Effect of Breastfeeding on Relieving Pain during Immunization in Infant.

Background Advantages due to immunization are numerous and cannot be avoided but at the same time pain inflicted on babies needs to be addressed when possible. Pain associated with immunization injections has often been overlooked when remedies are available. Objective To find out the effect of breastfeeding on relieving pain during immunization injection in infants. Method An experimental study was conducted at Immunization clinic of B.P. Koirala Institute of Health Sciences (BPKIHS). Total 124 subjects were divided randomly into two groups. Experimental subjects were allowed to breastfeed for 5-10 minutes before immunization while control group was immunized without breastfeeding. Interview Questionnaire was used to obtain demographic variables and measurements were obtained. Measures of pain was recorded using duration of cry and Modified Behavior Pain Scale, by Taddio et al. Data was analyzed by using SPSS 20.0 where variables were assessed with frequency tables, Pearson's Chi-Square test, independent t test and Mann Whitney U test. Result The mean pain score in experimental group was 7.10 and in control group 7.56 which was statistically significant (p=0.001). The median duration of cry was significantly shorter in experimental group i.e. 25 seconds (IQR: 20-30) than control group 42.5 seconds (IQR: 30-61.5) (p < 0.001). Conclusion Breastfeeding before immunization is effective in reducing pain in infants.

Prevalence of COMT Val158Met polymorphism in Eastern UP population.

Catechol-O-methyltransferase (COMT) is an abundant S-adenosylmethionine (SAM-)-dependent methyltransferase that methylates catechol compounds, including catecholamines and catecholestrogens.COMT  gene located at chromosome 22q11.2 contains a functional polymorphism at codon 158(Val158Met), which has been related to psychiatric diseases and different types of cancer. COMT might affect tHcy levels because as a by-product it converts SAM to S-adenosylhomocysteine (SAH), which is reversibly converted to homocysteine. The aim of the present study was to determine the frequency of COMT Val158Met polymorphism in scheduled caste (SC) population of Jaunpur district. Total 100 healthy unrelated subjects belonging to SC, between the age group of 18 to70 years were randomly selected for the present study. 3 ml blood samples were collected from each subject. The inclusion criteria of subjects for present study are that they should be domicile of Uttar Pradesh, and healthy without any individual/ family history of genetic or metabolic disorders. COMT Val158Met polymorphism analysis was done by PCR-RFLP method. The Val/Val genotype was found in 48 subjects, Val/Met in 40 subjects and Met/Met genotype in 12 subjects. Genotype frequencies of Val/Val, Val/Met and Met/Met were 0.48, 0.40 and 0.12 respectively. The allele frequency of Val allele was found to be 0.68 and Met allele frequency was 0.32.

Mixed method approach for determining factors associated with late presentation to HIV/AIDS care in southern India.

BACKGROUND: Early diagnosis and treatment of human Immunodeficiency virus (HIV) is not only beneficial for the people living with HIV/acquired immunodeficiency syndrome (AIDS) (PLHA) but for the public and society as well. The study was aimed to identify the factors associated with late presentation to HIV/AIDS care. MATERIALS AND METHODS: A facility-based unmatched case-control (1:1) study along with in-depth qualitative assessment was conducted at an ART Plus center at a district hospital, Udupi, southern India. A sample of 320 HIV patients (160 cases and 160 controls) was selected randomly between February and July 2014. Information regarding the patients were collected using an interviewer-administered semi-structured questionnaire. The qualitative component was assessed by in-depth interviews of 4 health professionals and 12 HIV-positive patients who were late for HIV care. The quantitative data were analyzed using Statistical Package for the Social Sciences (SPSS) version 15.0. The technique of thematic analysis was adopted for the analysis of qualitative data. RESULTS: HIV-positive individuals who lived with families [odds ratio (OR) = 5.11], the patients having non-AIDS comorbidities [OR= 2.19, 95% confidence interval (CI): 1.09-4.40], the patients who perceived fear of losing family [OR = 5.00, 95% CI: 2.17-11.49], the patients who perceived fear that their status will be ruined in the community [OR= 2.00, 95% CI: 1.01-3.97], the patients who perceived fear of side effects of ART medications [OR = 4.3, 95% CI: 2.65-11.33], the patients who perceived fear of losing confidentiality [OR = 4.94, 95% CI: 2.54-9.59], the patients those who lack information available on government services [OR = 4.12, 95% CI: 2.127-8.005], and the patients who consumed alcohol [OR= 3.52, 95% CI: 1.83-6.77] were found to be independently associated with the late presentation to HIV/AIDS care after adjusting for all known confounders in a multivariable analysis. The qualitative summary showed that the perceived HIV stigma, inadequate health education, lack of awareness on available government services, psychological problems, alcohol use, asymptomatic conditions, and financial problems are major barriers to access care early for the late presenters. CONCLUSION: The identified factors can be utilized for the formulation of policies and interventions by promoting early diagnoses and addressing special concerns such as stigma, disclosure, health education, and awareness.

