Assessment of Blood Lead Level of School Children in 10 Cities of India: A Cross-Sectional Study.

OBJECTIVES: To assess the blood lead level (BLL) of school children in 10 cities of India. METHODS: This multi-centric cross-sectional study enrolled participants from randomly selected schools. Data on demographic details, socioeconomic status (SES) and anthropometric indicators was collected. Samples were collected for assessment of lead level in blood. Inductively coupled plasma-optical emission spectrometry technique was used to assess BLL. RESULTS: From April 2019 through February 2020, 2247 participants were recruited from sixty schools (62.6% government schools) with equal gender distribution. The overall median (interquartile range) BLL was 8.8 (4.8, 16.4) µg/dl. The highest median (interquartile range) BLL was in Manipal 30.6 (23.0, 46.7) and lowest in Dibrugarh 4.8 (3.2, 7.0). Overall, 82.5% of participants had BLL above ≤4 µg/dl. Significant negative correlation was observed between BLL and SES (correlation= -0.24, p <0.001), anthropometric indicators (correlation= -0.11, p <0.001), hemoglobin level (correlation= -0.045, p = 0.03) and multivariate regression model showed association with gender, SES and anthropometric indicators. CONCLUSIONS: BLL are elevated in urban school going children and there is intercity variation. Hence, urgent focus is needed to reduce exposure to lead in India.

Association of dietary intake with micronutrient deficiency in Indian school children: a cross-sectional study.

Adequate nutrition is necessary during childhood and early adolescence for adequate growth and development. Hence, the objective of the study was to assess the association between dietary intake and blood levels of minerals (calcium, iron, zinc, and selenium) and vitamins (folate, vitamin B12, vitamin A, and vitamin D) in urban school going children aged 6-16 years in India, in a multicentric cross-sectional study. Participants were enrolled from randomly selected schools in ten cities. Three-day food intake data was collected using a 24-h dietary recall method. The intake was dichotomised into adequate and inadequate. Blood samples were collected to assess levels of micronutrients. From April 2019 to February 2020, 2428 participants (50⋅2 % females) were recruited from 60 schools. Inadequate intake for calcium was in 93⋅4 % (246⋅5 ± 149⋅4 mg), iron 86⋅5 % (7⋅6 ± 3⋅0 mg), zinc 84⋅0 % (3⋅9 ± 2⋅4 mg), selenium 30⋅2 % (11⋅3 ± 9⋅7 mcg), folate 73⋅8 % (93⋅6 ± 55⋅4 mcg), vitamin B12 94⋅4 % (0⋅2 ± 0⋅4 mcg), vitamin A 96⋅0 % (101⋅7 ± 94⋅1 mcg), and vitamin D 100⋅0 % (0⋅4 ± 0⋅6 mcg). Controlling for sex and socioeconomic status, the odds of biochemical deficiency with inadequate intake for iron [AOR = 1⋅37 (95 % CI 1⋅07-1⋅76)], zinc [AOR = 5⋅14 (95 % CI 2⋅24-11⋅78)], selenium [AOR = 3⋅63 (95 % CI 2⋅70-4⋅89)], folate [AOR = 1⋅59 (95 % CI 1⋅25-2⋅03)], and vitamin B12 [AOR = 1⋅62 (95 %CI 1⋅07-2⋅45)]. Since there is a significant association between the inadequate intake and biochemical deficiencies of iron, zinc, selenium, folate, and vitamin B12, regular surveillance for adequacy of micronutrient intake must be undertaken to identify children at risk of deficiency, for timely intervention.

Micronutrients and cognitive functions among urban school-going children and adolescents: A cross-sectional multicentric study from India.

BACKGROUND: Micronutrient deficiency (MD) is associated with deficits in cognitive functioning of children. However, no comprehensive multicentric study has been conducted in India to explore the role of multiple MD in cognition of children and adolescents. The present study aimed to explore association of MD with level of general intelligence and specific cognitive functions, in urban school-going children and adolescents across ten cities of India. METHOD: Cross-sectional multicentric study, enrolled participants aged 6-16 years. Blood samples were collected for biochemical analysis of calcium, iron, zinc, selenium, folate, vitamin A, D and B12. Colored Progressive Matrices / Standard Progressive Matrices (CPM/SPM), Coding, Digit Span and Arithmetic tests were used for the assessment of cognitive functions of participants. Height and weight measures were collected along with socio-economic status. RESULTS: From April-2019 to February-2020, 2428 participants were recruited from 60 schools. No MD was found in 7.0% (134/1918), any one MD in 23.8% (457/1918) and ≥ 2 MD in 69.2% (1327/1918) participants. In presence of ≥ 2 MD, adjusted odds ratio (OR) for borderline or dull normal in CPM/SPM was 1.63, (95% CI: 1.05-2.52), coding was 1.66 (95% CI: 1.02-2.71), digit span was 1.55 (95% CI: 1.06-2.25) and arithmetic was 1.72 (95% CI: 1.17-2.53), controlling for gender, socioeconomic status and anthropometric indicators. CONCLUSION: Since ≥ 2 MD were found in more than 2/3rd of participants and was associated with impairment in cognitive function, attempts must be made to ameliorate them on priority in school going children in India. TRIAL REGISTRATION NUMBER: CTRI/2019/02/017783.

Texture and rheological features of strain and pH sensitive chitosan-imine graphene-oxide composite hydrogel with fast self-healing nature.

