Biotinidase biochemical and molecular analyses: Experience at a large reference laboratory.

BACKGROUND: Biotinidase deficiency is caused by absent activity of the biotinidase, encoded by the biotinidase gene (BTD). Affected individuals cannot recycle the biotin, leading to heterogeneous symptoms that are primarily neurological and cutaneous. Early treatment with biotin supplementation can prevent irreversible neurological damage and is recommended for patients with profound deficiency, defined as enzyme activity <10% mean normal (MN). Molecular testing has been utilized along with biochemical analysis for diagnosis and management. In this study, our objective was to correlate biochemical phenotype/enzyme activity to BTD genotype in patients for whom both enzyme and molecular testing were performed at our lab, and to review how the correlations inform on variant severity. METHODS: We analyzed results of biotinidase enzyme analysis and BTD gene sequencing in 407 patients where samples were submitted to our laboratory from 2008 to 2020. RESULTS: We identified 84 BTD variants; the most common was c.1330G>C, and 19/84 were novel BTD variants. A total of 36 patients had enzyme activity <10% of MN and the most common variant found in this group was c.528G>T. No variant was reported in one patient in the profound deficiency group. The most common variant found in patients with enzyme activity more than 10% MN was c.1330G>C. CONCLUSIONS: Although enzyme activity alone may be adequate for diagnosing profound biotinidase deficiency, molecular testing is necessary for accurate carrier screening and in cases where the enzyme activity falls in the range where partial deficiency and carrier status cannot be discriminated.

A Systematic Review of the World's Largest Government Sponsored Health Insurance Scheme for 500 Million Beneficiaries in India: Pradhan Mantri Jan Arogya Yojana.

BACKGROUND AND OBJECTIVE: In pursuit of universal health coverage, India has launched the world's largest government-sponsored health insurance scheme, Pradhan Mantri Jan Arogya Yojana (PM-JAY) in 2018. This study aims to provide a holistic review of the scheme's impact since its inception. METHODS: We reviewed studies (based on interviews or surveys) published from September 2018 to January 2023, which were retrieved from PubMed, Web of Science, and Scopus database. The main outcomes studied were: (1) awareness; (2) utilization of scheme; (3) experiences; (4) financial protection; and (5) challenges encountered by both beneficiaries and healthcare providers. RESULTS: A total of 18 studies conducted across 14 states and union territories of India were reviewed. The findings revealed that although PM-JAY has become a familiar name, there remains a low level of awareness regarding various facets of the scheme such as benefits entitled, hospitals empanelled, and services covered. The scheme is benefitting the poor and vulnerable population to access healthcare services that were previously unaffordable to them. However, financial protection provided by the scheme exhibited mixed results. Several challenges were identified, including continued spending by beneficiaries on drugs and diagnostic tests, delays in issuance of beneficiary cards, and co-payments demanded by healthcare providers. Additionally, private hospitals expressed dissatisfaction with low health package rates and delays in claims reimbursement. CONCLUSIONS: Concerted efforts such as population-wide dissemination of clear and complete knowledge of the scheme, providing training to healthcare providers, addressing infrastructural gaps and concerns of healthcare providers, and ensuring appropriate stewardship are imperative to achieve the desired objectives of the scheme in the long-run.

A Review on Cementitious and Geopolymer Composites with Lithium Slag Incorporation.

This study critically reviews lithium slag (LS) as a supplementary cementitious material (SCM), thereby examining its physiochemical characteristics, mechanical properties, and durability within cementitious and geopolymer composites. The review reveals that LS's particle size distribution is comparable to fly ash (FA) and ground granulated blast furnace slag (GGBS), which suggests it can enhance densification and nucleation in concrete. The mechanical treatment of LS promotes early hydration by increasing the solubility of aluminum, lithium, and silicon. LS's compositional similarity to FA endows it with low-calcium, high-reactivity properties that are suitable for cementitious and geopolymeric applications. Increasing the LS content reduces setting times and flowability while initially enhancing mechanical properties, albeit with diminishing returns beyond a 30% threshold. LS significantly improves chloride ion resistance and impacts drying shrinkage variably. This study categorizes LS's role in concrete as a filler, pozzolan, and nucleation agent, thereby contributing to the material's overall reduced porosity and increased durability. Economically, LS's cost is substantially lower than FA's; meanwhile, its environmental footprint is comparable to GGBS, thereby making it a sustainable and cost-effective alternative. Notwithstanding, there is a necessity for further research on LS's fine-tuning through grinding, its tensile properties, its performance under environmental duress, and its pozzolanic reactivity to maximize its utility in concrete technologies. This study comprehensively discusses the current strengths and weaknesses of LS in the field of building materials, thereby offering fresh perspectives and methodologies to enhance its performance, improve its application efficiency, and broaden its scope. These efforts are driving the sustainable and green development of LS in waste utilization and advanced concrete technology.

