Plasma GDNF levels in spinal dysraphism and its relation with neurological impairment in children: A point of care study.

AIMS: GDNF plays a crucial role in the stimulation of recovery, neuroplasticity and synaptic reorganization after spinal cord injury providing neuroprotection and neuroregeneration. Plasma GDNF levels are upregulated in cases of spina bifida owing to the intrauterine damage of the exposed spinal cord. Our aim was to compare the plasma GDNF levels in patients of spina bifida with non-spina bifida cases and assess the correlation with neurological impairment at one year of follow up. METHODS: Single centre prospective analysis of cases of spina bifida from 2020 to 2022 at presentation and after one year of follow up post-surgery. Cases with hernia and hydrocele without any other disorders were recruited into the control group. Plasma GDNF levels were assessed with immunoassay kits and compared with neurological involvement. RESULTS: 85 cases were included in the study. GDNF levels were elevated in cases compared to controls (mean 6.62 vs 1.76) with significant p value (<0.01). Same was observed for open and closed defects (mean 7.63 vs 4.86: p < 0.01). At follow up of 52 cases post-surgery cases with neurogenic bladder with abnormal urodynamic studies, sphincter involvement and motor impairment had significantly elevated baseline levels of GDNF compared with those who did not have this neurological impairment (p < 0.01). DISCUSSION: The neurotrophic factor up-regulation can reflect an endogenous attempt at neuroprotection against the biochemical and molecular cascades triggered by the spinal cord damage. This upregulation can be represented as important biochemical markers of severe spinal cord damage and can be associated with severity of spine injury in MMC patients. Our results are in keeping with these findings, that, there were increased levels of plasma GDNF levels in cases of spinal dysraphism compared to control population. Also, the type of lesion reflecting the severity whether a closed or an open dysraphism, showed significant difference in levels between them suggesting, yet again, more damage in open defect as expected. The levels were higher with involvement of bladder, sphincter and lower limb power. CONCLUSION: There is significant elevation of plasma GDNF levels in cases of spina bifida and this elevation is proportional to the degree of spinal damage and hence the neurological impairment. GDNF levels are a good predictor for assessing the severity of the lesion and thus the outcome in these cases. Additional prospective and long-term studies with a larger cohort are needed for a better understanding of neurotrophin pattern modulation in MMC.

Assessment of Sexual Dimorphism in Mandibular Ramus: An Orthopanoramic Study.

Background Mandible is the largest and strongest bone of the face, is very durable, and hence remains well preserved than many other bones. In cases of mass disasters where an intact skull is not found, the mandible may play a vital role in sex determination as it is the most dimorphic bone of the skull. Morphometric analysis of mandibular ramus provides highly accurate data to discriminate sex. This can be accomplished by the use of panoramic radiography which is widely available and is used routinely to assess the mandibular structures. Objective To evaluate and compare the various parameters of the mandibular ramus and to determine the usefulness of the mandibular ramus as an aid in sex determination. Method Orthopantomograms of 140 samples (70 males and 70 females) were collected from the archives and traced manually on matte acetate tracing paper. Various parameters of mandibular ramus were measured on the right and left sides. The obtained measurements were subjected to discriminant function analysis. Result Mandibular measurements on the right side were greater than on the left side. However, only the ramus breath (minimum and maximum) and projective height of ramus were statistically significant (p < 0.05). All the measurements were higher for males than females. F-statistic values indicated that the highest sexual dimorphism was seen with the projective height of ramus and least with minimum ramus breath. Conclusion Mandibular ramus measurements can be a useful tool for gender determination and can be an essential tool in forensic science especially when there is damaged or partially preserved mandibles and may be helpful for medico-legal purpose in Nepal.

Spin reorientation in antiferromagnetic Dy2FeCoO6 double perovskite.

