Fabrication of visible-light-driven N-doped ordered mesoporous TiO2 photocatalysts and their photocatalytic applications.

Herein we report a facile method for the synthesis of N-doped crystalline mesoporous titanium dioxide (NMT) with ordered structure. Structural characterization and HR-TEM studies revealed that NMT exhibits pure anatase phase with highly crystalline ordered mesoporous structure in NMT. The N2 isotherms are of type IV with an H1 hysteresis loop and a pronounced capillary condensation step at high relative pressure for NMT, suggesting the presence of well-ordered mesoporous structure. The reflectance spectrum of NMT shows stronger absorption in the visible region above 400 nm, owing to the substitution of the lattice oxygen by nitrogen. XPS results proved the doping of nitrogen in to oxygen in TiO2 lattice, which confirmed by the presence of peak at 401 eV for N1s. The efficiency of photocatalyst was evaluated by the degradation of Rhodamine-B and antibacterial activity against E. coli under visible-light irradiation. N-doped mesoporous TiO2 shows superior photocatalytic and anti-bacterial activity compared to pure TiO2 under visible-light irradiation. The enhanced photocatalytic activity of NMT is attributed to synergistic effect of NMT that is N-doping and well ordered crystalline mesoporous structure with high surface area of NMT. These findings suggest that N-doped mesoporous TiO2 has potential application in many areas such as degradation of hazardous pollutants, anti-bacterial agents, fuel cells, battery electrode, sensors, opto electronic devices, photo active self-cleaning surfaces.

Development and Optimisation of Inhalable EGCG Nano-Liposomes as a Potential Treatment for Pulmonary Arterial Hypertension by Implementation of the Design of Experiments Approach.

Epigallocatechin gallate (EGCG), the main ingredient in green tea, holds promise as a potential treatment for pulmonary arterial hypertension (PAH). However, EGCG has many drawbacks, including stability issues, low bioavailability, and a short half-life. Therefore, the purpose of this research was to develop and optimize an inhalable EGCG nano-liposome formulation aiming to overcome EGCG's drawbacks by applying a design of experiments strategy. The aerodynamic behaviour of the optimum formulation was determined using the next-generation impactor (NGI), and its effects on the TGF-ß pathway were determined using a cell-based reporter assay. The newly formulated inhalable EGCG liposome had an average liposome size of 105 nm, a polydispersity index (PDI) of 0.18, a zeta potential of -25.5 mV, an encapsulation efficiency of 90.5%, and a PDI after one month of 0.19. These results are in complete agreement with the predicted values of the model. Its aerodynamic properties were as follows: the mass median aerodynamic diameter (MMAD) was 4.41 µm, the fine particle fraction (FPF) was 53.46%, and the percentage of particles equal to or less than 3 µm was 34.3%. This demonstrates that the novel EGCG liposome has all the properties required to be inhalable, and it is expected to be deposited deeply in the lung. The TGFß pathway is activated in PAH lungs, and the optimum EGCG nano-liposome inhibits TGFß signalling in cell-based studies and thus holds promise as a potential treatment for PAH.

Enhanced Thermoelectric Efficiency in P-Type Mg3Sb2: Role of Monovalent Atoms Codoping at Mg sites.

