Shelf life extension of muffins coated with cinnamon and clove oil nanoemulsions.

Clove and cinnamon based nanoemulsions (NE) were prepared with different levels of soy lecithin as a surfactant employing ultrasonication treatment. Increase in surfactant levels decreased the particle size (PS), polydispersity index (PDI) and zeta potential in both the NE. Cinnamon and clove based nanoemulsions were optimized at 1.5 and 2.0% SL, respectively based on their PS and PDI value. Nanoemulsions having the highest thermo stability were further selected to coat the muffin samples. NE Coated and uncoated muffins were evaluated for changes in density, moisture content, water activity, weight loss, texture, antioxidant activity, microbial activity and sensory scores during storage. NE coating significantly increased antioxidant activity of muffins by 26.89% (Cinnamon oil NE) and 37.31% (Clove oil NE). Furthermore during storage, coating of NE maintains the texture of the muffins, reduce the weight loss, density and moisture content to a greater extent in comparison to uncoated muffins. Antioxidant activity and total plate count of clove oil NE coated muffins were significantly higher than cinnamon oil NE coated muffins and while both the NE coating also effectively facilitated in extending the shelf life up to 6 days without any quality deterioration, which facilitated their use as a functional ingredient.

Why parents agree or disagree for minimally invasive tissue sampling (MITS) to identify causes of death in under-five children and stillbirth in North India: a qualitative study.

BACKGROUND: Information on exact causes of death and stillbirth are limited in low and middle income countries. Minimally invasive tissue sampling (MITS) is increasingly practiced in place of autopsy across several settings. A formative research documented the experiences of counselling and consenting for MITS in north India. METHODS: This exploratory qualitative study was conducted at a tertiary care hospital in Delhi. During the early implementation of MITS, observations of the counselling and consenting process (n = 13) for under-five child death and stillbirths were conducted. In-depth interviews with MITS team members (n = 3) were also conducted. Observation and interview data were transcribed and inductively analysed using thematic content analysis to identify emerging themes and codes. RESULTS: The MITS team participated in daily ward rounds for familiarisation with parents/families. Following death declaration the counselling was done in counselling corner of the ward or adjacent corridor. Mostly the counselling was targeted at the father and family members present, using verbal explanation and the consent document in local language. The key concerns raised by parents/family were possible disfigurement, time needed and possible benefits. Most of the parents consulted family members before consent. Among those who consented, desire for next pregnancy, previous pregnancy or neonatal loss and participation of treating senior doctor were the key factors. The negative experience of hospital care, poor comprehension and distance from residence were the factors for consent refusal. Lesser number of parents of deceased children consented for MITS compared to the neonates and stillbirths. CONCLUSIONS: The initial experiences of obtaining consent for MITS were encouraging. Consent for MITS may be improved with active involvement of the treating doctors and nurses, better bereavement support, private counselling area along with improvement in quality of care and communication during hospitalisation. Special efforts and refinement in counselling are needed to improve consent for MITS in older children.

Information about exact cause of death and stillbirth are essential for appropriate care of children and pregnant women. Autopsy assists in establishing exact cause of death, but not preferred by the parents/families. Minimally invasive tissue sampling (MITS) is a suitable alternate to autopsy for establishing causes of death and stillbirth. A pilot project on MITS was initiated at a tertiary care hospital in north India (New Delhi). An exploratory formative research was conducted to document the experiences of counselling and consenting for MITS. Under this study, observation of the counselling and consenting process for conduct of MITS in under-five children (including neonates) and stillbirths were done. Additionally, in-depth interviews with MITS team members were also conducted. Counselling for MITS was done in one corner of the ward or adjacent corridor and mostly targeted at the father and family members present. Counselling was primarily verbal explanation in local language. The key concerns from parents/family were disfigurement, time needed and possible benefits. Most of the parents consulted family members before decision. Benefit during next pregnancy, past previous pregnancy or neonatal loss and senior treating doctor's involvement were key factors for consent. Poor quality of care and comprehension were the reasons for refusal.