We explored the electronic and magnetic properties of the lanthanide double perovskite Dy2FeCoO6 by combining magnetization, Raman and Mössbauer spectroscopy and neutron diffraction along with density functional theory (DFT) calculations. Our magnetization measurements revealed two magnetic phase transitions in Dy2FeCoO6. First, a paramagnetic to antiferromagnetic transition at T N = 248 K and subsequently, a spin reorientation transition at T SR = 86 K. In addition, a field-induced magnetic phase transition with a critical field of H c ≈ 20 kOe is seen at 2 K. Neutron diffraction data suggested cation-disordered orthorhombic structure for Dy2FeCoO6 in Pnma space group which is supported by Raman scattering results. The magnetic structures ascertained through representational analysis indicate that at T N, a paramagnetic state is transformed to Γ5(Cx, Fy, Az) antiferromagnetic structure while, at T SR, Fe/Co moments undergo a spin reorientation to Γ3(Gx, Ay, Fz). The refined magnetic moment of (Fe/Co) is 1.47(4) µ B at 7 K. The antiferromagnetic structure found experimentally is supported through the DFT calculations which predict an insulating electronic state in Dy2FeCoO6.

Electronic, magnetic, optical and thermoelectric properties of Ca2Cr1-x Ni x OsO6 double perovskites.

With the help of density functional theory calculations, we explored the recently synthesized double perovskite material Ca2CrOsO6 and found it to be a ferrimagnetic insulator with a band gap of ∼0.6 eV. Its effective magnetic moment is found to be ∼0.23 µ B per unit cell. The proposed behavior arises from the cooperative effect of spin-orbit coupling and Coulomb correlation of Cr-3d and Os-5d electrons along with the crystal field. Within the ferrimagnetic configuration, doping with 50% Ni in the Cr-sites resulted in a half-metallic state with a total moment of nearly zero, a characteristic of spintronic materials. Meanwhile, the optical study reveals that both ε 1 xx and ε 1 zz decrease first and then increase rapidly with increasing photon energy up to 1.055 eV. We also found optical anisotropy up to ∼14 eV, where the material becomes almost optically isotropic. This material has a plateau like region in the σ xx and σ zz parts of the optical conductivity due to a strong 3d-5d interband transition between Cr and Os. In addition, we performed thermoelectric calculations whose results predict that the material might not be good as a thermoelectric device due to its small power factor.

Correlation of functional echocardiography and clinical parameters in term neonates with shock.

BACKGROUND: To evaluate the correlation between functional echocardiography and clinical parameters in term neonates with shock. METHOD: Cross sectional study of 30 full term newborns who were clinically detected to have shock compared to 30 full term hemodynamically stable neonates. For statistical analysis, cases were further sub classified into cardiogenic and septic shock. RESULT: Functional echocardiography revealed inferior vena cava collapsibility index (cIVC), fractional shortening (FS), ejection fraction (EF), cardiac output and superior vena cava (SVC) flow were significantly lower whereas myocardial performance index (MPI) was significantly higher in babies with cardiogenic and septic shock as compared to the controls. Left ventricular end diastolic area (LVEDA) was significantly higher in cardiogenic shock whereas it was significantly lower in septic shock as compared to the controls. Also, cIVC was significantly lower and LVEDA was significantly higher in cardiogenic as compared to the septic shock. In cardiogenic shock SVC flow correlated significantly with capillary filling time and systolic blood pressure. The correlation between functional echocardiographic parameters of cardiogenic and septic shock showed that EF, FS and MPI were positively and significantly correlated (r 0.742, p 0.022 for EF, r 0.766, p 0.016 for FS and r 0.478, p 0.05 for MPI) whereas SVC flow and cIVC were negatively and significantly correlated between cardiogenic and septic shock (r - 0.655, p 0.045 for SVC flow and - 0.578, p 0.05 for cIVC). CONCLUSION: In the complex environment of neonatal intensive care unit detection of shock continues to be a major challenge. Functional echocardiography provides an adjunct information to the clinical assessment of shock and helps in monitoring the response to treatment.

Cervical congenital infantile fibrosarcoma: a case report.

