Effectiveness of community-based treatment programs for treatment of uncomplicated severe acute malnourished children aged 6-59 months using locally produced nutrient dense foods: protocol for a multicentric longitudinal quasi-experimental study.

BACKGROUND: Severe acute malnutrition (SAM) is a major underlying cause of mortality among children. Around one third of the world's acutely malnourished children live in India. The WHO recommends community-based management of acute malnutrition (CMAM) for managing children with SAM. In India, different states are implementing community-based SAM treatment programme, hereinafter called CSAM, using varieties of locally produced nutrient dense food items with different nutrient compositions. The study will assess the effectiveness of these state specific CSAM interventions. METHODS: The longitudinal quasi-experimental study will be undertaken in two purposively selected blocks of one district each in the four intervention states and one comparison state. From each state, 200 SAM children identified using weight-for-length/height z-score (WHZ) < - 3 criteria will be enrolled in the study. Their anthropometric data and skinfold thickness will be taken on admission, at sixth week and at discharge by trained field investigators. Other child details, incidence of morbidity and socio-economic details will be collected on admission. To assess food consumption pattern including consumption of locally produced nutrient dense food supplements, dietary assessment, using 24-h dietary recall will be conducted on admission, at sixth week and at discharge. In addition, body composition parameters will be assessed for a sub-set of children using bio-electrical impedance analysis on admission and at discharge to analyse changes in total body water, fat-free mass, and fat mass. Post discharge, all study participants will be followed up monthly until 6 months. Atleast 10% of the sample will be checked for quality assessment. The study's primary outcome is cure rate defined as children attaining WHZ ≥ -2. Secondary outcomes include mean weight gain, mean length of stay, body composition parameters, relapse and mortality rates. Additionally, process evaluation and cost effectiveness analysis will be conducted. DISCUSSION: There is a shortage of robust evidence regarding the effectiveness of locally produced nutrient dense food supplements provided as part of the CSAM intervention in India. This study will contribute to evidence on effective strategies to manage children with uncomplicated SAM in India. The study protocol has all necessary ethical approvals. Written informed consent will be obtained from caregivers of the children. TRIAL REGISTRATION: The study is registered with Clinical Trial Registration of India (Registration No.: CTRI/2020/09/028013 ) Date of registration 24/09/2020.

Assessment of Cytokine and Herpesvirus Level in Peri-implantitis and Healthy Patients.

BACKGROUND: The present study was conducted to assess level of cytokine and herpesvirus in peri-implantitis and healthy patients. METHODOLOGY: Fifty patients with healthy dental implant (Group I) and dental implant with peri-implantitis (Group II) were enrolled. The level of interleukin (IL)-1 ß, IL-2, IL-4, IL-6, MCP-1 and tumor necrosis factor-α (TNF-α), and herpesvirus was estimated. RESULTS: The mean IL-1 ß level was 1.54 in Group I and 5.12 in Group II, IL-2 was 0.05 in Group I and 0.02 in Group II, IL-4 was 0.018 in Group I and 0.0021 in Group II, IL-6 was 0.83 in Group I and 0.92 in Group II, MCP-1 was 64.5 in Group I and 23.1 in Group II, and TNF-alpha was 1.54 in Group I and 1.05 in Group II. There was a significant higher level of TNF-alpha in virus + patients (P < 0.05). CONCLUSION: The cytokine level was increased in patients with peri-implantitis as compared to patients with healthy dental implants. Virus-positive patients exhibited higher cytokine levels than virus-negative patients.

Persistence, dissipation, and risk assessment of a combination formulation of trifloxystrobin and tebuconazole fungicides in/on tomato.

Multi-locational supervised field trials were conducted in different agro-climatic regions in India to study dissipation of trifloxystrobin and tebuconazole in tomato after spraying a combination formulation (trifloxystrobin 25% + tebuconazole 50%, 75WG) at recommended doses: (i) single (trifloxystrobin 87.5 g a.i. ha-1 + tebuconazole 175 g a.i. ha-1) and (ii) double (trifloxystrobin 175 g a.i. ha-1 + tebuconazole 350 g a.i. ha-1). Fruit samples were extracted with ethyl acetate using a modified QuEChERS method. The residues (parent fungicides + metabolite) were analyzed and confirmed by GC-ECD and GC-MS, respectively. The half-life (t1/2) of trifloxystrobin and tebuconazole in tomato varied from 1.08 to 1.72 and 1.13 -to 1.64 days at single; and 1.27 to 2.13 and 1.24 to 1.96 days at double dose, respectively. Since maximum residue limit (MRL) at pre-harvest interval (PHI) of 5 days is impractical, as tomato is usually harvested and consumed almost everyday after the last spray, the risk assessment was performed at minimum PHI of 1 day. Accordingly, on the basis of supervised field trial data and using OECD MRL calculator, MRL of 0.5 and 1.5 mg kg-1 at single dose were proposed for trifloxystrobin and tebuconazole in/on tomato, respectively.

