Partnering for rotavirus vaccine introduction in India: A retrospective analysis.

BACKGROUND: The pre-existing partner network created in India for the delivery of polio vaccines was initially used to eradicate polio and later on embedded in the health systems network to promote routine immunization and other health interventions efficiently. The experience from this network offered lessons for strengthening the health care systems and provided a well-established network that could be utilized for other vaccine initiatives. It has also been established that successful partnerships between a broad range of stakeholders provide support, strengthen the health system, and accelerate vaccine innovation, introduction, access, logistics, and communication support. However, beyond polio eradication, there have not been too many documented success stories of vaccine introduction, which could be replicated in other new vaccine introductions and allied health initiatives. The authors have reviewed the successful and time-bound introduction of rotavirus vaccine (RVV) in India in the present article. METHODS: The review was conducted based on a partnership framework which analysed multiple factors-partnership prerequisites, partnership model, partnership process, and partnership performance, thereby providing a comprehensive insight into the successful utilization of partnership networks for rotavirus vaccine introduction under the Universal Immunization Program in India. RESULTS & CONCLUSION: The review also highlights the role of a lead agency in creating a fertile ground for lush, efficient, and effective partnerships amongst different stakeholders. The already existing RVV partnership framework reviewed by the authors can be successfully utilized for future new vaccine introductions.

Responsiveness to oral prednisolone in severe asthma is related to the degree of eosinophilic airway inflammation.

BACKGROUND: Patients with severe asthma appear relatively corticosteroid resistant. Corticosteroid responsiveness is closely related to the degree of eosinophilic airway inflammation. The extent to which eosinophilic airway inflammation in severe asthma responds to treatment with systemic corticosteroids is not clear. OBJECTIVE: To relate the physiological and inflammatory response to systemic corticosteroids in asthma to disease severity and the baseline extent of eosinophilic inflammation. METHODS: Patients with mild/moderate and severe asthma were investigated before and after 2 weeks of oral prednisolone (Clintrials.gov NCT00331058 and NCT00327197). We pooled the results from two studies with common protocols. The US study contained two independent centres and the UK one independent centre. The effect of oral corticosteroids on FEV1 , Pc20, airway inflammation and serum cytokines was investigated. Baseline measurements were compared with healthy subjects. RESULTS: Thirty-two mild/moderate asthmatics, 50 severe asthmatics and 35 healthy subjects took part. At baseline, both groups of asthmatics had a lower FEV1 and Pc20 and increased eosinophilic inflammation compared to healthy subjects. The severe group had a lower FEV1 and more eosinophilic inflammation compared to mild/moderate asthmatics. Oral prednisolone caused a similar degree of suppression of eosinophilic inflammation in all compartments in both groups of asthmatics. There were small improvements in FEV1 and Pc20 for both mild/ moderate and severe asthmatics with a correlation between the baseline eosinophilic inflammation and the change in FEV1 . There was a ~50% reduction in the serum concentration of CXCL10 (IP-10), CCL22 (MDC), CCL17 (TARC), CCL-2 (MCP-1) and CCL-13 (MCP-4) in both asthma groups after oral corticosteroids. CONCLUSIONS AND CLINICAL RELEVANCE: Disease severity does not influence the response to systemic corticosteroids. The study does not therefore support the concept that severe asthma is associated with corticosteroid resistance. Only baseline eosinophilic inflammation was associated with the physiological response to corticosteroids, confirming the importance of measuring eosinophilic inflammation to guide corticosteroid use.

Evaluation of antinociceptive and anti-inflammatory activity of hydromethanol extract of Cocos nucifera L.

Cocos nucifera L. (family: arecaceae) is generally straight unbranched plant, traditionally cultivated for its fruit (coconut) in home gardens. In the present study, anti-inflammatory and antinociceptive (analgesic) activity of hydromethanol extract of Cocos nucifera L. (HECN) was evaluated in animal models. HECN showed significant (p < 0.05) and dosedependent anti-inflammatory activity in carrageenan induced paw oedema models of inflammation and the result was comparable with the standard drug diclofenac. In addition, the extract also showed highly significant (p < 0.01) antinociceptive activity. HECN treated group showed increase in the reaction time in hot plate method and decrease the writhing induced by acetic acid in mice when compared with control group animal. The anti-inflammatory and antinociceptive activity observed in the present study could be attributed largely to the presence of its antioxidant phytoconstituents such as flavonoid, saponin and polyphenols.

