Safety and efficacy of ayush rasayana A and B in improving functionality of the elderly – A single-arm multicenter study

Background: As per Ayurvedic classics, Ras?yana is a term used for unique therapeutic measures intended to improve cognition, memory, physical strength and delay the degenerative processes. Ayush Rasayana A & B are developed from extracts of herbs pertaining rasayana property. Aims & Objectives: To assess the safety and effectiveness of ‘Ayush Rasayana A and B’ in improving physical endurance, quality of life and cognition of elderly. Materials and Methods: This is an open label, single arm, multi-centre study among 256 apparently healthy elderly between 60?75 years. Ayush Rasayan A was given for 6 days and Ayush Rayana B for 180 days. The effect of the trial drug was seen on functional capacity, quality of life and cognitive function and, safety of the intervention was assessed through haematological and biochemical tests, clinical examination and incidence of adverse events. Results: Significant improvement in 6 minute walk test and HMSE score was observed at 187th as compared to baseline (p<0.0001). Quality of life of the participants especially in domains of physical health, social relationship and environment also improved at the end of intervention period (p<0.0001). The haematological and bio-chemical parameters showed no significant changes as compared to baseline and no adverse events were observed during the study. Conclusion: Ayush Rasayana A and Ayush Rasayana B, both were well tolerated by all the participants. This ayurvedic intervention can be safely given to apparently healthy elderly to improve their functionality, quality of life and cognition. However, a randomized controlled trial is warranted to substantiate the efficacy of this drug.

A study of pattern of vitamin D deficiency in newborns with reference to its gestational age and birth weight

Background: Deficiency of Vitamin D is a prominent health problem globally and its severity is significant in countries like India regardless of age, gender, race and geographical distribution. It is presently the most untreated nutritional deficiency worldwide. Vitamin D during pregnancy has an increasingly recognized range of functions such as' immune modulation, lung development etc. Hence, having the potential to' influence many factors in the developing fetus. Effects of vitamin D deficiency on fetal health is abundant; some being for brief period' of' time' and others may become apparent in later life. Objectives of this study the pattern of vitamin D deficiency in newborns with reference to its gestational age and birth weight.Methods: This was a hospital-based prospective observational study. Total 100 neonates born at MMIMSR, Ambala were enrolled out of which 50 were term and 50 preterm.Results: Out of 100 newborns delivered, 53 newborns were vitamin D deficient. Premature' newborns having 32 (60%) and term newborn having 21 (40%) were found to be deficient in vitamin D. Mean 25 (OH) levels were 21.81 ng/dl.Conclusions: More than half newborns were deficient in vitamin D. Premature newborns had relatively low levels as compared to the term newborns and the' difference' between' two were found' statistically significant.

An assessment of factors responsible for diarrhoea deaths of under five children in rural and urban settings of India

Background: Very little scientifically based information is available on cause-specific mortality rates of diarrhoea among all regions and populations wherein an inequitable proportion exits in low-income households, which have fewer resources and less knowledge to manage burden than high-income households. The strategic purpose of the study is to identify gaps in care seeking in order to make changes in approach to address these gaps either directly by working with the community and by doing area specific advocacy to improve service delivery through government channels.Methods: The study was conducted in nine locations (6 rural and 3 urban) of India. The ethical and confidentiality parameters of conducting verbal autopsies were followed and random sampling methodology was adapted.Results: Respondents of our study attributed 22% deaths to diarrhoea. From the study, it is revealed that children who passed stool for 5 or more number of times in a day are more likely to die 1.5 times than the children who passed stool for 3 times a day. Children having diarrhoea for 5 days or more than 5 days are more likely to die 1.6 times in comparison to the children who have had diarrhoea for 3 days. Approximately seven of the ten children died within five days of treatment.Conclusions: Information on diarrheal diseases, its determinants in India and preventive and control strategies in light of recent developments need to be reviewed for better planning and organization of health services within the community.