Mapping Cancer in Africa: A Comprehensive and Comparable Characterization of 34 Cancer Types Using Estimates From GLOBOCAN 2020.

Objective: Cancer incidence and mortality rates in Africa are increasing, yet their geographic distribution and determinants are incompletely characterized. The present study aims to establish the spatial epidemiology of cancer burden in Africa and delineate the association between cancer burden and the country-level socioeconomic status. The study also examines the forecasts of the cancer burden for 2040 and evaluates infrastructure availability across all African countries. Methods: The estimates of age, sex, and country-specific incidence and mortality of 34 neoplasms in 54 African countries, were procured from GLOBOCAN 2020. Mortality-to-incidence ratio (MIR) was employed as a proxy indicator of 5-year survival rates, and the socioeconomic development of each country was measured using its human development index (HDI). We regressed age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and MIR on HDI using linear regression model to determine the relationship between cancer burden and HDI. Maps were generated for each cancer group for each country in Africa. The data about the cancer infrastructure of African countries were extracted from the WHO Cancer Country Profiles. Results: In Africa, an estimated 1.1 million new cases [95% uncertainty intervals (UIs) 1.0 - 1.3 million] and 711,429 [611,604 - 827,547] deaths occurred due to neoplasms in 2020. The ASIR was estimated to be 132.1/100,000, varying from 78.4/100,000 (Niger) to 212.5/100,000 (La Réunion) in 2020. The ASMR was 88.8/100,000 in Africa, ranging from 56.6/100,000 in the Republic of the Congo to 139.4/100,000 in Zimbabwe. The MIR of all cancer combined was 0.64 in Africa, varying from 0.49 in Mauritius to 0.78 in The Gambia. HDI had a significant negative correlation with MIR of all cancer groups combined and main cancer groups (prostate, breast, cervical and colorectal). HDI explained 75% of the variation in overall 5-year cancer survival (MIR). By 2040, the burden of all neoplasms combined is forecasted to increase to 2.1 million new cases and 1.4 million deaths in Africa. Conclusion: High cancer mortality rates in Africa demand a holistic approach toward cancer control and management, including, but not limited to, boosting cancer awareness, adopting primary and secondary prevention, mitigating risk factors, improving cancer infrastructure and timely treatment.

Role of omega 3 and omega 6 poly unsaturated fatty acids (PUFA) and vitamin D deficiency as risk determinants of metabolic syndrome in obesity: Worksite based case-control observational study.

BACKGROUND AND AIMS: Risk factors for metabolic syndrome among obese population are not clear. The role of Eicosapentaenoic acid (EPA), Arachidonic acid (AA) Poly Unsaturated Fatty Acids (PUFA), their ratio and vitamin D deficiency as risk factors of metabolic syndrome (MS) was explored in obese worksite workers. METHODS: The 145 obese worksite workers were enrolled and MS was diagnosed using adult treatment panel III criteria. The levels of EPA, AA PUFA were estimated using liquid chromatography-Mass Spectrometer and vitamin D levels with ELISA method. The association of MS with the tertiles of EPA, AA PUFAs, their ratio and vitamin D was estimated by calculating odds ratio and 95% C.I., taking lowest tertiles as the reference group using logistic regression model adjusted for age and gender. RESULTS: 105 out of 145 obese worksite workers; 72.4%, 95% C.I. (64.5%, 79.5%) had metabolic syndrome. The odd of MS was significantly lower in the group having highest tertiles of EPA 0.24 (0.09, 0.71) and was higher 2.0 (1.02, 3.89) in subjects with highest tertiles of AA: EPA ratio. The AA PUFA and vitamin D levels had no significant association with MS. CONCLUSION: The low levels of omega 3 PUFA (EPA) and elevated ratio of AA: EPA PUFA was significantly associated with MS in obese works site workers.

