Status of Growth Monitoring in Anganwadi Centres of a Primary Health Centre, Thirubhuvanai, Puducherry

Purpose: To assess the status of growth monitoring activities and difficulties faced by anganwadi workers (AWWs) at the anganwadi centres (AWCs). Methodology: A survey was conducted among AWWs under a rural Primary Health Centre. Structured observations on weight measurement were made using a check list. Secondary data on record keeping and maintenance was collected. Findings: Study participants (n=20) had a 24 (± 10.25) years of experience in Integrated Child Development Services and underwent training once in two years. For advising mothers of malnourished children, deworming and immunization was not mentioned by majority AWWs. In AWCs, children less than 6 month were weighed on bathroom scale and not by Salter’s scale. Unclothing the child before weighing was practiced by only 10% AWWs. Nonfunctional weighing machine was the major problem reported by AWWs. Conclusion: There were gaps in the growth monitoring activities in AWCs of a PHC, Thirubhuvanai which needs to be tackled

Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome: A Case Report

The Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital disorder characterized by aplasia of the uterus and the upper part of vagina in an XX individual with normal development of secondary sexual characteristics. To help establish the best criteria for early diagnosis and treatment options for a comprehensive therapeutic approach to MRKH patients, we report the case of a 19-year-old woman who presented with primary amenorrhea. Correct evaluation of these patients and proper management is mandatory

Sodium alginate microspheres containing multicomponent inclusion complex of domperidone

Sodium alginate microspheres of domperidone for intranasal systemic delivery were developed to eliminate first pass metabolism, improve patient compliance and obtain improved therapeutic efficacy in treatment of migraine, gastro-esophageal reflux and chemotherapy induced nausea and vomiting. Domperidone was encapsulated as ternary inclusion complex with β-cyclodextrin and citric acid to improve solubility. The phase solubility studies were performed in order to select suitable acid and ternary inclusion complex was prepared by kneading method. The complex was characterized by differential scanning calorimetry, X-ray diffraction and Fourier transform infrared spectroscopy. In vitro dissolution study was carried out in simulated nasal electrolyte solution, pH 6.4. The microspheres of optimised ternary inclusion complex were prepared by emulsification-cross-linking method and were evaluated for particle size, encapsulation efficiency, equilibrium swelling degree, in vitro mucoadhesion and in vitro drug release. The effect of various formulation variables such as drug loading, polymer concentration, crosslinking agent concentration and cross-linking time on microsphere characteristics were studied. The microspheres size range was 57.63-65.3 µm, whereas the percentage drug encapsulation was within the range 15-50 %. All microspheres showed good bioadhesive properties. The formulation variables influenced the drug release profile. The treatment of in vitro release kinetics with kinetic equations indicated that the domperidone release followed Higuchi's matrix model.Colegio de Farmacéuticos de la Provincia de Buenos Aire

In vitro absorption studies of acyclovir using natural permeation enhancers

Gastroretentive Delivery Systems are employed to improve the bioavailability of drugs which are absorbed through upper part of GIT, by increasing their retention time. Incorporation of permeability enhancers in the formulations of such drugs can further increase their bioavailability; however their use in the formulations is questionable due to the toxicity exhibited by them. Acyclovir is a class III drug having low oral bioavailability due to improper absorption. Mucoadhesive tablets of acyclovir containing natural permeation enhancers were prepared by direct compression and evaluated for mucoadhesion strength, in-vitro dissolution parameters and in-vitro absorption studies. The formulations containing Aloe vera extract showed increase in the mucoadhesion strength and retarded the drug release. The in-vitro absorption studies revealed that the formulations containing Aloe vera extract (Enhancement Ratio 1.94) and chausath prahar pippal (Enhancement Ratio 1.87) showed significant increase in the permeation of the drug. The studies led to the conclusion that by formulating mucoadhesive tablets of acyclovir containing natural permeation enhancers increased the permeability, thus proving to be the cheaper and easily available alternative to the other permeation enhancers.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Smoking status and common carotid artery intima-medial thickness among middle-aged men and women based on ultrasound measurement: a cohort study

BACKGROUND: Cigarette smoking is an established causal factor for atherosclerosis. However, the smoking effect on different echogenic components of carotid arterial wall measured by ultrasound is not well elucidated. METHODS: Middle-aged men and women who had IMT measurement ≥ 0.7 mm at baseline and follow-up were included (N = 413, age 40–60 years at baseline in 1995). Intima-media thickness of common carotid artery (CCA-IMT) and its components (echogenic and echolucent layers) were measured at baseline and in the follow-up examination 3 years later. IMT and its components were compared across current, former and never smokers. Individual growth models were used to examine how smoking status was related to the baseline and progression of overall IMT and IMT components. RESULTS: For both men and women, current smoking was associated with thicker echogenic layer than never smokers; former smokers exhibited thinner echogenic layer than current smokers after adjustment for cigarette pack-years. Among women, current smoking was also associated with a thinned echolucent layer that resulted in a non-significant overall association of current smoking with IMT for women. CONCLUSION: Cigarette smoking is associated with carotid artery morphological changes and the association is sex-dependent. The atherogenic effect of smoking appears to be partly reversible among former smokers. IMT measurement alone may not be adequate to detect carotid atherosclerosis associated with cigarette smoking among middle-age women

Can rigorous impact evaluations improve humanitarian assistance?

Each year billions of US-dollars of humanitarian assistance are mobilised in response to man-made emergencies and natural disasters. Yet, rigorous evidence for how best to intervene remains scant. This dearth reflects that rigorous impact evaluations of humanitarian assistance pose major methodological, practical and ethical challenges. While theory-based impact evaluations can crucially inform humanitarian programming, popular methods, such as orthodox RCTs, are less suitable. Instead, factorial designs and quasi-experimental designs can be ethical and robust, answering questions about how to improve the delivery of assistance. We argue that it helps to be prepared, planning impact evaluations before the onset of emergencies

Childhood tuberculosis is associated with decreased abundance of T cell gene transcripts and impaired T cell function

The WHO estimates around a million children contract tuberculosis (TB) annually with over 80 000 deaths from dissemination of infection outside of the lungs. The insidious onset and association with skin test anergy suggests failure of the immune system to both recognise and respond to infection. To understand the immune mechanisms, we studied genome-wide whole blood RNA expression in children with TB meningitis (TBM). Findings were validated in a second cohort of children with TBM and pulmonary TB (PTB), and functional T-cell responses studied in a third cohort of children with TBM, other extrapulmonary TB (EPTB) and PTB. The predominant RNA transcriptional response in children with TBM was decreased abundance of multiple genes, with 140/204 (68%) of all differentially regulated genes showing reduced abundance compared to healthy controls. Findings were validated in a second cohort with concordance of the direction of differential expression in both TBM (r2 = 0.78 p = 2x10-16) and PTB patients (r2 = 0.71 p = 2x10-16) when compared to a second group of healthy controls. Although the direction of expression of these significant genes was similar in the PTB patients, the magnitude of differential transcript abundance was less in PTB than in TBM. The majority of genes were involved in activation of leucocytes (p = 2.67E-11) and T-cell receptor signalling (p = 6.56E-07). Less abundant gene expression in immune cells was associated with a functional defect in T-cell proliferation that recovered after full TB treatment (p<0.0003). Multiple genes involved in T-cell activation show decreased abundance in children with acute TB, who also have impaired functional T-cell responses. Our data suggest that childhood TB is associated with an acquired immune defect, potentially resulting in failure to contain the pathogen. Elucidation of the mechanism causing the immune paresis may identify new treatment and prevention strategies