Seroprevalence of celiac diseases in children suffering from severe acute malnutrition in age group of 1–5 years

Introduction: Celiac disease (CD) may be an underlying cause of malnutrition. Aim: The objective of this study was to find out the seroprevalence of CD in children suffering from severe acute malnutrition (SAM) in age group of 1–5 years. Materials and Methods: This was a prospective, observational, hospital-based study carried out at Malnutrition Treatment Centre attached with tertiary care pediatric hospital associated with the medical college of southern Rajasthan, from December 2017 to November 2018. A total of 110 children with SAM were enrolled and screened for CD on the basis of celiac serology (tissuetransglutaminase [tTg]-immunoglobulin A/G [IgA/IgG]). Results: Celiac serology was positivity in 30 (27.28%) cases; out of total 30 seropositive cases, 14 (46.66%) cases were seropositive for both tTg-IgA and IgG, while only tTg-IgA and only tTg-IgG were positive in 9 (30%) and 7 (23.33%) cases, respectively. Mean serotiter of serum tTg-IgA and IgG in seropositive cases was 134.01±198.74 and 49.05±25.74 unit/ml. Conclusions: High seroprevalence of CD in SAM should be taken as alert as CD may be an underlying cause and responsible for malnutrition. These children should be screened by celiac serology (tTg-IgA/IgG) to rule out CD

Detection of substrate binding motifs for morphine biosynthetic pathway intermediates in novel wound inducible (R,S)-reticuline 7-O-methyltransferase of Papaver somniferum

The benzylisoquinoline alkaloids (BIA) comprise a large and diverse group of nitrogen-containing secondary metabolites with about 2500 compounds identified in plants. BIA biosynthesis begins with the condensation of the tyrosine derived precursors dopamine and p-hydroxyphenylacetaldehyde to (S)-norcoclaurine. Subsequent regiospecific O- and N-methylations and aromatic ring hydroxylation lead to (S)-reticuline, which is the central intermediate for almost all BIAs. For morphinan alkaloid biosynthesis, (S)-reticuline undergoes an inversion of stereochemistry to (R)-reticuline, followed by C-C phenol coupling catalyzed by a unique cytochrome P450-dependent monooxygenase to yield salutaridine. The cDNA sequence of enzymes leading to (S)-reticuline, as well as those involved in the conversion of (R)-reticuline to salutaridine-7-O-acetate are already characterized. The inversion of (S)-reticuline to (R)-reticuline represent the important steps in morphine biosynthesis. Wound induced transcript accumulation in Papaver reveals a novel wound inducible EST (NCBI DbEST: GO238757) showing homology with (R,S)-reticuline 7-O-methyltransferase (ID: Q6WUC2) isolated from Papaver somniferum. We compare the substrate binding homology of this novel wound inducible (R,S)-reticuline 7-O-methyltransferase (7-OMT) using template of P. somniferum (Q6WUC2; gb|AAQ01668) as experimental control. Homology modeling with 70% identity & 85% similarity with catalytic site of template protein i.e., (Q6WUC2) short chain dehydrogenase/reductase (SDR), showed docking energy -69.9 and -75.8 kcal/mol with (S)-Reticuline (CID:439653) and (R)-Reticuline (CID:440586) respectively, which are comparable with experimental control binding site interaction energies. Docking of S- & R-reticuline into the active site revealed eight (F(5), E(18), W(24), C(47), F(44), P(45), C(46) and I(47) amino acids presumably responsible for the high substrate specificity of (R,S)-reticuline 7-O-methyltransferase

