Pediatric Asthma: Prevalence and Socio-Cultural Factors Affecting Asthma Management in a Rural Area of Northern Karnataka.

CONTEXT: Asthma prevalence and severity is increasing among Indian children. There is the paucity of data on pediatric asthma in rural India and treatment received by asthmatics is not up-to-standard treatment guidelines. AIM: The aim is to estimate asthma prevalence and factors influencing access to standard asthmatic care among 5-15 years aged children. SETTINGS AND DESIGN: Cross-sectional study conducted in rural north-Karnataka for 1 year. SUBJECTS AND METHODS: The International Study of Asthma and Allergies in Childhood questionnaire was administered to participants followed by clinical examination. A child was considered as asthmatic if there was affirmative response to: (a) History of wheeze in the past 12 months, (b) Physician diagnosed/ever asthma, (c) history of taking inhaled/oral bronchodilators. STATISTICAL ANALYSIS: All characteristics were summarized descriptively. RESULTS: Prevalence of Current-wheeze, Ever-asthma, and wheeze on exertion were 4%, 2%, and 3.7%, respectively. About 63.9% of asthmatics had severe-asthma and 44.4% reported severe attack of wheezing limiting speech. About 89% of current-wheezers used only oral medications for wheeze/asthma, 50% did not take medicines as per doctors' advice. None availed regular follow-up. Financial constraints and ignorance were major reasons cited. CONCLUSIONS: Illiteracy, poverty, lack of proper guidelines, and non-availability of inhalational medications have affected treatment adherence resulting in severe asthma.

An Arrow Poison (Abrus Precatorius) Causing Fatal Poisoning in a Child.

Ingestion of whole seeds of Abrus precatorius often does not produce serious illness. It generally presents initially with gastrointestinal manifestations. Haemolysis, acute renal damage, hepatotoxicity and seizures are the other manifestations. Herewith we report a child with accidental ingestion of abrus precatorius seeds who presented with altered sensorium and convulsions. The case is being reported on account of its rarity in its initial neurological manifestation and has not been reported earlier in paediatric age group.

Field Testing of Appropriate Technological Tool of Individualised Color Coded Any Day Neonatal Growth Monitoring Charts for Neonatal Care at Primary Health Care Level.

OBJECTIVE: To field test the Individualised Color Coded Any Day (ICCAD) growth monitoring charts at primary health care level in three districts of Maharashtra. METHODS: The present study was conducted in three districts of Maharashtra - Pune, Satara and Kolhapur and included newborns with weight ≥ 1500 g born during 1st May 2010 to 30th July 2011. Talukas were matched based on mortality and coverage indicators and put in study (ICCAD use) and control area (ICCAD non-use) from every District. Health centres were selected from each taluka where facilities of expert obstetric and pediatric services did not exist but number of deliveries conducted was high. Data was collected during neonatal period. Three patterns of ICCAD charts; 1500 g to 1999 g, 2000 to 2499 g and ≥2500 g; developed from daily weight record of 430 newborns for 30 d were used. Outcome measures were neonatal mortality rate (NMR) and weight gain in study and control groups. RESULTS: There were 6705 live births from study and 6341 from control area. The NMR of study area (6.3/1000 live births) was significantly lesser as compared to control area (10.6/1000 live births). Birth weight group specific NMR of birth weight between 1500 to <2000 g and ≥2500 g was significantly lower in study area as compared to control area. There was improvement in mean gain weight of 15 g, 43 g and 89 g for respective birth weight groups in ascending order. CONCLUSIONS: This innovative appropriate technological tool based on translational research of ICCAD neonatal growth monitoring charts appears to have benefited the decision of type of care.

Towards an understanding of bacterial metabolites prodigiosin and violacein and their potential for use in commercial sunscreens.

