PLA blended gelatine-based nanofibrous mats with enhanced hydrophobicity for soft tissue regeneration.

Wound healing requires a substantial amount of moisture for faster recovery. Completely hydrophobic or hydrophilic biomaterials are not suitable to be applied for cell growth in wounded areas. The study aimed to prepare a nanofibrous scaffold from the blend of a solution of hydrophobic PLA and a solution of hydrophilic gelatine. The stability of the blend was achieved using a surfactant and an electrospun nanofibrous scaffold was made out of the solution. The optimum composition of gelatine and PLA to make a scaffold of uniform fibre diameter was achieved with the help of conductivity, viscosity and FESEM analysis. The optimum scaffold was characterised by TGA, DSC and XRD analysis. The water contact angle of the optimum sample was observed at 27°. The blended scaffold was found non-toxic to cells and showed a 30% faster healing of wounds in the rat model test compared to the healing rate of the PLA scaffold or the gelatine scaffold alone. The histological assay also supported the blend scaffold as an encouraging material for tissue regeneration.

Fabrication and characterization of sustainable composites from animal fibers reinforced unsaturated polyester resin.

The research involves developing eco-friendly polymer composites by combining synthetic unsaturated polyester resin (UPR) with treated and untreated leather fibers (LF), cow hair fibers (CHF), and chicken feather fibers (CFF). By using these natural fibers instead of synthetic polymer, we aim to reduce the environmental impact while finding new purposes for waste materials from the poultry and tannery industries which would otherwise end up in garbage. The fibers were incorporated into the resin matrix at various weight percentages such as 2, 5, 7, 10, 12, and 15 % (w/w). Additionally, the properties of composites were improved by the addition of different types of inorganic nanoparticles, like CaCO3, Al2O3, and ZnO to the UPR matrix. These composites where inorganic materials were added as filler revealed better results than the neat composites. The composites showed the maximum overall mechanical properties in the bending modulus (BM), bending strength (BS), tensile modulus (TM), and tensile strength (TS) when 5 % of cow hair and chicken feather mixed fiber was used and ZnO was added as filler compared to the other composites. The highest values 4400.415, 68.91, 1788.74, and 34.95 N/mm2 of BM, BS, TM, and TS respectively, were found for the CFF + CHF + UPR + ZnO composite. Scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR) supported mechanical rather than chemical connections between fiber and UPR. Ionizing gamma radiation-modified fiber exhibited superior tensile characteristics when 5 % of cow hair and chicken feather mixed fiber was used.

Microplastics in multi-environmental compartments: Research advances, media, and global management scenarios.

During the past decades, microplastics (MPs) have become an emerging concern due to their persistence and potential environmental threat. MP pollution has become so drastic that it has been found in the human food chain, breast milk, polar regions, and even the Himalayan basin, lake, etc. Inflammation, pulmonary hypertension, vascular occlusions, increased coagulability and blood cell cytotoxicity, disruption of immune function, neurotoxicity, and neurodegenerative diseases can all be brought on by severe microplastic exposure. Although many MPs studies have been performed on single environmental compartments, MPs in multi-environmental compartments have yet to be explored fully. This review aims to summarize the muti-environmental media, detection tools, and global management scenarios of MPs. The study revealed that MPs could significantly alter C flow through the soil-plant system, the structure and metabolic status of the microbial community, soil pH value, biomass of plant shoots and roots, chlorophyll, leaf C and N contents, and root N contents. This review reveals that MPs may negatively affect many C-dependent soil functions. Different methods have been developed to detect the MPs from these various environmental sources, including microscopic observation, density separation, Raman, and FT-IR analysis. Several articles have focused on MPs in individual environmental sources with a developed evaluation technique. This review revealed the extensive impacts of MPs on soil-plant systems, microbial communities, and soil functions, especially on water, suggesting possible disturbances to vital ecological processes. Furthermore, the broad range of detection methods explored emphasizes the significance of reliable analytical techniques in precisely evaluating levels of MP contamination in various environmental media. This paper critically discusses MPs' sources, occurrences, and global management scenarios in all possible environmental media and ecological health impacts. Future research opportunities and required sustainable strategies have also been suggested from Bangladesh and international perspectives based on challenges faced due to MP's pollution.

Preparation and characterization of short date palm mat (DPM) fiber reinforced polystyrene composites: Effect of gamma radiation.

