet length and percent DNA in tail and olive moment) and formation of micronuclei (P <0.001) were observed. It also decreased the levels of malondialdehyde, while regulating the status of the total antioxidant capacity, superoxide dismutase, catalase, reduced glutathione, and glutathione transferase (P <0.05) when compared to the radiation control. Similarly, a decrease in caspase 3 cellular activity compared to the radiation control was observed. The results indicated the methanolic extract to be an effective radioprotector up to 4 Gy, by enhancing the antioxidant enzyme levels, scavenging the production of reactive oxygen species, reducing the damaging effects of radiation by increasing the DNA repair mechanism, and by inhibiting the mitochondrial apoptotic pathway. Therefore, methanolic extract of the Indian stinging nettle, Tragia involucrata L. has been proposed as a candidate with a radioprotective property, and further study on animal models would strengthen this claim

Inhibition of protein kinases by anticancer DNA intercalator, 4-butylaminopyrimido4',5':4,5thieno(2,3-)quinoline

Targeting protein kinases (PKs) has been a promising strategy in treating cancer, as PKs are key regulators of cell survival and proliferation. Here in this study, we studied the ability of pyrimido[4',5':4,5]thieno(2,3-)quinolines (PTQ) to inhibit different PKs by performing computational docking andscreening. Docking studies revealed that 4-butylaminopyrimido[4',5':4,5]thieno(2,3-)quinoline (BPTQ) has a higher order of interaction with the kinase receptors than other PTQ derivatives.screening confirms that BPTQ inhibits VEGFR1 and CHK2, with the ICvalues of 0.54 and 1.70 µmol/L, respectively. Further, cytotoxicity of BPTQ was measured by trypan blue assay. Treatment with BPTQ decreased the proliferation of HL-60 cells with an ICvalue of 12 µmol/L and induces apoptosis, as explicated by the fall in the mitochondrial membrane potential, annexin V labeling and increased expression of caspase-3. Taken together, these data suggest that BPTQ possess ability to inhibit PKs and to induce cell death in human promyelocytic leukemia cells.

Pattern of drug use in the management of psoriasis in a tertiary care hospital: a prospective study.

Background: Psoriasis is a chronic skin disease, characterized by chronic and recurrent scaly plaques with itching. The treatment modalities for psoriasis include topical, systemic, and phototherapy (PT). The pattern of therapy may vary depending upon the type, severity, and duration of the disease. As there are few reports in the Indian literature regarding the pattern of drug use in psoriasis and evaluating the efficacy and patient compliance to treatment, the present study was conducted. Methods: This was a prospective, observational study conducted on 121 newly diagnosed and untreated patients with psoriasis, who attended Dermatology outpatient department of a tertiary care hospital. The severity of the disease was assessed by baseline psoriasis area severity index (PASI) score. Most of the patients were treated with topical therapy consisting of glucocorticoids (GC) monotherapy or combination with, salicylic acid, calcitriol and coal tar. Systemic therapy and PT were considered only for severe cases of psoriasis with baseline PASI score >4. The patients were monitored every 2 weeks for 3 months. Results: The topical medications induced effective resolution of lesions in most of the patients, along with adequate symptomatic relief. The response to GC monotherapy was found significant (90.47%; p<0.001) and there was 76.13% decrease in PASI score in chronic plaque psoriasis, indicating significant improvement (p<0.001) after 12 weeks of therapy. More than 94% of study patients showed good compliance to medications and only 0.27% showed poor compliance, whereas the other patients showed a moderate compliance of 80-95%. Conclusions: Most of the patients with psoriasis can be effectively treated with topical medications, and additional systemic and/or PT may be required only for severe cases of chronic plaque psoriasis with baseline score >4. Regular follow-up is required not only to monitor the treatment response, but also to ensure good patient compliance by proper counseling.

Spectrum of purpura fulminans: Report of three classical prototypes and review of management strategies.

Purpura fulminans is a rare syndrome of intravascular thrombosis and hemorrhagic infarction of the skin that is rapidly progressive and is accompanied by vascular collapse and disseminated intravascular coagulation. It usually occurs in children, but this syndrome has also been noted in adults. The three forms of this disease are classified by the triggering mechanisms. We describe three classical cases of purpura fulminans of the three classical prototypes treated at our center and their varied clinical outcomes. We also describe a case of acute infectious purpura fulminans secondary to systemic leptospirosis which to our best knowledge is the first reported case in world literature. The various treatment options for purpura fulminans have also been reviewed.

Generalized eruptive histiocytosis mimicking leprosy.

