PAEDIATRIC SYMPTOMATIC SEIZURES IN INDIA: UNRAVELLING VARIED ETIOLOGIES AND NEUROIMAGING PATTERNS - A MULTICENTRIC STUDY.

Pediatric neuroimaging presents a unique set of challenges, primarily stemming from the intricacies of normal myelination processes occurring within the initial two years of life. This complexity is particularly pronounced in the context of pediatric epilepsy, where a substantial proportion of neuroimaging cases appears normal, especially in instances of idiopathic or provoked seizures. Nevertheless, abnormalities in neuroimaging tend to manifest in cases of acute or remote symptomatic seizures. Notably, the etiological landscape of seizures in children diverges significantly from that observed in adults, with neurodevelopmental, neurometabolic, and neuro-infectious factors emerging as predominant contributors. This multicentric study, conducted between November 2021 and November 2023, spanned diverse hospitals across various states in India. Encompassing children from birth to 12 years of age experiencing acute and remote symptomatic seizures, the study meticulously documented clinical and demographic profiles. Exclusion criteria were applied, excluding typical febrile seizures and idiopathic epilepsy syndromes to ensure a focused analysis. The study encompassed a total of 109 cases, revealing a spectrum of neuroimaging findings. Noteworthy among these were cortical malformations, including focal cortical dysplasia (12 cases), tuberous sclerosis (6 cases), polymicrogyria (3 cases), hemimegalencephaly (1 case), lissencephaly (1 case), schizencephaly (2 cases), heterotopias (3 cases), cavernous hemangioma (1 case), and AV malformation (1 case). Additionally, neoplastic lesions (6 cases), neurocysticercosis (5 cases), tuberculoma (4 cases), hippocampal sclerosis (3 cases), post-hypoxic and cerebrovascular accident gliosis (3 cases), leukodystrophies (2 cases), and non-lesional cases (58 cases) were documented. Pediatric neuroimaging in symptomatic seizures may present with normal findings, influenced by interpreter bias and the non-uniform availability of 3T MRI across different medical centers. The diverse causative factors for symptomatic seizures underscore the impact of demographic features, including the endemicity of specific infections and birth injuries, on the observed variability across medical centers. These findings underscore the imperative for a comprehensive understanding and standardization in pediatric neuroimaging practices.

Associations of Dual Task Exergaming with Cognitive-Motor Interference in Older Adults with Mild Cognitive Impairment: A Single-Arm Pilot Study.

Purpose: To examine the feasibility and effectiveness of dual task (DT) exergaming to improve volitional balance control in older adults with mild cognitive impairment (MCI). Methods: Ten older adults with MCI were examined at baseline (week-0) and post-training (week-5) on volitional balance control (maximum excursion of center of gravity, MXE [%]) while performing cognitive task (auditory clock test or letter number sequencing task) and on the NIH-motor and cognitive toolboxes. DT exergaming training lasted for 12 sessions which consisted of performing explicit cognitive tasks while playing the Wii-Fit balance games. Results: From pre- to post-training, MXE improved (p<0.05); however, cognitive accuracy (cognitive task) remained the same (p>0.05). Improvement in NIH motor and cognitive toolbox tests was observed post-training (p<0.05). Conclusion: DT exergaming was associated to improvements in balance control under attention-demanding conditions in MCI. Future studies may focus on examining the efficacy of such training.

Multiple neural tube defects may not be very rare.

BACKGROUND: Multiple neural tube defects (MNTDs) are a rare occurrence. Although the clinical incidence is small, MNTDs raise some interesting embryological queries. AIM: This study aims to investigate the morphological and clinical variations observed in neonates presenting with multiple neural tube defects and associated central nervous system anomalies. MATERIALS AND METHODS: This is a prospective study carried out at our institute to assess clinical and morphological variation in patients presenting with multiple neural tube defects. RESULTS: Among the 263 patients with a neural tube defect, who presented to our outpatient department and emergency departments, only 10 cases of MNTDs were identified. Thus, incidence of MNTDs in the cohort of patients affected with NTD was 0.038 %. Among the 10 patients, 9 had double neural tube defects and 1 patient had three neural tube defects. CONCLUSIONS: Multiple neural tube defects may not be very rare in the general population, especially the populations with high incidence of neural tube defects. Multisite closure theory has the versatility to explain various combinations of neural tube defects, but better insights into the molecular pathways governing this tightly regulated process can provide us the missing link in establishing the pathogenesis of multiple NTDs. It can also provide us with an opportunity to prevent NTDs or treat them in utero by pharmacological modulation of these signaling pathways.

