Nucleic acid analysis on paper substrates (NAAPs): an innovative tool for Point of Care (POC) infectious disease diagnosis.

The cost-effective rapid diagnosis of infectious diseases is an essential and important factor for curing such diseases in the global public health care picture. Owing to poor infrastructure and lack of sanitation, these diseases have an extreme impact on remote and rural areas, especially in developing countries, and there are unresolved challenges. Molecular diagnosis, such as nucleic acid analysis, plays a key role in the significant treatment of numerous infectious diseases. Current molecular diagnostic assays require a sophisticated laboratory setup with expensive components. Molecular diagnosis on a microfluidic point-of-care (POC) platform is attractive to researchers for disease detection with proper prevention. Compared to various microfluidic substrate materials, paper-based POC technologies offer significant cost-effective solutions over high-cost clinical instruments to fill the gap between the needs of users and affordability. Low-cost paper-based microfluidic POC technologies provide portable and disposable diagnostic systems for multiple disease detection that may be extremely useful in remote areas. This article presents a critical review of paper-based microfluidic device technology which has become an imminent platform to adjust the current health scenario for the detection of diseases using different stages of nucleic acid analysis, such as extraction, amplification and detection of nucleic acid, with future perspectives for paper substrates.

MEMS impedance flow cytometry designs for effective manipulation of micro entities in health care applications.

Efficient manipulation of micro biological cells has always been a very important task in healthcare sector for which a Micro Electro Mechanical System (MEMS) based impedance flow cytometry has been proven to be a promising technique. This technique utilise the advantage of dielectrophoresis (DEP) force which is generated by non-uniform electric field in a microfluidic channel using an appropriate external AC supply at certain frequency range. The DEP forces generated in micro-channel depend upon various biological and physical parameters of cell and suspending medium. Apart from that design parameters of microfluidic channel and dimension of electrodes used for generating DEP action also plays major role in micro cell/bead manipulation. This article give remarks on the operating parameters which affects the cell manipulation and interrogates the currently accepted various electrode orientations in microfluidic MEMS flow cytometer technologies for effective manipulation of micro entities like healthy human cells (T-lymphocytes, B- lymphocytes, Monocytes, Leukocytes erythrocytes and human kidney cells HEK293), animal cells (neuroblastoma N115 and sheep red blood cells), cancer cells (MCF-7, MDA-435 and CD34+), yeast cells (saccharomyces cerevisiae, listeria innocua and E. coli) and micro particles (polystyrene beads) based on their dielectric properties using DEP action. Article focuses on the key electrode orientations for generation of non-uniform electric field in microfluidic flow cytometer like tapered electrodes, trapezoidal electrode arrays, Interdigitated electrodes, curved microelectrode and 3D electrode orientations and give remarks on their advantages and limitations. The cell manipulation with current MEMS impedance flow cytometry orientations targeting possibilities of implementation of the lab-on-chip devices has been discussed.

Ziprasidone monotherapy in bipolar II depression: an open trial.

BACKGROUND: The use of atypical neuroleptics for bipolar depression is currently being studied extensively. Given ziprasidone's favorable side effect profile as compared to other atypical neuroleptics, and the dearth of studies of this drug in depressed bipolar patients, we initiated an 8 week open monotherapy trial in bipolar II patients suffering major depressive episodes. METHOD: Patients met DSM IV criteria for bipolar II disorder, were in a major depressive episode, and had a 17 item HAM-D score of 18 or greater. Ziprasidone was begun at 20 mg bid and raised step wise to 60 mg bid if needed and tolerated. Change was assessed on the HAM-D (primary outcome measure), HAM-A, MADRS, YMRS, CGI-S, CGI-I, BDI and Q-LES-Q scales. Safety and tolerability were assessed. The study was approved by Asentral IRB and all patients gave written informed consent. RESULTS: Thirty patients (including 6 early terminators) completed the study. Significant improvement was seen at all visits on HAM-D, CGI-S and BDI (beginning week 1), and on MADRS and HAM-A (beginning week 2). Nine patients (30%) were responders and 5 (17%) remitters at week 1; 18 (60%) were responders and 13 (43%) remitters by the end of treatment. There was one serious AE's that was not study drug related, and no patient became manic. Occasional mild hypomania responded to dosage reduction. Mean end of study dose was 58 mg/day. LIMITATIONS: Given the small sample size and lack of placebo control, the results must be considered preliminary. CONCLUSIONS: Ziprasidone at a relatively low dose appears to be a rapid, effective and generally well tolerated treatment for bipolar II patients experiencing major depression. However, larger, placebo-controlled trials are needed to confirm these findings.