Antioxidant properties, phenolics and flavonoids content of some economically important plants from North-west Indian Himalaya.

The present study investigated antioxidant properties, total phenolic and flavonoid contents in methanol extract of the leaf, stem bark, and fruit of Olea ferruginea Royle, Olea europaea L., and Tilia europaea L. grow naturally in the north-west Indian Himalaya. Phenolics and flavonoids content was found to be maximum in methanol extracts of stem bark and leaf (9.28 mg GAE/g fw and 14.73 mg QE/g fw, respectively) of O. ferruginea plants. Ferric reducing antioxidant power and DPPH radical scavenging activity were found to be maximum in leaf and stem bark (38.88 mM AAE/g fw and 20.31 mM AAE/g fw, respectively) of O. ferrugenia plants, whereas maximum ABTS radical scavenging activity (4.52 mM AAE/g fw) was recorded with stem bark of T. europaea plants. These tree species were found rich in natural compounds and also possess antioxidant activities. Therefore, their pharmaceutical and local uses for the health benefits are suggested.

Random amplified polymorphic DNA and inter simple sequence repeat markers reveals genetic diversity between micro propagated, wild and field cultivated genotypes of Gloriosa superba: an endangered medicinal plant.

Gloriosa superba L., an endangered medicinal plant with global interest due to presence of colchicine, an important alkaloid used in formulations of Indian and Traditional medicine. The plant has become endangered due to its unscientifically exploitation and high medicinal values. In the Present study 10 randomly amplified polymorphic DNA (RAPD) and 6 ISSR markers were employed to assess genetic divergence among micro propagated, wild and field cultivated plants of Gloriosa superba collected from different parts of India. In RAPD analysis, all the 10 accession with 10 RAPD primers amplified 466 fragments, with 96.43 % polymorphism and with an average of 46.6 bands per primer. The size of amplicons varied from 1656 to 100 bp. While, ISSR primers produced 328 fragments of which 298 were polymorphic with an average of 49.7 bands per primer with 91.83% polymorphism. The size of amplicons ranges from 2395 to 181 bp. RAPD, ISSR markers were also assessed by calculating polymorphic information content (PIC) to discriminate the genotypes, Average PIC value for RAPD, ISSR and combined RAPD + ISSR markers obtained was ≤ 0.50 suggesting the informativeness of markers. Jaccard's coefficient ranges from 0.18 to 0.75 (RAPD) and 0.17 to 0.61 (ISSR) and 0.21-0.52 for pooled ISSR and RAPD markers. The clustering pattern based on UPGMA analysis of the genotypes in the combined analysis revealed that the majority of the genotypes remained similar to the ISSR dendrogram, while the RAPD-based dendrogram showed some variation in the clustering of genotypes. The result of PCA scattered plot obtained were in agreement with the UPGMA dendrogram, which further confirms the genetic relationships explain by cluster analysis. Results confirmed that the genotype studied had good genetic diversity and can be used for identification, conservation, and future breeding program of Gloriosa species and consequently for the benefit of the pharmaceutical industries.

Global, regional, national burden of breast cancer in 185 countries: evidence from GLOBOCAN 2018.