Perceptions of family, community and religious leaders and acceptability for minimal invasive tissue sampling to identify the cause of death in under-five deaths and stillbirths in North India: a qualitative study.

BACKGROUND: Minimal invasive tissue sampling (MITS) has emerged as a suitable alternative to complete diagnostic autopsy (CDA) for determination of the cause of death (CoD), due to feasibility and acceptability issues. A formative research was conducted to document the perceptions of parents, community and religious leaders on acceptability of MITS. METHODS: This qualitative study was conducted at and around the Safdarjung Hospital, Delhi, India. Participants for in-depth interview included the parents who had either child or neonatal death or stillbirth and the key community and religious representatives. The focus group discussions (FGDs) involved community members. Process of obtaining consent for MITS was observed. Data were analyzed inductively manually for emerging themes and codes. RESULTS: A total of 104 interviews (parents of deceased children, neonates or stillbirths, n = 93; community members, n = 8 and religious leaders, n = 7), 8 FGDs (n = 72) were conducted and process of obtaining consent for MITS (n = 27) was observed. The participants were positive and expressed willingness to accept MITS. The key determinants for acceptance of MITS were: (1) understanding and willingness to know the cause of death or stillbirth, (2) experience of the healthcare received and trust, (3) the religious and sociocultural norms. Parents and community favored for MITS over CDA when needed, especially where in cases with past stillbirths and child deaths. The experience of treatment, attitude and communication from healthcare providers emerged as important for consent. The decision making process was collective involving the elders and family. No religious leader was against the procedure, as both, the respect for the deceased and need for medical care were satisfied. CONCLUSIONS: Largely, MITS appeared to be acceptable for identifying the causes of child deaths and stillbirths, if the parents and family are counseled appropriately considering the sociocultural and religious aspects. They perceived the quality of care, attitude and communication by the healthcare providers as critical factors for acceptance of MITS.

India tops the chart of childhood deaths and stillbirths globally. The causes of many childhood deaths and stillbirths remain unknown or ill-defined in India. For planning the health policies, program and clinical practices, the cause of death (CoD) and stillbirth are primarily determined by verbal autopsy (VA) method, which has several inherent limitations. The acceptance and implementation of complete diagnostic autopsy (CDA) or full autopsy for CoD determination is limited. Minimally invasive tissue sampling (MITS) is a suitable alternative to full autopsy for CoD determination. MITS has been found to be acceptable and being implemented in some low and middle income countries. Considering the multi-religion and sociocultural contexts of India, an understanding about the perceptions, practices, acceptance and barriers among the parents, community members and religious leaders regarding MITS was necessary for designing appropriate communication strategies and materials for consent. A qualitative study was undertaken in New Delhi, India using in-depth interviews with the parents of deceased children and stillbirths, community leaders, community health workers and religious leaders and focus group discussions with the community members and observation of obtaining consent for MITS. The parents and community members were positive about MITS and expressed willingness to accept it over full autopsy to know the CoD and stillbirths. The factors like past stillbirths and child deaths, experience of the healthcare received and trust, the religious and sociocultural norms emerged as important determinants for acceptance of MITS. The religious leaders were also positive about MITS if needed for treatment and benefit of the family.

Lipid profile of hyperlipidemic males after supplementation of multigrain bread containing sunflower (Helianthus annuus) seed flour.