The utilization of natural fiber reinforced polymer composites is growing fast in numerous sectors. In this study, the effect of the addition of short date palm mat (DPM) fibers in polystyrene matrix on the physico-mechanical and thermal properties were studied. Short DPM fiber reinforced polystyrene composites were produced by compression moulding process and the fiber content was 5, 10, 15, 20 and 25 wt%. Physico-mechanical and thermal properties were examined. Scanning electron microscopy (SEM) and Fourier-transform infrared (FT-IR) analysis of the composites were also done. The findings from the investigates exposed that the composites with 10 % fiber content showed improved mechanical and thermal characteristics as compared to other composites. The morphological analysis also supported the results where good interfacial bonding among fiber and polystyrene matrix was found for the composites with 10 % fiber content. The optimized (10 % fiber content) composites were exposed to gamma radiation (2.5-7.5 kGy) and the best result was found at 5.0 kGy radiation dose. Degradation of gamma irradiated composites was conducted in four different media such as water, acid, base, and brine.

Occurrence of shigellosis in pediatric diarrheal patients in Chattogram, Bangladesh: A molecular based approach.

Shigellaa Gram-negative, non-motile bacillus, is the primary causative agent of the infectious disease shigellosis, which kills 1.1 million people worldwideevery year. The children under the age of five are primarily the victims of this disease. This study has been conducted to assess the prevalence of shigellosis through selective plating, biochemical test and conventional PCR assays, where the samples were collected from suspected diarrheoal patients. Invasive plasmid antigen H (ipaH) and O-antigenic rfc gene were used to identify Shigella spp. and S. flexneri respectively. For validation of these identification, PCR product of ipaH gene of a sample (Shigella flexneri MZS 191) has been sequenced and submitted to NCBI database (GenBank accession no- MW774908.1). Further this strain has been used as positive control. Out of 204, around 14.2% (n = 29)(P> 0.01) pediatric diarrheoal cases were screened as shigellosis. Another interesting finding was that most of shigellosis affected children were 7 months to 1 year (P> 0.01).The significance of this study lies in the analyses of the occurrenceand the molecular identification of Shigellaspp. and S. flexneri that can be utilized in improving the accurate identification and the treatment of the most severe and alarming shigellosis.

The Prevalence of Multi-Drug Resistant Salmonella typhi Isolated From Blood Sample.

Typhoid is a major public health concern. Even though antibiotics are usually used to treat typhoid fever, the spread of multi drug resistant Salmonella typhi is making antibiotics much less effective. This study was conducted to assess the prevalence of multidrug-resistant Salmonella typhi from the clinical samples. During this study, 154 blood samples of suspected typhoid patients were collected from the hospital and diagnostic center located in Chattogram City, Bangladesh. Isolation and identification of Salmonella typhi was done by both biochemical tests. PCR analysis was also done for the confirmation of biochemical result. Antimicrobial susceptibility test was performed according to the Kirby-Bauer disk diffusion method against ampicillin, chloramphenicol, cefepime, cotrimoxazole, ceptriaxone, ciprofloxacin, nalidixic acid, and azithtomycin. Out of 154, 21 (13.64%) isolates were identified as Salmonella typhi and the prevalence of typhoid in Chattogram, Bangladesh was 13.64% (n = 21). It was also found that children under the age of 5 are the more vulnerable target of Salmonella typhi infection. Antibiotic resistance profiling revealed 85% isolates were Multi-Drug Resistant (MDR) and highest resistance was found in case of Nalidixic acid. Although, most of the isolated Salmonella typhi were MDR, first generation antibiotics Co-trimoxazile, Chloramphenicol, and Ampicillin were found effective against Salmonella typhi.

Automated quantification of meibomian gland dropout in infrared meibography using deep learning.

PURPOSE: Develop a deep learning-based automated method to segment meibomian glands (MG) and eyelids, quantitatively analyze the MG area and MG ratio, estimate the meiboscore, and remove specular reflections from infrared images. METHODS: A total of 1600 meibography images were captured in a clinical setting. 1000 images were precisely annotated with multiple revisions by investigators and graded 6 times by meibomian gland dysfunction (MGD) experts. Two deep learning (DL) models were trained separately to segment areas of the MG and eyelid. Those segmentation were used to estimate MG ratio and meiboscores using a classification-based DL model. A generative adversarial network was implemented to remove specular reflections from original images. RESULTS: The mean ratio of MG calculated by investigator annotation and DL segmentation was consistent 26.23% vs 25.12% in the upper eyelids and 32.34% vs. 32.29% in the lower eyelids, respectively. Our DL model achieved 73.01% accuracy for meiboscore classification on validation set and 59.17% accuracy when tested on images from independent center, compared to 53.44% validation accuracy by MGD experts. The DL-based approach successfully removes reflection from the original MG images without affecting meiboscore grading. CONCLUSIONS: DL with infrared meibography provides a fully automated, fast quantitative evaluation of MG morphology (MG Segmentation, MG area, MG ratio, and meiboscore) which are sufficiently accurate for diagnosing dry eye disease. Also, the DL removes specular reflection from images to be used by ophthalmologists for distraction-free assessment.