PURPOSE: This study aims to examine the burden of breast cancer in 185 countries in 2018. METHODS: The estimates of incidence, mortality, and prevalence of breast cancer were drawn from GLOBOCAN 2018. The overall burden of breast cancer was gauged using breast cancer burden index (BRCBI)-a novel index comprising age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), mortality-to-incidence ratio (MIR), prevalence-to-incidence ratio (PIR), and prevalence-to-mortality ratio (PMR). The socioeconomic status of countries was measured using human development index (HDI) RESULTS: Globally, breast cancer was responsible for an estimated 626,679 deaths at age-standardized rate of 13/100,000; there were 2.1 million cases diagnosed in 2018 at age-standardized rate of 46.3/100,000. The ASIR varied 22-fold from 5/100,000 (Bhutan) to 113.2/100,000 (Belgium). The ASMR varied 13-fold from 2.7/100,000 (Bhutan) to 36.9/100,000 (Fiji). The HDI exhibited a positive gradient with ASIR (r = 0.73), PIR (r = 0.98), and PMR (r = 0.85); with MIR, however, it exhibited a negative association (r = - 0.83). The BRCBI spanned from 0.70 in Somalia to 78.92 in South Korea and exhibited a positive association with HDI (r = 0.76). An additional 46,823 female lives in 2018 and a cumulative total of 333,304 lives could have been saved over 2013-2018, had countries performed as per their HDI. CONCLUSIONS: The substantial burden of breast cancer in developing and low-resource economies calls for a holistic approach to cancer management and control that includes oncologic infrastructure to provide cost-effective screening, diagnostic, therapeutic, and palliative services, greater breast cancer awareness, and mitigation of risk factors.

Ameliorative effect of Aloe gel against L-T4-induced hyperthyroidism via suppression of thyrotropin receptors, inflammation and oxidative stress.

Untreated hyperthyroidism may develop serious complications. This attempt was made to investigate the potential of Aloe vera gel in regulating experimentally induced hyperthyroidism in rats. Female Wistar rats were made hyperthyroid with L-thyroxine (L-T4) at 0.5 mg/kg/day, i.p. for 14 days and the effects of Aloe vera methanolic fraction (AVMF) (50 or 500 mg/kg/day, p.o.,) and a conventional antithyroid drug propylthiouracil (PTU) (10 mg/kg, i.p.) for 30 days were studied in those hyperthyroid rats. At the end, alterations in serum thyroid hormones and thyroid stimulating hormone (TSH); hepatic 5'mono-deiodinase-1(5'D1) activity, oxidative stress markers and antioxidants; serum inflammatory cytokines and the expression of thyrotropin receptor in thyroid gland were evaluated in all experimental animals. Hyperthyroid condition was confirmed by an increase in thyroid hormone levels and hepatic 5'D-1 activity with a decrease in TSH. However, either AVMF or PTU treatment in hyperthyroid rats decreased the levels of thyroid hormones and 5'D1 activity. AVMF administration in T4-induced rats also decreased the oxidative stress markers such as thiobarbituric acid reactive substances and lipid hydroperoxides and increased the antioxidant levels in liver tissues. Levels of liver marker enzymes, cytokines and different lipids were decreased in T4-induced AVMF treated rats. Further, a down regulation in the TSHR expression in thyroid was observed in AVMF or PTU treated groups. All these thyroid inhibiting effects were supported by an improvement in thyroid histology in hyperthyroid rats. It appears, about 15 compounds, as evidenced by LC-MS/MS study, mostly phenolics are involved in this anti-thyroid effects of the test compound.

Chavibetol corrects thyrotoxicosis through alterations in thyroid peroxidase.

Thyrotoxicosis is a clinical syndrome that commonly results from excess secretion and/or release of thyroid hormones in the circulation. It affects most of the body systems and if not treated properly may lead to serious health problems. In this investigation, we isolated a phenolic compound, chavibetol (CHV) from Piper betel leaf and evaluated its possible ameliorative effects in thyrotoxicosis of rats. Adult female rats were rendered thyrotoxic by the administration of L-thyroxine (L-T4) at 500 µg/kg/day, i.p., for 12 days, and then chavibetol (20.0 mg/kg, p.o.) was administered for 2 weeks. L-T4 administration elevated the concentration of serum thyroxine and triiodothyronine, activities of alanineaminotransferase and aspartate aminotransferase, and decreased the thyrotropin level as well as the expression of thyroid peroxidase (TPO). Further, it increased the activities of hepatic 5'mono-deiodinase-I, glucose-6--phosphatase, sodium-potasium-ATPase, and lipid peroxidation, and depleted the cellular antioxidants. However, chavibetol treatment to thyrotoxic rats normalized almost all these indices including TPO and also preserved the integrity of thyroid tissues suggesting its potential to correct thyrotoxicosis. Effects of CHV were more or less similar to a conventional antithyroid drug, propylthiouracil (PTU).