Sunflower seeds are produced and consumed worldwide due to their richness in heart friendly nutrients in the bakery products. Its effect on reducing the incidences of cardio vascular diseases have not been studied, through supplementary studies therefore present supplementation study was planned in which five samples of bread were prepared by using various multigrain flours and sunflower seed flour at five different levels of 2.5, 5, 7.5, 10 and 12.5%. The bread sample supplemented with 7.5% sunflower seed flour was found to be highly acceptable. Sunflower seeds were roasted at 60 °C for 10-15 min. Chemical analysis of sunflower seed flour (raw and roasted) and highly acceptable bread pertaining to proximate composition, in vitro protein digestibility, antioxidant activity, bioactive compounds, essential fatty acids and minerals was done using standard methods. Roasting of seeds resulted in significant increase in carbohydrates, protein digestibility, phosphorus, magnesium and copper contents. The most acceptable sample had good amount of energy (324.48 kcal), protein (10.61 g), fat (2.92 g), fibre (11.36 g), ash (3.29 g), antioxidant activity (12.13%), total phenols (31.54 mg), flavonoids (17.53 mg), omega 3 fatty acids (186.16 mg), omega 6 fatty acids (13,701.40 mg), phosphorus (68.74 mg), magnesium (28.13 mg) and copper (0.12 mg) per 100 g. Sixty hyperlipidemic males aged 30-50 years were supplemented with highly acceptable bread for four months. After the intervention period, mean daily intake of and nuts and oilseeds increased significantly (p < 0.01) and a significant increase (p < 0.01) in the intake of total fat, dietary fibre, PUFA, linoleic acid, ascorbic acid, alpha tocopherols and phosphorus was observed. The weight, BMI, total cholesterol, LDL cholesterol and triglycerides significantly reduced after the supplementation.

Perceptions of the healthcare providers regarding acceptability and conduct of minimal invasive tissue sampling (MITS) to identify the cause of death in under-five deaths and stillbirths in North India: a qualitative study.

BACKGROUND: India contributes the highest share of under-five and neonatal deaths and stillbirths globally. Diagnostic autopsy, although useful for cause of death identification, have limited acceptance. Minimally invasive tissue sampling (MITS) is an alternative to autopsy for identification of the cause of death (CoD). A formative research linked to pilot MITS implementation was conducted to document the perceptions and attitudes of the healthcare professionals and the barriers for implementation. METHODS: This exploratory qualitative study conducted at a tertiary care hospital in New Delhi, India included the hospital staffs. In-depth interviews were conducted with the doctors, nurses and support staffs from pediatrics, neonatology, obstetrics and forensic medicine departments. Inductive data analysis was done to identify the emerging themes and codes. RESULTS: A total of 26 interviews (doctors, n = 10; nurses, n = 9 and support staffs, n = 7) were conducted. Almost all professional and support staffs were positive about the MITS and its advantage for CoD identification including co-existing and underlying illnesses. Some opined conduct of MITS for the cases without clear diagnosis. All participants perceived that MITS would be acceptable for parents due to the non-disfigurement and preferred by those who had unexplained child deaths or stillbirths in past. The key factors for MITS acceptance were appropriate communication, trust building, involvement of senior doctors, and engagement of the counselor prior to deaths and training of the personnel. For implementation and sustenance of MITS, involvement of the institute authority and government stakeholders would be essential. CONCLUSIONS: MITS was acceptable for the doctors, nurses and support staffs and critical for better identification of the causes of death and stillbirths. The key facilitating factors and challenges for implementing MITS at the hospital in Indian context were identified. It emphasized on appropriate skill building, counseling, system organization and buy-in from institution and health authorities for sustenance of MITS.

In vitro nutrient digestibility and antioxidative properties of flour prepared from sorghum germinated at different conditions.

Germination can be used as a bio-processing practice to enhance the digestibility of nutrient and improve the bioactive compounds and rheological properties of food grains. In the present study, effect of germination time 12, 24, 36 and 48 h and temperature 25, 30 and 35 °C on carbohydrate profile, enzyme activity, in vitro nutrient digestibility, antioxidant activity, bioactive components and rheological characteristics of sorghum was examined. As time and temperature for germination progressed, it considerably enhance the activity of diastase enzyme and also the sugar content by hydrolysis of starch and further enhance the in vitro digestibility of starch by 10.50-36.25%. Germinated sorghum had high in vitro protein digestibility and it ranges from 57.50 to 77.91% as compared to native sorghum (54.09%). Germination of sorghum for longer time period at elevated conditions appreciably improve the antioxidant activity by 4.24-52.96%, total phenolic content and flavonoid content by 1.60-4.09 mgGAE/g and 60.30-94.03 mgQE/100 g, respectively Similarly reducing power increased from 29.27 to 47.19 µg AAE/g and metal chelating activity enhanced 19.48-52.09% as period for germination goes from 12 to 48 h and temperature from 25 to 35 °C. Increased enzyme activity during germination degrades the starch and thus lowers down the peak and final viscosity of sorghum. Increased enzymatic activity and higher antioxidant activity also lower down the lightness value by 12.48% while a* was increased by 6.78%. Germination of sorghum thus offers a tool to increase the nutrient digestibility and bioactive potential of sorghum without any chemical or genetic engineering.

