Placental and Neonatal Outcome in Maternal Malaria.

Objective: Primary: To determine the incidence of congenital malaria in a cohort of pregnant women in a hyper-endemic area of central India. Secondary: (1) To find out the placental weight and placental malaria positivity, and to assess fetal and neonatal outcome in terms of survival, mean hemoglobin and mean birth weight. Design: Prospective observational study. Setting: Maternity and neonatal ward of a tertiary level hospital attached to a medical college located in Rewa, Madhya Pradesh, India. Participants: Near term and term pregnant women admitted in the maternity ward with a singleton pregnancy, whose neonates were available for examination till at least 6 hours after birth. Methods: Thick and thin blood smear were examined for malarial parasites from mothers prior to delivery. Based on the results of peripheral smear they were divided into ‘exposed group’ (peripheral smear positive for malaria parasite) and unexposed group’ (smear negative for malaria parasite). These groups were then followed prospectively till delivery and subsequently till the mother and the neonates were discharged from the hospital. Outcome variables: Primary: Presence of asexual parasite in neonate. Secondary: Placental weight, presence of asexual malarial parasite in placenta, still births, early neonatal deaths, mean birth weight and mean hemoglobin. Results: Seventy-two (35.5%) of 203 blood smears of near term and term pregnant women were found positive for malaria parasite (60 P. vivax and 12 P. falciparum); rest 131 comprised the unexposed group. Six (2.95%) neonates had parasitemia (4 P. vivax and 2 P. falciparum). Of the 203 smears made from placental blood, 24 (11.8%) were positive for malaria parasite. The mean (SD) birth weight [2300 (472) g vs 2430 (322) g; P=0.98], proportion of preterm babies (6.9% vs 8.4%, P=0.71), incidence of still birth (4.2% vs 3.0%, P=1.0) and early neonatal death (2.8% vs 3.0%, P=1.0) were not significantly different between the exposed and unexposed group. Conclusions: The incidence of congenital malaria is low despite high maternal smear positivity for malaria.

Effectiveness of Anti Scorpion Venom for Red Scorpion Envenomation.

Objective: To study the efficacy of anti-scorpion venom plus prazocin. Methods: Comparison of clinical features, outcome and duration of stay between children receiving anti-scorpion venom plus prazocin or prazocin alone for management of red scorpion envenomation. Results: Requirement for dopamine and requirement and duration of dobutamine therapy were significantly less in patients received anti-venom plus prazocin than those had prazocin only. Faster recovery was seen in cases who received antiscorpion venom plus prazocin than prazocin only group. Conclusion: Anti-scorpion venom plus prazosin was safe and more effective than prazocin alone for scorpion envenomation.

Co-morbidities in Hospitalized Children with Severe Acute Malnutrition.

Objective: To study the co morbidities in hospitalized children with severe acute malnourishment. Methods: 104 severe acute malnourished children were included. Results: 54% had diarrhea and 27.8% had acute respiratory tract infections. Tuberculosis was diagnosed in 22% of cases (60.8% cases in children 6-12 mo old). Malaria and Measles were diagnosed in 3.8% each, and HIV infection was seen in 2.9% cases. Signs of vitamin B and vitamin A deficiency were seen in 14.4% and 5.8% cases, respectively. Malaria and HIV were not found to be major co morbid conditions. Conclusions: Timely identification and treatment of various co-morbidities is likely to break undernutrition-disease cycle, and to decrease mortality and improve outcome.

Latency Intervals of Moro Response: A Valuable Neuro-screening Tool.

Moro response in healthy term newborns were studied to determine latency interval, time taken for optimal response (embracing movement of arms), and total duration of reflex response. Latency interval for onset of response was 0.41-0.49. Time taken for optimal response was 0.910-1.041s. Total duration of Moro response was 2.34 -2.59 s. Values were similar for males and females. Optimal response in babies born by cesarean section were significantly delayed than vaginal babies.

Maxillary sinus tuberculosis various presentations.

Tuberculosis (TB) of the maxillary sinus is rare. We describe the clinical presentation, management and outcome in two human immunodeficiency virus (HIV) seronegative patients with histopathologically confirmed maxillary sinus TB. One of the patients who presented earlier in the course of the disease could be managed with antituberculosis treatment alone, while the other who presented late required surgical intervention as well.

Assessment of maternal-fetal and neonatal healthcare practices in an eastern Madhyapradesh district.

