Effect of deferasirox on serum ferritin level in children with thalassemia major: impact of transfusional iron load

Background: Ongoing transfusional iron load (TIL) is an important determinant while deciding starting and subsequent dose adjustment of deferasirox during course of chelation therapy. So present study aims to find out effect of different dosing of deferasirox over the serum ferritin level in children with thalassemia major with impact of rate of transfusional iron load.Methods: This one year observational study was carried out in 35 transfusion dependent ?-thalassemic patients aged 2-18 years. Patients with baseline serum ferritin 1000-1500ng/ml and/or receiving TIL 0.2-0.3mg/kg/day were started 20mg/kg/day deferasirox and patients with ferritin>1500ng/ml and/or having TIL > 0.3mg/kg/day were started 30mg/kg/day deferasirox. Serum ferritin was repeated in every three months. Dose adjustments were performed on serum ferritin trends in steps of 5-10mg/kg /day to maximum 40mg/kg/day. Evaluation of relationship between dose adjustment, percentage of reduction in serum ferritin and TIL was done.Results: Group-1 patients(42.8%) had TIL 0.2 to 0.3mg/kg/day whereas Group-2(37.1%) and Group-3(20%) children had TIL >0.3-0.4mg/kg/day and >0.4 mg/kg/day respectively. Starting dose of deferasirox in 25.7% patients was 20mg/kg/day and in rest were 30mg/kg/day. Average dose of deferasirox in group-1 was significantly lower as compared to group-2 and group-3 patients ( p< 0.05). Significant decline in mean serum ferritin was observed in all three groups (p < 0.05). There was a significant positive correlation between TIL and average drug dose prescribed (r=0.5411and p=0.0007) but negative insignificant correlation was observed with percentage of reduction in serum ferritin(r=0.0027and p=0.98).Conclusions: Deferasirox 30mg/kg/day significantly reduces serum ferritin and is well tolerated in majority of patients having TIL 0.3-0.4mg/kg/day where as 20mg/kg/day is required in patients having low transfusional iron intake.

Occupational hazards and health problems among traffic personnel of Mangaluru city

Background: Occupational health risks and hazards due to the polluted environment have become a serious public health concern. Thus, the duty-bound personnel like traffic police who are continuously exposed, may be at high risk and badly suffer from related health problems. This study was conducted to determine the prevalence of occupational hazards and related health problems among traffic personnel in Mangaluru city. It also aimed to determine the association between occupational hazards and health problems. Methods: This cross-sectional study was conducted among traffic personnel of Mangaluru city. A semi-structured questionnaire with established reliability and validity was used to measure occupational hazards, protective measures, and health problems. Results: The prevalence of respiratory morbidity, eye symptoms, and auditory symptoms was found to be 51.2%, 61.6%, and 47.5% respectively. Respiratory morbidity and duration of use of protective measures against air pollution are found to be significantly associated. The duration of exposure to noise pollution was also significantly associated with the auditory symptoms. Conclusions: Police personnel suffer from significant occupational health problems, due to hazards like air pollution and noise. Necessary protective measures should be taken to ensure the safety of traffic personnel. This study showed an association between occupational hazards and related health problems.

Diversity of Globins in Myxobacteria.

Globins are heme proteins that are capable of reversible oxygen binding. All globins can be classified into three families: the M (myoglobin-like), S (sensor) and T (truncated) globins. M and S globins exhibit the canonical 3/3 α-helical fold, and T globins are characterized by a 2/2 α-helical fold. Globins in the genomes of myxobacteria have not been characterized till date. Myxobacteria have very large genomes relative to other bacteria and have a unique life cycle that involves the aggregation of cells into fruiting bodies under starvation conditions. The diversity of globin like sequences in 14 sequenced genomes of myxobacteria is presented in this review. In myxobacterial globins some unusual domain architectures are identified that have not been characterized in bacteria so far; these are: i) a unique chimeric group I 2/2 HbN in the genome of Corallococcus coralloides DSM 2259; ii) M globin chimera harboring a central and a C-terminal globin domain in Sorangium cellulosum ‘so ce 56’ and Plesiocystis pacifica SIR-1 respectively; iii) two tandem globin domains on the same M globin polypeptide in the genomes of Sorangium cellulosum.

