An alkaloid enriched fraction from Murraya koenigii (L.) Spreng. Leaves ameliorate HFD-induced obesity and metabolic complexities in C57BL/6J mice.

ETHNOPHARMACOLOGICAL RELEVANCE: Murraya koenigii commonly known as curry leaf, is traditionally used in India to manage various ailments including diabetes mellitus. Curry leaves are well documented in Indian Ayurvedic system of medicine for beneficial effects in skin eruptions, dysentery, emesis, poisonous bites and bruises. The anti-hyperglycemic and anti-hyperlipidemic effects of curry leaf extracts have been demonstrated through several in vitro and in vivo experiments previously. AIM OF THE STUDY: To prepare an alkaloid enriched fraction (AEF) from M. koenigii and its evaluation on i) in vitro adipogenesis process and ii) in vivo high fat diet-induced obesity in C57BL/6J mice. MATERIALS AND METHODS: MKME and AEF were prepared from M. koenigii leaves. The four carbazole alkaloids (bioactive markers) isolated from AEF were quantitatively determined in the leaves by RP-HPLC method. MKME and AEF were studied for anti-obesogenic activity in adipocytes in vitro and in HFD-induced C57BL/6J obese mice in vivo. At the termination of the in vivo study, lipid profile, hepatic and renal injury and glucose levels were analyzed in the blood samples. Animal tissues were examined histopathologically to determine any signs of damage. Repeated dose oral toxicity study for 28 days on Sprague-Dawley rats was also performed to determine the safety profile of AEF. RESULTS: Both MKME and AEF displayed anti-obesogenic activity at 25 µg/ml concentration in vitro and showed 54.06 ± 3.86% and 37.46 ± 3.17% lipid accumulation, respectively compared to control. Further, supplementation of AEF and MKME in HFD-fed C57BL/6J mice helped in controlling weight gain, improved dyslipidemia and glucose intolerance significantly. AEF showed better anti-obesity activity than MKME both in vitro and in vivo study. Repeated administration of AEF up to 1 g/kg dose for 28 days showed no pathological tissue damage. Both MKME and AEF were standardized using a simple and validated RP-HPLC method. CONCLUSION: Present study was aimed at preparation of a novel alkaloid-enriched fraction from methanolic extract of M. koenigii leaf and its evaluation for anti-diabesity effect. Our results demonstrated AEF to be a promising plant-based therapy for ameliorating obesity and related metabolic complications in HFD-fed C57BL/6J mice.

Pancytopenia in celiac disease-A case series of 20 children.

Pancytopenia in children with celiac disease (CeD) is postulated to be due to nutritional deficiency such as vitamin B12, folate and copper or an autoimmune process resulting in aplastic anemia with hypoplastic marrow. In the present case series, we report the profile and explore the etiology of pancytopenia among children with CeD. There are only a few case reports of pancytopenia in children with CeD. We enrolled newly diagnosed cases of CeD and pancytopenia presenting in the celiac disease clinic over three years. Detailed evaluation was carried out for the cause of pancytopenia. We followed up on the cases for compliance and response to gluten-free diet at three months, six months and 12 months. Twenty patients were eligible for inclusion. They were divided into two groups: one with aplastic anemia with hypoplastic marrow labeled as Gp CeD-AA and the other with megaloblastic/nutritional anemia labeled as Gp CeD-MA. Patients in Gp CeD-MA presented with classical symptoms of CeD as recurrent diarrhea, abdomen distension, pallor and poor weight gain. They had none or just one transfusion requirement and had an early and complete recovery from pancytopenia. Patients in Gp CeD-AA presented with atypical symptoms such as epistaxis, short stature, fever, pallor and weakness. They had a multiple blood transfusion requirement and had delayed and partial recovery from pancytopenia. Pancytopenia is not a disease in itself but is the presentation of an underlying disease. It can occur due to various coexisting disorders in children with CeD, which can be as simple as nutritional deficiencies to as complex as an autoimmune process or malignancy. CeD should be included in the differential diagnosis of aplastic anemia as CeD and aplastic anemia both have a similar pathological process involving T cell destruction of tissues.

Quantitative analysis of tiliroside and other flavonoid glycosides in Hippophae salicifolia D. Don leaves by HPLC-PDA.

A new HPLC-PDA method was developed and validated for simultaneous determination of five phenolic compounds (trans-and cis- isomers of tiliroside, quercetin-3-O-ß-D-glucoside, ellagic acid, kaempferol-3-O-ß-D-glucoside and isorhamnetin-3-O-glucoside) in the leaves of Hippophae salicifolia D. Don. Of the five compounds, three (tiliroside, quercetin-3-O-ß-D-glucoside and ellagic acid) were isolated and characterised by spectroscopy techniques. The developed HPLC method provided a selective, sensitive and rapid analysis with good linearity (r2> 0.999), accuracy and precision. Also, the leaves of H. salicifolia were extracted by three different extraction techniques viz. reflux, microwave and ultrasound. Methanolic extracts prepared by reflux method showed the highest content of all the five compounds.

Experimental analysis of solar powered disinfection tunnel mist spray system for coronavirus prevention in public and remote places.