Cereal starch nanoparticles-A prospective food additive: A review.

Starch is one of the most abundant biopolymers in nature and is typically isolated from plants in the form of micro-scale granules. Raw starch has limited applications due to its innate disadvantages such as poor solubility in cold water, tendency to retrograde and high viscosity once it is gelatinized. Therefore, some degree of modification is required to enhance its functionality. Starch nanoparticle is one of the products of such modification. Chemical, enzymatic, and physical treatments are used for the preparation of starch nanoparticles and to study their granular and molecular structures. Characterization of starch nanoparticles on the size distribution, crystalline structure, and physical properties in relation to the starch sources and preparation methods can be done using various characterization tools e.g. Scanning Electron Microscopy, Transmission Electron Microscopy, Atomic Florescence Microscopy, etc. Starch nanoparticles can be used as a food additive as it has adverse range of uses in food such as emulsion stabilizer, fat replacer, Thickener, or rheology modifier etc.

Brain clearance of protein aggregates: a close-up on astrocytes.

Protein misfolding and accumulation defines a prevailing feature of many neurodegenerative disorders, finally resulting in the formation of toxic intra- and extracellular aggregates. Intracellular aggregates can enter the extracellular space and be subsequently transferred among different cell types, thus spreading between connected brain districts.Although microglia perform a predominant role in the removal of extracellular aggregated proteins, mounting evidence suggests that astrocytes actively contribute to the clearing process. However, the molecular mechanisms used by astrocytes to remove misfolded proteins are still largely unknown.Here we first provide a brief overview of the progressive transition from soluble monomers to insoluble fibrils that characterizes amyloid proteins, referring to α-Synuclein and Tau as archetypical examples. We then highlight the mechanisms at the basis of astrocyte-mediated clearance with a focus on their potential ability to recognize, collect, internalize and digest extracellular protein aggregates. Finally, we explore the potential of targeting astrocyte-mediated clearance as a future therapeutic approach for the treatment of neurodegenerative disorders characterized by protein misfolding and accumulation.

Physical, morphological and storage stability of clove oil nanoemulsion based delivery system.

Clove oil based Nanoemulsions (NE) were prepared ultrasonically using Tween 80 and soy lecithin as synthetic and natural surfactants, respectively. The developed NEs were characterized for various parameters (particle size, polydispersity index, zeta potential, morphology, viscosity, colour, turbidity and pH) and the comparative effect of both the surfactants at variable levels (oil:tween 80-1:1, 1:2, 1:3 and 1:4 and oil: soy lecithin- 1:1, 1:1.5 and 1:2) was assessed. It was found that the type of surfactant and oil to surfactant ratio significantly affected particle size and stability of NEs. The NE prepared using tween 80 @1:3 had smallest average droplet diameter (40.9 nm). The formulated NEs were stored at 25 °C and 4 °C and analyzed for turbidity, pH and phase separation up to 90 days. Results revealed that the type and concentration of the surfactant significantly influenced the particle size and stability of NEs. NEs prepared using tween 80 were found to be more viscous than those prepared with soy lecithin. The prepared clove oil NEs have important implication to be used as a natural delivery system to increase the shelf life of food products.

Physicochemical, thermal, pasting, morphological, functional and bioactive binding characteristics of starches of different oat varieties of North-Western Himalayas.

