Comparative toxicological studies of distillery effluent treatments such as UASB reactor followed by an oxidizer unit using Cyprinus carpio fish.

The aim of the present study was to evaluate the acute toxicity of anaerobically treated distillery effluent and oxidized effluent on freshwater fish, Cyprinus carpio. The untreated distillery effluent (Sample A) was treated with up-flow anaerobic sludge blanket (UASB) reactor (Sample B) and followed by an oxidizer system (Sample C and D) under optimized conditions. The comparative acute toxicity of Sample A and treated effluents (Sample B, C and D) was studied using Cyprinus carpio (common carp) as a model fish for various exposure times (24 to 96 h) after suitable dilutions. The parameters for toxicity determination included assessment of behavioural response of the fish under study and their mortality study, and histopathological analysis. The behavioural response parameters showed prominent changes as erratic swimming activity, increase in opercular movement, jerk and violent reaction, loss of equilibrium, and aggressiveness in fish when exposed to varying concentrations of distillery effluent. The prominent features of death were respiratory distress, paralysis and loss of equilibrium. The mortality study involved calculation of median lethal toxicity (LC50) using static bioassay method. The histopathological analysis of tissues like gills, intestine and kidney of exposed fish showed varied degrees of damage, which increased with increasing the strength of the distillery effluent. Thus, the present study underscores the effectiveness of the two-step process (anaerobic treatment followed by oxidation) for the treatment of distillery effluent in terms of significantly lesser dilution requirements (about 5-fold lesser as compared to the untreated effluent) before discharging the distillery effluent safely to the ecosystem.

Determinants of motor, language, cognitive, and global developmental delay in children with complicated severe acute malnutrition at the time of discharge: An observational study from Central India.

BACKGROUND: Undernutrition leads to impaired psychosocial and cognitive development. This study explored the developmental status of children with complicated severe acute malnutrition (SAM) and correlated it with various risk factors for SAM. METHODS AND FINDINGS: We recruited 100 children with SAM and no other associated significant health issues during the recovery phase of treatment using the Bayley Scales of Infant and Toddler Development III prior to discharge from the nutritional rehabilitation unit in R D Gardi Medical College, Ujjain, Central India. We also assessed composite developmental scores, developmental age equivalents, and average differences in developmental age. Risk factors for developmental delay were identified in children with complicated SAM. The results revealed that 75%, 75%, and 63% of children with SAM exhibited delay in motor (mean score: 78.22), language (mean score: 83.97), and cognitive (mean score: 78.06) domains, respectively. A total of 63% children exhibited delay by an average of 4-7 months in the total developmental age. The proportion of children with delay in motor, language, and cognitive domains was determined. An increased risk of global developmental delay was observedin children with a low birth weight (adjusted odds ratio [aOR]: 18.06, 95%CI: 2.08-156.56; P = 0.009), having working mothers (aOR: 17.54, 95%CI: 3.02-102.59; P = 0.001), weight-for-age less than three standard deviations (aOR: 6.09, 95%CI: 1.08-34.10; P = 0.04), and presence of severe anemia (aOR: 16.34, 95%CI: 2.94-90.73; P = 0.001). CONCLUSIONS: The results indicated that children with SAM exhibit developmental delay across all domains. Identifying multiple modifiable risk factors for developmental delay in children with SAM will be helpful in devising early interventional strategies in low-middle income countries; however, the exact timing of such interventions should be investigated.

Assessment of school readiness of children and factors associated with risk of inadequate school readiness in Ujjain, India: an observational study.

OBJECTIVE: School readiness is a condition or state indicating that the child is ready to learn in a formal educational set-up. The objective of this study was to estimate the prevalence of and factors associated with school readiness in urban schoolchildren in Ujjain, India. METHODS: This cross-sectional study was conducted from February 2016 to March 2017. Two English-medium schools were conveniently selected. All children aged 5-7 years were eligible to participate. A subscale of Differential Ability Scales-Second Edition, namely 'school readiness scale', was used to assess school readiness in three major domains-early number concept, matching letter-like forms and phonological processing. Data on factors associated with school readiness were collected through parent interview. Quantile regression analysis was used to explore school readiness scores. RESULTS: This study included 203 school-going children (105 boys and 98 girls) having a mean (SD) age of 67.7 (±0.51) months. The phonological processing and matching letter-like forms had 31.5% and 30.5% children, respectively, in lower quantiles (≤25th). The higher quantile (≥75th) scores were achieved for phonological processing and early number concept (47.7% and 44.8% children, respectively). The results of quantile regression showed negative association of school readiness scores with age of children, lower socioeconomic status and hospitalisation status, especially in the lower quantiles (≤25th). The 10th, 50th and 75th quantile scores were positively correlated with the increasing education status of the mother. Birth weight was positively associated with the median and higher quantile scores (≥75th). CONCLUSIONS: School readiness in a middle-class urban setting in India was negatively associated with lower age of the child, lower socioeconomic status, hospitalisation and positively correlated with increasing birth weight and maternal education. Lower quantile scores were achieved in matching letter-like forms, which measures complex visual-spatial processing, and phonological ability, which correlates with acquired verbal concepts. Focused interventions are needed to improve these skills.