Analysis of the Occurrence of Antibiotic Resistant Bacteria in the Hospital's Effluent and its Receiving Environment.

The use of antibiotics on a regular and excessive basis is a major factor in the spread of antibiotic-resistant bacteria. Patients discharge un-metabolized or relatively low doses of non-metabolized antibiotics through urine and stool, which might enter into the environment through sewage disposal and promote the emergence of antibiotic resistant bacteria. This study is designed to investigate how excessive use of antibiotics in the hospital sector and their release into hospital wastes contribute to the spread of antibiotic-resistant bacteria in different environmental settings. In this study, liquid hospital waste was collected from the sewage of Chittagong Medical College Hospital (CMCH), Bangladesh as well as from its distribution position in Chittagong city, Bangladesh. A total of 5 samples were collected from different positions in Chittagong city, including CMCH liquid waste. After collection, total bacteria and total cefixime resistant bacteria were counted by the total viable count (TVC) method. The result of bacteriological enumeration showed that a high magnitude of cefixime-resistant bacteria were available in all the hospital's associated waste samples. The highest proportion of cefixime resistant bacteria (23.35%) was found in sample 2, whereas 17.4%, 7.6%, 5%, and 1.32% were found in samples 1, 3, 4, and 5, respectively. The total number of cefixime-resistant bacteria decreased with the increase in distance between the sample collection site and the hospital drain. This means that resistant bacteria developed in the hospital effluent are transferred to the environmental distribution sites.

Fabrication and characterization of eco-friendly composite materials from natural animal fibers.

A large amount of useless portion, which is discharging from leather industries, pollutes the environment immensely. The discarded part needs to be recycled to yield other valuable products to subside environmental pollution. In this research, we utilized a rejected part (cow hair) of leather industries and unsaturated polyester resin (UPR) to fabricate valued composites to confine atmospheric pollution. A hand-lay-up technique, which is an easy and economical approach, was employed for composites fabrication. A number of cow hair fiber percentages (2, 5, 7, 10, 12, 15, and 20% by weight) were taken into consideration to investigate the impact of fiber loading on composites. Prepared composites were characterized by a few mechanical properties such as tensile strength (TS), tensile modulus (TM), elongation at break (EB), bending strength (BS), and bending modulus (BM). Fourier Transform Infrared (FTIR), Electron Scanning Microscopy (SEM), and water absorption were also performed to support the data in favor of mechanical properties. Optimum mechanical properties which were supported by the other analysis were achieved for 5% cow hair containing composites.

Antibiotic Resistance and Plasmid Profiling of Escherichia coli Isolated from Human Sewage Samples.

In developing countries, the occurrence of antibiotic resistance is increasing day by day and antibiotic resistant microorganisms are being found in almost every environmental setting. Plasmids are considered as the main vector in the procurement and propagation of antibiotic resistance in many microorganisms such as Escherichia coli (E. coli). The goal of this study was to examine the antibiotic resistance and screening of plasmid in E. coli strains which were previously identified from human sewage samples. During this study antibiotic susceptibility of E. coli isolates were determined by Kirby-Bauer disk diffusion method against 5 antibiotics (ampicilin, ceftriaxone, amoxicillin, ciprofloxacin, azithromycin). Furthermore, plasmid extraction of each isolate was done according to the protocol of FavorPrepTMPlasmid Mini Kit and plasmid profiling was done by agarose gel electrophoresis. In antibiotic sensitivity test, all E. coli strains showed resistance to ampicilin, amoxicillin, and ceftriaxone. In the plasmid profiling, it was revealed that all the isolates of E. coli harbored plasmids. The plasmid sizes ranged from approximately 1.5 to 15 kb. The findings of this study prove the consequences of antibiotic resistance as well as relationship of plasmid with antibiotic resistance which necessitates proper surveillance on antibiotic usage in the developing countries.