Feto maternal outcome in placenta previa and morbidly adherent placenta

Background: Placenta forms the most important link between the developing foetus and the mother. The placenta's health is crucial for the foetus' proper growth and development. The outcome of pregnancy is changed when there is a change in the placental location or architecture for both the mother and the foetus. No matter the cause, placenta previa increases maternal and foetal risks by several times. Aim and objectives of current study are to investigate the incidence of placenta previa in hospital obstetric patients and the maternal and fetal outcome in cases of placenta previa. Methods: 100 patients delivered in the Govt. Medical College, Kota with cases of placenta previa. Risk factors like Gestational age at the onset of bleeding, expectant management, gestational age at delivery and the mode of delivery. The birth weight and APGAR score of the newborn were observed. Results: The risk of placenta previa is 3 time higher in multigravida than primigravida. 52% chances of placenta previa with male babies. Peak incidence of bleeding is noted around 34-36 weeks. 92% of placenta previa cases were delivered LSCS. PPH was main morbidity out of all morbidities. 55% of babies were less than 2.4 Kg. 44% were anterior, 38% posterior and rest 6% central placenta previa. Conclusions: Placenta previa poses a serious risk to both the mother and the foetus, whether it is accidentally discovered by ultrasound or as a result of a clinical emergency like a haemorrhage in the mother. The best outcome can be achieved with an accurate diagnosis, prudent expectant management, blood transfusion as necessary, and prompt delivery.

Home Secretary - Open Letter: Hidden Harm Summit for Domestic Abuse 21 May 2020 COVID-19 Impact

Dear Home Secretary. We are writing to you to ask that your Government takes urgent steps to reduce the impact of the domestic abuse within Black, African, Asian and other Minority Ethnic heritage communities – during the Covid-19 lockdown and in the future. Additionally, to recognise the impact of ‘honour’ abuse, forced and child marriage, and female genital mutilation (FGM) in its agenda

Taxonomic studies of Eulophid parasitoids (Hymenoptera: Chalcidoidea) collected from Uttarakhand, India

A sound taxonomic knowledge base is a prerequisite for effective conservation, environment assessment, ecological research, management and sustainable use of biological resources. Parasitoids are the major component of the biocontrol, so the correct identification of the parasitoid is very important task. Eulophidae is a large family of the superfamily Chalcidoidea and comprises promising biocontrol agents for the control of insect pests causing harm to agricultural ecosystem. The present study has been done to provide the account and occurrence of 4 genera belonging to subfamily Entedoninae, Eulophinae and Tetrastichinae. Entedon costalis Dalman, Diglyphus horticola Khan, Hemiptarsenus varicornis (Girault), and Neotrichoporoides viridimaculatus (Fullaway) was collected from Uttarakhand (India) and described in detail with additional morphological characters that aids in clear identification of the parasitoids. Entedon costalis is recorded from this region with additional characters for identification

Study of pregnancy induced hypertension in relation to placental and fetal birth weight

Background: A healthy placenta is the most important factor in producing a healthy baby. Placenta which is the most important organ for maintaining and continuing healthy pregnancy and fetal growth. Study aimed to evaluate Pregnancy induced hypertension in relation to placental and fetal birth weight.Methods: Total 200 mothers participated in the study, various parameters related with placental and fetal weight were calculated and analysed.Results: This study observed the reduction of placental weight in the hypertensive disorders. Placental weight shows marked variation in all the groups and coefficient of variation was higher in severe PIH group, but mean weight was less with increased severity of PIH. Baby weight shows marked variation in all the groups and coefficient of variation was increased with severity of PIH and mean weight was less with increased severity of PIH. Placental weight was significantly reduced in pre-eclamptic pregnancies and it was directly correlated with fetal birth weight.Conclusions: Hypertensive disorders of pregnancy adversely influence the placental weight, which ultimately, adversely influence the maternal and perinatal outcomes

Risk Factors and the Incidence of Diabetes Insipidus after Pituitary Surgery

Background:  To improve patient care, determining the post-surgery risk factors for diabetes insipidus are extremely significant. We demonstrated the pre-operative factors and postoperative incidence of diabetes insipidus in pituitary surgery. Materials and Methods:  Patients of both genders with ages between 18-65 years having pituitary adenoma amenable to surgery were included. The sample size mainly constitutes macroadenomas and giant adenomas i.e., greater than 1 cm and equal to or greater than 4 cm, respectively. The Hosmer-Lemeshow test was used to measure model fit. The receiver operator characteristic curve was used to evaluate the model and variables such as preoperative serum sodium and urine specific gravity. Results:  Only 210 of 279 patients met the selection criteria. Most of the patients have lesions greater than 1cm, as a result of which a greater number of patients had undergone transcranial approach. Out of these patients, 27% have developed diabetes insipidus. The mean age was 53 years in the non-DI group, whereas, 47 years was the mean age in the patients with DI. 25% of females and 31% of males developed diabetes insipidus. 75% of females and 64% of males did not develop DI. The highest percentage (61%) of patients who developed DI came from giant adenomas.  Conclusion:  Giant adenomas, aggressively primarily treated adenomas, and those lesions that were approached transcranially, showed an increased risk of diabetes insipidus and those who have undergone redo surgery have reduced incidence of diabetes insipidus