Effect of Yoga versus Light Exercise to Improve Well-Being and Promote Healthy Aging among Older Adults in Central India: A Study Protocol for a Randomized Controlled Trial.

BACKGROUND: Aging is a natural process associated with many functional and structural changes. These changes may include impaired self-regulation, changes in tissues and organs. Aging also affects mood, physical status and social activity. There are adverse changes in cognitive behavior, perceived sensation and thinking processes. Regular physical activity can alleviate many health problems; yet, many older adults are inactive. Yoga is one of the scientific and popular lifestyle practice considered as the integration of mind, body and soul. Results of previous studies reported positive effects of yoga on multiple health outcomes in elderly. However, there is scarcity of scientific information where yoga's effect is examined on over well-being and on multiple health outcomes simultaneously in elderly. This protocol describes methods for a 12-week yoga-based intervention exploring the effects of yoga on well-being in physically inactive elderly living in community. Methods and analysis: This two group parallel single blind randomized controlled trial that will be conducted at a designated facility of R.D. Gardi Medical College, Ujjain, Madhya Pradesh, Central India. A 12-week 60-min yoga intervention three times weekly is designed. Comparison group participants will undergo a 60-min program comprising light exercise focusing on conventional stretching to improve mobility. After screening, 144 participants aged 60-80 years will be recruited. The primary outcome is subjective well-being. Secondary outcomes include mobility, fall risk, cognition, anxiety and depression, mood and stress, sleep quality, pain, physical activity/sedentary behavior and cardio-metabolic risk factors. Assessments will be conducted at baseline (0 week), after the intervention (12+1 week) and at follow-up (36+1 week). Intention-to-treat analyses with mixed linear modeling will be applied. DISCUSSION: Through this trial, we aim to determine whether elderly people in the intervention group practicing yoga show more favorable primary (well-being) and secondary outcomes than those in the light exercise focusing on conventional stretching group. We assume that yoga may be practiced to maintain health, reduce particular symptoms commonly associated with skeletal pain, assist in pain relief and enhance well-being. We anticipate that practicing yoga will improve well-being and mental health and may lead to significant improvement in depression, pain and sleep quality.Ethics and dissemination: This study is approved by the Institutional Ethics Committee of R.D. Gardi Medical College, Ujjain, IEC Ref No. 09/2018. All participants would be provided with written and verbal information about the purpose of the project and would be free to withdraw from the study at any time. Refusal to participate in the study would not have any negative consequences. Confidentiality of the information of each participant would be ensured. Knowledge obtained would be disseminated to stakeholders through workshops, meetings and relevant scientific conferences. TRIAL REGISTRATION: The trial is prospectively registered with the Indian Council of Medical Research Trial Registry CTRI/2018/07/015051.

Formulation of a self-emulsifying system for oral delivery of simvastatin: in vitro and in vivo evaluation.

The objective of the present work was to formulate a self-emulsifying drug delivery system (SEDDS) for simvastatin, which is widely used in the treatment of hypercholesterolemia and dyslipidemia as an adjunct to diet. Simvastatin SEDDS were formulated using a 1:1 (V/V) mixture of diesters of caprylic/capric acids and polyglycolyzed glycerides with varying concentrations of polyoxy castor oil and C8/C10 mono-/diglycerides. The developed SEDDS were evaluated for turbidimetry, droplet size analysis, drug content and in vitro diffusion profiles. In vivo performance of the optimized formulation was evaluated in rats using pharmacodynamic marker parameters like plasma total cholesterol (CH), triglycerides (TG) and high-density lipoprotein (HDL-CH) for 21 days. SEDDS containing 9.1% (m/m) simvastatin and 23.0% (m/m) of each excipient showed minimum mean droplet size (124 nm) and optimal drug diffusion. This test formulation showed significant reduction in plasma CH and TG (around 5-fold and 4-fold, respectively), while HDL-CH concentration was markedly higher (2-fold) compared a reference simvastatin suspension formulation after oral administration for 21 days of study. Test formulation has shown enhanced pharmacodynamic performance compared to reference formulation in rats. The study illustrated the potential of simvastatin SEDDS for oral administration and its biopharmaceutic performance.

Infantile tremor syndrome: Role of Vitamin B12 revisited.

OBJECTIVE: To study the role of Vitamin B12 as an etiological factor in patients of infantile tremor syndrome (ITS). METHODS: Twelve consecutive admissions of children diagnosed clinically as ITS were assessed. Assessment was done using a predefined pro forma to document patient demographic factors, general examination, systemic examination as well as relevant hematological and biochemical investigations. RESULTS: Out of the 12 cases of ITS, 6 were males and 6 were females. Two cases had serum B12 levels below reference values, five had levels in low normal range, and remaining five had normal values. CONCLUSIONS: Role of Vitamin B12 deficiency as an etiological factor in the patients of ITS is inconclusive.