Starches were isolated from five oat varieties (SFO-1, SFO-3, Sabzar, SKO-20 and SKO-96) grown in North-Western Himalayas of India. Moisture content of the varieties ranged from 9.25 ± 0.09 to 13.21 ± 0.11 %, indicating their shelf-stability. Results suggested >90 % purity of starches as was evident from values of ash, proteins, and lipids. Amylose content results showed that all starches fall within category of intermediate-amylose starches. Lambdamax, blue value and OD620/550 were found significantly (p ≤ 0.05) higher in SKO-20. Sabzar exhibited higher starch hydrolysis percentage of 85.16 % whereas, lowest was observed in SKO-20 (78.12 %). Degree of syneresis was higher in SKO-20 however, its freeze-thaw stability was lesser. Wide peak in FTIR spectra at 3320 cm-1 confirms nature of starches. SKO-20 exhibited significantly higher onset gelatinization temperature (65.19 ± 1.06 °C) and enthalpy (15.78 ± 0.15 J/g) whereas, Sabzar exhibited lowest enthalpy. Pasting characteristics indicated lowest and highest final viscosity in SKO-20 (341.30 ± 2.11 mPas) and SKO-96 (1470 ± 4.56 mPas), respectively. SEM results indicated irregular and polygonal shape of starches with size <10 µm. SKO-20 exhibited lowest disintegration time of 2.08 ± 0.01 min and Sabzar showed highest (3.31 ± 0.07 min). SKO-20 released more curcumin (71.28 %) whereas, Sabzar released less. This suggests that SKO-20 could be used as better excipient for delivery of curcumin at target site.

Functional properties of pasta enriched with variable cereal brans.

To explore the potentiality of cereal brans for preparation of fiber enriched pasta, various cereal brans (Wheat, Rice, Barley and Oat) were added at 0, 5, 10, 15, 20 and 25 per cent to durum wheat semolina. The effect of cereal bran enrichment on the colour, cooking, sensory quality and shelf life of enriched pasta was assessed at ambient temperature. Pasta prepared with added fiber at 25 per cent level had the highest protein and dietary fiber content as compared to control. Enrichment with variable fiber sources improved the brightness of pasta, as colour of pasta enhanced significantly. Addition of cereal brans resulted an increase in the water absorption and cooking losses of pasta. This effect was dependent on the level and type of cereal brans. Significant correlation (r = 0.80) was obtained between water absorption and volume expansion in all types of bran enriched pasta. At 25 per cent level of supplementation, maximum solids were leached into cooking water. Bran enriched pasta required less cooking time for complete gelatinization of starch. Increasing level of cereal brans had significantly affected the overall acceptability of enriched pasta. Cooking quality of pasta remained constant during storage. Non significant effect of storage was found on water activity, free fatty acids. Enriched pasta (15 per cent level of wheat, rice and oat bran and 10 per cent barley bran) was highly acceptable upto 4 months of storage with respect to quality.

Grief reaction and psychosocial impacts of child death and stillbirth on bereaved North Indian parents: A qualitative study.

BACKGROUND: Grief following stillbirth and child death are one of the most traumatic experience for parents with psychosomatic, social and economic impacts. The grief profile, severity and its impacts in Indian context are not well documented. This study documented the grief and coping experiences of the Indian parents following stillbirth and child death. METHODS: This exploratory qualitative study in Delhi (India) included in-depth interviews with parents (50 mothers and 49 fathers), who had stillbirth or child death, their family members (n = 41) and community representatives (n = 12). Eight focus group discussions were done with community members (n = 72). Inductive data analysis included thematic content analysis. Perinatal Grief Scale was used to document the mother's grief severity after 6-9 months of loss. RESULTS: The four themes emerged were grief anticipation and expression, impact of the bereavement, coping mechanism, and sociocultural norms and practices. The parents suffered from disbelief, severe pain and helplessness. Mothers expressed severe grief openly and some fainted. Fathers also had severe grief, but didn't express openly. Some parents shared self-guilt and blamed the hospital/healthcare providers, themselves or family. Majority had no/positive change in couple relationship, but few faced marital disharmony. Majority experienced sleep, eating and psychological disturbances for several weeks. Mothers coped through engaging in household work, caring other child(ren) and spiritual activities. Fathers coped through avoiding discussion and work and professional engagement. Fathers resumed work after 5-20 days and mothers took 2-6 weeks to resume household chores. Unanticipated loss, limited family support and financial strain affected the severity and duration of grief. 57.5% of all mothers and 80% mothers with stillbirth had severe grief after 6-9 months. CONCLUSIONS: Stillbirth and child death have lasting psychosomatic, social and economic impacts on parents, which are usually ignored. Sociocultural and religion appropriate bereavement support for the parents are needed to reduce the impacts.