Estimation and risk assessment of flubendiamide on fodder berseem clover (Trifolium alexandrinum L.) by QuEChERS methodology and LC-MS/MS.

The residues of flubendiamide from berseem were extracted and cleaned up by the QuEChERS approach and analysed by liquid chromatography/mass spectrometry (LC-MS/MS). The dissipation studies on berseem were carried out by application of flubendiamide at five different dosages i.e. 24, 36, 48, 72 and 96 g a.i. ha(-1). The residues reached below determination limit (BDL) of 0.01 mg kg(-1) in 7, 10, 10, 15 and 15 days for 24, 36, 48, 72 and 96 g.a.i. ha(-1)dosages, respectively. Half-life (t1/2) of flubendiamide on berseem was observed to be 1.08, 1.88, 1.94, 2.26 and 2.27 days, respectively, at 24, 36, 48, 72 and 96 g a.i. ha(-1). Theoretical maximum residue contributions (TMRC) values reached below the maximum permissible limit (MPI) for 3, 5 and 7 days in treatments at 24, 36 and 48 g.a.i. ha(-1), respectively, whereas in case of higher dose treatments i.e. 72 and 96 g a.i. ha(-1), the residues of flubendiamide reached below MPI after 10 days of treatment. These data could provide guidance for the proper and safe use of this pesticide on berseem in India.

Degradation pattern and risk assessment of chlorantraniliprole on berseem (Trifolium alexandrinum L.) using high performance liquid chromatography.

The persistence pattern of chlorantraniliprole on berseem leaves and its risk assessment for the safety of cattle were studied. QuEChERS method was used for the extraction and cleanup of samples and the residues of chlorantraniliprole were estimated using high performance liquid chromatography (HPLC) and confirmed by Liquid Chromatograph-Mass Spectrometer (LCMS-MS). The dissipation studies on berseem were carried out by application of chlorantraniliprole at five different dosages i.e. 11.6, 17.1, 23.1, 34.7 and 46.2 g a.i. ha(-1). Average initial deposits of chlorantraniliprole were found to be 0.47, 0.61, 0.78, 1.15 and 1.31 mg kg(-1), respectively. The residues reached below determination limit (BDL) of 0.01 mg kg(-1) in 5, 7, 7, 10 and 10 days for 11.6, 17.1, 23.1, 34.7 and 46.2 g a.i. ha(-1) dosages, respectively. Half-life (t1/2) of chlorantraniliprole on berseem was observed to be 0.93, 1.14, 1.06, 1.00 and 1.33 days, respectively, at 11.6, 17.1, 23.1, 34.7 and 46.2 g a.i. ha(-1). It was found that the theoretical maximum residue contributions (TMRC) values reached below maximum permissible intake (MPI) on 0 day in berseem samples treated with chlorantraniliprole. These studies, therefore suggest that the use of chlorantraniliprole formulation at different dosages does not seem to pose any hazards to the consumers and a waiting period of one day is suggested to reduce the risk before consumption of berseem leaves. These data could provide guidance for the proper and safe use of this pesticide on berseem in India.

Risk assessment of ß-cyfluthrin and imidacloprid in chickpea pods and leaves.

Dissipation of ß-cyfluthrin and imidacloprid in chickpea pods and leaves was measured following three applications of Solomon 300 OD (ß-cyfluthrin 9 percent +imidacloprid 21 percent) at 200 and 400mLha(-1). Residues of ß-cyfluthrin on chickpea pods and leaves were found to be below its limit of quantification (LOQ) of 0.01mgkg(-1) after 7 days at both the dosages. Similarly, imidacloprid residues were found to be below its LOQ of 0.01mgkg(-1) at 10 days. Half-life periods on chickpea pods and leaves for ß-cyfluthrin were found to be 1.06 and 0.58 days, whereas for imidacloprid these values were observed to be 2.07 and 1.75 days at recommended dose. As the theoretical maximum residue contributions on chickpea pods and leaves are found to be less than the maximum permissible intake values even on 0 day, therefore consumer health risks are minimal at both the dosages on chickpea.