Preliminary clinical assessment and non- toxicity evaluation of an ayurvedic formulation BGR-34 in NIDDM.

In view of the overall health impact of NIDDM, inventers understand the necessity of improving glycemic control in adults with type 2 diabetes. BGR-34 provides an effective treatment option for adults with type 2 diabetes who have been inadequately controlled on lifestyle with or without other oral hypoglycemic agents (OHGAs) such as metformin, sulfonylurea, or a glitazones. BGR-34 is an appropriate option to consider for addition to a managed care drug formulary. Treatment with BGR-34 produced clinically relevant and statistically significant reductions in all three key measures of glucose control studied -FPG, PPBG and HbA1c- when compared with placebo. BGR-34, showed the promising result with respect to glycemic parameters in NIDDM patient with a significant reduction in fasting blood sugar by 34.3%, postprandial blood sugar 35.5% & glycosylated haemoglobin by 20.31% as compared to placebo group showing a reduction by 13.2%, 10.9% & 10.87% respectively. The trial has also been registered to CTRI, India. This study has been registered in the clinical trial registry-India.

Prevalence of Extended Spectrum Beta-Lactamase Producing Klebsiella Pneumoniae Isolated From Urinary Tract Infected Patients.

BACKGROUND: Klebsiella pneumoniae, one of the bacterial agents associated with urinary tract infection has been often implicated as a major extended spectrum beta-lactamase (ESBL) producer in last few decades. This study was designed to assess the prevalence of ESBL producing Klebsiella pneumoniae in urinary isolates at a tertiary care hospital in Kathmandu, Nepal, from July to December 2014. METHODS: One thousand nine hundred eighty six mid-stream urine specimens were collected aseptically from the clinically suspected patients of urinary tract infections attending Capital Hospital and Research Center, Kathmandu. The samples were processed following standard guidelines as recommended by American Society for Microbiology (ASM) and the isolates including Klebsiella spp. were identified using the specific biochemical and sugar fermentation tests recommended by ASM. Antibiotic sensitivity testing was done by modified Kirby-Bauer disk diffusion method and interpreted following Clinical and Laboratory Standards Institute (CLSI) guidelines. Klebsiella pneumoniae isolates showing resistance upon initial screening with ceftriaxone (30 µg) disc were then confirmed for ESBL production by phenotypic confirmatory disc diffusion test (PCDDT) using ceftazidime (30 µg) and ceftazidime + clavulanic acid (30 µg + 10µg) and cefotaxime (30 µg) and cefotaxime + clavulanic acid (30 µg +10µg) disc as per CLSI guidelines. RESULTS: Out of a total 1986 specimens investigated, Escherichia coli was isolated in 309 (83.9%) and Klebsiella pneumoniae in 38 (10.3%) cases. Initial screening with ceftriaxone disc revealed 18 isolates of Klebsiella pneumoniae to be resistant. Further testing by PCDDT method confirmed 7 (18.4%) Klebsiella pneumoniae isolates to be ESBL producers. CONCLUSIONS: Compared to some earlier studies done in Nepal, higher prevalence of ESBL-producing Klebsiella pneumoniae was observed warranting a national surveillance for routine monitoring of ESBL producing Klebsiella pneumoniae isolates.

Lower respiratory tract infections among HIV positive and control group in Nepal.

Lower respiratory tract infections (LRTIs) are the most frequent respiratory diseases among HIV infected patients and are frequently the first clinical manifestations of the HIV infections. LRTIs are common not only among the HIV seropositive cases but also the commonest domiciliary and nosocomial infections among the general population. The present study was carried out to determine the comparative prevalence of common bacterial and fungal organism among the HIV positive and control population. This cross sectional study was conducted among 220 people attending National Public Health Laboratory, Kathmandu, Nepal. Out of them 120 were HIV sero-positive and rest were HIV sero-negative. Sputum samples were collected and processed soon after its collection. Macroscopic examination was done to determine the sample integrity. Gram stain, AFB stain and KOH preparation was performed for preliminary identification of the pathogens. Culture was carried out for bacterial and fungal pathogens. Antibiotic susceptibility test (Kirby-Bauer disc diffusion method) was performed from the isolated organisms. The 85 out of 120 HIV sero-positive patients were found to be infected with one or more microbial pathogens. The overall infection rate was found to be significantly lower in HIV seronegative people (27 %). Among HIV seropositive cases prevalence of LRTIs was strongly associated with lower CD4 counts (<200/mm(3)). The prevalence of mycobacterium tuberculosis was found to be 10 % among HIV/AIDS patients which was significantly higher than among the non-HIV cases (3 %). The bacterial pathogens was observed among 46.6 % of HIV positive and 22.0 % of HIV negative people. Among the positive cases, K. pneumoniae was the predominant bacterial pathogens, followed by E. coli and S. pneumoniae. C. albicans was found to be predominant fungal pathogen followed by Aspergillus spp. germ tube negative Candida spp. and Penicillium spp. Similar types of organisms were found to be associated with LRTIs among HIV positive and negative people. The prevalence of both fungal and bacterial infections was significantly higher among HIV seropositive people than HIV seronegative people. All in all, lower respiratory tract illness is significantly higher in HIV/AIDS cases than in HIV seronegative cases.