Managing patients of shock and acute kidney injury in tertiary care cardiac ICU: Experience with continuous renal replacement therapy.

BACKGROUND: Clinical experience on details of CRRT initiation and outcomes in cardiac intensive care unit (CICU) patients is not available from developing countries like India. This study shares the 5-year clinical experience of managing CICU patients requiring CRRT in a tertiary care cardiac center of North India. MATERIALS AND METHODS: Medical records of all CICU patients with acute kidney injury (AKI) managed by CRRT from October 2011 to September 2016 at tertiary referral center in North India were retrospectively reviewed. Multiple logistic regression analysis was used to identify predictors of post-CRRT mortality. RESULTS: A total of 630 patients received CRRT during the study period. Most commonly AKI developed in patients with acute coronary syndrome (30.2 %) with cardiogenic shock. 55.9 % of the CRRT patients were >60 years of age, and/or on multiple supports in ICU including, mechanical ventilation, high doses of inotropes & vasopressors and other cardiovascular support. Of those on CRRT, 130 (20.6 %) patients had died, 215 (34.1 %) were discharged and 285 (45.2 %) could not complete the desired course. Multivariate regression analysis showed independent association of mortality with high vasoactive-inotropic score, single CRRT cycle and low mean arterial pressure in CRRT patients. CONCLUSION: About 34.1 % of patients receiving CRRT were alive at discharge, emphasizing the feasibility and utility of CRRT as a promising modality in this population for improving outcomes.

Perceptions of the parents of deceased children and of healthcare providers about end-of-life communication and breaking bad news at a tertiary care public hospital in India: A qualitative exploratory study.

BACKGROUND: Parents of dying children face unique challenge and expect compassionate support from health care providers (HCPs). This study explored the experiences of the parents and HCPs about the end-of-life care and breaking bad news and related positive and negative factors in Indian context. METHODS: This qualitative exploratory study was conducted at paediatrics department of a tertiary care hospital in Delhi. In-depth interviews with the parents (n = 49) and family members (n = 21) of the children died at the hospital and HCPs (6 doctors, 6 nurses and 4 support staffs) were conducted. Also events and communication around death of eight children were observed. Data were inductively analysed using thematic content analysis method to identify emerging themes and codes. RESULTS: Doctors were the lead communicators. Majority of parents perceived the attitude, communication and language used as by resident doctors as brief, insensitive and sometimes inappropriate or negative. They perceived that the attitude and communication by senior doctor's as empathetic, positive and complete. Parents recalled the death declaration by resident doctors as non-empathetic, blunt and cold. Most parents received no emotional support from HCPs during and after death of their child. All doctors expressed that death of their patients affected them and their emotions, which they coped through different activities. The overcrowded wards, high workload, infrastructural limitation and no formal communication training added to the emotional stress of the HCPs. CONCLUSIONS: Majority of the communication by the HCPs during the hospitalisation and end-of-life period were perceived as suboptimal by the parents. The HCPs were emotionally affected and faced end-of-life communication challenges. The study highlights the communication by HCPs and support for parents during the end-of-life communication and breaking bad news. It suggests adoption of context specific communication protocol and materials and training of HCPs in communication to improve the quality of care.

Do anti-platelet drugs improve duration of continuous renal replacement therapy? A retrospective cohort study in cardiac ICU patients.

