Experience with Generic Pegylated L-asparaginase in Children with Acute Lymphoblastic Leukemia from a Tertiary Care Oncology Center in South India.

Dhaarani JayaramanBackground Acute lymphoblastic leukemia (ALL) is a common type of leukemia in children. The innovator pegylated L-asparaginase has several advantages over native L-asparaginase; however, its use in India is limited due to availability and cost. Therefore, a generic pegylated L-asparaginase can be considered as an alternative to the innovator molecule. Methods A retrospective study was conducted to assess the outcome (minimal residual disease [MRD]) and toxicity of a generic pegylated L-asparaginase (Hamsyl) at the end of induction therapy. Results Eighty-eight (80.7%) and 21 (19.3%) patients had received generic pegylated L-asparaginase and conventional asparaginase, respectively, as a part of their treatment protocol. Nearly 82% of patients had B-type ALL. Eight-one percent of children had a white blood cell count of fewer than 50,000/mm 3 . At the end of induction, 80.7% (88) of children were minimal residual disease (MRD)-negative, and at the end of augmented consolidation therapy, 20.2% were MRD-negative. Ten percent of patients exhibited allergic reactions. Two children had pancreatitis, and one child had central venous thrombosis. Conclusion The generic pegylated L-asparaginase (Hamsyl) was effective and safe for use in pediatric ALL.

Germplasm variability-assisted near infrared reflectance spectroscopy chemometrics to develop multi-trait robust prediction models in rice.

Rice is a major staple food across the world in which wide variations in nutrient composition are reported. Rice improvement programs need germplasm accessions with extreme values for any nutritional trait. Near infrared reflectance spectroscopy (NIRS) uses electromagnetic radiations in the NIR region to rapidly measure the biochemical composition of food and agricultural products. NIRS prediction models provide a rapid assessment tool but their applicability is limited by the sample diversity, used for developing them. NIRS spectral variability was used to select a diverse sample set of 180 accessions, and reference data were generated using association of analytical chemists and standard methods. Different spectral pre-processing (up to fourth-order derivatization), scatter corrections (SNV-DT, MSC), and regression methods (partial least square, modified partial least square, and principle component regression) were employed for each trait. Best-fit models for total protein, starch, amylose, dietary fiber, and oil content were selected based on high RSQ, RPD with low SEP(C) in external validation. All the prediction models had ratio of prediction to deviation (RPD) > 2 amongst which the best models were obtained for dietary fiber and protein with R 2 = 0.945 and 0.917, SEP(C) = 0.069 and 0.329, and RPD = 3.62 and 3.46. A paired sample t-test at a 95% confidence interval was performed to ensure that the difference in predicted and laboratory values was non-significant.

Fabricate, advancement, molecular docking and DNA reactivity of preferred divalent metal(II) complexes attributing (E)-N'-((6-hydroxybenzo[d]oxazol-5-yl) methylene)isonicotinohydrazide.

A series of metal(II) complexes (M=Co (II), Ni(II) and Cu(II)) supported by Schiff base ligand (L=(E)-N'-((6-hydroxybenzo[d]oxazol-5-yl)methylene)isonicotinohydrazide) has been designed and developed from condensation of 6-hydroxybenzo[d]oxazole-5-carbaldehyde and isoniazid. The ligand (H2L) and its metal(II) complexes were structurally characterized utilizing a variety of physicochemical and spectroscopic approaches. The study shows that Schiff bases (H2L) act as monobasic tridentate ONO ligand and conform to octahedral geometry according to the general formula [M(HL)2]. Furthermore, the interaction of these complexes with CT-DNA was investigated at pH = 7.2, utilizing UV-visible absorption, and viscosity measurement. In order to determine the mechanism of binding of the metal(II) complexes to the B-DNA dodecamer, docking studies were conducted using an AutoDock Vina 1.2.0 tool. The photo induced cleavage reveals that the ligand (H2L) and its complexes have UV-visible photo nuclease properties against pUC19 DNA by agarose gel electrophoresis technique. Studies showed that the complexes evaluated firmly bind to CT-DNA via intercalative mode and provides a distinctive pattern of DNA binding.