Pattern of non-fatal injuries in road traffic crashes in a hilly area: A study from Shimla, North India.

RESEARCH QUESTION: What are the various injuries in road traffic crash cases? OBJECTIVES: To study various non-fatal injuries in road traffic crash cases. STUDY DESIGN: Hospital based Descriptive study. STUDY POPULATION: The study population comprised of 401 consecutive cases of non- fatal injuries involved in road traffic crashes and reported at Indira Gandhi Medical College hospital, Shimla. STUDY PERIOD: 1(st) June 2005 to 31(st) May 2006. STUDY VARIABLES: Demographic characteristics of the victims, pattern of injuries and hospital stay of the victims. Types of crashes, time, day and month of crashes, vehicles involved in crashes, use of protective gear etc. STATISTICAL ANALYSIS: Percentages, Proportions. RESULTS: 73% of the injured victims were young between 20-49yrs, male to female ratio being 5.3:1. Employees (34.7%) and occupants of transport vehicles (45.9%) constituted the maximum number of the victims. Major injuries (fractures and abd. injuries) were reported in 53.4% of the victims and fractures of lower limb were the commonest of the injuries (26.3%). Use of seat-belt was found to be alarmingly low (14.3%) amongst the four- wheeler users and its non-use was found to be significantly associated with the major injuries. Helmet was used by 36 cases (66.7%) out of total of 54 users of motorized two-wheelers at the time of crash. Human error was the most reported cause of crash (82%) and the most common mode of crash was skidding and/rolling down (55%).23.1% of the drivers were reported to have consumed alcohol at the time of crash.

Behavioural and emotional problems in school going adolescents.

BACKGROUND: Adolescents are highly vulnerable to psychiatric disorders. This study aimed to explore the prevalence and patterns of behavioural and emotional problems in adolescents. It was also aimed to explore associations between socioenvironmental stressors and maladaptive outcomes. METHOD: A school based cross-sectional study was conducted between January and July 2008. A stratified random sampling was done. 1150 adolescents in 12 to 18 year age group in grades 7 to 12 in 10 co-educational schools (government run and private) were the subjects of the study. Behavioural and emotional problems were assessed using Youth Self-Report (2001) questionnaire. Family stressors were assessed using a pre-tested 23 item questionnaire. Univariate and multivariate analysis were performed. Multiple logistic regression analysis was also done. RESULTS: Prevalence of behavioural and emotional problems in adolescents was found to be 30%, with girls exceeding boys in all age groups. Internalizing syndrome was the most common (28.6%) psychiatric problem. On stepwise regression analysis, a perceived lack of emotional proximity to mother had the highest odds (3.489) followed by addiction in father (2.642) and marital discord in parents (1.402). Type of school, type of family, socioeconomic status, relationship with father, mother&s employment and educational status were not found to be significantly associated CONCLUSION: An alarming number of our adolescents suffer from emotional and behavioural problems which have their roots in the family environment. These data suggest urgency in establishing a school based mental health service.

Molecular biological characterization and biostimulation of ammonia-oxidizing bacteria in brackishwater aquaculture.