The yin and yang of leukotriene B4 mediated inflammation in cancer.

The high affinity leukotriene B4 receptor, BLT1 mediates chemotaxis of diverse leukocyte subsets to the sites of infection or inflammation. Whereas the pathological functions of LTB4/BLT1 axis in allergy, autoimmunity and cardiovascular disorders are well established; its role in cancer is only beginning to emerge. In this review, we summarize recent findings on LTB4/BLT1 axis enabling distinct outcomes toward tumor progression. In a mouse lung tumor model promoted by silicosis-induced inflammation, genetic deletion of BLT1 attenuated neutrophilic inflammation and tumor promotion. In contrast, in a spontaneous model of intestinal tumorigenesis, absence of BLT1 led to defective mucosal host response, altered microbiota and bacteria dependent colon tumor progression. Furthermore, BLT1 mediated CD8+ T cell recruitment was shown to be essential for initiating anti-tumor immunity in number of xenograft models and is critical for effective PD1 based immunotherapy. BLT2 mediated chemotherapy resistance, tumor promotion and metastasis are also discussed. This new information points to a paradigm shift in our understanding of the LTB4 pathways in cancer.

Identification of Potential PPAR γ Agonists as Hypoglycemic Agents: Molecular Docking Approach.

Peroxisome proliferator-activated receptor gamma (PPAR γ) has become an attractive molecular target for drugs that aim to treat hyperglycemia. The object of our study is to identify the required molecular descriptor and essential amino acid residues for effective PPAR γ agonistic activity. In this work, we employed Molegro Virtual Docker program in all molecular docking simulations. Accuracy of receptor-compound docking was validated on a set of 15 PPAR γ-compound complexes for which crystallographic structures were available. The reliability of the docking results was acceptable with good root-mean-square deviation value (<2 Å). A significant correlation between different data derived from docking calculations and experimental data was revealed. Our results allowed identification of compounds with potential to become drugs against hyperglycemia.

Preparation and properties evaluation of biolubricants derived from canola oil and canola biodiesel.

This study demonstrates the evaluation and comparison of the lubricity properties of the biolubricants prepared from the feed stocks such as canola oil and canola biodiesel. Biolubricant from canola biodiesel has a low cloud and pour point properties, better friction and antiwear properties, low phase transition temperature, is less viscous, and has the potential to substitute petroleum-based automotive lubricants. Biolubricant from canola oil has high thermal stability and is more viscous and more effective at higher temperature conditions. This study elucidates that both the biolubricants are attractive, renewable, and ecofriendly substitutes for the petroleum-based lubricants.

Towards further understanding on the antioxidative activities of Prunus persica fruit: a comparative study with four different fractions.

In the present study we have evaluated the antioxidant activities of different fractions (hexane, ethyl acetate, n-butanol and aqueous fractions) of Prunus persica fruit. For extraction simple warring blender method was employed and total phenolic and flavonoid contents were correlated with different antioxidant activities (total antioxidant, 2,2-diphenyl-1-picrylhydrazyl (DPPH), H2O2 scavenging, superoxide radical scavenging, iron chelating and their reducing power properties). Different in vitro antioxidant studies showed that ethyl acetate and n-butanol fractions had the maximum activities that were well correlated with total phenolic and flavonoid contents. Maximum yield (25.14±2.2%) was obtained in its aqueous fraction. Both ethyl acetate and n-butanol fractions showed significant inhibitory effects on different antioxidant activities. A significantly high correlation coefficient existed between total antioxidant activities and with total phenolic as well as total flavonoid contents. It appears that ethyl acetate and n-butanol fractions of P. persica may serve as new potential sources of natural antioxidants and could be of therapeutic use in treating several diseases.

Clinical and radiographic evaluation of zinc oxide with aloe vera as an obturating material in pulpectomy: an in vivo study.