OBJECTIVES: To exploit the microbial ecology of bacterial metabolite production and, specifically, to: (i) evaluate the potential use of the pigments prodigiosin and violacein as additives to commercial sunscreens for protection of human skin, and (ii) determine antioxidant and antimicrobial activities (against pathogenic bacteria) for these two pigments. METHODS: Prodigiosin and violacein were used to supplement extracts of Aloe vera leaf and Cucumis sativus (cucumber) fruit which are known to have photoprotective activity, as well as some commercial sunscreen preparations. For each, sunscreen protection factors (SPFs) were determined spectrophotometrically. Assays for antimicrobial activity were carried out using 96-well plates to quantify growth inhibition of Staphylococcus aureus and Escherichia coli. RESULTS: For the plant extracts, SPFs were increased by an order of magnitude (i.e. up to ~3.5) and those for the commercial sunscreens increased by 10-22% (for 4% w/w violacein) and 20-65% (for 4% w/w prodigiosin). The antioxidant activities of prodigiosin and violacein were approximately 30% and 20% those of ascorbic acid (a well-characterized, potent antioxidant). Violacein inhibited S. aureus (IC50 6.99 ± 0.146 µM) but not E. coli, whereas prodigiosin was effective against both of these bacteria (IC50 values were 0.68 ± 0.06 µM and 0.53 ± 0.03 µM, respectively). CONCLUSION: The bacterial pigments prodigiosin and violacein exhibited antioxidant and antimicrobial activities and were able to increase the SPF of commercial sunscreens as well as the extracts of the two plant species tested. These pigments have potential as ingredients for a new product range of and, indeed, represent a new paradigm for sunscreens that utilize substances of biological origin. We discussed the biotechnological potential of these bacterial metabolites for use in commercial sunscreens, and the need for studies of mammalian cells to determine safety.

Phytolatex synthesized gold nanoparticles as novel agent to enhance sun protection factor of commercial sunscreens.

OBJECTIVE: To study the potential of phytolatex (latex of Jatropha gossypifolia) fabricated gold nanoparticles as promising candidate in sunscreen formulations for enhancement in sun protection factor. METHODS: In this study, plant latex was used as reducing and capping agent to synthesize gold nanoparticles. Latex fabricated gold nanoparticles were characterized by different analytical techniques such as UV-Vis spectroscopy, Fourier transforms infrared spectroscopy, dynamic light scattering, zeta potential, transmission electron microscopy and X-ray diffraction. Potential of sunscreen preparations containing gold nanoparticles to protect skin from UV radiation was investigated by in vitro sun protection factor analysis. Transmission electron microscopy and UV-Vis spectroscopy techniques were used to get insight into mechanism by which AuNPs enhance sun protection factor of sunscreen. RESULTS: Monodisperse gold nanoparticles were synthesized using plant latex without need of hazardous chemical reducing and capping agents. Gold nanoparticles showed surface plasmon resonance peak at 550 nm in UV-Vis spectroscopic study. Gold nanoparticles were spherical and triangular in shape with size range of 30-50 nm. The zeta potential of gold nanoparticles was found to be -9.39 ± 0.19 mV. XRD analysis confirmed face-centred cubic (fcc) structure of gold nanoparticles. Incorporation of latex synthesized gold nanoparticles (2 and 4 [% w/w]) into commercial sunscreens increased the sun protection factor from 2.43 ± 0.74 to 24.11 ± 0.46% than sunscreen devoid of gold nanoparticles. From UV-Vis absorption spectroscopy and TEM analysis, it was observed that gold nanoparticles enhance the sun protection factor of commercial sunscreens due to reflection and scattering of UV radiation. CONCLUSION: Phytolatex synthesized gold nanoparticle is novel agent to enhance sun protection factor of commercial sunscreens. Gold nanoparticles aggregation in commercial sunscreen was the main factor behind SPF enhancement. This study showed that gold nanoparticles are potent alternative to traditionally used hazardous titanium dioxide and zinc oxide nanoparticles in sunscreen.

Production of the bioinsecticide Bacillus thuringiensis subsp. israelensis with deltamethrin increases toxicity towards mosquito larvae.