Preferential mode of zinc and adherence to treatment: zinc syrup or zinc tablet

Background: Diarrhoea has evident itself among the leading causes of under-five childhood mortality globally as well as in India. Although the benefits of zinc supplementation in diarrhoea management have been established, there remain many barriers to the widespread implementation of this treatment strategy. In India, a very small proportion of children in need, 20 per cent in urban and merely 5 per cent in rural, have access to zinc supplementation. The study aimed to assess zinc adherence in the community and find out the preferential mode of zinc as tablet or syrup, to stick to the scheduled adherence.Methods: The proposed method of study is a simple household survey complimented by secondary research around the preference and usage of zinc and ORS among under five children, suffered from diarrhoea in the last 14 days preceding the survey date.Results: The study revealed that 95 per cent of the respondents preferred zinc syrup over zinc tablet for treatment of diarrhoea due to its ease to administer and palatable taste to children. Eighty nine per cent of the total urban and 62 per cent of total rural respondents received zinc in syrup form, indicating the preferred mode of zinc by service providers over tablets.Conclusions: It has been observed that the caregivers tend to give the complete dosage of zinc if it is available in the syrup form. However, it is important to generate evidence to understand the preferential mode of zinc; tablet or syrup in terms of administration of drug, its usage and its cost.

Malaria transmission in Tripura: disease distribution & determinants.

Background & objectives: Malaria is a major public health problem in Tripura and focal disease outbreaks are of frequent occurrence. The State is co-endemic for both Plasmodium falciparum and P. vivax and transmission is perennial and persistent. The present study was aimed to review data on disease distribution to prioritize high-risk districts, and to study seasonal prevalence of disease vectors and their bionomical characteristics to help formulate vector species-specific interventions for malaria control. Methods: Data on malaria morbidity in the State were reviewed retrospectively (2008-2012) for understanding disease distribution and transmission dynamics. Cross-sectional mass blood surveys were conducted in malaria endemic villages of South Tripura district to ascertain the prevalence of malaria and proportions of parasite species. Mosquito collections were made in human dwellings of malaria endemic villages aiming at vector incrimination and to study relative abundance, resting and feeding preferences, and their present susceptibility status to DDT. Results: The study showed that malaria was widely prevalent and P. falciparum was the predominant infection (>90%), the remaining were P. vivax cases. The disease distribution, however, was uneven with large concentration of cases in districts of South Tripura and Dhalai coinciding with vast forest cover and tribal populations. Both Anopheles minimus s.s. and An. baimaii were recorded to be prevalent and observed to be highly anthropophagic and susceptible to DDT. Of these, An. minimus was incriminated (sporozoite infection rate 4.92%), and its bionomical characteristics revealed this species to be largely indoor resting and endophagic. Interpretation & conclusions: For effective control of malaria in the State, it is recommended that diseases surveillance should be robust, and vector control interventions including DDT spray coverage, mass distribution of insecticide-treated nets/ long-lasting insecticidal nets should be intensified prioritizing population groups most at risk to avert impending disease outbreaks and spread of drug-resistant malaria.

Emergence of Antibiotic-Producing Microorganisms in Residential Versus Recreational Microenvironments.

Aims: To identify novel antibiotic-producing microbial strains with unprecedented pertinence. We hypothesize that site-specific soil samples will contain a variety of antibioticproducing species (APS) with diverse specificity of molecular elements. Place and Duration of Study: Laboratory of Microbiology, Division of Biological and Health Sciences, University of Pittsburgh, Bradford, PA-16701, USA, between August 2010 and May 2011. Methodology: The environmental soil samples were collected from residential and recreational sites in Southern, PA, USA at longitude: -76 42 21.7116, latitude: 39 56 35.7252; approximately 201 meters above sea level. Over 70 natural antibiotic-producing soil bacteria were screened against 19 pathogenic microorganisms. Agar-plug assay was established to identify the antibiotics’ potency and pathogenic inhibitory index calculations were employed to measure the inhibitory potential of each isolate; 16S rRNA sequencing was used for microbial classification. Results: A total of 71 microorganisms from residential soil demonstrated zones of inhibition (ZOI), followed by 9 organisms from recreational soil sample. A total of 15 bioactive strains demonstrated convincing growth inhibitory properties against 16 clinically relevant pathogens; 40% revealed pDNA presence, of which 67% exhibited stringent potencies against S. aureus. We observed a highly bioactive residential soil microbiota compared to recreational soil. Conclusion: 16S rRNA sequence analysis corroborated several of the species belonging to Enterobacteriaceae, Xanthomonadaceae, and Bacillaceae. These findings may indicate a co-evolutionary biosynthesis of novel antibiotics driven by the increase of bioactive microbiota in residential environments.

A study on socio-demographic characteristics of alcoholics attending the de-addiction center at Burdwan medical college and hospital in West Bengal.