Airway wall geometry in asthma and nonasthmatic eosinophilic bronchitis.

BACKGROUND: Variable airflow obstruction and airway hyperresponsiveness (AHR) are features of asthma, which are absent in nonasthmatic eosinophilic bronchitis (EB). Airway remodelling is characteristic of both conditions suggesting that remodelling and airway dysfunction are disassociated, but whether the airway geometry differs between asthma and nonasthmatic EB is uncertain. METHODS: We assessed airway geometry by computed tomography (CT) imaging in asthma vs EB. A total of 12 subjects with mild-moderate asthma, 14 subjects with refractory asthma, 10 subjects with EB and 11 healthy volunteers were recruited. Subjects had a narrow collimation (0.75 mm) CT scan from the aortic arch to the carina to capture the right upper lobe apical segmental bronchus (RB1). In subjects with asthma and EB, CT scans were performed before and after a 2-week course of oral prednisolone (0.5 mg/kg). RESULTS: Mild-moderate and refractory asthma were associated with RB1 wall thickening in contrast to subjects with nonasthmatic EB who had maintained RB1 patency without wall thickening [mean (SD) % wall area and luminal area mild-t0-moderate asthma 67.7 (7.3)% and 6.6 (2.8) mm(2)/m(2), refractory asthma 67.3 (5.6)% and 6.7 (3.4) mm(2)/m(2), healthy control group 59.7 (6.3)% and 8.7 (3.8) mm(2)/m(2), EB 61.4 (7.8)% and 11.1 (4.6) mm(2)/m(2) respectively; P < 0.05]. Airway wall thickening of non-RB1 airways generation three to six was a feature of asthma only. There was no change in airway geometry of RB1 after prednisolone. Proximal airway wall thickening was associated with AHR in asthma (r = -0.56; P = 0.02). CONCLUSIONS: Maintained airway patency in EB may protect against the development of AHR, whereas airway wall thickening may promote AHR in asthma.

Jejunal GIST with extramural hemangiomatous component presenting as an obscure lower GI bleed: a case report.

GISTS (Gastrointestinal stromal tumours) are malignant form of sarcoma of the digestive tract. Various unusual presentations and morphological variants of GIST have been described, including extramural components of GIST. The literature has no reference regarding an extramural hemangiomatous component of a GIST. Here we present a case of 54-year-old women with this unusual morphological condition presenting as an obscure lower GI bleed. Diagnosis in this case was made by subjecting the resected specimen to immunohistochemical analysis.

Routine immunisation in India.

Vaccine preventable diseases have been reduced in the country since the routine immunisation programme started in 1978 as the Expanded Programme on Immunisation, then in 1985 renamed as Universal Immunisation Programme. Re-emergence of some vaccine preventable disease is a concern to all and the Government of India has launched a new multiyear plan to strengthen the routine immunisation. A number of recommendations was made to address the weaknesses in the programme. Some newer initiatives were also made under the multiyear plan and National Rural Health Mission to strengthen the routine immunisation. The general practitioners can play a positive role while immunising children as per Universal Immunisation Programme. Routine immunisation is one of the key components of polio eradication.

Evaluation of antipyretic potential of Vernonia cinerea extract in rats.

The methanol extract of the whole plant of Vernonia cinerea (MEVC) was evaluated for its antipyretic potential on normal body temperature and yeast-induced pyrexia in rats. MEVC significantly reduced the normal body temperature at doses of 250 and 500 mg/kg body weight p.o. MEVC also lowered the elevated body temperature in the case of yeast-induced pyrexia in a dose dependent manner. The antipyretic effect of the extract at a dose of 500 mg/kg was identical to that of the standard drug paracetamol.