Background: Adequate knowledge about the maternal and child health care is meager in rural areas of India. Paying less attention to the maternal-neonatal health plays a crucial role in infant mortality. Aims & Objective: This study was designed to assess the awareness and practices of parents in relation to maternal-fetal and neonatal healthcare. Material and Methods: A total of 230 parents were included and the study was conducted over a period of one year. A pre-set questionnaire was used to obtain the data. Results: Diminished antenatal and post natal care caused by poor personal hygiene and lack of environmental sanitation was found among most cases. 71.3% were using hand pumps as water source and 76% were using open field for defecation. 50.7% female did not have antenatal checkups. Almost 90% of mothers received tetanus toxoid vaccine during gestational period. 34.7% deliveries were conducted by untrained dais at home. 98% children vaccinated against polio virus. 48% of the mothers initiated breastfeeding immediately after delivery. Majority of the mothers (42%) started complementary feeds to their children at the age of 6 months. 89.1% of mothers fed their children with additional feeds. Maximum (63%) number of parents did not possess the Below Poverty Line (BPL)/Deendayal Antyodaya Yojna Card. Conclusion: There is an imperative situation to educate the mothers and dais with respect to the maternal fetal health care. Also, flourishing new interventions are required to bring down the neonatal morbidity and mortality.

Locally-Prepared Ready-to-Use Therapeutic Food for Children with Severe Acute Malnutrition: A Controlled Trial.

Objective: To compare the efficacy of locally-prepared readyto- use therapeutic food (LRUTF) and locally-prepared F100 diet in promoting weight-gain in children with severe acute malnutrition during rehabilitation phase in hospital. Study design: Non-randomized Controlled trial. Setting: Pediatric ward of tertiary care public hospital in Central India. Study period: 1 October, 2009 to 30th May, 2010. Subjects: Children aged 6 to 60 months, diagnosed as severe acute malnutrition and hospitalized during study period. Intervention: Random group allocation followed for selection of intervention and control cohorts. The control cohort enrolled during October 1, 2009 to January 31, 2010 received F100 while the intervention cohort enrolled during 1 February to 15 May 2010 received LRUTF. Subjects receiving either of the two therapeutic foods were temporally separated to minimize the spillover effect. The study subjects and the technician delegated for measuring weight was blinded for type of intervention. Primary outcome variable: Rate of weight-gain/kg/day. Results: There were 49 subjects in each group. Both groups were comparable. Rate of weight-gain was found to be (9.59±3.39 g/kg/d) in LRUTF group and (5.41 ± 1.05 g/kg/d) in locally prepared F100 group. Significant difference in rate of weight gain was observed in LRUTF group (P<0.0001; 95% CI 3.17-5.19). No serious adverse effect was observed with use of LRUTF. Conclusion: LRUTF promotes more rapid weight-gain when compared with F100 in patients with severe acute malnutrition during rehabilitation phase.

Phytotoxicity of volatile oil from Eucalyptus citriodora against some weedy species.

A study was undertaken to explore the phytotoxicity of volatile essential oil from Eucalyptus citriodora Hook. against some weeds viz. Bidens pilosa, Amaranthus viridis, Rumex nepalensis, and Leucaena leucocephala in order to assess its herbicidal activity. Dose-response studies conducted under laboratory conditions revealed that eucalypt oils (in concentration ranging from 0.0012 to 0.06%) greatly suppress the germination and seedling height of test weeds. At 0.06% eucalypt oil concentration, none of the seed of test weeds germinated. Among the weed species tested, A. viridis was found to be the most sensitive and its germination was completed inhibited even at 0.03%. Not only the germination and seedling growth, even the chlorophyll content and respiratory activity in leaves of emerged seedlings were severely affected. In A. viridis chlorophyll content and respiratory activity were reduced by over 51% and 71%, respectively, even at a very low concentration of 0.06%. These results indicated an adverse effect of eucalypt oils on the photosynthetic and energy metabolism of the test weeds. A strong negative correlation was observed between the observed effect and the concentration of eucalypt oil. Based on the study, it can be concluded that oil from E. citriodora possess strong inhibitory potential against weeds that could be exploited for weed management.

Metabolic variation in rice cultivars of contrasting salt tolerance and its improvement by zinc in sodic soil.

