Ferritin as an indicator of disease activity in Hodgkin lymphoma in pediatric patients.

INTRODUCTION: Hodgkin lymphoma is a malignant proliferation of lymphatic system which when advanced can involve the bone marrow. It is usually indolent and responds to chemotherapy. However the prediction of rapidly progressive disease is often dependent on lot of clinicopathological parameters. Serum ferritin may act as a marker for disease activity in these patients. But the prior studies have failed to establish its role or group the patients into prognostic categories. AIMS: To study the status of serum ferritin at time of admission and after completion of chemotherapy and also iron overload induced organ involvement in the form of hepatic, cardiovascular and thyroid dysfunction in nine patients admitted in our ward with Hodgkin lymphoma and receiving treatment in the form of chemotherapy. METHODOLOGY: A spectrum of clinicopathological variables were tested at baseline and after treatment liver function test, thyroid function test, 2D echocardiography, Ultrasound abdomen, PET scan and serum ferritin level. CONCLUSION: Serum ferritin at baseline statistically correlated with disease activity however the final ferritin values reduced to significant values in patient that underwent remission, and hence grouping of patients based on serum ferritin values can serve as better outcome predictors. Although transfusion requirement was very rare in the patients the levels of serum ferritin correlated with disease activity. Serum ferritin level may act as a predictor of disease activity and remission.

Immediate "Kangaroo Mother Care" and Survival of Infants with Low Birth Weight.

BACKGROUND: "Kangaroo mother care," a type of newborn care involving skin-to-skin contact with the mother or other caregiver, reduces mortality in infants with low birth weight (<2.0 kg) when initiated after stabilization, but the majority of deaths occur before stabilization. The safety and efficacy of kangaroo mother care initiated soon after birth among infants with low birth weight are uncertain. METHODS: We conducted a randomized, controlled trial in five hospitals in Ghana, India, Malawi, Nigeria, and Tanzania involving infants with a birth weight between 1.0 and 1.799 kg who were assigned to receive immediate kangaroo mother care (intervention) or conventional care in an incubator or a radiant warmer until their condition stabilized and kangaroo mother care thereafter (control). The primary outcomes were death in the neonatal period (the first 28 days of life) and in the first 72 hours of life. RESULTS: A total of 3211 infants and their mothers were randomly assigned to the intervention group (1609 infants with their mothers) or the control group (1602 infants with their mothers). The median daily duration of skin-to-skin contact in the neonatal intensive care unit was 16.9 hours (interquartile range, 13.0 to 19.7) in the intervention group and 1.5 hours (interquartile range, 0.3 to 3.3) in the control group. Neonatal death occurred in the first 28 days in 191 infants in the intervention group (12.0%) and in 249 infants in the control group (15.7%) (relative risk of death, 0.75; 95% confidence interval [CI], 0.64 to 0.89; P = 0.001); neonatal death in the first 72 hours of life occurred in 74 infants in the intervention group (4.6%) and in 92 infants in the control group (5.8%) (relative risk of death, 0.77; 95% CI, 0.58 to 1.04; P = 0.09). The trial was stopped early on the recommendation of the data and safety monitoring board owing to the finding of reduced mortality among infants receiving immediate kangaroo mother care. CONCLUSIONS: Among infants with a birth weight between 1.0 and 1.799 kg, those who received immediate kangaroo mother care had lower mortality at 28 days than those who received conventional care with kangaroo mother care initiated after stabilization; the between-group difference favoring immediate kangaroo mother care at 72 hours was not significant. (Funded by the Bill and Melinda Gates Foundation; Australian New Zealand Clinical Trials Registry number, ACTRN12618001880235; Clinical Trials Registry-India number, CTRI/2018/08/015369.).

Effect of debranning on grains and meal characteristics of different Indian and exotic wheat varieties.

The objective of this work was to evaluated the effects of debranning (2% and 4%) of Indian and exotic wheat varieties on pasting, protein profile and rheological properties of meal. Exotic varieties grains showed significant difference in cooking properties despite having similar protein content. Debranned grains of exotic varieties showed significantly lower water uptake (WU) than those from Indian varieties. Ash content, protein content and mixographic properties (mixing time, dough strength) of meal decreased with increase in extent of debranning. With increase in debranning level unextractable polymeric proteins (UnEx-PP) decreased while unextractable monomeric proteins (UnEx-MP) increased. Exotic varieties had lower extractable PP as compared to Indian wheat varieties. With increase in debranning level pasting parameters (final, breakdown and peak viscosity) increased. Exotic varieties showed the higher gluten strength indicated by mixographic parameters. Wheat grains debranned to 4% debranning level showed better cooking properties. Exotic wheat varieties showed better pasting and mixing properties as compared to Indian wheat varieties.