Screening of wild plant species for antibacterial activity and phytochemical analysis of Tragia involucrata L.

Eight wild plant species namely Tragia involucrata L., Cleistanthus collinus (Roxb.)Benth. Ex Hook.f., Sphaeranthus indicus L., Vicoa indica (L.) Dc., Allmania nodiflora (L.) R.Br. ex wight., Habenaria elliptica Wight., Eriocaulon thwaitesii Koern. and Evolvulus alsinoides L. were used for phytochemical extraction with four different solvents. Antibacterial activity of these plants was studied against Escherichia coli NCIM 2065 using Kirby Bauer agar disc diffusion assay. Effective antibacterial activity was shown by T. involucrata acetone extract (27.3 mm), compared to standard medicinal drug amoxicillin (28.3 mm). Minimum inhibitory concentration (MIC) of T. involucrata extract was 15 mg/mL and hence, it could be pursued further for obtaining phytomedicine. Biochemical constituents of T. involucrata fresh leaf were: sugars (55 mg/g), starch (0.7182 mg/g), proteins (0.0166 mg/g) and lipids (170 mg/g). Alkaloids, tannins, phenolic compounds, flavonoids and steroids were also observed qualitatively.

Spontaneous intestinal perforation.

Neonatal necrotizing enterocolitis, the most common gastrointestinal emergency in neonates, typically affects the preterm infants and carries high mortality. Classic clinical trad consists of abdominal distension, bloody stools, and pneumatosis intestinalis. Occasionally, signs and symptoms may not be classic and a number of papers have highlighted the difficulty of relying on radiological features to make a definitive diagnosis of necrotising enterocolitis. We report herein a case of neonate referred to us as a case of obstructed inguinal hernia and was diagnosed as a necrotizing enterocolitis perforation revealed by a rare manifestation of pneumoscrotum.

Extraadrenal pheochromocytoma with renal artery "pseudostenosis"-an important pitfall.

Pheochromocytoma and renal artery stenosis are two common causes of surgically correctable childhood hypertension that may coexist. We describe a case of extraadrenal pheochromocytoma with left upper polar renal artery pseudostenosis. The tumor was excised, preserving the accessory renal artery and kidney. The child was normotensive and did not require drugs postoperatively. Radiologic appearance of stenosis does not necessarily mean fixed renal artery stenosis, especially with a pheochromocytoma because it may exist as a result of vasospastic effects of the pheochromocytoma. Incorrect diagnosis may result in untoward risk and unnecessary procedures for the patient, hence the need to remember this pitfall.

Novel association of multiple gastrointestinal anomalies in a single patient: can Sonic Hedgehog explain it?

The occurrence of four gastrointestinal (GIT) anomalies in a single patient is extremely rare. Only one report of four GIT anomalies in a child has been published in the English literature. The current report presents a child with four anomalies and discusses the molecular mechanisms which control the development of the gastrointestinal tract.

Rhizobacterial population density and nitrogen fixation in seagrass community of Gulf of Mannar, India.

Seagrass rhizosphere generally supports high bacterial population density which plays a major role in determining the nutrient cycles of the sea. Higher densities of total heterotrphic bacteria (26.3 x 10(6) CFU g(-1)), nitrogen fixing (27.3 x 10(3) CFUg(-1), ammonifying (44.66 x 10(6) MPN g(-1)) and nitrifying bacteria (42.33 X 10(6) MPN g(-1)) have been registered in the seagrass areas than the non seagrass area. In particular, all these rhizosphere microbial population was higher in Thalassia hemprichii. The rates of nitrogen fixation was recorded in the different species of seagrasses such as Enhalus acoroides (1.166 n mol g(-1) d(-1)), Halophila ovalis (0.166 n mol g(-1) d(-1)), Thalassia hemprichii(18.5 n mol g(-1) d(-1)), Cymodocea serrulata (10.5 n mol g(-1) d(-1)), Halodule uninervis (5.375 n mol g(-1) d(-1)) and Syringodium isoetifolium (0.666 n mol g(-1) d(-1)) using gas chromatography. The average nitrogen fixation by the seagrasses of Gulf of Mannar alone was estimated to be 7640.58 n mol m(-2) d(-1) and the contributions from the rhizosphere microbes will increase the quantity to many fold.