Prevalence of alcohol use in India is reported to be 21.4% and there is increasing alcohol intake among the young people. The present study was undertaken to study the socio-demographic characteristics of patients having alcohol-related disorders attending the de-addiction center at Burdwan Medical College in West Bengal and to find out some factors responsible for that. A clinic-based descriptive cross-sectional study was conducted among 187 patients with the help of pre-tested pre-designed schedule after obtaining informed consent. Data analysis was carried out with the help of Epi info software version 6. Majority of the patients were male, in productive age group and married. Age of initiation and amount of alcohol intake were significantly associated with positive family history of alcoholism. Children having family history of alcoholism should be counseled to prevent development of alcoholism.

Inhibitory effect of antibodies against human chorionic gonadotropin on the growth of colorectal tumour cells.

Human chorionic gonadotropin (hCG) was initially believed to be secreted exclusively by the embryo with its primary function being “rescue” of the corpus luteum. However, recently it has been found that the hormone (or its individual subunits) is also secreted by many cancers and that in many cases secretion is associated with poor patient prognosis. In this study, we assessed the presence of hCG in colorectal cancer cells (CCL-253) and evaluated the anti-tumour effects of anti-hCG antibodies in vitro and in vivo. Anti-hCG antibodies were reactive with CCL-253, as revealed by confocal immunoflourescence microscopy; both cell surface and intracellular expression were observed. Western blot analysis showed that antibodies appeared to interact with several moieties, indicating a level of cross-reactivity. Anti-hCG antiserum specifically reduced the viability of tumor cells and the addition of complement increased in vitro anti-tumor effects. In nude mice implanted with CCL-253 cells, administration of anti-hCG antiserum caused a significant reduction in tumor volume; all treated animals survived, while mortality was observed in control animals. Results suggest that anti-hCG antibodies can mediate significant anti-tumor activity both in vitro and in vivo and lend support to the rationale of anti-hCG immunization in the therapy of gonadotropin- sensitive cancers.

Atypical presentation of pediatric bipolar mood disorder : two case reports

Objective: This case reports highlight atypical presentation of pediatric bipolar mood disorder. Pediatric bipolar disorder is said to be a rare condition with some distinct differences from adult bipolar disorder. Despite the ongoing controversy regarding its exact typology, pediatric bipolar mood disorder is being reported in the form of case reports and in systematic research. Pediatric bipolar disorder is difficult to diagnose because its presentation of symptoms overlaps considerably with conduct problems, and ADHD (attention deficit hyperkinetic disorder). Methods: We report two cases which met a diagnosis of pediatric mood disorder where the presentation of symptoms was unique and atypical. Results: The cases are presented so that they help to raise pertinent questions regarding phenomenology, duration, episodic nature of the illness and management of this important group of disorders. Conclusion: Pediatric bipolar disorder should be viewed with seriousness and pediatric mania should be given importance in the assessment of the typology, prognosis and management of this important group of childhood disorder.

Neurocognitive impairment in early HIV-positive individuals.

The study was carried out to find out the cognitive impairment if any, in early stages of human immunodeficiency virus-positive patients and if there is any cognitive impairment, then its association with duration of illness detection. Fifty patients with early stages of HIV and 50 matched controls were compared in various neuropsychological tests along with demographic profiles. Seropositive patients had poorly performed in digit symbol substitution test, trail making test and controlled word association test. This impairment had no association with duration of detection of illness. It is not known whether mild neurocognitive disorder predisposes patients to the development of frank dementia. Cognitive impairment should be identified early in order to maximise functional status, enhance quality of life and survival time.

A Study of Mass Psychogenic Illness in a High School of West Bengal.

Twenty students were affected in an epidemic of mass psychogenic illness occured in a high school of West Bengal, India in 2004. Our objective was to study and find out any related cause which may help in spread of illness and various management issues. We isolated the patients in hospital wards and interviewed each, arranged a group discussion with students, guardians, teachers and local leaders to alleviate the anxiety. Social stress due to rapid urbanization, individual stressful factors were associated with the event. Proper knowledge of mass psychogenic illness and its management is must for both psychiatrists, and primary care physicians.

A rare injury of distal radial and ulnar epiphysis.

Radial epiphyseal injuries are common. Ulnar epiphyseal injury is responsible for majority of cases of growth arrest and is commonly missed. The occurrence of associated ulnar epiphyseal injury is very rare and a concomitant type II injury of both radial and ulnar epiphyseal injury is also uncommon. A four-year follow-up of a 10-year-old boy with the above injury at right wrist is being reported in this article. At four years he has a negative ulnar variance but with excellent function and cosmesis.