Suture less 3D mesh repair of sliding inguinal hernia: a case report

Sliding hernias involving the urinary bladder are rare, almost exclusively seen in men. As a result of slipping of the posterior parietal peritoneum on the underlying retroperitoneal structures, the posterior wall of the sac is not formed of the peritoneum alone, but by a portion of the bladder on either side. This case report presents the case of a 54 year old male patient with  Right groin swelling since two years, gradually increasing in size with complaints of  pain at the site of the swelling prior to voiding and also, an increase in the size of the swelling on retaining urine for a long duration. Based on clinical and radiological findings patient was diagnosed with Sliding inguinal hernia with bladder component, and underwent Open suture less 3D Mesh repair, with replacement of the bladder in the retroperitoneal space. The aim of this case report is to highlight the successful surgical management of a rare sliding hernia involving the urinary bladder using suture less 3D mesh repair

Antibody Mediated Targeted Drug Delivery System To Improve Immunotherapy In Pancreatic Cancer

About 95% of tumor arises from epithelial cell lining ducts known to be pancreatic ductal adenocarcinomas, with less than 5-7% survival rate. Unfortunately, little progress has been seen in the outcomes of patients with PDAC as tumor develops high desmoplasia and chemo-resistance to chemotherapeutic drugs, such as gemcitabine (Gem). Immunotherapy has shown promising results in cancers, except pancreatic cancer due to their characteristic fibrotic tumor microenvironment. The therapies are unable to penetrate to the fibrotic tumors leading to insufficient availability of the therapeutic drugs at the tumor site. A recently identified mucin, MUC13 is aberrantly expressed in pancreatic tumors but not in normal pancreas. This makes MUC13 as an excellent protein for specifically targeting pancreatic tumors. In this project, we demonstrate a unique ability of our in-house generated mouse and humanized monoclonal antibody of MUC13 to penetrate and target pancreatic cancer. These antibodies have been conjugated with our recently developed novel patented superparamagnetic iron oxide nanoparticles (SPIONS). The aim of our study is to deliver stroma targeting drugs efficiently to pancreatic tumors that would soften the tumors to improve the response of checkpoint immunotherapies. The stroma targeting drugs used are curcumin and AMD3100, which are both in clinical trials for human use. This study is unique as it will utilize MUC13 antibodies for targeting the pancreatic tumor site and SPION nanoparticle system for delivering the stroma depleting drugs, which would help in improving immunotherapy response. Our results demonstrate that our MUC13 antibody conjugated SPIONS can efficiently internalize the PDAC cells. SPION-MUC13 using Indocyanine dye (ICG) specifically reached to the tumor site in an orthotopic pancreatic cancer model as indicated by ICG fluorescence. MUC13-SPION formulation led to an enhanced uptake in MUC13 positive (MUC13+) PanCa cells, compared with MUC13 null (MUC13-) cells as demonstrated by immunofluorescence, Prussian blue staining and flow cytometry experiments. Interestingly, the formulation resulted in sustained delivery of curcumin (CUR), enhanced inhibition of cell proliferation, migration and invasion in MUC13+ cells as compared with MUC13- cells, which suggests the targeting efficacy of the formulation. Additionally, the treatment of cells with the formulation inhibited the tumor spheroid formation and growth. The formulation softens up the tumors for therapies that can result in improved response to checkpoint immunotherapies. Therefore, this study indicates high significance of MUC13-SPIONS for achieving pancreatic tumor specific delivery of drugs. Efficient MUC13 conjugated SPION-CUR can potentiate checkpoint immunotherapies, inhibit tumor growth and its progression, which will be conducted in continuation in a pancreatic orthotopic mice model. This study has a potential to reduce morbidity and mortality caused by the disease and improve survival in patients