BACKGROUND: Congenital infantile fibrosarcoma is a rare mesenchymal tumor seen in children as well as adults. The congenital variety is rare and out of the reported cases only one case sited in the neck has been reported so far. Another such case is presented here who was successfully managed. CASE PRESENTATION: A 3-month-old Hindu baby boy presented with a congenital neck swelling. The apparent clinical diagnosis was lympho-venous malformation. With a remote possibility of malignancy, an excisional biopsy was done. Histopathology revealed congenital infantile fibrosarcoma. CONCLUSION: A successful excision of cervical congenital infantile fibrosarcoma has not been reported. This diagnosis should be kept as a possibility in all congenital cervical swellings. These are commonly misdiagnosed as lympho-venous malformations and histopathology is confirmatory.

Vegetation dynamics in Bishrampur collieries of northern Chhattisgarh, India: eco-restoration and management perspectives.

Phytosociological study in and around reclaimed coal mine site is an essential requirement for judging restoration impact on a disturbed site. Various studies have been aimed towards assessing the impact of different restoration practices on coal mine wastelands. Plantation scheme in a scientific way is the most suitable approach in this context. During the present investigation, an effort have been made to assess the vegetation dynamics through structure, composition, diversity, and forest floor biomass analysis in and around Bishrampur collieries, Sarguja division, northern Chhattisgarh, India. We have tried to develop strategies for eco-restoration and habitat management of the concerned study sites. Four sites were randomly selected in different directions of the study area. We classified the vegetation community of the study sites into various strata on the basis of height. Two hundred forty quadrats were laid down in various directions of the study area to quantify vegetation under different strata. During our investigation, we found eight different tree species representing four families in the different study sites. The density of the various tree species ranged between 40 and 160 individuals ha-1. The density of sapling, seedling, shrub, and herb ranged between 740 and 1620; 2000 and 6000; 1200 and 2000; and 484,000 and 612,000 individuals ha-1, respectively, in different directions. The diversity indices of the tree reflected highest Shannon index value of 1.91. Simpsons index ranged between 0.28 and 0.50, species richness ranged between 0.27 and 0.61, equitability up to 1.44, and Beta diversity ranged between 2.00 and 4.00. Total forest floor biomass ranged between 4.20 and 5.65 t/ha among the study sites. Highest forest floor biomass occurred in the south direction and lowest at east direction. Total forest floor biomass declined by 6.19% in west, 13.10% in north, and 25.66% in east direction, respectively. The mining activities resulted significant damage to natural vegetation and its dynamics. The study indicated that Acacia mangium, Cassia siamea, and Dalbergia sissoo can be recommended for effective eco-restoration of the concerned sites due to cosmopolitan distribution, high regeneration potential, as well as existence in the form of various girth classes with stable population structure.

Testicular Tumors in Undescended Testes in Children Below 5 y of Age.

OBJECTIVE: To evaluate the presentation, treatment and outcome of testicular tumors in undescended testes (UDT) in boys below 5 y of age. METHODS: Case records of boys below 5 y of age, diagnosed to have germ cell tumors (GCT) in the UDT were reviewed. RESULTS: Seven children in the age range of 05-54 mo (mean 26 mo) were included. While five of these 7 (71 %) presented with abdominal mass [one antenatally detected], 2 (29 %) were detected to have a GCT during orchiopexy. In three of these five with abdominal mass, the alpha-fetoprotein (αFP) was markedly elevated. Two of these three with elevated αFP were endodermal sinus tumors while the third was embryonal carcinoma. The 4th patient with an abdominal mass was diagnosed to have an immature teratoma (IMT) while the patient with antenatally diagnosed mass had a mature cystic teratoma (MT). Both the patients with incidentally detected mass during the orchiopexy had mature teratoma (MT). All the seven children are alive and disease free at last follow-up. CONCLUSIONS: Though rare, boys with impalpable undescended testes may develop germ cell tumors early in childhood. These can be managed with chemotherapy and resection and have a good disease free outcome.