Clinical Profile and Immediate Outcome of Children Admitted With Acute Glomerulonephritis in Pediatrics Department of A Tertiary Level Hospital.

Acute post-streptococcal glomerulonephritis (APSGN) is the commonest cause of acute glomerulonephritis (AGN), which usually present with gross hematuria, mild edema, oliguria, hypertension and varying degree of renal insufficiency. It is more common among the population of school going age where poverty, overcrowding and poor hygienic conditions are prevailing. This cross sectional observational study was aimed to know the socio-demographic variables, clinical profile and immediate outcome of AGN in hospitalized children and was conducted in the Pediatric department of Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from November 2014 to April 2015. A detailed history was taken from the parents in each case with a written questionnaire. A written consent was also taken from the guardian of the including patients and also permission was taken from the ethical committee of MMCH. Thorough clinical examination and available relevant investigations were done in all patients. Progresses of the patient were monitored by daily clinical examinations and also by investigations. Data were analyzed by statistical package for social science (SPSS) windows version 18. Results were verified by doing standard test for significance. Among total 60 cases male was 58.3% & female was 41.7%. The common age group of presentation was between 7-12 years (73%), peak age of incidence was 7-9 years. Most of them came from low socioeconomic status (83.3%), 63.3% from rural area with average 5-6 member's family size. Most of the parents were illiterate. History of (H/O) skin infection was present in 35(58.3%) patients, 15(25%) had H/O sore throat, 15% did not give any H/O infection before presentation. Average duration of gap between infection and appearance of clinical feature was 7-14 days in 73.40%and 15-21 days was in 45.7% in case of sore throat & skin infection respectively. Almost all (95%) patients presented with puffiness of face, others presented with scanty micturition, gross hematuria, respiratory distress, fever, convulsion and altered sensorium. Edema (75%), hypertension (88.3%), pallor (38%), tachypnea (25%), tachycardia (26.7%) were the important clinical findings. Microscopic hematuria was present among 96.66% patients; low complement level was found in 85% cases. There is significant association between low socioeconomic statuses with more hospital stay. Only one patient died due to heart failure and 98.3% patient had complete recovery. Results of this study conclude that most of the patients came from rural illiterate family with low socioeconomic background. Skin infection is the commonest cause of acute glomerulonephritis. Edema, scanty micturation, hematuria and hypertension are the common mode of presentation. Heart failure and hypertensive encephalopathy are the common complication of AGN. Immediate prognosis of AGN was excellent.

Effect of dye and temperature on the physico-mechanical properties of jute/PP and jute/LLDPE based composites.

Jute fabrics and unidirectional jute fiber reinforced polypropylene (PP) and linear low density polyethylene (LLDPE) based composites were prepared successfully by compression molding technique. The unidirectional jute fiber was treated with Reactive Orange HB® and Deep Blue LW® dye to investigate physico-mechanical properties. The Reactive Orange HB® treated composites showed relatively better mechanical properties than the Deep Blue LW® treated composites. The jute fiber-based composites showed higher mechanical properties than that of jute-based fabrics. The polypropylene-based composites showed better mechanical properties than that of LLDPE. The variations of mechanical properties were also observed. The highest mechanical properties were at -18 °C and lowest at 50 °C. Water absorbent, SEM and FT-IR analysis of the composite was also carried out.

Multiple regulatory mechanisms of the biological function of NRF3 (NFE2L3) control cancer cell proliferation.

Accumulated evidence suggests a physiological relationship between the transcription factor NRF3 (NFE2L3) and cancers. Under physiological conditions, NRF3 is repressed by its endoplasmic reticulum (ER) sequestration. In response to unidentified signals, NRF3 enters the nucleus and modulates gene expression. However, molecular mechanisms underlying the nuclear translocation of NRF3 and its target gene in cancer cells remain poorly understood. We herein report that multiple regulation of NRF3 activities controls cell proliferation. Our analyses reveal that under physiological conditions, NRF3 is rapidly degraded by the ER-associated degradation (ERAD) ubiquitin ligase HRD1 and valosin-containing protein (VCP) in the cytoplasm. Furthermore, NRF3 is also degraded by ß-TRCP, an adaptor for the Skp1-Cul1-F-box protein (SCF) ubiquitin ligase in the nucleus. The nuclear translocation of NRF3 from the ER requires the aspartic protease DNA-damage inducible 1 homolog 2 (DDI2) but does not require inhibition of its HRD1-VCP-mediated degradation. Finally, NRF3 mediates gene expression of the cell cycle regulator U2AF homology motif kinase 1 (UHMK1) for cell proliferation. Collectively, our study provides us many insights into the molecular regulation and biological function of NRF3 in cancer cells.