Here we report a smart Chitosan-isophthalaldehyde-Graphene oxide (CS-ISD-GO) hydrogel as a "multicomponent hydrogel". We witnessed an unprecedented pH responsive changes in viscoelasticity, stretchability, adhesiveness, self-healing and self-adaptability upon changing the pH and concentration of CS and ISD that was authenticated by texture and rheological analysis. The GO provides physical crosslinks and antibacterial properties to the hydrogel. Taking the advantage of dynamic nature of covalent and non-covalent interactions, we tuned the hydrogel adhesion and stretchability in response to the pH changes. Further self-healing of hydrogels was fully investigated by measuring thixotropic response over more than three cycles of strain sweep and real time optical imaging and video recording techniques. The recorded videos display 100 % self-healing response within a time frame of 2-6 min. These properties were observed only over small range of pH (4.5-5.5). The hydrogel becomes mechanically strong above pH 5.5 and becomes unstable above pH 7 leading to subsequent disintegration. The characterization of hydrogel was carried by FTIR, FESEM and TGA analysis. In addition, the hydrogel was reduced using NaBH4 for drug release. The reduced gel appears to be stable at lower pH values also. The reduced hydrogel may potentially be used for drug release purpose with low toxicity.

Prevalence of specific micronutrient deficiencies in urban school going children and adolescence of India: A multicenter cross-sectional study.

INTRODUCTION: Childhood and adolescence require adequate amount of micronutrients for normal growth and development. The primary objective of study was to assess the prevalence of deficiencies of Vitamins (Vitamin A, 25 Hydroxy Vitamin D, Vitamin B12 and Folate) and minerals (Calcium, Zinc, Selenium and Iron), among urban school going children aged 6-11 and 12-16 years in ten cities of India. Secondary objective was to find the association between micronutrient deficiencies with sociodemographic and anthropometric indicators. METHODS: A multi-center cross-sectional study was conducted across India. Participants in the age groups of 6 to 11 years (group 1) and 12 to 16 years (group 2) were selected from randomly chosen schools from each center. Data on socio economic status, anthropometric measures was collected. Blood samples were collected for biochemical analysis of micronutrients. Point estimates and 95% confidence intervals was used to assess the prevalence of deficiencies. Associations were observed using chi square, student t test and ANOVA test. RESULTS: From April 2019 to February 2020, 2428 participants (1235 in group 1 and 1193 group 2) were recruited from 60 schools across ten cites. The prevalence of calcium and iron deficiency was 59.9% and 49.4% respectively. 25 Hydroxy Vitamin D deficiency was seen in 39.7% and vitamin B12 in 33.4% of subjects. Folate, Selenium and Zinc were deficient in 22.2%, 10.4% and 6.8% of subjects respectively. Vitamin A deficiency least (1.6%). Anemia was prevalent in 17.6% subjects and was more common among females. CONCLUSION: One or more micronutrient deficiencies are found in almost one half of school going children in urban area. Hence efforts must be made to combat these on priority. TRIAL REGISTRATION NUMBER: CTRI/2019/02/017783.

Viscoelastic and smart swelling disposition of Carboxymethylcellulose based hydrogels substantiated by Gemini surfactant and in-vitro encapsulation and controlled release of Quercetin.

CMC-SA-12-E2-12 hydrogels were prepared from Carboxymethylcellulose (CMC), succinic acid (SA) (biocompatible cross-linker) and Ethane-1,2-diyl-bis(N, N-dimethyl-N-dodecylammoniumacetoxy) (referred as 12-E2-12) (0.0006, 0.0015, 0.003, 0.0045 mMoles) by thermal treatment with economical and easy solution polymerization strategy. The CMC-SA-12E2-12 hydrogels were characterized for mechanical and viscoelastic properties like self-healing, viscosity and modulus using rheological analysis. Further the structural, morphological and thermal properties were investigated by FTIR, SEM and TGA analysis. The investigation revealed significant modulation in mechanical, viscoelastic, self-healing and drug release behavior with the addition of 12-E2-12. The CMC-SA-12-E2-12 hydrogels were investigated for drug release studies in PBS 7.4 for 48 h using Quercetin dihydrate. The results showed sustained release behavior at optimised concentration values of surfactant. Release data fitted nicely to the Higuchi model and hence the release could be seen to be diffusion controlled phenomenon or Fickian diffusion. The biocompatibility of cross-linker and surfactant may potentially make the hydrogels suitable for drug delivery applications.

Theophylline for renal function in term neonates with perinatal asphyxia: a randomized, placebo-controlled trial.

OBJECTIVE: To study whether prophylactic theophylline can reduce the incidence and/or severity of renal failure in term infants with perinatal asphyxia. STUDY DESIGN: Term neonates with severe perinatal asphyxia were randomized to receive a single dose of either theophylline (study group, n = 40) or placebo (control group, n = 30) during the first hour of life. Daily weight, output/input ratio, 24-hour fluid intake, and urine volumes were recorded during the first 5 days of life. Those infants with asphyxial renal failure were followed up for 1 year. RESULTS: The incidence of severe renal dysfunction was increased in the control group. Creatinine clearance was higher and excretion of beta 2 microglobulin (beta2M) was lower in the theophylline group. Conversely, the glomerular filtration rate was lower in the control group. In infants with renal failure, serum creatinine and creatinine clearance returned to normal in the neonatal period, and the increased beta2M excretion normalized by age 6 weeks. CONCLUSIONS: A single dose of theophylline within the first hour of birth in term neonates with perinatal asphyxia results in a significant decrease in serum creatinine level and urinary excretion of beta2M, along with an increase in creatinine clearance.