Formulation and evaluation of insitu mucoadhesive nasal gels of metoclopramide hydrochloride

The prolonged residence of drug formulation in the nasal cavity is of utmost importance for intranasal drug delivery. The objective of the present investigation was to develop a mucoadhesive in situ gel with reduced nasal mucocilliary clearance in order to improve the bioavailability of the antiemetic drug, Metoclopramide Hydrochloride. The in situ gelation upon contact with nasal mucosa was conferred via the use of the thermogelling Methyl cellulose whereas mucoadhesion and drug release enhancement were modulated via the use of sodium alginate and polyethylene glycol polymers respectively. The results revealed that the mucoadhesive polymer increased the gel viscosity but reduced its sol gel transition temperatures and the drug release. The inclusion of polyethylene glycol polymer counteracted the effect of mucoadhesive polymer where by it decreased the gel consistency and increased the sol gel transition as well as in vitro drug diffusion. The in vitro tests performed for mucoadhesive strength and drug diffusion showed that nasal in situ gelling formulations prepared are having good mucoadhesive strength with nearly100% drug diffusion within four hours. So this study points to the potential of mucoadhesive in situ nasal gel in terms of ease of administration, accuracy of dosing, prolonged nasal residence and improved nasal bioavailability

Granisetron versus Granisetron-Dexamethasone for Prevention of Postoperative Nausea and Vomiting in Pediatric Strabismus Surgery: A Randomized Double-Blind Trial

Aim. Efficacy of granisetron and combination of granisetron and dexamethasone was evaluated for prevention of postoperative nausea and vomiting (PONV) in children undergoing elective strabismus surgery. Methods. A total of 136 children (1–15 years) were included. Children received either granisetron (40 mcg/kg) [group G] or combination of granisetron (40 mcg/kg) and dexamethasone (150 mcg/kg) [group GD]. Intraoperative fentanyl requirement and incidence and severity of oculocardiac reflex were assessed. PONV severity was assessed for first 24 hours and if score was >2, it was treated with metoclopramide. Postoperative analgesia was administered with intravenous fentanyl and ibuprofen. Results. The demographic profile, muscles operated, and fentanyl requirement were comparable. Complete response to PONV in first 24 hours was observed in 75% (51/68) of children in group G and 76.9% (50/65) of children in group GD, which was comparable statistically (p=0.96, Fisher exact test; OR 1.11, 95% CI 0.50, 2.46). Incidence of PONV between 0 and 24 hours was comparable. One child in group G required rescue antiemetic in first 24 hours and none of the children had severe PONV in group GD. There was no significant difference in incidence or severity of oculocardiac reflex. Conclusion. Dexamethasone did not increase efficacy of granisetron for prevention of PONV in elective pediatric strabismus surgery. Registration number of clinical trial was CTRI/2009/091/001000

Animals and their products utilized as medicines by the inhabitants surrounding the Ranthambhore National Park, India

The present ethnozoological study describes the traditional knowledge related to the use of different animals and animal-derived products as medicines by the inhabitants of villages surrounding the Ranthambhore National Park of India (Bawaria, Mogya, Meena), which is well known for its very rich biodiversity. The field survey was conducted from May to July 2005 by performing interviews through structured questionnaires with 24 informants (16 men and 8 women), who provided information regarding therapeutic uses of animals. A total of 15 animals and animal products were recorded and they are used for different ethnomedical purposes, including tuberculosis, asthma, paralysis, jaundice, earache, constipation, weakness, snake poisoning. The zootherapeutic knowledge was mostly based on domestic animals, but some protected species like the collared dove (Streptopelia sp.), hard shelled turtle (Kachuga tentoria), sambhar (Cervus unicolor) were also mentioned as important medicinal resources. We would suggest that this kind of neglected traditional knowledge should be included into the strategies of conservation and management of faunistic resources in the investigated area

Study protocol for economic evaluation of probiotic intervention for prevention of neonatal sepsis in 0-2-month old low-birth weight infants in India: the ProSPoNS trial