Generalized eruptive histiocytosis (GEH) is a rare cutaneous histiocytosis that mainly affects adults and presents with multiple symmetric papules on face, trunk, and proximal extremities. GEH is included in type IIa (histiocytes involving cells of dermal dendrocyte lineage) of histiocytic disorders. Clinical and pathological correlations are required for differentiating GEH from other histiocytic disorders and from lepromatous leprosy which clinically mimic GEH and is prevalent in India. We report a case of a middle-aged woman who presented with generalized asymptomatic papules and nodules and was treated for leprosy but was finally diagnosed to have GEH after clinical, histopathological, and immunohistochemical correlation. Furthermore, the newer lesions also showed features of progressive nodular histiocytosis.

Biological properties of 8-methoxypyrimido[4(1),5(1):4,5]thieno(2,3-b)quinoline-4(3H)-one, a new class of DNA intercalating drugs.

BACKGROUND & OBJECTIVES: The compounds containing novel tetracyclic condensed quinoline ring system is of interest because of its close relationship with anticancer drug ellipticine. 8-Methoxypyrimido[4(1),5(1):4,5]thieno(2,3-b)quinoline-4(3H)-one (MPTQ) was investigated to study its effect on in vitro growth inhibition and clonogenic cell survival assay on three tumour cell lines, human promyelocytic leukemia HL-60, melanoma B16F10 and neuro 2a. A systematic study was carried out to evaluate its antitumour efficacy against B16 murine melanoma. Antiinflammatory and analgesic activities of MPTQ were also studied. METHODS: The cytotoxicity of MPTQ on HL-60, B16F10 and neuro 2a cells was estimated by trypan blue exclusion test. The antitumour activity was evaluated using single dose, multiple/daily injections (days 3-6) or intermittent treatments over two weeks against s.c. implanted B16melanoma, both in terms of increased life span and tumour growth inhibition. Antiinflammatory activity was seen on carrageenan induced hind paw oedema. Counting the number of abdominal constrictions after the injection of acetic acid assessed the analgesic response. RESULTS: MPTQ is cytotoxic to all the cell lines tested and ID50 being in the range of 0.08-1.0 microM. MPTQ was studied for anticancer activity in the clonogenic assay. Drug was applied over a wide dose range by 24 h exposure, yielding clear dose-response effects. In vivo antitumour efficacy against B16 melanoma showed evidence of major antitumour activity for MPTQ. Single and multiple i.p. doses of drug proved high level activity against the s.c. grafted B16melanoma, significantly increasing survival (P<0.001) and inhibiting tumour growth (T/C of 3.0%). A reduction (76.48%) in paw volume was noted in 40 mg/kg dose of which was comparable to antiinflammatory activity of 150 mg/kg i.p. of phenylbutazone. Analgesic activity was found to be of peripheral type as there was reduction of 74 per cent in writhing response by MPTQ in dose of 40 mg/kg in mice. INTERPRETATION & CONCLUSION: The results suggested that the compounds containing pyrimidothienoquinoline system particularly 8-methoxy derivative might be potentially useful antitumour agent. We conclude that the correlation of physicochemical properties of the new series of pyrimidothienoquinolines with their pharmacological properties, might help in trying to understand the mechanism of pyrimidothienoquinolines series.

Mechanism of plant growth promotion by rhizobacteria.

Plant growth results from interaction of roots and shoots with the environment. The environment for roots is the soil or planting medium which provide structural support as well as water and nutrients to the plant. Roots also support the growth and functions of a complex of microorganisms that can have a profound effect on the growth anti survival of plants. These microorganisms constitute rhizosphere microflora and can be categorized as deleterious, beneficial, or neutral with respect to root/plant health. Beneficial interactions between roots and microbes do occur in rhizosphere and can be enhanced. Increased plant growth and crop yield can be obtained upon inoculating seeds or roots with certain specific root-colonizing bacteria- 'plant growth promoting rhizobacteria'. In this review, we discuss the mechanisms by which plant growth promoting rhizobacteria may stimulate plant growth.

Comparative evaluation of fine needle aspiration cytology and biopsy of testis in diagnosis of male infertility.

Infertility has a fair degree of male factor contribution in its aetiology, hence needs complete evaluation of male partner especially the status of spermatogenesis. In the present study comparative evaluation of fine needle aspiration cytology (FNAC) and biopsy of testis showed 90% accuracy of FNAC in respect of histopathological diagnosis of spermatogenesis. FNAC is a safe, fairly accurate, outdoor investigation in infertile man and it is devoid of the complications of haematoma formation, suppression of spermatogenesis and antigenic stimulation as seen with testicular biopsy.

Sigmoido-rectal intussusception.

Sigmoido-rectal intussusception is the least common type of intussusception seen in infants and children and is therefore usually misdiagnosed as rectal prolapse. Delay in diagnosis and treatment is due to lack of its awareness amongst surgeons, incomplete assessment of the prolapsed bowel at the anal orifice, and absence of classical traid of intussusception i.e. palpable abdominal mass, colicky abdominal pain, and bleeding per rectum.