In the present study, molecular methods based on sequencing of clone libraries have been used to provide sequence and the phylogenetic information of ammonia oxidizing bacteria (AOB). Ammonia monooxygenase (amoA) gene, which catalyzed the oxidation of ammonia to hydroxyl amine in the initial rate-determining step of nitrification was targeted for detection and characterization of AOB using gene-specific primers. The amoA genes obtained through the clone library construction are closely affiliated with Nitrosomonas sp. and other uncultured beta proteobacteria. The levels of nucleotide similarity and amino acid similarity ranged from 85-99% and 83-88%, respectively. The level of conservation of the amino acid sequences is 73%. The use of a matrix prepared from abundantly available lignocellulosic agrowaste-bagasse has successfully been demonstrated for biostimulation of AOB in aquaculture environment by supplementing nutritional requirement facilitating the biofilm mode of growth of the autotrophic consortia. Present study is useful in predictability and reliability of the treatment of ammonia in brackishwater aquaculture.

Bagasse-assisted bioremediation of ammonia from shrimp farm wastewater.

Development of new economically feasible ecofriendly products from agricultural wastes or byproducts for shrimp farm wastewater treatment is the objective of our continued research. Ammonia is a nitrogenous toxicant, which is commonly found in wastewater from shrimp farms. In the present study, we explored the possibility of the use of simply and inexpensively prepared bagasse products so that this abundant crop byproduct could be used to remove ammonia from shrimp farm wastewater. Bagasse, a natural highly fibrous lignocellulosic byproduct of sugarcane, was converted into five different products. Experimental results have shown that ammonia is efficiently removed from wastewater by four bagasse products with a dose of 1 to 6 g/L within 24 hours. The effect of bagasse products on other water quality parameters and growth kinetics of biofilm bacteria onto bagasse fiber have also been studied. Efficacies of products were compared by using statistical analysis. Products developed from bagasse are useful and economical.

Acute toxicity of some heavy metals to Lates calcarifer fry with a note on its histopathological manifestations.

Static bioassay tests for acute toxicity of four heavy metals to fry of the fish Lates calcarifer in brackishwater medium were conducted. The 96 h LC50 values of metals such as Hg, Cu, Cr, and Mn for two different size groups 11 +/- 3 mm and 24 +/- 4 mm were found to be 0.085, 1.3, 27.9, and 220 mg/L and 0.20, 1.8, 33, and 250 mg/L, respectively. The rank order of toxicity of metals was found to be Hg > Cu > Cr > Mn. Using the safe concentration factor of 0.01, the allowable safe concentration for Hg, Cu, Cr, and Mn in brackishwater are 0.00085-0.002, 0.013-0.018, 0.279-0.33, and 2.20-2.50 mg/L, respectively. The damage caused to different organ systems of the fish, exposed to the heavy metals, agrees with the rank order of the toxicity. Heavy nerve tissue necrosis was observed in fish exposed to mercury. Copper induced gill epithelial necrosis and kidney tubular degeneration. Chromium and manganese accounted for various histopathological manifestations involving vital organs such as liver and kidney.

Studies on the use of neem products for removal of ammonia from brackishwater.

Laboratory experiments were carried out to investigate the ammonia removal from brackishwater (Salinity 16 +/- 1 ppt) using natural plant products such as seed powder and seed oil from neem (Azadirachta indica) and commercially available neem products-neemazal and neemgold. The experimental results showed that ammonia removal was effective with 90 mg/l of neem oil, whereas, neem seed powder at 90 mg/l registered an increase in ammonia levels throughout the course of the experiment. Neem oil, neemazal, and neemgold at 90 mg/l were effective in decreasing the total ammonia nitrogen (TAN) level of 0.40-0.45 mg/l in 96 h. The effect of initial ammonia concentrations on the ammonia removal using neem oil revealed that percentage ammonia removal decreased with an increase in initial ammonia concentration.

Patterning an epidermal field: Drosophila lozenge, a member of the AML-1/Runt family of transcription factors, specifies olfactory sense organ type in a dose-dependent manner.