BACKGROUND: Pulp therapy for pulpally involved primary teeth continues to be a challenge to clinicians. One of the major areas of continued research is in the area of finding obturating materials to suit the specific properties of these teeth. Zinc oxide eugenol is used frequently in pulpectomy for the obturation of the primary teeth. AIMS: To evaluate clinically and radiographically a mixture of zinc oxide eugenol and aloe vera as an obturating material. MATERIALS AND METHODS: A total of 50 children, aged between 4 and 9 years, who were screened for unilateral or bilateral carious deciduous molars were studied. Out of these, 15 children were randomly selected for endodontic treatment. Obturation was done with a mixture of zinc oxide powder and aloe vera gel. Clinical and radiographic evaluation was done after 7 days, 1 month, 3 months, 6 months, and 9 months. The data were statistically analyzed. RESULTS AND CONCLUSION: Endodontic treatment using a mixture of zinc oxide powder and aloe vera gel in primary teeth has shown good clinical and radiographic success. A detailed observational study with longer follow-up will highlight the benefits of aloe vera in primary teeth as an obturating medium.

Case report of a small outbreak of epidemic dropsy.

Epidemic dropsy results from use of edible oils adulterated with Argemone mexicans oil. We report of the disease in a family caused due to sesame oil adulteration. Peculiarity to report this disease is that it occurred due to consumption of contaminated sesame seeds oil instead of mustard oiland secondly epidemic dropsy is also not very common in western Rajasthan. Five members of a family presented to the hospital with history of generalised body swelling, itching and marked cutaneous flush. Few of them also have shortness of breath, dry cough, palpitation, diarrhoea, vomiting and haemoptysis. On physical examination rashes, pallor and signs of cardiac failure were present in few patients. None of them had neurological symptoms and signs. After multiple interviews history of consumption of home made sesame seeds oil was explored in the family and the differential diagnosis of epidemic dropsy was made. Edible oil sample of the sesame seeds oil turned out to be positive for sanguinarine. Sanguinarine and dehydrosanguinarine are two major toxic alkaloids of Argemone oil, which cause widespread capillary dilatation, proliferation and increased capillary permeability. Leakage of the protein-rich plasma component into the extracellular compartment leads to the formation of oedema. There is no specific therapy. Removal of the adulterated oil and symptomatic treatment of congestive cardiac failure and respiratory symptoms, along with administration of anti-oxidants and multivitamins, remains the mainstay of treatment.

Pathway to psychiatric care in a tertiary mental health facility in Jaipur, India.

PURPOSE: This study was planned to evaluate the pathway to care of mentally ill patients attending a tertiary mental health facility in Jaipur to highlight the difficulties of mentally ill and their relatives in accessing appropriate care. METHODS: Seventy-six patients, who attended the Out Patient Department of Psychiatry of a tertiary care hospital in Jaipur, India for the first time, were enrolled in this study. The family members of the patients were interviewed to evaluate the pathway to care using the Encounter form developed by the WHO. RESULTS: The patients were predominantly young adults, male, from rural, agrarian but educated background and a majority of them presented with psychotic illnesses. It was seen that there were five major gateways to care of the mentally ill in the region, Faith healers being the most popular portal of care. The median duration of untreated illness (DUI) was 6 months, and subjects had already visited, 2 carers before visiting any mental health professional. The median monetary cost of the pathway was Rs. 3565. Patients suffering from psychotic illnesses presented earlier. Those who used psychiatric services as first portal of care had different socio-demographic variables as compared to clients who used other services. CONCLUSION: This pathway to psychiatric care study in Jaipur, India demonstrated that referral pathway heavily relies on faith healers. The study indicates possible fields and gives indications, underlining the importance of improving awareness campaigns that will facilitate the recognition of psychiatric disorders.

Sustainable effect of Ayurvedic formulations in the treatment of nutritional anemia in adolescent students.