Enhancement of mechanical and thermal properties of Ixora coccinea L. plant root derived nanocellulose using polyethylene glycol-glutaraldehyde system.

Nanocellulose fibers are widely acknowledged as a more sustainable alternative to polyimide and polyethylene terephthalate-based plastic films derived from petrochemicals. Cellulose is also utilised in packaging, tissue engineering, electronic, optical, and sensor applications, pharmaceutical applications, cosmetic applications, insulation, water filtration, and hygiene applications, as well as vascular grafts. In the present study to improve the tensile and thermal properties of cellulose nanofibers, polyethylene glycol (PEG 600) with varying concentrations was produced by solvent casting and chemically crosslinked with glutaraldehyde (GA). The effects of various PEG 600 concentrations on nanofibers and the morphology of the resulting nanofibers were investigated. The effects of GA on PEG-nanocellulose morphology, average diameter, tensile strength, elongation, and thermal characteristics were investigated. Strong (GA)-based acetal linkages are used to substitute secondary hydrogen bonds in nanocellulose films. The 1% PEG 600 plasticized nanocellulose scaffolds cross-linked with GA showed a higher tensile modulus (93 MPa) than its GA untreated nanocellulose scaffolds (69 MPa). The Young's modulus of the scaffold is increased up to 83.62 MPa. The crystallinity index values of GA-treated scaffolds were increased, and the mechanical characteristics were greatly improved, according to Fourier transform infrared (FTIR) and XRD analysis on the films. The thermogravimetric analysis (TG/DTG/DSC) of the GA treated plasticized nanocellulose scaffold showed maximum decomposition temperature (Tmax) at 360.01 °C.

Evaluation of cytogenetic and molecular markers with MTX-mediated toxicity in pediatric acute lymphoblastic leukemia patients.

PURPOSE: Pediatric acute lymphoblastic leukemia (pALL) patients have better overall survival and methotrexate (MTX) is an effective drug used in their treatment. However, the treatment-related adverse effects (TRAEs) have a bigger impact on the therapy. In this study, we have evaluated the association of polymorphisms in genes encoding proteins engaged in MTX metabolism, and the cytogenetic aberrations with TRAEs. METHODS: A total of 115 patients between the age of 1 and 18 years (average: 6.6) under maintenance therapy were selected for the study. SLC19A1 (c.80G > A), MTHFR (c.677C > T; c.1298A > C), and TYMS (c.*450_*455del) genotypes were determined using PCR techniques and Sanger sequencing. Cytogenetic and SNP findings were analyzed for any association with the reported toxicities using odds ratio, chi-square test, multifactor dimensionality reduction (MDR) analysis for synergistic effect and, multinomial logistic regression analysis for the likelihood of adverse events. RESULTS: Among the evaluated genetic variations, SLC19A1 (c.80G > A) was significantly associated with TRAEs (OR = 5.71, p = 0.002). Multinomial logistic regression analysis (chi-sq = 16.64, p < 0.001) and MDR analysis (chi-sq = 10.51 p < 0.001) confirmed the finding. On the other hand, no significant association was observed between adverse events and any specific cytogenetic aberration. CONCLUSION: SLC19A1 facilitates the import of cyclic dinucleotides and reduced folates, evaluating genotypes in this gene can help in better management of patients on methotrexate treatment. Assessing a broader gene panel can help in finding more associated markers and delivering personalized medicine to the patients.

Rotula aquatica Lour. mitigates oxidative stress and inflammation in acute pyelonephritic rats.

The current study evaluates the efficacy of methanolic extract of Rotula aquatica Lour. (MERA) against inflammatory changes associated with acute pyelonephritis. The antioxidant enzymes such as SOD, CAT, GPx, GR and oxidative stress markers like GSH content, malondialdehyde (MDA) level, nitrate level, reactive oxygen species (ROS) level and renal toxicity markers were evaluated in this study. The mRNA level expression of Toll-like receptor 4 (TLR-4), nuclear transcription factor kappa B (NF-κB), tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and Tamm Horsfall protein (THP) were studied by RT-PCR analysis. The oral administration of MERA increases the antioxidant enzyme status in pyelonephritis rat. The elevated levels of oxidative stress markers in pyelonephritic rats were ameliorated by the administration of MERA at 100 mg/kg and 200 mg/kg bwt of the rat. The mRNA level expression of major genes were restored to normal level by MERA.