Due to natural abundance, low cost, and compatibility with sustainable green technology, Mg3Sb2-based Zintl compounds are comprehensively explored as potential thermoelectric materials for near-room temperature applications. The effective use of these materials in thermoelectric devices requires both p and n-type Mg3Sb2 having comparable thermoelectric efficiency. However, p-type Mg3Sb2 has inferior thermoelectric efficiency efficiency compared to its n-type counterpart due to low electrical conductivity (∼103Sm-1). Here, we show that codoping of monovalent atoms (Li-Ag, and Na-Ag) at the Mg site of Mg3Sb2 produces a synergistic effect and boosts the electrical conductivity, which enhances the thermoelectric properties of p-type Mg3Sb2. While, Ag prefers to occupy the Mg2 site, Li and Na are favorable at the Mg1 site of Mg3Sb2 lattice. Compared to Li-Ag codoping, Na-Ag codoping in Mg3Sb2 is found to be more effective for increasing the charge carrier concentration and significantly augmenting the electrical conductivity. The dominance of the three-phonon scattering mechanism in Li and Li-Ag doped Mg3Sb2 and the four-phonon scattering process for the Na and Na-Ag doped Mg3Sb2 are confirmed. Due to the simultaneous increase in electrical conductivity and decrease in thermal conductivity, the zT value ∼0.8 at 675 K achieved for Mg2.975Na0.02Ag0.005Sb2 is the highest value among p-type Mg3Sb2. Our work shows a constructive approach to enhance the zT of p-type Mg3Sb2 via monovalent atoms codoping at the Mg sites.

Enhancing cycle life and usable energy density of fast charging LiFePO4-graphite cell by regulating electrodes' lithium level.

Range anxiety is a primary concern among present-day electric vehicle (EV) owners, which could be curtailed by maximizing the driving range per charge or reducing the charging time of the lithium-ion battery (LIB) pack. Maximizing the driving range is a multifaceted task as charging-discharging the LIB up to 100% of its nominal capacity is limited by the cell chemistry (voltage window) and cell operating conditions. Our studies on commercial LiFePO4/graphite cells show that a cycle life of 4320 is achieved at 4C rate with 80% SOC-100% DOD combination (12 min charging time), which is the highest among the works reported with this cell chemistry. Complete utilization of electrodes' lithium during cycling resulted in the lowest cycle life of 956. This study demonstrates LIB charging-discharging protocol enabling longer driving range with quicker charging times. Besides, it might endow promising possibilities of future EV LIB packs with reduced size/weight and high safety.

Development and evaluation of nanoemulsion and microsuspension formulations of curcuminoids for lung delivery with a novel approach to understanding the aerosol performance of nanoparticles.

Extensive research has demonstrated the potential effectiveness of curcumin against various diseases, including asthma and cancers. However, few studies have used liquid-based vehicles in the preparation of curcumin formulations. Therefore, the current study proposed the use of nanoemulsion and microsuspension formulations to prepare nebulised curcuminoid for lung delivery. Furthermore, this work expressed a new approach to understanding the aerosol performance of nanoparticles compared to microsuspension formulations. The genotoxicity of the formulations was also assessed. Curcuminoid nanoemulsion formulations were prepared in three concentrations (100, 250 and 500 µg/ml) using limonene and oleic acid as oil phases, while microsuspension solutions were prepared by suspending curcuminoid particles in isotonic solution (saline solution) of 0.02% Tween 80. The average fine particle fraction (FPF) and mass median aerodynamic diameter (MMAD) of the nebulised microsuspension formulations ranged from 26% and 7.1 µm to 40% and 5.7 µm, for 1000 µg/ml and 100 µg/ml respectively. In a comparison of the low and high drug concentrations of the nebulised nanoemulsion, the average FPF and MMAD of the nebulised nanoemulsion formulations prepared with limonene oil ranged from 50% and 4.6 µm to 45% and 5.6 µm, respectively; whereas the FPF and MMAD of the nebulised nanoemulsion prepared with oleic acid oil ranged from 46% and 4.9 µm to 44% and 5.6 µm, respectively. The aerosol performance of the microsuspension formulations were concentration dependent, while the nanoemulsion formulations did not appear to be dependent on the curcuminoids concentration. The performance and genotoxicity results of the formulations suggest the suitability of these preparations for further inhalation studies in animals.

Technique for cryopreservation of intestinal smooth muscle cells.