Introduction: The ProSPoNS trial is a multicentre, double-blind, placebo-controlled trial to evaluate the role of probiotics in prevention of neonatal sepsis. The present protocol describes the data and methodology for the cost utility of the probiotic intervention alongside the controlled trial. Methods and analysis: A societal perspective will be adopted in the economic evaluation. Direct medical and non-medical costs associated with neonatal sepsis and its treatment would be ascertained in both the intervention and the control arm. Intervention costs will be facilitated through primary data collection and programme budgetary records. Treatment cost for neonatal sepsis and associated conditions will be accessed from Indian national costing database estimating healthcare system costs. A cost–utility design will be employed with outcome as incremental cost per disability-adjusted life year averted. Considering a time-horizon of 6 months, trial estimates will be extrapolated to model the cost and consequences among high-risk neonatal population in India. A discount rate of 3% will be used. Impact of uncertainties present in analysis will be addressed through both deterministic and probabilistic sensitivity analysis. Ethics and dissemination: Has been obtained from EC of the six participating sites (MGIMS Wardha, KEM Pune, JIPMER Puducherry, AIPH, Bhubaneswar, LHMC New Delhi, SMC Meerut) as well as from the ERC of LSTM, UK. A peer-reviewed article will be published after completion of the study. Findings will be disseminated to the community of the study sites, with academic bodies and policymakers. Registration: The protocol has been approved by the regulatory authority (Central Drugs Standards Control Organisation; CDSCO) in India (CT-NOC No. CT/NOC/17/2019 dated 1 March 2019). The ProSPoNS trial is registered at the Clinical Trial Registry of India (CTRI). Registered on 16 May 2019. Trial registration number: CTRI/2019/05/019197; Clinical Trial Registry

Epidemiology and risk factors of chronic kidney disease in India – results from the SEEK (Screening and Early Evaluation of Kidney Disease) study

Background: There is a rising incidence of chronic kidney disease that is likely to pose major problems for both healthcare and the economy in future years. In India, it has been recently estimated that the age-adjusted incidence rate of ESRD to be 229 per million population (pmp), and >100,000 new patients enter renal replacement programs annually. Methods: We cross-sectionally screened 6120 Indian subjects from 13 academic and private medical centers all over India. We obtained personal and medical history data through a specifically designed questionnaire. Blood and urine samples were collected. Results: The total cohort included in this analysis is 5588 subjects. The mean ± SD age of all participants was 45.22 ± 15.2 years (range 18–98 years) and 55.1% of them were males and 44.9% were females. The overall prevalence of CKD in the SEEK-India cohort was 17.2% with a mean eGFR of 84.27 ± 76.46 versus 116.94 ± 44.65 mL/min/1.73 m2 in non-CKD group while 79.5% in the CKD group had proteinuria. Prevalence of CKD stages 1, 2, 3, 4 and 5 was 7%, 4.3%, 4.3%, 0.8% and 0.8%, respectively. Conclusion: The prevalence of CKD was observed to be 17.2% with ~6% have CKD stage 3 or worse. CKD risk factors were similar to those reported in earlier studies. It should be stressed to all primary care physicians taking care of hypertensive and diabetic patients to screen for early kidney damage. Early intervention may retard the progression of kidney disease. Planning for the preventive health policies and allocation of more resources for the treatment of CKD/ESRD patients are imperative in India

Traditional knowledge on zootherapeutic uses by the Saharia tribe of Rajasthan, India

The present zootherapeutic study describes the traditional knowledge related to the use of different animals and animal-derived products as medicines by the Saharia tribe reside in the Shahabad and Kishanganj Panchayat Samiti's of Baran district of Rajasthan, India. A field survey was conducted from April to June 2006 by performing interview through structured questionnaire with 21 selected respondents, who provided information regarding use of animals and their products in folk medicine. A total of 15 animal species were recorded and they are used for different ethnomedical purposes, including cough, asthma, tuberculosis, paralysis, earache, herpes, weakness, muscular pain etc. The zootherapeutic knowledge was mostly based on domestic animals, but some protected species like the peacock (Pavo cristatus,), hard shelled turtle (Kachuga tentoria), sambhar (Cervus unicolor) were also mentioned as medicinal resources. We would suggest that this kind of neglected traditional knowledge should be included into the strategies of conservation and management of faunistic resources. Further studies are required for experimental validation to confirm the presence of bioactive compounds in these traditional remedies and also to emphasize more sustainable use of these resources

