ABSTRACT
OBJECTIVE: Intussusception has been linked with rotavirus vaccine (RVV) as a rare adverse reaction. In view of limited background data on intussusception in India and in preparation for RVV introduction, a surveillance network was established to document the epidemiology of intussusception cases in Indian children. METHODS: Intussusception in children 2-23 months were documented at 19 nationally representative sentinel hospitals through a retrospective surveillance for 69 months (July 2010 to March 2016). For each case clinical, hospital course, treatment and outcome data were collected. RESULTS: Among the 1588 intussusception cases, 54.5% were from South India and 66.3% were boys. The median age was 8 months (IQR 6, 12) with 34.6% aged 2-6 months. Seasonal variation with higher cases were documented during March-June period. The most common symptoms and signs were vomiting (63.4%), bloody stool (49.1%), abdominal pain (46.9%) and excessive crying (42.8%). The classical triad (vomiting, abdominal pain, and blood in stools) was observed in 25.6% cases. 96.4% cases were diagnosed by ultrasound with ileocolic location as the commonest (85.3%). Management was done by reduction (50.8%) and surgery (41.1%) and only 1% of the patients' died. 91.1% cases met Brighton criteria level 1 and 3.3% Level 2. Between 2010 and 2015, the case load and case ratio increased across all regions. CONCLUSION: Intussusception cases have occurred in children across all parts of the country, with low case fatality in the settings studied. The progressive rise cases could indicate an increasing awareness and availability of diagnostic facilities.
Subject(s)
Intussusception , Rotavirus Vaccines , Child , Child, Preschool , Humans , India/epidemiology , Infant , Intussusception/epidemiology , Male , Retrospective Studies , Rotavirus Vaccines/adverse effects , Tertiary Care CentersABSTRACT
N-Alkenyl iminium ions serve as conduits to three-component [4 + 2] cycloaddition reactions accessing structurally and stereochemically diverse piperidine derivatives. These cationic 2-azadienes participate in endo- or exo-selective [4 + 2] cycloadditions with electron-rich and neutral alkene dienophiles to generate a tetrahydropyridinium ion as the initial cycloadduct. In situ nucleophilic addition to the cycloaddition-derived iminium ion completes the three-component coupling sequence and affords a versatile synthesis of structurally complex piperidines.
Subject(s)
Alkenes/chemistry , Imines/chemistry , Piperidines/chemical synthesis , Cyclization , Indoles/chemistryABSTRACT
We offer a novel methodology for formulating liposomes by incorporating sequence-specific collagen-mimetic peptides such that they are specifically "uncorked" by a matrix metalloproteinase, MMP-9. By encapsulating carboxyfluorescein (as a self-quenching fluorescent dye), we demonstrate that the time-dependent release of the dye from liposomes is due to the specific enzymatic cleavage of the surface-exposed collagen-mimetic peptides. The specificity of such cleavage is attested by the fact that the liposomal "uncorking" and their content release occur only by MMP-9 and not by a general proteolytic enzyme, trypsin, despite the fact that the collagen mimetic peptides contain the trypsin cleavage site. The mechanistic details underlying the formulations of liposomes and their enzyme-selective "uncorking" and content release are discussed. Arguments are presented that such liposomes can be fine-tuned to serve as the drug delivery vehicles for the detection and treatment of various human diseases, which occur due to the overexpression of a variety of pathogenic matrix metalloproteinases.
Subject(s)
Liposomes/chemistry , Liposomes/metabolism , Matrix Metalloproteinase 9/metabolism , Amino Acid Sequence , Biomimetics , Collagen/chemistry , Collagen/metabolism , Fluorescent Dyes/metabolism , Humans , Lipoproteins/chemistry , Lipoproteins/metabolism , Peptides/chemistry , Peptides/metabolism , Substrate Specificity , Time Factors , Transition Temperature , Trypsin/metabolismABSTRACT
To determine the duration of lactation which is associated with weight loss in rural Bangladeshi mothers and also to determine the relationship with consumption patterns of principal food items, a cross-sectional study was carried out among 791 lactating rural Bangladeshi mothers aged 18-40 years. Results were compared with 333 non-pregnant and non-lactating mothers of a similar age group. The duration of lactation was up to 60 months. The mean difference in body-weight and body mass index (BMI) of lactating mothers who breastfed their children up to 24 months was significantly lower compared to non-lactating mothers of the same age group, but no differences were observed for those who breastfed beyond 24 months. The frequency of consumption of principal food items was comparable between the non-lactating and the lactating mothers who breastfed beyond 24 months. Results of multiple linear regression analysis showed that body-weight of mothers was negatively correlated with 1-12 month(s) and 13-24 months of lactation after controlling for height, education, and food consumption (slope -1.04, p<0.05 and slope -1.23, p<0.05 respectively). Height and consumption of meat and milk were significantly positively correlated with body-weight (slope 0.53, p<0.001; slope 1.44, p<0.001; and slope 0.75, p<0.05 respectively). The study concluded that Bangladeshi women who breastfed up to 24 months were of lower weight than non-lactating mothers, most likely due to the effect of lactation. These mothers were not taking any additional foods during their lactating period. Based on the findings of the study, it is recommended that mothers consume additional energy-rich foods during the first 24 months of lactation to prevent weight loss.
Subject(s)
Energy Intake/physiology , Feeding Behavior/physiology , Lactation/physiology , Weight Loss , Adolescent , Adult , Animals , Bangladesh , Case-Control Studies , Cross-Sectional Studies , Female , Humans , Linear Models , Meat , Milk , Rural Population , Time Factors , Women's HealthABSTRACT
A triggered release methodology of liposomal contents via the enzyme MMP-9 is described.
Subject(s)
Liposomes/chemistry , Matrix Metalloproteinase 9/chemistry , Oligopeptides/chemistry , Arthropod Proteins , Models, BiologicalABSTRACT
This randomized double blind community trial was conducted on Ascaris infested children (n = 85) aged 2 to 12 years and was aimed to study the impact of deworming on nutritional status, in an urban slum of Dhaka, Bangladesh. The change of weight gain was significantly higher in children given anthelmintics than those given placebo (0.92 kg vs. 0.54 kg). A multiple linear regression model shows that after controlling sex, deworming and height were positively correlated while age and weight were negatively correlated with weight change.