A preliminary evaluation of comparative effectiveness of riluzole in therapeutic regimen for irritable bowel syndrome

Objective: To develop agents that are specifically effective in controlling the key disturbance of visceral hyperalgesia besides abating of associated multiple symptoms, and evaluate comparative effectiveness for IBS symptom relief for standard regimen (antispasmodic and probiotic) and add-on amitriptyine or riluzole regimens following two weeks administration.Methods:groups were studied. First group received standard treatment (mebeverine 200 mg twice daily and probiotic 200 mg twice daily). Second group received add-on amitriptyline 25 mg before bedtime, while the third group got add-on riluzole 50 mg twice daily. Overall gastrointestinal symptom rating scale improving symptoms and hospital anxiety depression scale improving associated psychological morbidity were employed as measures at induction and at two-week follow-up period. Individual symptom scores were also examined to define the outcome profiles.Results:108 patients with visceral hypersensitivity accompanying IBS, divided into three rating scale score, not the other two regimens. Pain relief was seen with both riluzole and amitriptyline regimens significantly superior to standard treatment regimen, but riluzole effect appeared specific and independent anxiolytic effect. Amitriptyline caused relief in diarrhea and did not benefit in constipation point to non-specific remedial role in IBS. Riluzole regimen resulted in significant reduction of overall gastrointestinal symptom Conclusions: Riluzole specifically relieves visceral hypersensitivity and is proved to be superior to current treatments in IBS patients. It appears a lead remedy based on glutamate transporter mechanisms in visceral hypersensititvity.

Formulation and evaluation of herbal antioxidant face cream of Nardostachys jatamansi collected from Indian Himalayan region

Objective:To prepare and evaluate a herbal antioxidant face cream which is made by the ethanol extract of Nardostachys jatamansi (Valerianceae). Methods: Antioxidant activity of ethanol extract was assessed by previously reported 2, 2-Diphenyl-1-picrylhydrazyl method. By discovering different types of formulations, such as oil in water, we were able to create several face creams respectively classified from F1 to F6, by incorporating different concentrations of stearic acid and acetyl alcohol. The evaluation of all formulations (F1 to F6) has been done by the analysis of different parameters like pH, viscosity, spread ability and stability. Results: An ethanol fraction analyzed from a sample of Nardostachys jatamansi showed a significant antioxidant activity with an IC50 value of 58.39 μg/mL while for ascorbic acid the IC50 value was 46.68 μg/mL. Among the six formulations (F1-F6) F5 and F6 showed good spread ability, good consistency, homogeneity, appearance, pH;there is no proof of a separation phase and ease of removal. Also the formulations F5 and F6 showed no redness or edema or erythema and irritation during irritancy studies. Conclusions:These formulations can be safely used on the skin. Hence, the study suggests that the composition of extract and the base of the cream F5 and F6 are more stable and safe, but it may produce synergistic action.

Antibiotic pressure mediated selection of non-biofilm forming strain of Elizabethkingia meningosepticum causing fatal nosocomial meningitis in a term infant.

We describe a fatal case of hospital acquired meningitis in a term infant due to the antibiotic pressure mediated selection of Elizabethkingia meningosepticum. The antibiotics were administered for multi-drug resistant Acinetobacter baumannii infection. The strain was also phenotypically characterized for beta lactamase production, biofi lm forming capability and resistance to in use disinfectants.

Myrica esculenta Buch.-Ham. ex D. Don.-a potential ethnomedicinal species in a subtropical forest of Meghalaya, northeast India

Objective: To determine the effect of anthropogenic activities on the population structure and regeneration efficacy of Myrica esculenta (M. esculenta), an ethnomedicinally important tree species in sub-tropical forests of Meghalaya. Methods: The population structure and regeneration potential of M. esculenta were studied by using quadrat method. Results: The regeneration status of M. esculenta was highly influenced by disturbance. Presence of limited number of seedlings in the forest floor denotes the lack of seeds in the forests. The low conversion of seedling into saplings was mainly due to the removal saplings by the indigenous community, who residing in the vicinity of the forest for meeting their requirement of fuel wood. Conclusions:The findings of the present study indicate that overexploitation of M. esculenta may cause threat to extinction from wild. There is an obvious need to explore non timber forest products to a desired pace that will minimize the pressure on a particular species by providing alternative to a species, leading to sustainable utilization of genetic resources.