POLYMORPHISM IN THE CODING REGION SEQUENCE OF GDF8 GENE IN INDIAN SHEEP.

The present study was undertaken to identify polymorphism in the coding sequence of GDF8gene across indigenous meat type sheep breeds. A 1647 bp sequence was generated, encompassing 208 bp of the 5'UTR, 1128 bp of coding region (exon1, 2 and 3) as well as 311 bp of 3'UTR. The sheep and goat GDF8 gene sequences were observed to be highly conserved as compared to cattle, buffalo, horse and pig. Several nucleotide variations were observed across coding sequence of GDF8 gene in Indian sheep. Three polymorphic sites were identified in the 5'UTR, one in exon 1 and one in the exon 2 regions. Both SNPs in the exonic region were found to be non-synonymous. The mutations c.539T > G and c.821T > A discovered in this study in the exon 1 and exon 2, respectively, have not been previously reported. The information generated provides preliminary indication of the functional diversity present in Indian sheep at the coding region of GDF8gene. The novel as well as the previously reported SNPs discovered in the Indian sheep warrant further analysis to see whether they affect the phenotype. Future studies will need to establish the affect of reported SNPs in the expression of the GDF8 gene in Indian sheep population.

Detection of Ralstonia solanacearum from asymptomatic tomato plants, irrigation water, and soil through non-selective enrichment medium with hrp gene-based bio-PCR.

Bacterial wilt of tomato caused by Ralstonia solanacearum (Smith) Yabuuchi et al. (Microbiol Immunol 39:897-904, 1995) is a serious disease, which causes losses up to 60 % depending on environmental conditions, soil property, and cultivars. In present investigation, nucleotide sequences of virulence, hypersensitive response and pathogenicity (hrp) gene were used to design a pair of primer (Hrp_rs 2F: 5'-AGAGGTCGACGCGATACAGT-3' and Hrp_rs 2R: 5'-CATGAGCAAGGACGAAGTCA-3') for amplification of bacterial genome. The genomic DNA of 27 isolates of R. solanacearum race 1 biovar 3 & 4 was amplified at 323 bp. The specificity of primer was tested on 13 strains of R. solanacearum with other group of bacteria such as Xanthomonas oryzae pv. oryzae, X. campestris pv. campestris, and X. citri subsp. citri. Primer amplified DNA fragment of R. solanacearum at 323 bp. The sensitivity of the primer was 200 cfu/ml and improved further detection level by using non-specific enrichment medium casamino acids-pepton-glucose broth followed by PCR (BIO-PCR). Out of 130 samples of asymptomatic tomato plants, irrigation water, and soil collected from bacterial wilt infested field in different agro-climatic regions of India, R. solanacearum was detected from 86.9, 88.5, and 90.9 per cents samples using BIO-PCR, respectively. The primer was found specific for detecting viable and virulent strains of R. solanacearum and useful for the diagnosis of R. solanacearum in tomato seedlings and monitoring of pathogen in irrigation water and soil.

Understanding socio economic contexts of female sex workers in eastern Nepal.

The present focus is mostly laid on high risk behavior of commercial sex workers without any consideration of their location, educational status and other socio-cultural norms. Thus, we designed a study to understand socio demographic characteristics, lifestyle of female sex workers and search for driving factors for prostitution in eastern Nepal. A descriptive study was conducted in three districts of Eastern Nepal in 2012 over the period of six months. The data regarding their socio demographic characteristics, income, reason for joining sex trade and future choice regarding the profession were recorded from 210 female sex workers through face-to-face interviews. Majority (53.3%) of respondents belonged to the productive age group of 20-29 years, more than one thirds (43.3%) had not received any form of formal education and were unmarried. More than half (53.80%) were presently living alone and about one thirds of the women (31.90%) were minors when they joined this profession. Major portion of the sample (94.80%) worked more than three days a week with median income of 15 thousand per month and 41 percent had sex with more than or equal to ten clients per week. Poor economic condition was the most frequent (47.6%) factor leading to joining of sex trade however, more than two thirds, (72.80%) wanted to quit the profession. Given low level of education, relatively low income, and young age among this population, empowerment and alternative employment/education opportunities should be created to develop this part of Nepalese society.