Attempts were made to develop a simplified procedure for long-term cryopreservation of intestinal smooth muscle cells (ISMC). ISMC were collected from the ileum of Sprague-Dawley neonatal rats through cellular dissociation in trypsin. Cryopreservation method comprised of a rapid 1-step (protocol 1) and a slow 3-step (protocol 2) freezing of ISMC for 1week. Preparations were thawed and single ISMC were assessed via the comet assay and damaged DNA was quantified through comet tail moment. The control unfrozen ISMC exhibited DNA damage of 2.34+/-0.35 compared to ISMC cooled via protocol 2 (2.62+/-0.36) and protocol 1 (10.15+/-0.72). Thereafter, protocol 2 freezing method was adopted and ISMC were cryopreserved for 1-week, 1-month, and 4-months to analyse the temporal and long-term cryopreservation of ISMC. This revealed a DNA damage of 2.62+/-0.36 (1-week), 3.81+/-0.72 (1-month), and 5.1+/-0.9 (4-months). Gradual cooling is suitable for continuing storage of ISMC and although fluctuation in cryoinjury is observed with time this is considered to reflect cell-to-cell variability.

Net costs from three perspectives of using low versus high osmolality contrast medium in diagnostic angiocardiography.

OBJECTIVES: We conducted an economic analysis to assess the extent to which a reduction in adverse drug reactions induced by low osmolality compared with high osmolality contrast media during diagnostic angiocardiography would result in savings to hospitals, society and third-party payers that would offset the substantially higher price of low osmolality contrast medium. BACKGROUND: Substitution of low osmolality for high osmolality contrast media in the approximately 1 million diagnostic angiocardiographic procedures performed each year in the United States could substantially increase health care costs. Cost-effectiveness estimates should include savings that might occur through reduced costs of managing adverse drug reactions. METHODS: In a randomized clinical trial of 505 persons under-going diagnostic angiography with either high osmolality or low osmolality contrast medium, we measured and compared 1) material costs of contrast media, and 2) costs from three perspectives of incremental resources used to manage contrast-related adverse drug reactions. We also performed sensitivity analyses to examine the effect of different assumptions with regard to relative risk, absolute risk and costs of adverse drug reactions on estimates of net cost of use of high osmolality and low osmolality contrast media. RESULTS: One-hundred thirty-seven (54.2%) of 253 patients receiving high osmolality contrast medium and 44 (17.5%) of 252 patients receiving low osmolality contrast medium experienced adverse drug reactions. The average cost (from society's perspective) of resources used to manage adverse drug reactions per patient undergoing angiography was significantly (p = 0.0001) greater for high osmolality (mean $249) versus low osmolality (mean $92) contrast medium. Differential costs (from the hospital's perspective) were $67 greater for high osmolality contrast medium. Charges and professional fees (from the payer's perspective) were $182 greater for high osmolality (mean $312) than for low osmolality (mean $130) contrast medium (p = 0.42, NS). The higher differential and average costs of managing adverse drug reactions with high osmolality contrast medium offset 33% and 75%, respectively, of the $207 difference in mean material costs, but these estimates are sensitive to infrequent high cost cases. CONCLUSIONS: Although low osmolality contrast medium is not cost-saving in diagnostic angiocardiography, its higher price is partially offset by lower management costs of adverse drug reactions. The cost offset for the hospital is lower than that for society and may not be realized by third-party payers. These methods and results may be useful in establishing clinical and payment guidelines for use of alternative contrast media in diagnostic angiocardiography.

Hydrogen bonding patterns in the cocrystals of 5-nitrouracil with several donor and acceptor molecules.