Sense organ development in the Drosophila antenna is initiated by the selection of a founder cell from an epidermal field. This cell is believed to recruit neighbours to form a cluster of cells which then divides to form a mature sense organ. In most systems so far studied, sense organ type appears to be specified by the identity of proneural genes involved in the selection of precursors. The regulation of proneural gene expression is, in turn, controlled by the prepatterning genes. In the antenna, the only known proneural function is that of atonal, a gene that is involved in founder cell choice in the sensilla coeloconica, and no prepatterning gene function has yet been demonstrated. In this study, we show that Lozenge, a protein which possesses a DNA binding domain similar to that of the Acute myeloid leukemia-1/Runt transcription factors, functions in a dose-dependent manner to specify the fate of the other two types of sense organs in the antenna: the sensilla trichoidea and the sensilla basiconica. Our results suggest that Lozenge may act on the epidermal field, resulting in founder cells acquiring specific cell fates that lead to the development of an appropriate type of sense organ.

Awareness of hypertension among a north Indian population.

Developing countries are going through a demographic transition. Non-communicable diseases like hypertension are emerging in epidemic proportions. Education and awareness among people is the key to reduce the burden of the disease. To see the levels of awareness and characteristic of aware and unaware hypertensives, 7630 employees in Shimla town were screened for hypertension. Hypertension was detected in 2535 cases of which 559 (22.05%) were aware. The aware hypertensives were predominantly symptomatic and had higher age and blood pressure than the unaware hypertensives. The aware hypertensives were predominantly overweight. This low level of awareness highlights the need for a comprehensive hypertension education programme to be taken up at the national level.

Atonal is a proneural gene for a subset of olfactory sense organs in Drosophila.

BACKGROUND: The antenna of the adult fruit fly, Drosophila melanogaster, is covered with three morphologically distinct types of olfactory sense organs. In addition, mechano- and hygro-sensitive receptors are also present on its surface. While much has been learnt about the development of peripheral nervous system in Drosophila, the mechanisms underlying the development of olfactory sensilla are just beginning to be unraveled. The antennal sense organs have several properties that make them distinct from other sense organs. While each sensillum type is arranged in a well-defined region of the antenna, the position of an individual sensillum is not fixed. The development of these sense organs appears to combine an initial step of cell recruitment, as in photoreceptors, followed by cell lineage mechanisms, as in the development of other external sense organs. The earliest step in development, the selection of a sensory organ precursor, involves the interaction of proneural and neurogenic genes. The proneural gene for the antennal sense organs has been elusive so far. RESULTS: We show that the basic helix-loop-helix (bHLH) transcription factor encoded by atonal (ato) is a proneural gene for one morphological type of olfactory sensilla on the antenna and for all the olfactory sensilla on the maxillary palp. Loss of function and overexpression experiments together reveal that ato is both necessary and sufficient to specify these sensilla. Immunohistochemical experiments show that Ato expresses in a dynamic pattern in the developing antennal disc. CONCLUSIONS: Our results demonstrate that ato acts solely in the specification of antennal sensilla coeloconica. This along with our previous observation that the AS-C genes do not function in antenna allows us to suggest that other proneural genes must operate in the specification of sensilla basiconica and trichoidea. Our experiment involving overexpression of extramacrochaetae, a negative regulator of bHLH encoding genes, results in a significant reduction in the number of all three types of antennal sensilla. This suggests that the unidentified proneural gene(s) possibly encode bHLH factors.

Distinct mechanisms of action of the Lozenge locus in Drosophila eye and antennal development are suggested by the analysis of dominant enhancers.

The development of the olfactory sense organs on the antenna of the fruit fly Drosophila utilises mechanisms distinct from those used in the rest of the adult peripheral nervous system. Lozenge (lz) is the only locus hither-to identified as required for the development of antennal sense organs. In addition to effects on the antenna, mutations in lz also affect the development of the eye and maxillary palp. We have used the readily-scored eye-phenotype in a temperature sensitive lz allele to screen for dominant modifiers of phenotypes at this locus. We analyse the phenotypes of both intragenic and extragenic modifiers. Our results reinforce the view from developmental studies that lz functions in eye and antennal development in distinct ways.

Direct detection of hepatitis B virus from dried blood spots by polymerase chain reaction amplification.

The presence of hepatitis B virus DNA in the sera of individuals is the most definitive marker of an active viral infection. We have used polymerase chain reaction detection of hepatitis B virus DNA directly on whole blood dried as a spot on filter paper. The method is rapid, specific, and sensitive and has the ability to detect as little as 10 virus particles by ethidium bromide staining of the polymerase chain reaction-amplified products. The method is cost-effective, and the stability of the spots makes the collection and transportation of potentially infectious blood safe.