Precocious puberty in a child: A rare cause and review of literature.

Precocious puberty (PP) in pediatric office practice is challenging as the cause varies from benign to malignant conditions. Adrenocortical tumors are rare in childhood and pseudo-precocious puberty is the most common clinical presentation in children. We report a case of a 5-year-old boy who presented with features of abdominal distention and virilization, and his abdominal magnetic resonance imaging (MRI) revealed an adrenal tumor which was confirmed as adrenocortical carcinoma by biopsy. This case report highlights the importance of the awareness among general practioners and pediatricians to rule out adrenocortical tumors while evaluating a child with PP.

Implications of undernutrition in children with acute lymphoblastic leukaemia during induction therapy – experience from a developing country

@#Introduction: Undernutrition is an important prognostic factor in children with acute lymphoblastic leukaemia (ALL) and higher incidences of mortality are reported during induction remission in severely undernourished children. This study was conducted to assess the prevalence and implications of malnutrition among ALL children during induction therapy. Methods: All children ≤18 years diagnosed and treated for ALL at our institution, between June 2010 to July 2016 were included in this retrospective cohort study. Nutrition was assessed by body mass index-forage z-scores calculated using World Health Organization’s Anthro (<5 years) and Anthro-Plus Software (≥5 years). Children with a z-score of <-2 standard deviation (SD) were classified as undernourished. All events and outcomes were compared between undernourished and adequately nourished children. Results: A total of 72 children were included in this study. Nineteen (26.4%) were undernourished at the time of diagnosis. Twenty-eight (38.8%) children had significant weight loss. Sixty-seven of them attained remissions by the end of induction chemotherapy. Five children who died had significant weight loss. Children with significant weight loss during induction phase had a higher risk of developing complications such as febrile neutropenia, pneumonia, mucositis, and drug interruptions. Those with a deteriorating nutritional status had a higher chance of poor treatment outcome (p=0.05, CI=95%). Conclusion: It is important to assess and monitor the nutrition status of children and timely nutritional intervention is essential. A simple, cost effective nutritional intervention that will decrease morbidity and mortality associated with the disease must be devised.

A Journey Across Oceans With a Heavy Heart: Rare Presentation of a Pediatric Malignancy.

Myeloid sarcoma, due to extramedullary deposition of myeloblasts, is one of the rare presentations in acute myeloid leukemia. We present an extremely rare case of a 5-year-old boy with cardiac myeloid sarcoma. Noninvasive mode of diagnosis, timely initiation of chemotherapy and meticulous supportive care are the keys to successful outcome. (Level of Difficulty: Intermediate.).

Interaction of eugenol with xanthine oxidase: Multi spectroscopic and in silico modelling approach.

Eugenol, a major component in clove has various biological activities. The current study focused to the binding potential of eugenol with Xanthine oxidase (XO) were evaluated using multi spectroscopic techniques and in silico docking studies. Xanthine oxidase, a superoxide generating enzyme, catalyses hypoxanthine and xanthine to uric acid. An excessive uric acid and superoxide anion radical in our body causes many serious clinical complications. The activity and the structural alterations can be a significant method to reduce this kind of risk factors. The results obtained from the fluorescence titration exhibited the interactions initiated by a static quenching mechanism. The ultraviolet (UV), fourier-transform infrared (FTIR), circular dichroism (CD) spectroscopic analysis of eugenol bind with XO indicated the secondary structural alteration in XO. Docking studies showed molecular level interaction of eugenol with the amino acid residues of Thr 1010, Phe 914, Phe 1009, Leu 1014, Phe 1009, Val 1011, Arg 880, Ala 1078, Glu 802, Leu 648and Leu 873 which residing at the catalytic active site of the XO. These results inferred that the eugenol can interact with XO in a remarkable manner and these findings provide a supporting data for the XO inhibition studies to propose a new lead compound.