OBJECTIVE: The objective of this study was to investigate the impact of anti-platelet drug/s on duration of continuous renal replacement therapy (CRRT) in those patients where anti-coagulants were not used due to certain contraindications and in cases where patients were on anti-platelet drugs and were given anti-coagulant during CRRT. METHOD: This single-center, retrospective cohort study was conducted using the medical records patients treated with CRRT in the cardiac ICU of the inpatient urban facility, located in North India. Data was collected from only those patients who received CRRT for the duration of at least 12 h. Patient's in NAC group were not on any anti-platelet/s and did not receive anti-coagulant during CRRT. AC and AP group patients received anti-coagulant alone or were already on anti-platelet/s and did not receive anti-coagulant respectively while ACAP group patients were on anti-platelet drug/s and also received anti-coagulant during CRRT. RESULT: Patients in AC, AP, or ACAP group showed significantly (p < 0.001) higher CRRT filter life compared to NAC group. The median CRRT filter life was significantly higher in the ACAP group compared to AC (p < 0.05) and AP (p < 0.001) groups. CONCLUSION: This study indicates that systemic anti-platelet therapy can provide additional support in critical patients undergoing CRRT even with or without anti-coagulant therapy. However, the increase in CRRT filter life was more profound in patients who were on anti-platelet/s and also received anti-coagulant drug/s during CRRT.

Critical Reviews on Pediatric Dosage Form Developments and Medical Devices.

The pediatric population is generally considered as "miniature adults," but they actually differ from adults due to their different body compositions and varied stages of organ development, which alter essential biopharmaceutical parameters. The physiological differences between the pediatric population and the adult population alter the essential kinetics and dynamics of the same drug administered at the same dose. For pediatric patients, the drug dose is generally calculated using different formulas based on age, body surface area, or weight, or is simply reduced to half of adult dose. This, however, is not the correct practice. New approaches have emerged for designing customized formulations and medical devices for the pediatric population. Examples of customized formulations are "mini-tablets" and "oro-dispersible films," which attempt to ease the administration of solid oral dosage forms. These specially designed medical devices have shown the ability to overcome many challenges in dose administration to children. One such medical device is the "oral solid dosage pen," which allows for dose adjustment by cutting a tablet-like drug carrier at a predefined height and offers flexibility and convenience for dose administration to the pediatric population. Other medical devices, such as the Nipple Shield Delivery System (NSDS) and Medibottle also aid in efficient drug delivery to pediatrics. This review summarizes the challenges in dosage form design and advances in suitable medical devices for better administration to the pediatric population to overcome accidents due to medical errors, incomplete absorption, and toxicity.

Expedient Synthesis of Lupulones and Their Derivatization to 2,8-7H-Dihydrochromen-7-ones.

A convenient and improved method for the synthesis of beta acids or lupulones, which are known to possess e. g. anti-cancer, anti-inflammatory, anti-oxidative and antimicrobial activity, has been developed successfully. Further derivatization of these complex structures to the corresponding dihydrochromen-7-ones, including the natural product machuone, was realized to simplify their analysis and to confirm their molecular structure. In addition to practical and safe laboratory procedures, the advantages associated with this new approach involve the use of water as a solvent and the direct crystallization of lupunones from acetonitrile, rendering our strategy more efficient and benign as compared to available methods.

ImmtorLig_DB: repertoire of virtually screened small molecules against immune receptors to bolster host immunity.