Hard, medium-hard and extraordinarily soft wheat varieties: Comparison and relationship between various starch properties.

Starches from extraordinarily soft wheat (Ex-SW), medium-hard wheat (MHW) and hard wheat (HW) varieties were evaluated for various properties and their relationship with each other was established. Varieties showed wide variation in grain hardness index (GHI) that varied between 17 and 95. Starches were evaluated for physicochemical properties, granule size distribution, starch morphology, pasting and thermal properties. Starches from MHW showed the presence of the largest proportion of A-type granules and the smallest proportions of B-type and C-type granules whereas Ex-SW showed the greatest proportion of C-type granules. Starches from HW and MHW varieties showed lower swelling power (SP) and higher amylose content (AC) than that from Ex-SW varieties. Starches from HW varieties had greater crystallinity than starches from Ex-SW. Transition temperatures of starch gelatinization decreased with decrease in GHI.

Fractionation and grain hardness effect on protein profiling, pasting and rheological properties of flours from medium-hard and extraordinarily soft wheat varieties.

In the present study coarse fraction (CF), medium fine fraction (MFF) and fine fraction (FF) were separated from flours milled from medium-hard and extraordinarily soft wheat varieties and were evaluated for various quality characteristics. Grain hardness of medium-hard and extraordinarily soft wheat varieties varied from 77 to 80 and 17 to 18, respectively. Ash and protein content was the highest for FF and the lowest for CF. Varieties with greater hardness produced higher CF and lower of FF. FF showed higher unextractable polymeric protein (UnEx-PP) and dough stability as compared to MFF and CF. FF showed lower damage starch content as related by lower Sodium SRC (NaSRC) as compared to MFF and FF. CF showed higher paste viscosities than FF and difference were greater amongst fractions from varieties with lower grain hardness. FF with greater proportion of small size particles showed greater accumulation of 98 kDa and 85 kDa PPs than CF. This study demonstrated that fractionation of flours can be employed to produce fractions with varied gluten strength required for production of various products.

Seasonal Variation and Dengue Burden in Paediatric Patients in New Delhi.

OBJECTIVE: We conducted a study to find a relationship between main weather parameters with admission of positive dengue cases in a tertiary hospital. METHODS: Retrospective analysis was undertaken to identify epidemiological trend of dengue in 2016 from paediatric wards of a tertiary hospital in New Delhi. Data were collected on patient particulars and daily weather from January to December 2016. RESULTS: A total of 266 confirmed cases of dengue were considered. Relative humidity (RH) was associated with burden of positive dengue cases. On week-wise analysis, each surge of dengue admission was preceded by heavy rain 4-6 weeks earlier. Monthly averaged daily temperature range and RH were noted to have strong correlations with dengue burden, keeping an interval of 2 months in between. CONCLUSIONS: Weather parameters seem to influence magnitude of dengue epidemic, particularly in dengue season. There is need to have an in-depth study about developing a prediction model for dengue epidemic.

Extraordinarily soft, medium-hard and hard Indian wheat varieties: Composition, protein profile, dough and baking properties.

Hard wheat (HW), medium-hard wheat (MHW) and extraordinarily soft wheat (Ex-SW) varieties with grain hardness index (GHI) of 83 to 95, 72 to 80, 17 to 29 were evaluated for pasting, protein molecular weight (MW) distribution, dough rheology and baking properties. Flours from varieties with higher GHI had more protein content, ash content and paste viscosities. Ex-SW had more glutenins proportion as compared to HW and MHW. Flours from Ex-SW varieties showed lower NaSRC, WA and mixographic parameters as compared to HW and MHW. Dough from flours milled from Ex-SW had higher Intermolecular-ß-sheets (IM-ß-sheets) than those from MHW and HW. Muffins volume increased with decrease in GHI, Ex-SW varieties had more muffin volume and less air space. The accumulation of polypeptides (PPs) varied significantly in different varieties. Ex-SW variety (QBP12-10) showed accumulation of 98, 90, 81 and 79kDa PPs, which was unique and was different from other varieties.

Neonaticide in India and the stigma of female gender: report of two cases.

Neonaticide is known to occur across the globe in both developed and developing countries, but has rarely been reported from India. Two similar cases of female neonaticide are presented which were committed by their mothers while in the maternity ward. The social issues and maternal provocation highlighted in this report are different from those reported in world reviews of neonaticide.