Pharmacogenetic evaluation of 6-mercaptopurine-mediated toxicity in pediatric acute lymphoblastic leukemia patients from a South Indian population.

Aim: To evaluate the variants in the genes coding for the proteins involved in thiopurine and folate metabolism with treatment related adverse effects (TRAEs). Materials & methods: Eleven variants in seven candidate genes were genotyped in 127 pediatric acute lymphoblastic leukemia patients under 6-mercaptopurine (6-MP) treatment to infer the association of selected genotypes with TRAEs. Results: Among the genotypes inspected, NUDT15 (c.415C>T) and SLC19A1 (c.80G>A) showed a significant association with the TRAEs (odds ratio = 4.01, p = 0.002 and odds ratio = 7.78, p = 0.002). Conclusion:SLC19A1 and NUDT15 play an important role in the metabolism of 6-MP and it is necessary to spot other variants in associated pathways and investigate the factors that can impact 6-MP metabolism.

Addressing Reemergence of Diphtheria among Adolescents through Program Integration in India.

We report a diphtheria outbreak mostly among children (median 12 years; range 4-26 years) of a religious minority in urban India. Case-fatality rate (15%, 19/124) was higher among unimmunized patients (relative risk 4.1, 95% CI 1.5-11.7). We recommend mandating and integrating immunization into school health programs to prevent reemergence.

In vitro enzyme inhibition and in vivo anti-hyperuricemic potential of eugenol: an experimental approach.

Xanthine oxidase (XO) is accountable for the uric acid synthesis in the body and is considered as a prominent therapeutic target in urate lowering treatment. Eugenol is a natural compound commonly found in clove, cinnamon, etc. and has various biological activities. This study was designed to examine the anti-hyperuricemic effect of eugenol by in vitro and in vivo studies. Potassium oxonate (PO) was used to induce hyperuricemia in Wistar rats. Different doses of eugenol (1.25, 2.5, and 5 mg/kg bwt orally) were used for the treatment and various biological function markers (renal, hepatic, and hematological) were analyzed. The IC50 value obtained for eugenol was 3.51 ± 0.002 µM. The kinetic studies revealed that the eugenol exhibited a mixed type of inhibition. Abnormality in the levels of various biological function markers was observed in the PO treated rats. Upon the eugenol treatment, those biological function markers were retained near to its normal values. The study proved the anti-hyperuricemic potential of eugenol against the PO induced hyperuricemia model.

Increased nitrogen use efficiency in crop production can provide economic and environmental benefits.

Potential economic and environmental benefits of increasing nitrogen-use efficiency (NUE) are widely recognized but scarcely quantified. This study quantifies the effects of increased NUE on 1) the national agricultural economy using a simulation model of US agriculture and 2) regional water quality effects using a biogeochemical model for the Arkansas-White-Red river basin. National economic effects are reported for NUE improvement scenarios of 10%, 20%, 50%, and 100%, whereas regional water quality effects are estimated for a 20% NUE improvement scenario in the Arkansas-White-Red river basin. Simulating a 20% increase in NUE in row crops is shown to reduce N requirements by 1.4 million tonnes y-1 and increase farmer net profits by 1.6% ($743 million) per year by 2026 over the baseline simulation for the same period. For each 10% increase in NUE, annual farm revenues for commodity crops increased over the baseline by approximately $350 million per year by 2026. Changes in crop prices and land-use relative to the baseline were less than 2%. This suggests a net benefit even though fertilizer cost savings can result in increased cultivation of land, i.e., 'Jevon's paradox'. Results from the biogeochemical model of the Arkansas-White-Red river basin suggest that a 20% increase in NUE corresponds to a 5.72% reduction in nitrate loadings to freshwaters, with higher reductions in agricultural watersheds. The value of these reductions was estimated as $43 ha-1, for a total of $15.3 to 136.7 million yr-1 in avoided water treatment costs. After estimating the social value of increased NUE, we conclude with a discussion of potential strategies to increase efficiency and the research needed to achieve this goal. These include perennialization of the agricultural landscape, genetic crop improvement, targeted fertilizer application, and manipulation of the plant-root microbiome.