Lessons Learned About Designing and Conducting Studies From HRI Experts

The field of human-robot interaction (HRI) research is multidisciplinary and requires researchers to understand diverse fields including computer science, engineering, informatics, philosophy, psychology, and more disciplines. However, it is hard to be an expert in everything. To help HRI researchers develop methodological skills, especially in areas that are relatively new to them, we conducted a virtual workshop, Workshop Your Study Design (WYSD), at the 2021 International Conference on HRI. In this workshop, we grouped participants with mentors, who are experts in areas like real-world studies, empirical lab studies, questionnaire design, interview, participatory design, and statistics. During and after the workshop, participants discussed their proposed study methods, obtained feedback, and improved their work accordingly. In this paper, we present 1) Workshop attendees’ feedback about the workshop and 2) Lessons that the participants learned during their discussions with mentors. Participants’ responses about the workshop were positive, and future scholars who wish to run such a workshop can consider implementing their suggestions. The main contribution of this paper is the lessons learned section, where the workshop participants contributed to forming this section based on what participants discovered during the workshop. We organize lessons learned into themes of 1) Improving study design for HRI, 2) How to work with participants - especially children -, 3) Making the most of the study and robot’s limitations, and 4) How to collaborate well across fields as they were the areas of the papers submitted to the workshop. These themes include practical tips and guidelines to assist researchers to learn about fields of HRI research with which they have limited experience. We include specific examples, and researchers can adapt the tips and guidelines to their own areas to avoid some common mistakes and pitfalls in their research

Environmental surveillance for Salmonella Typhi and its association with typhoid fever incidence in India and Malawi

Background Environmental surveillance (ES) for Salmonella Typhi potentially offers a low-cost tool to identify communities with a high burden of typhoid fever. Methods We developed standardised protocols for typhoid ES, including sampling site selection, validation, characterisation; grab or trap sample collection, concentration; and quantitative PCR targeting Salmonella genes (ttr, staG and tviB) and a marker of human faecal contamination (HF183). ES was implemented over 12-months in a historically high typhoid fever incidence setting (Vellore, India) and a lower incidence setting (Blantyre, Malawi) during 2021-2022. Results S. Typhi prevalence in ES samples was higher in Vellore compared with Blantyre; 39/520 (7.5%, 95% Confidence Interval 4.4-12.4%) vs. 11/533 (2.1%, 1.1-4.0%) in grab and 79/517 (15.3%, 9.8-23.0%) vs. 23/594 (3.9%, 1.9-7.9%) in trap samples. Detection was clustered by ES site and correlated with site catchment population in Vellore but not Blantyre. Incidence of culture-confirmed typhoid in local hospitals was low during the study and zero some months in Vellore despite S. Typhi detection in ES. Conclusions ES describes the prevalence and distribution of S. Typhi even in the absence of typhoid cases and could inform vaccine introduction. Expanded implementation and comparison with clinical and serological surveillance will further establish its public health utility

Traditional zootherapeutic studies in India: a review

The present study aims to review the zootherapeutic practices of the different ethnic communities of India. This work is also an attempt to present a list of animals' use for medicinal purposes by different communities of India. Data were gathered from 15 published research papers of various authors on zootherapeutic studies in India from 2000 to 2007. Approximately 109 animals and their 270 uses are reported in traditional medicine in different parts of India. Of these, the highest numbers of animal species (42, 38.5%) with 50 (18.5%) uses have been reported for the treatment of Respiratory system related problems. Rheumatic and other pains are treated with 32 species (29.4%) in 34 (12.9%) uses. Gastric problems are reported to be treated with 22 (20.2%) species in 26 (9.9%) uses. The mammals constitute the highest number of animals used for medicinal purposes. 44 (40%) mammals, 24 (22%) invertebrates, 18 (17%) birds, 12 (11%) reptiles, nine (8%) fishes and two (2%) amphibians have been reported for medicinal purposes. Of the total 109 animal species reported, 76(70%) are included in IUCN red data list and 36 (33%) animal species are listed in CITES appendix I, II, and III. This work will be helpful in biodiversity conservation in India and also give a clue to investigate bio-active compound in these animal raw materials