OBJECTIVES: Anemia is a serious health problem in Indian school children. High prevalence of anemia has been reported in nonpregnant adolescent girls. An investigation was initiated to study the effect of two non-iron-containing Ayurvedic preparations-Sootshekhar Rasa plus Sitopaladi Churna-in improving nutritional anemia among adolescent students. DESIGN: This was a single-blinded, randomized, controlled study. SETTING: The study setting was Dehradun district, North India. SUBJECTS: The subjects comprised a total of 1646 boys and girls, aged 11-18 years, attending school in Dehradun district. INTERVENTION: As per World Health Organization guidelines, a total of 1322 adolescent anemic students were randomly divided into 5 groups. Students of group I (control) received starch. Group II, III, and IV students received Sootshekhar Rasa (SR) plus Sitopaladi Churna (SC) in various combinations, namely, SR 125 mg + SC 500 mg daily, SR 250 mg + SC 400 mg daily, and SR 250 mg + SC 400 mg weekly, respectively. Group V student were given iron and folic acid tablet. All the students received treatment for 90 days and were followed up for the next 180 days. OUTCOME MEASURE: The outcome measure was to evaluate the effect of Sootshekhar Rasa plus Sitopaladi Churna in improving nutritional anemia. RESULTS: The overall prevalence of anemia was found to be 81.3%. At baseline, the mean hemoglobin (Hb) was 97.4 +/- 13.2 g/L and ranged from 96.4 +/- 0.8 g/L to 98.3 +/- 0.8 g/L in various groups. At end of follow-up (day 270), a significant increase in Hb levels from baseline was observed in all treatment groups; however, the Hb gain (6.9 +/- 0.6 g/L) in group III and group V (3.64 +/- 0.56 g/L) differed significantly from the control group. A total of 155 students dropped out of the study due to various reasons not related to treatment. No adverse side-effect of Ayurvedic medication was noted in any student. CONCLUSIONS: We conclude that a daily dose of Sootshekhar Rasa (250 mg) plus Sitopaladi Churna (400 mg) can produce sustainable improvement of nutritional anemia in adolescent students.

The improvement of care for paediatric and congenital cardiac disease across the World: a challenge for the World Society for Pediatric and Congenital Heart Surgery.

The diagnosis and treatment for paediatric and congenital cardiac disease has undergone remarkable progress over the last 60 years. Unfortunately, this progress has been largely limited to the developed world. Yet every year approximately 90% of the more than 1,000,000 children who are born with congenital cardiac disease across the world receive either suboptimal care or are totally denied care.While in the developed world the focus has changed from an effort to decrease post-operative mortality to now improving quality of life and decreasing morbidity, which is the focus of this Supplement, the rest of the world still needs to develop basic access to congenital cardiac care. The World Society for Pediatric and Congenital Heart Surgery [http://www.wspchs.org/] was established in 2006. The Vision of the World Society is that every child born anywhere in the world with a congenital heart defect should have access to appropriate medical and surgical care. The Mission of the World Society is to promote the highest quality comprehensive care to all patients with pediatric and/or congenital heart disease, from the fetus to the adult, regardless of the patient's economic means, with emphasis on excellence in education, research and community service.We present in this article an overview of the epidemiology of congenital cardiac disease, the current and future challenges to improve care in the developed and developing world, the impact of the globalization of cardiac surgery, and the role that the World Society should play. The World Society for Pediatric and Congenital Heart Surgery is in a unique position to influence and truly improve the global care of children and adults with congenital cardiac disease throughout the world [http://www.wspchs.org/].

Effects of fly ash incorporation on heavy metal accumulation, growth and yield responses of Beta vulgaris plants.

Use of fly ash (FA) to agriculture is not always beneficial, however, utilization of lower concentration of FA as soil amendment is suitable for better management of few crops. The present study was conducted to study the effects of various concentrations of FA (0%, 5%, 10%, 15% and 20%) on heavy metal accumulation, growth, and yield responses of palak (Beta vulgaris L. var All Green H1). The results showed that application of FA caused significant reductions in growth, biomass and yield responses of B. vulgaris plants at different ages of observations. The concentrations of all the heavy metals increased significantly with increasing concentrations of FA. Metal pollution index (MPI) of both roots and shoots showed significant and negative relationships with the yield of B. vulgaris plants. The study concludes that B. vulgaris plant is sensitive to FA concentrations used in this study. It is further recommended that leafy vegetable like B. vulgaris is not a suitable crop to be grown in a region where FA is used for amendment of agricultural soils.