Evaluation of anti-inflammatory activity of Vernonia cinerea Less. extract in rats.

The methanol extract of the whole plant of Vernonia cinerea Less. was evaluated for its anti-inflammatory activity in acute (carrageenin, histamine and serotonin induced rat paw edema) and a chronic model (cotton pouch induced granuloma). The methanol extract (250 and 500 mg/kg(-1) p.o.) exhibited significant activity (p < 0.001) against all phlogistic agents used in a dose dependant manner. In the chronic model (cotton pouch granuloma method) the methanol extract exhibited significant anti-inflammatory activity. All these effects were compared with standard drug phenylbutazone (100 mg/kg(-1) p.o.).

Antibacterial activity of Vernonia cinerea.

The benzene extract of Vernonia cinerea showed a broad spectrum of antibacterial activity.

Antibacterial activity of Terminalia pallida.

The methanol extract of the dried fruit powder of Terminalia pallida was evaluated for antimicrobial activity. The methanol extract showed a broad spectrum of antibacterial activity.

Primary omental torsion: case report.

Primary omental torsion is a rare condition. It is confused with acute appendicitis. Presence of a normal appendix at surgery should raise the suspicion of omental torsion.

Serological study of human toxoplasmosis in Calcutta.

A total of 248 randomly selected subjects from urban, semiurban and rural areas of Calcutta was studied serologically for the prevalence of antibody to Toxoplasma gondii using latex agglutination technique. Fifty-nine (23.79%) out of these 248 subjects were found to possess anti-toxoplasma antibody. Seropositivity was found to be higher in females (25%) as compared to males (22.32%). Agewise highest positivity (30.5%) for toxoplasma antibody was observed in the third decade and lowest in the first decade of life, though all the age groups were involved by this protozoal infection. Sexwise distribution of anti-toxoplasma antibody showed highest positivity rate in the third decade in males and in the fourth decade in females. Twenty-five per cent of the subjects had history of contact with cat and/or soil and most of the subjects belonged to the middle and low income groups.

Bulk Superconductivity at 122 K in T1(Ba,Ca)2Ca3Cu4O10.5+8 with Four Consecutive Copper Layers.

The observed increase of superconducting transition temperature (T(c)) with the number of copper oxide planes continues in the four-[CuO(2)](-2) layer (single TI layer) oxide superconductor, which has been prepared with > 80% purity and was magnetically aligned for crystallographic identification. A master scaling curve is proposed, which ties together the T(c)'s of virtually all known Bi and Tl oxide superconductors, and shows that the Tl(Bi) layers play an essential role in the superconductivity. publication 350 of the Barnett Institute.

N-Phenyl-N'-acetylthiourea-a specific reagent for photometric determination of ruthenium.

N-Phenyl-N'-acetylthiourea is recommended as a specific chelating agent for the spectrophotometric determination of ruthenium. The blue complex formed in 5-8M hydrochloroic acid is not extractable into common organic solvents but is soluble in 30% ethanol solution. The colour is stable for up to 48 hr and Beer's law is obeyed at 650 nm over the metal concentration range 2-18 mug/ml. The molar absorptivity is 4.7 x 10(3) l.mole(-1). cm(-1).

Intra-H-2 recombination inH-2(b)/H-2 (t1) heterozygotes in the mouse : II. Characterization of recombinant haplotypesat2, at3, andat4.

Four cases of intra-H-2 recombination were detected during serological screening of 1066 backcross animals produced fromH-2(b)/H-2(t1) heterozygous mice. Three of the intra-H-2 recombinants received theK region fromH-2(t1) and theD region from theH-2(b) parental chromosome. The remaining recombinant received theK region from theH-2(b) parental chromosome and theD region fromH-2(t1). Three of the four recombinants have been developed into inbred lines TBR2, TBR3, and TBR4 and were assigned the haplotype designations at(2), at(3), and at(4). Ss typing revealed that TBR2 and TBR3 originated fromK- S interval crossover events, while the remaining two recombinants resulted from crossing over in theS- D interval.