: Cocrystals of 5-nitrouracil with solvent molecules, dioxane, pyridine, DMSO, formamide and ethanol as well as with piperazine, N, N'-dimethylpiperazine, 3-aminopyridine and diazabicyclo [2.2.2]octane obtained by deliberate inclusion, have been examined by X-ray crystallography. The tape structure found in the parent centric form of nitrouracil is retained with some modifications in the cocrystals with dioxane, piperazine, diazabicyclo [2.2.2]octane, N,N'-dimethylpiperazine, pyridine and DMSO, with the guest molecules forming alternate tapes. In cocrystals involving formamide, ethanol and 3-aminopyridine, the molecular tapes exhibit mixed compositions. The observed bonding patterns have been classified into six schemes. Interestingly, quadruple type hydrogen bonding patterns are seen in cocrystals containing 3-aminopyridine or ethanol and water, while a network of acyclic tetrahedral pentamers of water is found in the cocrystal containing diazabicyclo [2.2.2]octane and water.

Tuberculin skin test reactivity, anergy, and HIV infection in hospitalized patients. Longcope Firm of the Osler Medical Housestaff.

PURPOSE: Detection of latent tuberculosis infection is an important step in the control of tuberculosis because high-risk persons may be given preventive therapy. The value of tuberculin skin testing in individuals with human immunodeficiency virus (HIV) infection, however, is limited by anergy. We evaluated the prevalence of tuberculin skin test reactivity, anergy, and HIV infection in a group of hospitalized patients in an area where both tuberculosis and HIV infection are prevalent. PATIENTS AND METHODS: Three hundred fifty-one patients consecutively admitted to a medical service of a large urban teaching hospital were enrolled in the study. All those with no documented history of a positive tuberculin skin test were evaluated on admission with purified protein derivative (PPD) by the Mantoux test, and with anergy testing using a multiple-puncture device. HIV testing was offered to all patients who did not have a known history of HIV infection, and was performed when informed consent was obtained. RESULTS: Forty-one patients (12%) had a documented history of a positive PPD. Of the remaining 310 patients, 62 (20%) had a PPD response of > or = 10 mm induration. Fifty-two (15%) of the 351 patients were HIV positive. None of the HIV-infected patients was PPD positive. Anergy was found in 63% of the HIV-infected patients and 28% of the HIV-seronegative patients. Independent risk factors for a positive PPD included age > 55, male sex, and hypertension. HIV infection, current steroid use, and a history of cancer were associated with a negative PPD. Independent risk factors for anergy included HIV infection, current corticosteroid use, renal failure pneumonia, and a history of cancer. Of the 62 new PPD-positive patients, 30 (48%) were candidates for chemoprophylaxis. Additionally, 30 (63%) of 48 HIV-seropositive patients who were completed testing were anergic and might be candidates for chemoprophylaxis. Almost all of the patients eligible for chemoprophylactic therapy would have been detected if only patients at increased risk for developing tuberculosis were screened. CONCLUSIONS: Tuberculosis infection, HIV infection, and anergy were common in patients admitted to this medical service. Interpretation of PPD reactivity was confounded by a high prevalence of anergy, particularly in HIV-infected patients. A large proportion of patients tested were candidates for chemoprophylaxis. Routine tuberculin skin testing with anergy testing for high-risk patients on admission to the hospital is useful for identifying patients who might benefit from prophylaxis to help control the spread of tuberculosis.

Hepatitis B-related polyarteritis nodosa complicated by pulmonary hemorrhage.

A 34-year-old man presented with fever, weight loss, paresthesia, abdominal pain, and hypertension. He had hepatitis B antigenemia, with negative antineutrophil cytoplasmic antibody, antinuclear antibody, and antiglomerular basement membrane serology results. Renal arteriography showed multiple intrarenal microaneurysms. In spite of therapy with antiviral agents (lamivudine, famciclovir), prednisone, cyclophosphamide, and plasmapheresis, renal function deteriorated. He later developed rapidly progressive dyspnea and hemoptysis. Diffuse alveolar hemorrhage was confirmed by bronchoscopy. He died of respiratory failure. The cause of pulmonary hemorrhage in this case of polyarteritis nodosa is unclear, but may include underlying capillaritis, cocaine-induced pulmonary hemorrhage, or recurrent attacks of malignant hypertension.

An experimental charge density study of the effect of the noncentric crystal field on the molecular properties of organic NLO materials.