The severity of Zn deficiency increased with increase in soil exchangeable sodium percentage (ESP) with salt sensitive variety M1-48 scoring 6 at ESP 62 as against only score 3 by salt tolerant variety Pokkali under similar soil conditions. Strikingly, zinc contents were much higher in salt tolerant variety than in salt sensitive one. Zinc application increased zinc concentration in the roots by a factor of 2.85 to 3.87 in Pokkali whereas it rose from 2.37 to 4.35 times in M1-48 depending upon ESP but in the leaves it registered increase of 1.5 to 1.8 times only. In general, the concentrations of reducing sugar were less (about 2.2%) than that of non-reducing (about 3.8%) in both the varieties under normal soil conditions. However, the concentration of reducing sugar doubled (4.2-4.4%) at the highest ESP 62, whereas the concentration of non-reducing sugar though increased (4.1 to 5.1%) but not as vigorously as reducing one. Zinc application reduced the concentration of reducing sugar but not that of non-reducing at similar ESP values. In Pokkali, the concentrations of total sugar increased from 6% at ESP 20 to 9.34% at ESP 62, whereas it registered enhancements of 5.98 to 8.6% in M1-48 under similar conditions. The nitrate reductase (NR) activity decreased with increase in soil sodicity however, the varietal differences in NR activity were wider under Zn-stress than under conditions of applied zinc with Pokkali registering higher NR activities. Carbonic anhydrase activities were higher in salt tolerant variety. Inhibition in carbonic anhydrase activity amounted to 23 and 45% in salt-sensitive variely M1-48 whereas only 19 and 33% in salt-tolerant variety Pokkali at ESP 41 and 62, respectively. The effects of zinc application at higher soil sodicity were more obvious in salt-sensitive variety than in salt-tolerant one. The findings suggest that the tolerance to Zn stress runs parallel to salt tolerance abilities of rice varieties.

Inhibitory effect of high soil pH on growth and mineral metabolism of rice and its reversal by zinc.

Increasing soil pH retarded growth, tillers and bio-mass production of rice cultivar Sarjoo-52. Application of 10 to 15 kgZn ha(-1) increased the bio-mass by 33 to 41% at pH 8.5 and 27 to 32% at pH 10.3. Panicle length, rachis branches, total spikelets, filled grains, grain size were all adversely affected to the tune of 19, 23, 40, 74 and 21%, respectively by higher soil alkalinity at pH 10.3. Alkalinity resulted in 19, 31 and 65% spikelet sterility which reduced to 3, 21 and 55% at pH 8.5, 9.5 and 10.3, respectively by Zn applied @ 15 kg ha(-1). Grain yield reduced to 50% at pH 10.3 but Zn in general, raised the yield levels by 1.6 to 2.3, times. The chlorophyll decreased by 36 to 50% whereas carbonic anhydrase activities decreased only by 13% due to increase in soil sodicity and alkalinity. Further, increase in pH caused significant decrease in Zn, Ca, Mg, P and K concentrations but phenomenal rise in Na content Zinc application, apart from increasing tissue Zn content, elevated Ca :Na and K :Na ratio resulting in improved growth and yield of rice under soil sodicity and alkalinity.

Effect of potash alum (aluminium potassium sulphate) on human semen and sperm.

25 normal and healthy human volunteers were engaged in this investigation. The different concentration of potash alum solution have different effects on sperm, motility/death and fructose level of the semen. Higher concentration have higher effects.

Demonstration of acid-fast bacilli in buffy coat and bone marrow smear--a diagnostic tool in pulmonary tuberculosis.

Buffy coat smears prepared from peripheral blood and bone marrow aspirate obtained from proved 60 untreated cases of pulmonary tuberculosis were stained with Ziehl-Neelsen method and thoroughly screened for presence of tubercle bacilli. Acid-fast bacilli were detected in 55% cases in buffy coat, 48.3% cases in bone marrow, 38.3% cases both in buffy coat and bone marrow and 65% cases either in buffy coat or in bone marrow or in both. Considering the fact that demonstration of acid-fast bacilli may not be possible in more than 25-50% of the suspected cases of tuberculosis, these techniques are recommended for evaluation of their utility in establishing diagnosis of tuberculosis, particularly in reference to sputum negative cases of pulmonary tuberculosis and tuberculosis of inaccessible extrapulmonary sites.

Copper, zinc, calcium and magnesium in chronic renal failure.

Estimation of copper, zinc, calcium and magnesium was done in plasma, erythrocytes and urine of twenty patients with chronic renal failure of diverse aetiologies. Twenty normal individuals formed the control group. Significant plasma hypozincaemia and hypozincuria was observed in uraemic patients, though the concentration of zinc in erythrocytes was significantly higher than in controls. The copper content of the erythrocytes was significantly higher in patients when compared to controls, while the reverse was true for its excretion in the urine. The increased level of copper in the erythrocytes showed a correlation with increasing severity of renal failure. Significant hypocalcaemia was seen in the erythrocytes and plasma of uraemic patients, though magnesium level was elevated. Urinary excretion, however, of both calcium and magnesium were markedly reduced in these patients. The magnesium levels in plasma and urine showed a significant correlation with the severity of renal failure.