Cell-death assessment by fluorescent and nonfluorescent cytosolic and nuclear staining techniques.

Apoptosis, a genetically programmed cellular event leads to biochemical and morphological changes in cells. Alterations in DNA caused by several factors affect nucleus and ultimately the entire cell leading to compromised function of the organ and organism. DNA, a master regulator of the cellular events, is an important biomolecule with regards to cell growth, cell death, cell migration and cell differentiation. It is therefore imperative to develop the staining techniques that may lead to visualize the changes in nucleus where DNA is housed, to comprehend the cellular pathophysiology. Over the years a number of nuclear staining techniques such as propidium iodide, Hoechst-33342, 4', 6-diamidino-2-phenylindole (DAPI), Acridine orange-Ethidium bromide staining, among others have been developed to assess the changes in DNA. Some nonnuclear staining techniques such as Annexin-V staining, which although does not stain DNA, but helps to identify the events that result from DNA alteration and leads to initiation of apoptotic cell death. In this review, we have briefly discussed some of the most commonly used fluorescent and nonfluorescent staining techniques that identify apoptotic changes in cell, DNA and the nucleus. These techniques help in differentiating several cellular and nuclear phenotypes that result from DNA damage and have been identified as specific to necrosis or early and late apoptosis as well as scores of other nuclear deformities occurring inside the cells.

Biodegradation of sulfosulphuron in agricultural soil by Trichoderma sp.

UNLABELLED: Sulfosulphuron-degrading fungus was isolated by enrichment technique from the sulfosulphuron-contaminated soil of wheat rhizosphere. To assess the biodegradation potential of isolated Trichoderma sp., minimal potato dextrose agar broth with different levels of sulfosulphuron (up to 2 g l(-1) ) was evaluated in the growth and biotransformation experiments. ESI LC-MS/MS analysis revealed the presence of degradation products 2-amino-4,6-dimethoxypyrimidine (I) and 2-ethylsulfonyl imidazo{1,2-a} pyridine-3-sulfonamide-2-ethylsulfonyl imidazo{1,2-a} pyridine-3-sulfonamide (II) indicating the cleavage of the urea bridge and the presence of the by-product N-(4,6-dimethoxypyrimidin-2-yl)urea (III) indicating the degradation of sulfonylamide linkage. Two other metabolites, N-(4,6-dimethoxypyrimidin-2-yl)-N'-hydroxyurea (IV) and N, N'-bis(4,6-dimethoxypyrimidin-2-yl)urea (V), were also identified. From the previous reports, it was found that the degradation of sulfonyl urea herbicides took place through the chemical degradation of the sulfonylurea bridge followed by microbial degradation. During this investigation, Trichoderma sp. grew well with and degraded sulfosulphuron via both the decarboxylation on the sulphonyl urea bridge and the hydrolytic cleavage of the sulfonylamide linkage as demonstrated by the formation of metabolites. Trichoderma is nonphytopathogenic in nature, and some species of it restrict the growth of soil-dwelling phytopathogens. Therefore, it is a promising candidate for the decontamination of soil from sulfosulphuron residues. SIGNIFICANCE AND IMPACT OF THE STUDY: The degradation of sulfosulphuron by any individual fungus is being reported for the first time. Trichoderma sp. isolated from wheat-rhizospheric soil could survive in minimal broth rich in sulfosulphuron. Previous reports have described the complete degradation of any sulfonyl urea herbicides by micro-organisms only after the pH-dependent chemical hydrolysis of the sulfonyl urea bridge of the herbicide. This study demonstrates the novel result that the Trichoderma sp. utilized the sulfosulphuron as a sole carbon source and degraded it by cleaving sulfonyl urea bridge and sulfonylamide linkage. Thus, the application of Trichoderma sp., which is nonphytopathogenic, has the potential to decontaminate agricultural soil from sulfosulphuron load.

Genotype prevalence and allele frequencies of 5,10-methylenetetrahydrofolate reductase (MTHFR) C677T mutation in two caste groups of India.