Isoformononetin, a methoxydaidzein present in medicinal plants, reverses bone loss in osteopenic rats and exerts bone anabolic action by preventing osteoblast apoptosis.

PURPOSE: Daidzein (Daid) has been implicated in bone health for its estrogen-'like' effects but low bioavailability, unfavorable metabolism and uterine estrogenicity impede its clinical potential. This study was aimed at assessing isoformononetin (Isoformo), a naturally occurring methoxydaidzein, for bone anabolic effect by overcoming the pitfalls associated with Daid. METHODS: Sprague-Dawley ovariectomized (OVx) rats with established osteopenia were administered Isoformo, 17ß-oestradiol (E2) or human parathyroid hormone. Efficacy was evaluated by bone microarchitecture using microcomputed tomography and determination of new bone formation by fluorescent labeling of bone. Osteoblast apoptosis was measured by co-labeling of bone sections with Runx-2 and TUNEL. Biochemical markers of bone metabolism were measured by ELISA. Plasma and bone marrow levels of Isoformo and Daid were determined by LC-MS-MS. Rat bone marrow stromal cells were harvested to study osteoblastic differentiation by Isoformo and Daid. New born rat pups were injected with Isoformo and Daid to study the effect of the compounds on the expression of osteogenic genes in the calvaria by real time PCR. RESULTS: In osteopenic rats, Isoformo treatment restored trabecular microarchitecture, increased new bone formation, increased the serum osteogenic marker (procollagen N-terminal propeptide), decreased resorptive marker (urinary C-terminal teleopeptide of type I collagen) and diminished osteoblast apoptosis in bone. At the most effective osteogenic dose of Isoformo, plasma and bone marrow levels were comprised of ~90% Isoformo and the rest, Daid. Isoformo at the concentration reaching the bone marrow achieved out of its most effective oral dosing induced stromal cell mineralization and osteogenic gene expression in the calvaria of neonatal rats. Isoformo exhibited uterine safety. CONCLUSIONS: Our study demonstrates that Isoformo reverses established osteopenia in adult OVx rats likely via its pro-survival effect on osteoblasts. Given its bone anabolic and anti-catabolic effects accompanied with safety at uterine level we propose its potential in the management of postmenopausal osteoporosis.

Synthesis and anticancer activity of 2-benzylidene indanones through inhibiting tubulin polymerization.

In an attempt to discover a potent and selective anticancer agent, gallic acid has been modified to benzylidene indanones as tubulin polymerization inhibitors. These compounds were evaluated against several human cancer cell lines and also evaluated for inhibition of tubulin polymerase in in vitro assays. Three of the analogues exhibited strong cytotoxicity against human cancer cell lines IC(50)=10-880 nM and also showed tubulin polymerization inhibition (IC(50)=0.62-2.04 µM). Compound 9j, the best candidate of the series was found to be non-toxic in acute oral toxicity in Swiss-albino mice up to 1000 mg/kg dose.

Cerebral venous sinus thrombosis in children with nephrotic syndrome.

Nephrotic syndrome in infancy and childhood can be associated with thromboembolic complications. We describe two cases of nephrotic syndrome who presented with non-specific findings. Magnetic resonance imaging brain with magnetic resonance venography showed thrombosis of multiple venous sinuses. Patients were successfully treated with anticoagulants and there was complete resolution of thrombosis on repeat imaging.

Factors associated with patient delay in diagnosis of pulmonary tuberculosis in a district.