The structure, packing, and charge distribution in molecules of nonlinear optical materials have been analysed with reference to their counterparts in centrosymmetric structures based on low temperature X-ray measurements. The systems studied are the centric and noncentric polymorphs of 5-nitrouracil as well as the diamino, dithio, and thioamino derivatives of 1,1-ethylenedicarbonitrile; the latter possesses a noncentric structure. The molecular structure of 5-nitrouracil is invariant between the two forms, while the crystal packing is considerably different, leading to dimeric N-H·âˆ™âˆ™O rings in the centric polymorph and linear chains in noncentric one. There is an additional C-H·âˆ™âˆ™O contact in the centric form with a significant overlap of the electrostatic potentials between the alkenyl hydrogen atom and an oxygen atom of the nitro group. The dipole moment of 5-nitrouracil in the noncentric form is much higher (µ=9 D) than in the centric form (≈6 D). Among the 1,1-ethylenedicarbonitriles, there is an increased charge separation in the noncentric thioamino derivative, leading to an enhanced dipole of 15 D compared to the centric diamino (5 D) and dithio (6 D) derivatives. The effect of the crystal field is borne out by semiempirical AM1 calculations on the two systems. Dipole moments calculated for the molecules in the frozen geometries match closely with those obtained for centric crystals from the experimental charge densities. The calculated values of the dipole moment in the frozen or optimized geometries in the noncentric structures are, however, considerably lower than the observed value. Furthermore, the conformation of the S-CH(3) group in the noncentric crystal is anti with respect to the central C=C bond while the syn conformation is predicted for the free molecule in the optimized geometry.

Fatiguing isometric contraction of hind-limb muscles results in the release of immunoreactive neurokinins from sites in the rostral medulla in the anesthetized cat.

Antibody-coated microprobes were used to determine whether immunoreactive neurokinins (irNK) were released from sites in the brainstem during fatiguing isometric contractions of the triceps surae muscles in cats anesthetized with alpha-chloralose. Contractions were generated by stimulating the tibial nerve using a microprocessor-controlled stimulator. Microprobes were inserted into the periaqueductal grey (P 0.5-1.0 mm) or the medullary brainstem (either 3.0 or 3.5 mm rostral to the obex) prior to, during and following fatiguing contractions. No release of irNK was detected from the periaqueductal grey as a result of fatiguing isometric contractions. When probes were inserted 3.0 mm rostral to the obex, a basal release of irNK was detected from the medulla but this was inhibited during isometric contractions from sites corresponding to the lateral tegmental field. When probes were inserted into the more rostral site in the medulla (3.5 mm rostral to the obex), irNK were released in response to contractions from sites corresponding to lateral reticular nucleus, ventral regions of the nucleus tractus solitarius and the medial vestibular nucleus. No irNK were released from this site (3.5 mm rostral to obex) either during passive leg flexing, during nerve stimulation following gallamine injection and muscle paralysis or during stimulation of the central end of the cut tibial nerve. These results demonstrate that neurokinins are released from discrete sites in the medulla in response to fatiguing muscle contractions and suggest that tachykinin neurons may be a component of the pathways regulating blood pressure during ergoreceptor activation.

Detection of immunoreactive substance P-like substances from cat brainstem sites during fatiguing isometric contractions.

Isometric contractions were generated on the left hindlimb muscles from adult cats (n = 11) anesthetized with alpha-chloralose (75 mg/kg) to determine whether immunoreactive substance P (irSP) was released from either the right periaqueductal grey (PAG) or ventrolateral medulla (VLM), sites shown to be involved with the integration of the muscle pressor response. The release of immunoreactive SP was measured using SP antibody-coated microelectrodes that were inserted into the PAG or the VLM during periods of rest, fatiguing isometric contractions and post-contraction. Mean arterial pressure increased by 78 +/- 11 mmHg during the contractions. There was a release of irSP from sites in the medulla during the contractions compared to the non-contraction periods but none was detected from the PAG in response to muscle stimulation. These results provide further evidence that SP-like substances may be involved with the central integration of the muscle pressor response.