There is a pressing need to accelerate the development of advanced technologies to prevent Coronavirus in large gatherings. The present system is an integration of tunnel disinfectant spray system and solar setup which utilises the solar energy to power a pump which pushes the required amount of chemical mixture into the nozzles of the spray system in order to eliminate any incoming virus or bacteria on the clothes of a particular person without wetting it. Data was gathered for a mall in New Delhi related to occupancy levels before and after lockdown. A 47% and 35% spike in energy and disinfectant mixture to pump was evaluated on weekends. A 70% reduction in operating cost was registered for solar based system in comparison to non-solar setup. Optimum conditions by considering efficiency and cost effectiveness evaluated are 8 number of nozzles, nozzle angle 55 degrees spray pressure 200 bar, and pressure 200 bar.

A Hospital-Based Multi-Centric Study to Determine the Clinico-Epidemiological Profile of Intussusception in Children < 2 Years in Rajasthan, India.

OBJECTIVE: To determine the clinical and epidemiological profile of Intussusception in children aged <2 y after introduction of rotavirus vaccine in Universal Immunization Programme of Rajasthan. METHOD: This was a hospital-based multi-centric surveillance study conducted at three tertiary care sentinel sites in Rajasthan over a period of 2 y. Children <2 y of age admitted with intussusception as per Brighton's criteria 1 were enrolled. Demographic details including age, sex, clinical presentation, diagnostic methods, duration of symptoms, mode of treatment, and complications were recorded and analyzed. RESULTS: During the study period of 2 y, the authors identified 164 cases of intussusception based on level-1 Brighton's criteria. Median age at presentation was 7 mo [Interquartile range (IQR) 5-10 mo] with a male to female ratio of 2:1. Pain abdomen and blood stained stool were the commonest presenting complaints (88.4% and 81.7%, respectively). Commonest site of intussusception was Ileocolic (82.32%). Pathological lead point was identified in 18.9% cases. Distinct seasonality was observed as maximum cases of intussusception were detected in the months of Jan-March (34.1%). Surgical intervention was required in the 89.63% cases. The median time duration between onset of symptoms and admission at sentinel site was 2 d (IQR 1-3 d). Proportion of cases that required surgery increased as the time interval between onset of symptoms and admission increases. CONCLUSION: Intussusception is a common surgical condition among children under-two years of age with majority of cases occurring during infancy. Case management is dependent primarily on time duration elapsed between symptoms onset and admission to tertiary care centre. Early case detection and timely referral may provide an opportunity to avoid surgical interventions.

Post Vaccination Epidemiology and Genotyping of Rotavirus Gastroenteritis at a Tertiary Care Centre of North-East Rajasthan.

OBJECTIVES: To estimate the proportion of rotavirus diarrhea among hospitalized children aged under-five years, to determine the circulating rotavirus genotypes and to know impact rotavirus vaccine on prevalence and severity of rotavirus diarrhea. METHODS: This study was a hospital based cross-sectional observational study conducted over a period of 29 mo (September 2017 through January 2020). Stool samples were collected from children who fall within the age range of 0-59 mo with acute diarrhea attending emergency or needing admission. Stool samples were tested for rotavirus by the enzyme linked immune-sorbent assay (ELISA) and genotyped using published methods. RESULTS: Out of 1480 samples, 360 (24.32%) cases were positive for rotavirus by ELISA, majority of them were male (62.97%). Maximum rotavirus positivity was found in the age group of <11 mo (55.27%). Statistically significance difference was seen in episodes of diarrhea and experience of vomiting in rotavirus diarrhea cases. Highest prevalence has been seen during winter season. The most prevalent G and P type combinations were G3P [8] strains [122 (34.08%)], G2P [4] [83 (23.18%)], G1P [8] [27 (7.54%)] and G9P [4] [20 (5.59%)]. Mixed strains contribute a significant proportion of stool sample. CONCLUSIONS: Rotavirus is an important cause of diarrhea in hospitalized children. There is continued circulation of G9 and G12 strains and the emergence of G3P [8] as most common strain.

Early Infant Feeding Practices May Influence the Onset of Symptomatic Celiac Disease.

PURPOSE: To study whether breastfeeding and breastfeeding status during gluten introduction influences the age at diagnosis of celiac disease (CD). In addition to study, whether the timing of gluten introduction influences the age at diagnosis of CD. METHODS: It was a hospital based observational study. Total 198 patients diagnosed with CD as per modified European Society of Pediatric Gastroenterology, Hepatology and Nutrition (2012) criteria, aged between 6 months to 6 years were included. Detail history taken with special emphasis on breastfeeding and age of gluten introduction. Standard statistical methods used to analyze the data. RESULTS: Mean±standard deviation age of onset and diagnosis of CD in breastfed cases was 2.81±1.42 years and 3.68 ±1.55 years respectively as compared to 1.84±1.36 years and 2.70±1.65 years respectively in not breastfed cases (p<0.05). Those who had continued breastfeeding during gluten introduction and of longer duration had significantly delayed onset of disease. The age at onset of CD was under one year in 40.42% of the cases, who had started gluten before 6 months of age compared to only 12.58% of those who had started gluten later (p<0.001). The proposed statistical model showed that two variables, i.e., breast feeding status during gluten introduction and age at gluten introduction positively influencing the age at diagnosis of CD. CONCLUSION: Delayed gluten introduction to infant's diet along with continuing breastfeeding, delays symptomatic CD. However, it is not clear from our study that these infant feeding practices provide permanent protection against the disease or merely delays the symptoms.