The aim of the present study was to investigate the distribution of 5,10-methylenetetrahydrofolate reductase (MTHFR) polymorphism in two caste group populations of eastern Uttar Pradesh. This mutation has been suggested to be positively associated with the risk of several congenital and multifactorial disorders. Frequency of mutant T allele differs in various ethnic and geographical populations of the world. MTHFR C677T mutation analysis was carried out by PCR-RFLP (Polymerase Chain Reaction-Restriction Fragment Length Polymorphism) method and the samples studied were randomly selected from the healthy individuals belonging to two caste populations. In Brahmin samples, genotype frequencies of CC, CT and TT were 0.727, 0.25 and 0.023 respectively whereas in Rajput samples, CC genotype was observed in 88 samples, CT genotype in 25 and TT genotype was found in 2 samples. Frequency of mutant T allele was found to be 0.147 in Brahmin and 0.126 in Rajput populations. The percentage of CT genotype and C allele were high in both the populations.

A Quick Laboratory Method for Assessment of Blood Penetration and Splash Resistance of PPE Fabrics During the COVID-19 Pandemic Situation.

In the current outbreak of COVID-19, healthcare facilities are hit by a shortage of supply of Personal Protective Equipments (PPE) owing to extensive local and global demands and restrictions on their import or export. To circumvent this, trials with several indigenous materials suitable to qualify for PPEs and sterilization techniques for their reuse are being carried out. Prior to their commercialisation, it is imperative to evaluate the resistance of the PPE fabrics against penetration of synthetic blood under applied pressure, 40-300 mmHg as per test standards. Generally, two types of tests are recommended, Penetration Test and Splash Resistance Test, the former being more stringent. While the final certification of PPEs is carried out by authorised agencies, a first impression quick estimate of the choice of fabric can be made using a simple laboratory set-up. This study describes setups developed in the laboratory to carry out these tests. Evaluation of the fabrics, post-gamma irradiation, was also carried out. Microscopic examinations were performed to investigate radiation-induced structural changes in fabrics showing degraded performance. This set-up is useful for selection of fabrics and to assess the feasibility of reuse of PPEs, which is the need of the hour in this pandemic situation.

Adipokine Visfatin's Role in Pathogenesis of Diabesity and Related Metabolic Derangements.

Visfatin is one of the prominent adipokines secreted by adipose tissue. The level of visfatin increases significantly in persons with obesity owing to increased body mass index (BMI). During obesity, the adipocytes, which populate adipose tissue, undergo hypertrophy and hyperplasia and secrete a number of adipocytokines including visfatin. Visfatin, which also acts as an enzyme nicotinamide phosphoribosyl transferase, is one of the prominent adipokines that influence metabolic homeostasis in the body. Visfatin exists in two forms, extracellular and intracellular, and enacts a multitude of actions. The direct and indirect evidence gathered from in-vitro, in-vivo and clinical studies indicate that visfatin modulates obesity and metabolic syndrome-related pathophysiological activities including enhanced inflammation, angiogenesis, synthesis of NAD mononucleotide, and upregulation of antiapoptotic proteins in a number of cell types. It has been implicated in a number of obesity-related alterations and metabolic derangement such as diabetes, cardiovascular complications and some forms of cancers. In this review, the novel hypothesis about the role of visfatin in diabesity has been proposed which implies recent advances in studies about the pathophysiological roles of visfatin during obesity and chronic high glucose in the circulation. Visfatin at high concentration attracts immune cells and produces chronic inflammation in adipocytes. Additionally, it induces insulin resistance in many tissues and causes pancreatic beta cells dysfunction at later stages. Further, its potential as an important target to develop molecular medicine in diabesity and related metabolic syndrome has been highlighted.

Utilization of services for institutional deliveries in Gorkha District.

BACKGROUND: Adequate health services for improving maternal and neonatal health is an important global health issues. Institutional delivery is most important component to address maternal and neonatal issue. Institutional delivery service utilization assures safe birth and minimizes the maternal morbidity and mortality. This study was aimed to assess the utilization of institutional delivery service among the mothers of Gorkha district. METHODS: A cross sectional study of 180 mothers having child below 2 years residing in Palungtar municipality was done between March to July 2015. Information was collected by using an interviewer administered semi-structured questionnaire. Chi-square test was used to for data analysis. RESULTS: Of total, 93.3% of the mother gave birth to their current child at health institution. The study variables like age at marriage, knowledge on delivery incentive, long waiting hours at health facility, Information on maternal health before current pregnancy, age at first pregnancy, gestational age at first ANC visit and women knowing differences between home and institutional delivery were independent factors influencing utilization of institutional delivery service. CONCLUSIONS: Promotion of information, education and communication on maternal health services and delivery incentives could result in utilization of institutional delivery services.