Expression of heat shock protein70 in oral submucous fibrosis and oral squamous cell carcinoma: an immunohistochemical study.

BACKGROUND: Heat shock proteins are a highly conserved group of protective cellular proteins whose synthesis is increased in response to a variety of environmental or pathophysiological stresses. Heat shock proteins are useful biomarkers for carcinogenesis in tissues and signal the degree of differentiation and the aggressiveness of cancers. Regulation of heat shock protein 70 (HSP70) expression in oral submucous fibrosis is not known much, and the aim of this study was to evaluate HSP70 expression in oral submucous fibrosis and oral squamous cell carcinoma by immunohistochemical method and to understand the role of HSP70 in tumorigenesis. MATERIALS AND METHODS: Immunohistochemical method was used to detect HSP70 expression in normal oral mucosa, oral submucous fibrosis (n=30) and oral squamous cell carcinoma (n=20). HSP70 immunoreactivity was correlated with histological and clinicopathological features. RESULTS: A significant increase in expression of HSP70 was observed (P<0.000) as the tissue progressed from oral submucous fibrosis towards oral squamous cell carcinoma. CONCLUSION: HSP70 is synthesized upon stress situations arising in cells of all living organisms. Expression of HSP70 indicates that stress plays an important role as a predisposing factor in oral submucous fibrosis and its subsequent progression to oral squamous cell carcinoma.

Effects of environment and education on knowledge and attitude of nursing students towards leprosy.

The objective of this cross-sectional comparative study was to find the effects of environment and education on knowledge and attitude of nursing students towards leprosy. Data were collected, using a pretested questionnaire, from the first year and third year students of a School of Nursing attached to a leprosy specialty hospital and also from a comparable School of Nursing attached to a general hospital. The results showed that trainees acquired more knowledge on leprosy during training in both schools of nursing. However, those trained in leprosy hospital environment had higher knowledge and attitude scores than those trained in general hospital environment. The attitude of the trainees attached to leprosy hospital was favourable even before they had formal training in leprosy. Those trained in the general hospital showed more favourable attitude after training compared to before training. School of Nursing attached to leprosy hospital provided an atmosphere conducive to learning and understanding more about leprosy. The trainees retained what was learnt because of regular association with patients affected by leprosy. For employment in hospital or community based services or research related to leprosy, nurses trained in a leprosy hospital would have added value of knowledge and attitude.

Biological activity of sea anemone proteins: I. Toxicity and histopathology.

The crude as well as partially purified protein fractions from anemone species viz. Heteractis magnifica, Stichodactyla haddoni and Paracodylactis sinensis, collected from the Gulf of Mannar, south east coast of India were found to be toxic at different levels to mice. The mice showed behavioral changes such as loss of balance, opaque eyes, tonic convulsions, paralysis, micturiction, flexing of muscles, prodding (insensitive to stimulii), foaming from mouth and exophthalmia. The toxic proteins upon envenomation produced several chronic and lethal histopathological changes like formation of pycnotic nuclii and glial nodules in the brain; heamolysis, thrombosis and myocardial haemorrhage in the heart; granulomatous lesions, and damage to the hepatic cells in the liver and haemorrhage throughout the kidney parenchyma and shrinkage of glomerular tufts in the kidney. The toxins proved to be neurotoxic, cardiotoxic, nephrotoxic and hepatotoxic by their action on internal organ systems. The toxins were also thermostable till 60 degrees C and had considerable shelf life.

Biological activity of sea anemone proteins: II. Cytolysis and cell line toxicity.

Potent cytolytic activity was exhibited by proteins extracted from three sea anemones viz. Heteractis magnifica, Stichodactyla haddoni and Paracodylactis sinensis by affecting the red blood corpuscles (RBC) and the mouse fibroblast cell line (L929) and leukemia cell line (P388). Crude toxin of all the three anemone species induced spontaneous hemolysis of chicken, goat and human erythrocytes. The crude toxin of H. magnifica (0.98 mg/ml) elicited hemolysis at levels of 4096, 512 and 4096 HU (hemolytic unit) in chicken, goat and human erythrocytes respectively. Subsequently, the crude toxin of S. haddoni (0.82 mg/ml) exhibited a hemolytic activity of 256, 128 and 512 HU and that of P. sinensis (0.60 mg/ml) had a hemolytic activity of 128, 4096 and 512 HU. Most of the partially purified proteins of these anemones also exhibited the activity against the three different erythrocytes. The viability of L929 and P388 was adversely affected on adding the crude toxins. The symptoms of toxicity shown by the cells were rounding, lysis and detachment from the substratum. These effects were the least in S. haddoni, as compared to those the crude toxins of the other two species. Inhibition of growth of L929 exhibited by the toxin of the three species ranged between 61.08 and 93.38%. Similarly, inhibition of the growth of P388 ranged between 51.32 and 86.16%. The present investigation reveal the cytotoxic nature of anemone toxins.