Evaluation of a model curriculum on substance abuse at The Johns Hopkins University School of Medicine.

Beginning in 1985, The Johns Hopkins University School of Medicine developed a model curriculum on alcohol abuse to enhance the education of medical students in issues related to the abuse of alcohol and other drugs. By 1987, preclinical courses (given in years one and two) reflected the goals of the curriculum; however, integration of the curriculum into the clinical courses (given in years three and four) was only partially successful. This paper reports on nine annual surveys of students (the classes of 1989-1992) that were conducted from 1987 to 1990 to measure the effects of the curriculum, using previously validated instruments to record the students' knowledge, attitudes, beliefs in role responsibility, and confidence in clinical skills. Significant improvements occurred in the students' attitudes, beliefs in role responsibility, and confidence in skills during their preclinical years. These positive changes were stronger, and better sustained during the clinical years, in students who participated in special programs or elective courses focusing on substance abuse; the positive changes were not always sustained in other students. The authors suggest that enhanced experiential sessions, elective programs, and greater emphasis during the clinical years on issues relating to substance abuse are necessary for maintaining the desirable educational outcomes of a substance abuse management curriculum, and that an intensive program against a backdrop of curriculum reform is a useful model.

Perceptions & practices of diabetics in Pondicherry.

The knowledge, attitude and self care regarding diabetes was assessed in 150 diabetics, residing in Pondicherry, using a pre-tested schedule addressing six areas of diabetic self-care. Observations made included the ability of the patients to test, interpret and record the result of urine examination; diet practices; and insulin use. The knowledge, attitude and practices of diabetics were less than satisfactory in all the areas of self-care. Up to 80 per cent had a complication or associated disease. Most of the patients appreciated the need for dietary care or medication, but only 50 per cent regulated their diet. Of the 97 per cent using anti-diabetic agents, some were using them harmfully. Only 10.6 per cent of the patients tested their urine, though 71 per cent were aware of the need for this. Only 34 per cent saw a physician regularly. None of the patients had any formal education regarding diabetes.

Serum lipid and lipoprotein fractions in bengal gram and biochanin A induced alterations in atherosclerosis.

Serum lipids and lipoproteins were studied in rabbits fed on egg yolk supplemented diet to induce hypercholesterolemia. Bengal gram and synthetically pure isoflavone Biochanin A have been used as lipodiatic agents in this study. Rabbits were divided into four groups: Group A were fed on egg yolk supplement alone to form the positive control group, Group B were fed with 40 gms of overnight soaked bengal gram (Cicer arietinum), Group C were fed with 50 mgs of Biochanin A fortnightly, Group D was negative control group fed on pelleted laboratory feed. Serum samples were taken every month and total cholesterol, triglycerides and HDL cholesterol were estimated. The other lipoproteins like LDL cholesterol and VLDL cholesterol were obtained by calculations. The Group B and C showed a significant decrease of their lipids and lipoprotein in comparison to Group A thereby indicating the lipodiatic effect of these two substances. However, HDL cholesterol showed an increase in these two groups thereby proving that an increased HDL cholesterol has a protective effect on the atherosclerotic process.

Studies on serum and tissue lipid fractions in Bengal gram induced retardation of experimental atherosclerosis.

Serum and tissue lipid levels were studied in rabbits in whom egg yolk was used to induce atherosclerosis and Bengal gram was supplemented in the diet as a lipodiatic agent. Monthly serological and tissue studies were done to assess the levels of total cholesterol, triglycerides and phospholipids and it was found that egg yolk feeding leads to statistically significant increases in all these fractions in the serum, liver, adrenals, heart and aorta. Bengal gram supplementation of the diet led to flattening of the atherosclerotic plaques and showed statistically significant decline in the organs with the exception of the kidney. This study confirms the lipodiatic effect of the bengal gram and its beneficial effect on the atherosclerotic plaque.