Host directed therapies to boost immunity against infection are gaining considerable impetus following the observation that use of antibiotics has become a continuous source for the emergence of drug resistant strains of pathogens. Receptors expressed by the cells of immune system play a cardinal role in initiating sequence of events necessary to ameliorate many morbid conditions. Although, ligands for the immune receptors are available; but their use is limited due to complex structure, synthesis and cost-effectiveness. Virtual screening (VS) is an integral part of chemoinformatics and computer-aided drug design (CADD) and aims to streamline the process of drug discovery. ImmtorLig_DB is a repertoire of 5000 novel small molecules, screened from ZINC database and ranked using structure based virtual screening (SBVS) against 25 immune receptors which play a pivotal role in defending and initiating the activation of immune system. Consequently, in the current study, small molecules were screened by docking on the essential domains present on the receptors expressed by cells of immune system. The screened molecules exhibited efficacious binding to immune receptors, and indicated a possibility of discovering novel small molecules. Other features of ImmtorLig_DB include information about availability, clustering analysis, and estimation of absorption, distribution, metabolism, and excretion (ADME) properties of the screened small molecules. Structural comparisons indicate that predicted small molecules may be considered novel. Further, this repertoire is available via a searchable graphical user interface (GUI) through http://bioinfo.imtech.res.in/bvs/immtor/ .

Goat lung surfactant for treatment of respiratory distress syndrome among preterm neonates: a multi-site randomized non-inferiority trial.

OBJECTIVE: To investigate the safety and efficacy of goat lung surfactant extract (GLSE) compared with bovine surfactant extract (beractant; Survanta®, AbbVie, USA) for the treatment of neonatal respiratory distress syndrome (RDS). STUDY DESIGN: We conducted a double-blind, non-inferiority, randomized trial in seven Indian centers between June 22, 2016 and January 11, 2018. Preterm neonates of 26 to 32 weeks gestation with clinical diagnosis of RDS were randomized to receive either GLSE or beractant. Repeat dose, if required, was open-label beractant in both the groups. The primary outcome was a composite of death or bronchopulmonary dysplasia (BPD) at 36 weeks postmenstrual age (PMA). Interim analyses were done by an independent data and safety monitoring board (DSMB). RESULT: After the first interim analyses on 5% enrolment, the "need for repeat dose(s) of surfactant" was added as an additional primary outcome and enrolment restricted to intramural births at five of the seven participating centers. Following second interim analysis after 98 (10% of 900 planned) neonates were enroled, DSMB recommended closure of study in view of inferior efficacy of GLSE in comparison to beractant. There was no significant difference in the primary outcome of death or BPD between GLSE group (n = 52) and beractant group (n = 46) (50.0 vs. 39.1%; OR 1.5; 95% CI 0.7-3.5; p = 0.28). The need for repeat dose of surfactant was significantly higher in GLSE group (65.4 vs. 17.4%; OR 9.0; 95% CI 3.5-23.3; p < 0.001). CONCLUSIONS: Goat lung surfactant was less efficacious than beractant (Survanta®) for treatment of RDS in preterm infants. Reasons to ascertain inferior efficacy of goat lung surfactant requires investigation and possible mitigating strategies in order to develop a low-cost and effective surfactant.

Morphometric Analysis of Odontometric Parameters for Gender Determination.

INTRODUCTION: In contemporary human population, males exhibit larger size of dentition as compared to females. Additionally, these odontometric parameters show variation in members of same species and also show regional variation. AIM: To evaluate sexual dimorphism of four maxillary odontometric parameters such as Intercanine Width (ICW), Interpremolar Width (IPW), Arch Length (AL) and Combined Width (CW) of six maxillary anterior teeth, to determine percentage of sexual dimorphism of all four odontometric parameters singly or in combination and also to determine sensitivity, specificity and overall accuracy of odontometric parameters for sex determination. MATERIALS AND METHODS: This cross-sectional study was conducted on 200 subjects (100 males, 100 females). Four odontometric parameters ICW, IPW, AL and CW were measured directly on the subject and the data thus collected was subjected to statistical analysis. RESULTS: Discriminant statistical analysis (d square test) revealed that all the four odontometric maxillary parameters exhibited greater mean values in males as compared to females. The difference was found to be statistically highly significant (p<0.001) for ICW and IPW for sexual dimorphism. Also, combination of parameters such as ICW, IPW further improved assessment. CONCLUSION: The study concluded that linear odonotometric parameters ICW, IPW along with AL, CW show significant sexual dimorphism. Hence, odontometric parameters offer simple, reliable and cost-effective way of determining sex in any forensic investigation.