Serum ovotransferrin as a biomarker of inflammatory diseases in chickens.

Infectious and metabolic disorders are common in poultry and cause stress, poor performance, and mortality that results in considerable economic loss. Identifying the nature of stress in chickens will assist the development of appropriate measures to improve health and welfare. Acute phase proteins are hepatic proteins, the blood concentrations of which change significantly in the event of many health problems including inflammation and physical injuries. Thus, acute phase proteins are used as nonspecific diagnostic markers for various health disorders. Our previous studies showed that serum ovotransferrin (OVT) is an acute phase protein in chickens. Therefore, in the present study, we investigated whether OVT concentration can be a marker of physiological stress using sera from chickens with different infectious and metabolic disorders. A competitive enzyme immunoassay was developed to measure serum OVT concentrations. The results show that with experimentally induced pulmonary hypertension syndrome and tibial dyschondroplasia, there were no significant changes in OVT levels compared with matched controls. In contrast, when chickens were infected with microbes such as the bacterium Escherichia coli, or protozoan parasites such as Eimeria maxima and Eimeria tenella, there was a significant increase in the levels of OVT in the serum. Chickens with spontaneous autoimmune vitiligo also showed a significant increase in blood OVT levels. These studies suggest that blood OVT concentration is modulated under inflammatory and microbial stress and can therefore be used as a diagnostic marker of infection and inflammation in chickens.

Direct screening identifies mature beta-defensin 2 in avian heterophils.

Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS) was used to screen avian heterophils in the m/z range of 1 to 20 kDa with an objective to identify specific cell-associated peptides that may be reflective of their functional physiology. The MALDI-TOF-MS profiles of crude heterophil extract showed a high intensity peak with average mass of m/z 3916.1 for chicken and m/z 4129.6 for turkey. To identify these peaks, we first purified m/z 3916.1 from chicken bone marrow extract using reverse-phase high performance liquid chromatography (RP-HPLC). Edman sequencing and peptide mass fingerprinting exclusively confirmed this peptide as beta-defensin 2 (BD2) or gallinacin-2, a broad-range antimicrobial peptide. A Uniprot database search followed by the MASCOT sequence query revealed m/z 4129.6 to be the corresponding turkey ortholog of avian beta-defensin 2 (AvBD2), also called turkey heterophil peptide 2. Both AvBD2 peptides are 36 amino acids long including a highly conserved region with 6 invariant cysteines forming the 3 disulfide bonds characteristic of defensins. The method confirmed the existence of the complete mature peptide sequence of the turkey heterophilic BD2 previously proposed based on cDNA analysis. These results demonstrate that screening of the crude extract by MALDI-TOF-MS can identify cell- or tissue-associated peptides in their functional or mature forms, raising the possibility that such peptides can be used as biomarkers in their altered physiological states.

Physico-chemical and microbial characteristics of the coral reef environment of the Gulf of Mannar marine biosphere reserve, India.

Investigation on physico-chemical parameters and bacteial characteristics of the coral reef environs of the Gulf of Mannar biosphere reserve was studied. The study found the influence of different physico-chemical parameters on one another and also on the distribution of the total heterotrophic bacteria (THB) in the coral reef areas. Nutrients exhibited considerable seasonal and spatial variations with influence on the bacterial population. Coral reef areas recorded higher bacterial population density both in water (3.5 to 18 x 10(5) CFU ml(-1)) and sediment (1 to 14 x 10(7) CFU g(-1)) samples than the non coral reef areas (3.4 to 10.5 x 10(4) CFU ml(-1) in water and 0.9 to 7 x 10(6) CFU g(-1)). The study also found the dominance of gram negative groups at all the three stations (64.73, 63,5 and 72.59%) with Pseudomonas contributing maximum number of strains in all the samples. In addition Vibrio, Aeromonas, Flavobacterium, Cytophaga, Enterobacter and Alcaligenes were also recorded. The gram positive group was represented by Bacillus, Micrococcus, Arthrobacter and Corynebacterium. The genetic composition of THB isolated from the coral mucus revealed the presence of Vibrio and Micrococcus in all the coral mucus.