Cysteinyl Leukotrienes (CysLTs): Role in Obesity-Induced Asthma.

Epidemiological studies associate obesity with onset of asthma, especially in obese children, suggesting obesity as the risk factor for asthma. Obesity-induced chronic inflammation has been implicated in the lung inflammation, yet specific mediators and mechanisms are lacking. Obesity is associated with increased expression of 5-lipoxygenase (5-LO) pathway and increased Leukotrienes (LTs) production has been observed in obese asthma patients. However, the precise mechanism that predisposes lungs inflammation in obese is not clearly understood. This article discusses the production and regulation of LTs in obese individuals and presents probable mechanisms regarding the role of LTs in lung inflammation that may lead to obesity-induced asthma. Leukotrienes are well known mediators of asthma but their role in obesity-induced asthma is not clearly understood and thus needs further research. Since efficient antagonists and inhibitors of 5-LO pathways are known, understanding of molecular mechanism of LTs, especially Cysteinyl-LTs, in obesity-induced asthma could lead to optimal treatment regimens for the prevention and treatment of asthma in obese individuals.

Current prospective of aldose reductase inhibition in the therapy of allergic airway inflammation in asthma.

The prevalence of asthma and costs of its care have been continuously increasing, but novel therapeutic options to treat this inflammatory disease have not been brought to the US market. Current therapies such as inhaled steroids, long-acting beta-agonist bronchodilators, antihistamines and immunomodulators may control the symptoms of allergic asthma but fail to modify the underlying disease. Excessive use of steroids and other immunosuppresents alter the patient's quality of life, produce undesirable toxicities, and increase the risk of other pathologies such as diabetes. Hence novel therapeutic options to manage asthma are desirable. In the present review, we have discussed the role of the polyol pathway enzyme aldose reductase (AR) in the amplification of allergic airway inflammation. Recent studies have indicated that AR inhibition prevents the NF-κB-dependent generation of pro-inflammatory cytokines and chemokines in mouse models of allergic airway inflammation indicating the potential use of AR inhibition as a novel tool to control allergic responses. Since orally available AR inhibitors have already undergone phase III clinical trials for diabetic neuropathy and appear to have a manageable side effects profile, they could be readily developed as potential new drugs for the treatment of asthma and related complications.

Emerging role of antioxidants in the protection of uveitis complications.

Current understanding of the role of oxidative stress in ocular inflammatory diseases indicates that antioxidant therapy may be important to optimize the treatment. Recently investigated antioxidant therapies for ocular inflammatory diseases include various vitamins, plant products and reactive oxygen species scavengers. Oxidative stress plays a causative role in both non-infectious and infectious uveitis complications, and novel strategies to diminish tissue damage and dysfunction with antioxidant therapy may ameliorate visual complications. Preclinical studies with experimental animals and cultured cells demonstrate significant anti-inflammatory effects of a number of promising antioxidant agents. Many of these antioxidants are under clinical trial for various inflammatory diseases other than uveitis such as cardiovascular, rheumatoid arthritis and cancer. Well planned interventional clinical studies in the field of ocular inflammation will be necessary to sufficiently investigate the potential medical benefits of antioxidant therapies for uveitis. This review summarizes the recent investigations of novel antioxidant agents for ocular inflammation, with selected studies focused on uveitis.

Understanding the role of aldose reductase in ocular inflammation.

Aldose reductase, although identified initially as a glucose-reducing enzyme via polyol pathway, is believed to be an important component of antioxidant defense system as well as a key mediator of oxidative stress-induced molecular signaling. The dual role played by AR has made it a very important enzyme for the regulation of not only the cellular redox state by detoxifying the reactive lipid-aldehydes generated by lipid peroxidation which is crucial in the cellular homeostasis, but also in the regulation of molecular signaling cascade that may regulate oxidative stress-induced cytotoxic events. Search for the new molecular targets to restrain the oxidative stress-induced inflammation has resulted in the identification of AR as an unanticipated mediator of oxidative stress-induced signaling. Although, in last one decade or so AR has been implicated in various inflammation-related diseases conditions ranging from diabetes, sepsis, cancer, cardiovascular and ocular inflammation, however, a critical evaluation of the clinical efficacy of AR inhibitors awaits a better understanding of the role of AR in regulating inflammation, especially in ocular inflammation.