UNLABELLED: Bacillus thuringiensis subsp. israelensis is a bioinsecticide used for larval mosquito control and it represents a safe alternative to chemical insecticides. Despite its environmental safety, it is less efficient and persistent than chemical insecticides. To bypass these limitations, we propose to combine the advantages of chemical and biological insecticides by producing Bti in a medium supplemented with a chemical insecticide (DDT, deltamethrin, permethrin, propoxur or temephos). Among the investigated insecticides, the addition of deltamethrin in the medium induced a higher toxicity (over 6.72-fold) of the composite deltamethrin-Bti towards mosquito larvae as compared to Bti alone. This was mainly due to the insertion of deltamethrin into the membranes of Bti spores, as evidenced by a quantification of membrane-extracted deltamethrin by HPLC. This composite larvicide is a promising tool to decrease the quantity of chemicals dispersed in the environment, to increase the efficacy of Bti and to facilitate its widespread use as a transition between chemical and biological insecticides. Further experiments are required to characterize the mechanisms that underline the incorporation of deltamethrin into Bti to optimize the production and the toxicity of this composite larvicide. SIGNIFICANCE AND IMPACT OF THE STUDY: This study is the first report of an increased efficacy of the mosquitocidal bioinsecticide Bacillus thuringiensis subsp. israelensis (Bti) when produced with a chemical insecticide. The results clearly demonstrate that deltamethrin is able to synergize the insecticidal activity of Bti through inclusion into spore membranes, reducing off-target and nonspecific toxicity occurring when the chemical is used alone as sprays. This new composite chemical-biological insecticide can become an invaluable tool as an intermediate between single chemical usage and the widespread use of Bti, notably in developing countries with limited financial resources for intensive mosquito control campaigns.

Formulation, in vitro drug release study and anticancer activity of 5-fluorouracil loaded gellan gum microbeads.

5-Fluorouracil loaded calcium-zinc-gellan and calcium-zinc-gellan-ethyl cellulose microbeads were successfully prepared by simple ionotropic gelation and oil in water ionotropic gelation technique, respectively. Prepared microbeads were characterized by scanning electron microscopy, Fourier transform infrared spectroscopy and evaluated for particle size, drug content, encapsulation efficiency, drug release and cell cytotoxicity study. Microbeads formed were spherical with rough surface. As concentration of gellan and ethyl cellulose has increased encapsulation efficiency, particle size and sustained drug release effect also increased. The release of 5-fluorouracil from microbeads has followed Hixson Crowell model suggesting the mechanism of drug release as dissolution controlled. Cytotoxicity analysis on HT-29 human colon cancer cell lines indicated that 5-FU loaded gellan gum/gellan in combination with ethyl cellulose microbeads leads to sustained releases of drug and thus delayed apoptosis over a long period of time. The formulation with drug:gellan:ethyl cellulose ratio 2.5:7.5:1 was found to be more effectual in terms of sustained drug release activity in addition to anti-cancer activity.

Improved compressibility, flowability, dissolution and bioavailability of pioglitazone hydrochloride by emulsion solvent diffusion with additives.

Spherical agglomerates of pioglitazone hydrochloride were prepared by the emulsion solvent diffusion method with additives (polyethylene glycol 6000, polyvinyl pyrrolidone, beta cyclodextrin, eudragit RS100, low acyl gellan gum and xanthan gum) using methanol, chloroform and water as a good solvent, bridging liquid and poor solvent respectively. Prepared agglomerates were evaluated for compressibility, solubility, dissolution rate and bioavailability, and characterized by SEM, XRPD, DSC and FTIR spectroscopy. Particle size, flowability, compactibility, packability, solubility, dissolution rate and bioavailability of plain agglomerates and agglomerates with additives (except with polyvinyl pyrrolidone) were advantageously improved compared with raw crystalline pioglitazone hydrochloride. These improved properties for direct compression were due to their large-spherical shape and enhanced fragmentation during compaction, together with increased tensile strength and reduced elastic recovery of the compacts. XRPD and DSC studies indicated polymorphic transition of pioglitazone hydrochloride from form II to I during recrystallization but this was not associated with any chemical transition, as indicated by FTIR spectra, well supported by stability studies. Thus spherical crystallization by the emulsion solvent diffusion method with selected additives is a satisfactory method for direct tableting of pioglitazone hydrochloride giving improved bioavailability.

Tick induced facial palsy.

We report a 3-year old boy with acute onset of left sided facial palsy secondary to tick infestation in the left ear. On 7th day of follow-up, following tick removal, the facial palsy had resolved.

Seroprevalence of hepatitis A virus antibody in Bijapur, Karnataka.