Spectral reflectance properties of mangrove species of the Muthupettai mangrove environment, Tamil Nadu.

In the Muthupettai mangrove environment, spectral properties of six mangrove species viz. Avicennia marina, Aegiceras corniculatum, Excoecaria agallocha, Acanthus ilicifolius, Suaeda monoica and S. maritima was studied using Multi band Ground Truth Radiometer (Model-041). The study found that the chlorophyll concentration of different mangrove leaves varies between 0.05 and 0.36 mg g(-1), registering the minimum in S. maritima and maximum in E. agallocha. Interestingly species with higher chlorophyll concentration showed lower reflectance values alteast in the spectral bands 1 and 2. E. agallocha registered 0.36 mg g(-1) of chlorophyll while it recorded only 2.18 and 2.43% reflectance where as S. maritima recorded 3.16 and 3.27% of reflectance in bands 1 and 2. This indicates chlorophyll concentration is one of major factors responsible in determining the reflectance pattern of the pant communities. The spectral properties of mangroves were largely differed with that of the water and soil samples collected from the same locations, these results favourd the utilization of remotely sensed data for depicting various water and soil quality parameters from that of mangrove species in the mangrove environment. This study also found that the difference in reflectance of mangroves at canopy level is not only influenced by the chlorophyll content of species but also by the prevailing environmental condition and background reflectance of soil and water as well.

Probiotics in aquaculture: importance and future perspectives.

Aquaculture is one of the fastest developing growth sectors in the world and Asia presently contributes about 90% to the global production. However, disease outbreaks are constraint to aquaculture production thereby affects both economic development of the country and socio-economic status of the local people in many countries of Asia-Pacifi c region. Disease control in aquaculture industry has been achieved by following different methods using traditional ways, synthetic chemicals and antibiotics. However, the use of such expensive chemotherapeutants for controlling diseases has been widely criticized for their negative impacts like accumulation of residues, development of drug resistance, immunosuppressants and reduced consumer preference for aqua products treated with antibiotics and traditional methods are ineffective against controlling new diseases in large aquaculture systems. Therefore, alternative methods need to be developed to maintain a healthy microbial environment in the aquaculture systems there by to maintain the health of the cultured organisms. Use of probiotics is one of such method that is gaining importance in controlling potential pathogens. This review provides a summary of the criteria for the selection of the potential probiotics, their importance and future perspectives in aquaculture industry.

Studies on L-asparaginase enzyme of actinomycetes isolated from estuarine fishes.

Actinomycetes were isolated from different organs viz. skin, gills and gut contents of three species of fishes viz. Mugil cephalus (Linnaeus, 1758), Chanos chanos (Forskal, 1775) and Etroplus suratensis (Bloch, 1780) using three different media from the Vellar estuary, situated along the southeast coast of India. Among the three fishes, M. cephalus harboured highest number of actinomycetes population in all the three body parts examined followed by C. chanos and E. suratensis. Out of the three body parts of all fishes, gut contents had highest actinomycetes population followed by gills and skin. Among the three media used for isolation of actinomycetes, Kuster's agar medium was found to be suitable than the starch casein agar and glucose asparagine agar media. Out of the 40 strains isolated, only six strains (LA-2, LA-8, LA-15, LA-20, LA-29 and LA-35) showed significant L-asparagianse activity and were taken up for further studies. Impact of various physical and chemical factors such as pH, temperature, sodium chloride concentration, carbon sources and amino acids on the growth of actinomycetes and L-asparaginase activity was also studied. Optimum growth and enzyme activity was noticed under pH 7 to 8, temperature 37 degrees C, 1-2% sodium chloride concentration, sucrose as carbon source and without any amino acids. Analysis of the cell components of the isolated strains has revealed the wall type-I (the wall type-I is typical for the genus Streptomyces) and the strains were micromorphologically similar to the genus Streptomyces. Hence, the morphological, physiological and biochemical along with the micromorphological results obtained for the L-asparaginase producing strains were compared and the strains were tentatively identified as Streptomyces aureofasciculus (LA-2), S. chattanoogenesis (LA-8), S. hawaiiensis (LA-15), S. orientalis (LA-20), S. canus (LA-29) and S. olivoviridis (LA-35).