Methanolic Extract of Muntingia Calabura L. Mitigates 1,2-Dimethyl Hydrazine Induced Colon Carcinogenesis in Wistar Rats.

OBJECTIVE: The present study aimed to evaluate the efficacy of methanolic extract of Muntingia calabura L. leaves (MEMC) in ameliorating oxidative stress and inflammation associated with 1,2-dimethyl hydrazine (DMH) induced colon cancer. METHODS: The antioxidant enzymes, oxidative stress markers, liver and renal toxicity markers were evaluated. Histopathological examination of colon tissues was carried out with the aid of alcian blue stain and Hematoxylin and Eosin stain. RESULTS: MEMC supplementation at doses of 100 and 200 mg/kg body weight of rats causes the antioxidant enzymic levels to retain near to its normal range. Meanwhile the oxidative stress markers, which showed an elevation from its normal level upon DMH administration, gets significantly reduced on MEMC treatment. Histopathological observation also revealed that the severity of colorectal cancer was reduced by the supplementation of MEMC. CONCLUSION: The findings from the present study showed that MEMC can exert a potential role to ameliorate the oxidative stress and inflammation associated with colorectal cancer.

Ethyl acetate fraction of Muntingia calabura L. exerts anti-colorectal cancer potential via regulating apoptotic and inflammatory pathways.

ETHNOPHARMACOLOGICAL RELEVANCE: Muntingia calabura L. is a plant with traditional pharmacological relevance. The various plant parts are used by tribal communities for treating gastric ulcers, prostate gland swellings, headache, cold etc. Hence, an attempt was made to evaluate the anti-colorectal cancer potential of ethyl acetate fraction of M. calabura (EFMC). MATERIALS AND METHODS: HR LC-MS analysis was carried out for the identification of compounds present in EFMC. 1,2 Dimethylhydrazine (DMH) induced animal model was used for the evaluation of anti-CRC potential of EFMC. Antioxidant enzyme status, oxidative stress marker status, hepatic and renal function marker level were determined. Evaluation of mRNA level expression of inflammatory and apoptotic genes, hematological and histopathological examinations were also carried out to figure out the extent of colorectal cancer (CRC) and the beneficial role offered by EFMC. RESULTS: HR LC-MS analysis of EFMC revealed the presence of ten pharmacologically active compounds. EFMC treatment made the altered levels of antioxidant enzymes, oxidative stress markers, liver and renal function markers to retain near to its normal range. The hematological and histopathological evaluations also confirmed the anti-CRC effects exhibited by EFMC. EFMC offered a regulatory control over the inflammatory and apoptotic genes thereby mitigating the damaging effects of CRC. CONCLUSION: The present study depicted the presence of therapeutically active compounds exhibiting strong antioxidant, anti-inflammatory and anticancer potential. The beneficial role offered by these compounds could be responsible for the amelioration of DMH induced CRC. Hence, EFMC can be used as an anti-CRC agent in human subjects.

Hevea brasiliensis mediated synthesis of nanocellulose: Effect of preparation methods on morphology and properties.

In present research, Hevea brasiliensis (Rubber Wood) converted into cellulose by pre-treatment with NaOH (5%) and NaClO2 (5%). In addition, the cellulose was converted to nanocellulose (NC) using ionic liquid, acid hydrolysis and TEMPO oxidation accompanied by ultra-sonication. The prepared nanocellulose characterized by X-ray diffraction (XRD), Scanning Electron Microscopy (SEM), Atomic Force Microscopy (AFM), Fourier transformation infrared spectroscopy (FT-IR). Thermal properties have been studied using thermogravimetric and differential thermal Analysis (TGA/DTA). FT-IR results clearly suggested that the synthetic approaches employed did not alter the principle chemical structure of rubber wood cellulose. SEM and AFM monographs reveal that synthetic approaches affect the morphology/surface topology of prepared nanocellulose. Among the three kinds of NC, NC by TEMPO approach had the largest aspect ratio and superior thermal stability.