Acinar Cell Carcinoma of the Pancreas: A Case Report.

Acinar cell carcinoma (ACC) of the pancreas is a very rare neoplasm. We report a case of pancreatic acinar cell carcinoma involving the uncinate process of the pancreas. A 45 year old man presented with a painful upper abdominal mass without any jaundice or weight loss. Computed Tomography (CT) and Magnetic Resonance Cholangio-Pancreatography (MRCP) indicated a mass lesion in the uncinate process of the pancreas. He underwent Whipple's procedure (Pancreaticoduodenectomy). Histological slides revealed features of Acinar cell carcinoma (ACC) in the uncinate process of the pancreas and a lymph node.

Possible roles of the transcription factor Nrf1 (NFE2L1) in neural homeostasis by regulating the gene expression of deubiquitinating enzymes.

The transcription factor Nrf1 (NFE2L1) maintains protein homeostasis (proteostasis) by regulating the gene expression of proteasome subunits in response to proteasome inhibition. The deletion of the Nrf1 gene in neural stem/progenitor cells causes severe neurodegeneration due to the accumulation of ubiquitinated proteins in Purkinje cells and motor neurons (Nrf1 NKO mice). However, the molecular mechanisms governing this neurodegenerative process remain unclear. We demonstrate herein that the loss of Nrf1 leads to the reduced gene expression of the deubiquitinating enzymes (DUBs) but not proteasome subunits in Nrf1 NKO mice between P7 and P18. First, we show that K48-linked polyubiquitinated proteins accumulate in Nrf1-deficient Purkinje cells and cerebral cortex neurons. Nevertheless, loss of Nrf1 does not alter the expression and proteolytic activity of proteasome. A significantly reduced expression of deubiquitinating enzymes was also demonstrated in Nrf1-deficient cerebellar tissue using microarray analysis. The genome database further reveals species-conserved ARE, a Nrf1 recognition element, in the regulatory region of certain DUB genes. Furthermore, we show that Nrf1 can activate Usp9x gene expression related to neurodegeneration. Altogether these findings suggest that neurodegeneration in Nrf1 NKO mice may stem from the dysfunction of the ubiquitin-mediated regulation of neuronal proteins.

Serum Zinc, Copper, Magnesium & Phosphorus Level in Children with Severe Acute Malnutrition (SAM).

Malnutrition is widely prevalent among hospitalized children in most developing countries including Bangladesh. Though malnutrition accounts for the high rate of under 5 mortality sometimes it is overlooked. Keeping in this in mind A comparative cross sectional study was done in Mymensingh Medical College Hospital from 1st October 2009 to 31st May 2011. Children aged 1-5 years with presence of one or more criteria WHM <70%, WHZ-score <-3SD, Bipedal edema & Mid upper arm circumference <110mm were taken as study group and children aged 1-5 years with normal growth allowable normal range of variation is between 3rd and 97th centile curve or median (50th centile) ±2SD of weight for age growth chart (CDC growth chart, USA, 2000) were taken as reference group. Persistent diarrhea, Patients taking medications containing zinc, copper, magnesium, phosphorus & calcium, PEM with shock were excluded from study group. Nutritional assessment was done according to WHO criteria of SAM. Serum Zinc, Copper Magnesium and Phosphorus level were determined by Atomic Absorption Spectrometry using UNICAM - AA Spectrometer, model no. 969, Spain. Total 120 study populations were taken. Ninety Out of 120 were taken as a study group (SAM) & 30 were reference group. In reference group serum Zn, Cu, Mg, P value was 103.80±8.86µg/dl, 135.92±13.57µg/dl, 2.31±0.18mg/dl, 3.96±0.22mg/dl respectively. In study group serum Zn, Cu, Mg, P value was 60.33±11.08µg/dl, 80.60±15.46µg/dl, 1.47±0.22mg/dl, 2.00±0.52mg/dl respectively. All these results show that there is significant difference between study group & reference group. Considering the decreased level of these parameters, close biochemical monitoring and follow up should be emphasized for the children with SAM.

USP15 stabilizes the transcription factor Nrf1 in the nucleus, promoting the proteasome gene expression.