BACKGROUND: Tuberculosis one of the major public health problems that is affecting large number of people each year including Nepal. METHODS: A descriptive cross sectional study was conducted in Sunsari district of Nepal. The patients with pulmonary tuberculosis patients from 14 DOTS centers in the District were interviewed. Face to face interview by using structured questionnaire was used for data collection. Extra pulmonary tuberculosis and patients under Category II were excluded from the study.Data entry and analysis was carried out in SPSS version 16. Pearson Chi square test was used to test the association between outcome variable with different categorical independent variables. RESULTS: Out of the total 215 patients, 91 (65.6%) were male, 109 (50.7%) were from rural residence, 69 (32.1%) were illiterate, 147 (68.4%) were married and 141 (66%) were sputum positive. The overall median patient delay was 42 days. About 145 (67.4%) of the patients had delayed their first consultation for more than 30 days. The patient delays were 56 out of 68 (82.4%) in age above 50 years patients, 121 out of 161 (75.2%) in married patients, 37 out of 45 (82.2%) in Kirats, 55 out of 69 (72.7%) in illiterates and 95 out of 124 (76.6%) in those who travel the distance of 2 or more km from the place of residence to health facility. CONCLUSIONS: Since the time duration before the treatment and diagnosis in TB patients is long, this study emphasizes the need of awareness about symptoms of tuberculosis among general population.

Outbreak of cholera in Tilathi VDC Saptari Nepal.

BACKGROUND: On 2011, Cluster of cholera cases was reported in the Tilathi VDC of Saptari, Nepal. OBJECTIVE: The outbreak was investigated to identify the etiological agent and possible source of infection and guiding the prevention and control measures. METHODS: Demographic and clinical details were collected from the suspected case-patients, and the outbreak was described by time, place, and person. Focus group discussion and Key informant interview were conducted to assess the practice of sanitation, source of drinking water and probable cause of diarrheal disease. Five stool samples and 10 water samples of tube well and ponds were collected and microbiological study was done in BPKIHS Dharan. RESULTS: A total of 111 persons suffered with diarrhea and 02 died of it (attack rate 3.05%, case fatality rate 1.8%). All age groups were affected with disease (median age 26 yrs) and males were affected more than females. Descriptive epidemiology suggested the clustering of cases were around the pond where they clean utensils, take bath and wash clothes. The Vibrio cholerae 01 El Tor, Ogawa serotype was isolated in 03 out of 05 suspected stool samples and in all three of the pond water samples. They reported that most of the houses do not have the toilet and people do not wash their hands regularly with soap and water after defecation. CONCLUSION: Vibrio cholerae was the causative agent behind the outbreak and probable source of infection was the problematic pond water which they used for different purpose. Immediate chlorination of the pond was recommended to halt further spread of the epidemics.

Risk factors associated with low birth weight.

BACKGROUND: Babies with a birth weight of less than 2500 grams, irrespective of the period of their gestation are termed as Low Birth Weight (LBW) babies. Despite consistent efforts to improve the quality of maternal and child health, more than twenty million low birth-weight (LBW) babies are born every year throughout the world. Though, the health situation of Nepal has improved substantially over the years, the low birth-weight (LBW) rate still high. The present study was to explore the effects of various maternal risk factors associated with low birth-weight of institutionally delivered newborns. METHODS: A cross sectional hospital based study was conducted in Obstetrics and Gynaecology ward of Janakpur Zonal Hospital, Janakpur, Nepal from December 2009 to January 2010. Altogether 306 respondents were taken and respondents were mothers who have delivered newborns in hospital. RESULTS: A total of 1426 birth occurred during the study period (December 2009 to January 2010), of which 306 met the study criteria. Among which 66 (21.56%) were low birth weight (LBW) and 240 were normal birth weight (NBW). Overall mean birth weight was found to be 2.75 ± 0.639 kg. Out of total 21.56% newborns were weighing less than 2.50 kg and mean birth weight was 1.96 ± 0.409 kg. The study also shows that majority 73 (86%) of the research centers didn't start the research yet. CONCLUSIONS: This study suggests that there are several factors interplaying which lead to LBW babies. Socio-demographic factors (maternal age, educational level and economic status) and antenatal care are more important.