We studied the seroprevalence of anti-HAV IgG in children of Bijapur a tier III city/backward district in Karnataka and its relation with sociodemographic parameters. Out of 142 children, 6 months to 15 years who were included, 63 (44.4%) were sero positive, suggesting that Bijapur is a low endemic area.

Larvicidal activities of six plants extracts against two mosquito species, Aedes aegypti and Anopheles stephensi.

Larvicidal activity of crude chloroform, dichloromethane and methanol extracts of the leaves and roots of six Indian plants, Aegle marmelos L., Balanites aegyptica L., Calotropis gigantica L., Murraya koenigii L., Nyctanthes arbor-tristis L. and Plumbago zeylanica L., were tested against the early fourth instar larvae of Aedes aegypti L. and Anopheles stephensi. The larval mortality was observed after 24 h of exposure. All extracts showed moderate larvicidal effects. However, the highest larval mortality was found in methanol extracts of P. zeylanica roots and B. aegyptica roots against Ae.aegypti (LC50 169.61 mg/lit, 289.59 mg/lit) and An.stephensi (LC50 222.34 mg/lit, 102.29 mg/lit), respectively. The methanol extracts of plants were more effective than the other extracts. This is an ideal eco-friendly approach aid for the control of mosquito species, Ae. aegypti, and An.stephensi.

Childhood brucellosis--a microbiological, epidemiological and clinical study.

A total of 5726 blood specimens (from children aged 14 years and younger) were studied for the serological evidence of brucellosis. Ninety-three (1.6 per cent) showed diagnostic agglutinin titres with a geometric mean titre of 403 (SD +/- 547). Forty-three (59.7 per cent) blood specimens yielded the growth of Brucella melitensis. Thirty-nine patients (41.93 per cent) were shepherds, who constituted the major occupational group affected in the present series. More than 60 per cent of the patients had a history of both consumption of fresh goat's milk and close animal contact. The habit of consuming fresh goat's milk to obtain relief from chronic ailments was noted in nine patients. Seventy-three (78.49 per cent) were males and 20 (21.51 per cent) were females, with a male to female ratio of 3:1. The disease occurred mainly in the school age group (mean age 10.3 years). All the patients had an acute history of less than 2 months. Forty-nine (52.68 per cent) patients presented with persistent fever, 19 (20.43 per cent) with joint pain, and the rest with a combination of fever and joint pain with and without low backache, fever being the commonest complaint. One case presented with involuntary movements of limbs alone and the other with burning feet only. Pityriasis alba was the consistent physical finding, with fever in the majority of the patients. The major joint found to be involved was the knee (52.77 per cent). The synovial fluid obtained from the knee joint of five patients demonstrated Brucella agglutinins and also three grew B. melitensis. Eight patients presented with complications that included skin lesions (3), carditis (2), neurobrucellosis such as chorea (1), peripheral neuritis (1), and meningitis (1). Brucella melitensis biotype 1 was successfully isolated from the papular eruption of one out of three cases who presented with skin lesions. To our knowledge this is the fourth confirmed isolation of B. melitensis from skin lesions with brucellosis, reported in the literature. The cerebrospinal fluid obtained from the meningitis patient was positive for B. agglutinins. To our knowledge chorea of brucellar origin appears to be the first case reported in the literature. In 15 cases (16.13 per cent) brucellosis was suspected clinically whereas 78 (83.87 per cent) cases, only serological evidence of brucellosis confirmed the diagnosis. None of the cases relapsed. In our experience an initial combination therapy with a three-drug regimen followed by a two-drug regimen for a minimum of 6 weeks has been found to be effective in the prevention of a relapse.

Optimization of media by evolutionary algorithms for production of polyols.

Biotransformation of sucrose-based medium to polyols has been reported for the first time using osmophilic yeast, Hansenula anomala. A new, real coded evolutionary algorithm was developed for optimization of fermentation medium in parallel shake-flask experiments. By iteratively employing the nature-inspired techniques of selection, crossover, and mutation for a fixed number of generations, the algorithm obtains the optimal values of important process variables, namely, inoculum size and sugar, yeast extract, urea, and MgSO4 concentrations. Maximum polyols yield of 76.43% has been achieved. The method is useful for reducing the overall development time to obtain an efficient fermentation process.