The transcriptional factor Nrf1 (NF-E2-related factor 1) sustains protein homeostasis (proteostasis) by regulating the expression of proteasome genes. Under physiological conditions, the transcriptional activity of Nrf1 is repressed by its sequestration into the endoplasmic reticulum (ER) and furthermore by two independent ubiquitin-proteasome pathways, comprising Hrd1 and ß-TrCP in the cytoplasm and nucleus, respectively. However, the molecular mechanisms underlying Nrf1 activation remain unclear. Here, we report that USP15 (Ubiquitin-Specific Protease 15) activates Nrf1 in the nucleus by stabilizing it through deubiquitination. We first identified USP15 as an Nrf1-associated factor through proteome analysis. USP15 physically interacts with Nrf1, and it markedly stabilizes Nrf1 by removing its ubiquitin moieties. USP15 activates the Nrf1-mediated expression of a proteasome gene luciferase reporter and endogenous proteasome activity. The siRNA-mediated knockdown of USP15 diminishes the Nrf1-induced proteasome gene expression in response to proteasome inhibition. These results uncover a new regulatory mechanism that USP15 activates Nrf1 against the ß-TrCP inhibition to maintain proteostasis.

Antibody titre against 3 doses of hepatitis B vaccine among preterm and term babies.

This cross sectional study was conducted to assess seroprotection by completed 3 doses of hepatitis B vaccine in routine EPI schedule in preterm & LBW as well as term appropriate weight babies and to compare the immune response among them. The study was conducted in EPI centre of Dhaka Medical College Hospital where 50 preterm (<37 completed weeks of gestation) and low birth weight (<2500 gm) infants enrolled in group A and 50 term (37-42 completed weeks of gestation) appropriate weight (≥2500 gm) in group B. All infants were immunized with 3 doses of hepatitis B vaccine according to EPI schedule and first vaccine was given at 6 weeks after birth and subsequent doses are given at one month interval. Adverse events were monitored. Anti HBs titre was determined 1 month after 3rd dose of vaccine from serum by ELISA method (VITROS anti HBs reagent pack). Seroprotectivity (anti HBs titres >10 mIU/ml) of hepatitis B vaccine after 3 doses were 94% and 98% in group A and B respectively (p>0.05). However, the preterm infants had a lower geometric mean titre of antibodies after 3 doses of vaccine than did the term infants (92.75 mIU/ml vs. 310.59 mIU/ml respectively; p<0.001). After 3 doses of hepatitis B vaccine though the seroprotective anti HBs titre (i.e. >10 mIU/ml) was ~96% irrespective of gestational age and birth weight but good antibody titre (i.e. >100 mIU/ml) was found among preterm babies having gestational age >34 weeks (73.6%) and birth weight >2000 gm (64%).

Community Kangaroo Mother Care: implementation and potential for neonatal survival and health in very low-income settings.

OBJECTIVE: Immediate Kangaroo Mother Care (KMC), an intervention following childbirth whereby the newborn is placed skin-to-skin (STS) on mother's chest to promote thermal regulation, breastfeeding and maternal-newborn bonding, is being taught in very low-income countries to improve newborn health and survival. Existing data are reviewed to document the association between community-based KMC (CKMC) implementation and its potential benefits. STUDY DESIGN: New analyses of the sole randomized controlled study of CKMC in Bangladesh and others' experiences with immediate KMC are presented. RESULT: Newborns held STS less than 7 h per day in the first 2 days of life do not experience substantially better health or survival than babies without being held STS. CONCLUSION: Most women who were taught CKMC hold their newborns STS, but do so in a token manner unlikely to improve health or survival. Serious challenges exist to provide effective training and postpartum support to achieve adequate STS practices. These challenges must be overcome before scaling up.

An unusual bisnor-clerodane diterpenoid from Polyalthia simiarum.

The stem bark of Polyalthia simiarum has yielded a new bisnor-type clerodane diterpenoid, 2-oxo-14,15-bisnor-3,11E-kolavadien-13-one (1), and three previously known clerodane derivatives, kolavenic acid (2), 16beta-hydroxycleroda-3,13(14)Z-dien-15,16-olide (3), and 16-oxocleroda-3,13(14)E-dien-15-oic acid (4). The structures of these compounds were unambiguously determined by extensive NMR studies as well as by comparison with related compounds. Till now this is the second report of the occurrence of any unusual C-18 clerodane diterpenoid from nature. The crude light petroleum extract and the purified compound 3 demonstrated moderate free radical scavenging activity with IC50 values of 21.5 and 23.5 microg/mL, respectively.