A rare wandering splenic cyst removed with laparoscopic assistance.

This is a report of the first case of a true cyst arising in a wandering spleen. Laparoscopic splenectomy was attempted. The spleen was mobilized under laparoscopic control and the cyst aspirated. Dissection of the pedicle was technically feasible. However, the procedure was aborted due to uncontrollable bleeding from a moderate-sized artery. Although the whole procedure was not completed laparoscopically, laparoscopic assistance facilitated extirpation of the spleen through a 5-cm oblique left iliac fossa incision in a minimally invasive fashion.

Immune status of low birth weight babies.

PIP: An attempt was made to evaluate the humoral and cellular immune status of preterm and small for dates babies born at All India Institute of Medical Sciences Hospital. The study sample included 24 term small-for-dates babies and 12 preterm babies (gestation of less than 37 weeks) and 20 term appropriate-for-dates babies who served as controls. The small-for-dates babies were subdivided into the following 2 subgroups on the basis of severity of intrauterine growth retardation (IUGR): mild IUGR -- babies weighing between 3rd and 10th percentile for their gestation; and severe IUGR -- babies weighing less than 2 S.D. or 3rd percentile for their gestation. The levels of immunoglobulin G (IgG), M (IgM), and A (IgA) were determined in the cord blood using the single radical diffusion technique. The B-lymphocytes were identified and counted by the surface membrane immunoglobulin (SmIg) using immunofluorescence technique. The cellular immune response was assessed by counting T-lymphocytes by E-rosette technique employing sheep red blood cells. The neonates with severe IUGR and preterm babies had significantly lower levels of IgG. The levels of IgM and IgA did not differ significantly in the 4 groups. The preterm babies had significantly higher percentage of B-lymphocytes though the absolute count was not significantly different from normal newborn babies. The absolute count B cells was significantly low in babies with severe IUGR. The babies with severe IUGR had significantly low absolute and percentage count of E-rosette forming cells as compared to normal newborn babies. The findings suggest that low birth weight babies with severe IUGR are at a greater risk to develop bacterial infection due to deficiency of both humoral and cellular immune host defenses. In contrast, preterm babies are immunologically competent though passively transferred maternal IgG levels are low. It is desirable to study the duration of immunodeficiency caused by severe IUGR and its reversibility on nutritional rehabilitation. In view of the wide prevalence of IUGR in India it is possible that inadequacy of cell mediated immune response in these infants may be associated with poor "takes" following at birth BCG and small pox vaccinations. The vaccination schedule may have to be modified depending upon the duration of immunodeficiency in babies with IUGR.^ieng

Coverage of, and compliance with, mass drug administration under the programme to eliminate lymphatic filariasis in India: a systematic review.

India's mass drug administration (MDA) programme to eliminate lymphatic filariasis (PELF) covers all 250 endemic districts, but compliance with treatment is not adequate for the programme to succeed in eradicating this neglected tropical disease. The objective of our study was to systematically review published studies on the coverage of and compliance with MDA under the PELF in India. We searched several databases-PubMed/Medline, Google Scholar, CINAHL/EBSCO, Web of Knowledge (including Web of Science) and OVID-and by applying selection criteria identified a total of 36 papers to include in the review. Overall MDA coverage rates varied between 48.8% and 98.8%, while compliance rates ranged from 20.8% to 93.7%. The coverage-compliance gap is large in many MDA programmes. The effective level of compliance, ≥65%, was reported in only 10 of a total of 31 MDAs (5 of 20 MDAs in rural areas and 2 of 12 MDAs in urban areas). The review has identified a gap between coverage and compliance, and potentially correctable causes of this gap. These causes need to be addressed if the Indian programme is to advance towards elimination of lymphatic filariasis.