Outcome of Early Onset Sepsis and Clinical Profile of Very Low Birth Weight Neonates; A Cross Sectional Study

Background: Septicaemia in neonates in the first month or before and after delivery is considered as major cause of mortality and morbidity in the developing countries despite the development of broad spectrum antimicrobial drugs. Early diagnosis of sepsis is necessary to increase the life expectation of neonates with sepsis. Moreover, sepsis induced mortality can be decreased via prevention of sepsis, timely diagnosis and intensive supportive care. Methods: The study involved 200 neonates weighing less than1499 grams, delivered or admitted in extramural NICU with one clinical feature and one risk factor for sepsis as mentioned in the inclusion criteria were recruited for the study. Blood culture reports for promoting rational antibiotic use and clinical follow up of the child till completion of hospital stay was done to study outcome of neonatal septicemia and then treatment plan was modified accordingly. Results: 40% of bacteria culture cases were gram positive while 60% of bacteria culture cases were gram negative. Pulmonary hemorrhage (36%) followed by septic shock (30%) and hyaline membrane disease (27%) were the most common cause of death in the present study. 80% of gram negative and 20% of gram positive organisms were involved in all the deaths caused due to sepsis. The mortality rate was significantly higher for out born neonates (50%) as compared to inborn neonates (34%) out born neonates (50%) as compared to inborn neonates (34%). Conclusion: Present study confirmed the presence of major concern about the high rate of sepsis among very low birth weight infants. Antibiotic therapy should be considered in absence of clinical features if >2 risk factors of sepsis are present. Blood culture should be done in all suspected cases of neonatal septicemia, which provides early confirmation of sepsis. To keep the infection rates low, strict protocol for asepsis in neonatal units must be adhered to when handling these high-risk infants as prevention is better than cure.

Effect of lisinopril and perindopril on serum lipid profile in Albino rabbits

Background: Hypertension with dislipidemia is becoming a common morbidity, since ACE inhibitors are the first line of antihypertensive drugs so present study was undertaken with the aim to evaluate the possible effects of ACE inhibitor on lipid profile in albino rabbits.Methods: The study was conducted in the Department of Pharmacology and Therapeutics, GSVM Medical College, Kanpur. Rabbits were divided into 2 groups with 6 in each group. Rabbits of Group I was given Lisinopril in dose of 0.25mg/kg and of group II was given Perindopril in dose of 0.20mg/kg for a period of 6 weeks. Lipid profile estimation (Serum Total cholesterol, serum HDL, serum LDL, serum Triglycerides and serum VLDL) was done at day 0, 7, 21 and 45 respectively.Results: After analysis Rabbits of group-I (Lisinopril) showed 3.1% decrease in serum cholesterol level at 45th day (P<0.001). Serum HDL level increased by 6.4% and 14.3% at day 21 and 45 respectively (P<0.05). Increase in serum Triglyceride level was 2.6% at day 45 (P>0.05). Serum LDL level decreases by 4.4% and 8.6% at day 21 and 45 respectively (P<0.001). There was no significant change in Serum VLDL level. Rabbits of group- II (Perindopril) showed decreased total cholesterol levels by 2.6% (P<0.05). There was an increase in HDL level by 6.8 % at day 45(P<.05). Triglycerides and VLDL levels were not significantly altered while serum LDL level decreases by 6.7% at day 45 (P<0.01).Conclusions: From our study it was concluded that Lisinopril had a favourable effect on serum lipid profile by decreasing total cholesterol, increasing serum HDL level. It may increase triglycerides, decrease LDL. Perindopril increase serum HDL and decreases LDL, there is no significant change in cholesterol, TG and VLDL levels.

A comparative 2D QSAR study on a series of hydroxamic acid-based histone deacetylase inhibitors vis-à-vis comparative molecular field analysis (CoMFA) and comparative molecular similarity indices analysis (CoMSIA).

A quantitative structure-activity relationship (QSAR) study was performed on a series of indole amide analogues reported by Dai et al. [Bioorg Med Chem Lett (2003), 13, 1897-1901] to act as histone deacetylase (HDAC) inhibitors. The multiple regression analysis (MRA) revealed a model showing the significant dependence of the activity on molar refractivity (MR) and global topological charge index (GTCI) of the compounds, suggesting that inhibition of the HDAC by this series of compounds might involve the dispersion interaction with the receptor, where charge transfer between pairs of atoms might greatly help to polarize the molecule. The MRA results were then compared with those obtained by Guo et al. [Bioorg Med Chem (2005), 13, 5424-5434] by comparative molecular field analysis (CoMFA) and comparative molecular similarity indices analysis (CoMSIA). It was found that MRA gave as good results and had as good predictive ability as CoMFA and CoMSIA. Besides, MRA was also able to throw the light on the physicochemical properties of the molecules that were involved in drug-receptor interactions, while CoMFA and CoMSIA could not. The dispersion interaction between the molecule and the active site of the receptor is suggested to be the main interaction.

Novel molecular aberrations and pathologic findings in a tubulocystic variant of renal cell carcinoma.

Tubulocystic renal cell carcinoma (TRCC) is an indolent type of renal cell carcinoma with a good prognosis based on the limited number of published cases. Herein, we describe the unusual clinical, pathologic and molecular fi ndings in a case of TRCC. Our patient with TRCC had two local recurrences and a brain metastasis following radical nephrectomy. Unusual histologic fi ndings included focal solid growth pattern and cytologic atypia. A genome-wide molecular inversion probe assay identifi ed copy number (CN) loss in three chromosome regions and one region with copy-neutral loss of heterozygosity (copy-neutral LOH). Copy number variations (CNVs) were observed (chromosomes 4p16.1 and 17q21.31-q21.32) in both the tumor and the normal tissue, and most likely represents benign variations. The loss of entire chromosomes 9, 18 and 15 and copy-neutral LOH involving 6p22.1 was observed only in the tumor. The presence of these clinical, pathologic and molecular fi ndings could be related to an increased risk for tumor recurrence and poor prognosis. The novel molecular fi ndings described in TRCC might represent new targets for novel therapies.

Socio-demographic correlates of breast-feeding in urban slums of Chandigarh.

RESEARCH QUESTION: Whether socio-demographic factors are associated with initiation of breast-feeding in urban slums of Chandigarh. OBJECTIVES: (1) To study the prevailing breast-feeding practices adopted by mothers, (2) To study the socio-demographic factors associated with initiation of breast-feeding. STUDY DESIGN: Cross-sectional. PARTICIPANTS: Mothers of infants willing to participate in the study in the selected area. SAMPLE SIZE: A total of 270 respondents. STUDY VARIABLES: Social and demographic characteristics like age, socioeconomic status, educational level, birth interval, parity, gender preference, natal care practices, etc.; and variables related to various aspects of breast-feeding practices like prelacteal feed, initiation of feeding, colostrum feeding, reasons of discarding colostrum, etc. STATISTICAL ANALYSIS: Chi-square test and odd ratios along with their respective 95% confidence intervals, multiple logistic regression analysis. RESULTS: Out of all 270 respondents, 159 (58.9%) initiated breast-feeding within 6 h of birth, only 43 (15.9%) discarded colostrum and 108 (40.0%) mothers gave prelacteal feed. Illiterate/just literate mothers who delivered at home were found at significantly higher risk of delay in initiation of breast-feeding on the basis of multiple logistic regression analysis. SUGGESTIONS: Promotion of institutional deliveries and imparting health education to mothers for protecting and promoting optimal breast-feeding practices are suggested.