Screening of infants and young children with hyperbilirubinemia for sensorineural hearing impairment: an institutional study

Background: Jaundice is one of the most common problems occurring in newborns. Severe neonatal hyperbilirubinemia is a common cause of sensory neural hearing loss. It is important to identify and treat the jaundice early, to prevent complications like encephalopathy leading to hearing loss. Early detection of hearing loss is important for early intervention. The aim of the study was to evaluate the prevalence of sensorineural hearing loss (SNHL) in children with hyperbilirubinemia and to correlate the degree of hearing loss with degree of hyperbilirubinemia. Methods: The 50 cases including newborn and young children (<12 years of age) having history of hyperbilirubinemia and exchange transfusion were included in this study. After the approval and clearance from institutional ethical committee, this study was conducted from April 2021 to March 2022 in the department of ENT, govt. medical college Amritsar in co-ordination with department of pediatrics. Results: On comparing brain stem evoked response audiometry (BERA) and otoacoustic emissions (OAE) results, it was found that out of 50 patients BERA was abnormal in 8 patients while 42 had normal BERA. 18% (9) patients had abnormal OAE results out of which 7 had bilateral REFER result while 2 had unilateral REFER result. On comparing the OAE and BERA for sensitivity and specificity, the sensitivity was 92.9% in right ear while specificity was 62.5%, whereas in left ear sensitivity was 95.2% while specificity was 75%. Conclusions: According to our study the prevalence of sensorineural hearing impairment comes out to be 16% as per BERA. BERA is more sensitive and specific as compared to OAE. But still OAE can be used as screening test considering the cost factor and ease of conducting OAE test while BERA is a confirmatory test for SNHL

A DESCRIPTIVE STUDY ON NUTRITIONAL STATUS ASSESSMENT AND MORBIDITY PATTERN OF ADOLESCENTS (10–16 YEARS) RESIDING IN URBAN SLUMS OF AMRITSAR, PUNJAB

Objectives: To assess the nutritional status and morbidity pattern of adolescents age 10–16 years and to determine the various factors associated with under-nutrition. Methods: A descriptive cross-sectional study was conducted among 1600 households which were selected by systematic random sampling method from 64 slum areas. All adolescents aged 10–16 years were included. Required information was collected on a pretested performa. Height and weight were measured to assess their nutritional status and haemoglobin estimation was done by Sahli’s method. Descriptive statistics (frequencies and proportions) and univariate logistic regression were done to determine various factors associated with under nutrition. Results: Out of 603 study participants, 75% of adolescents were under-weight. About 82.3% had anemia. About 36% suffered from one or more infectious disease in the last 3 months. Going to school, occupation, female sex, and suffering from any infectious disease in the past 3 months were found to be associated with malnutrition. Addiction was reported in 9% of study participants. Conclusions: High prevalence of under-nutrition and anemia in our study reflects inequitable distribution of resources, low purchasing capacity of foods, and unequal food sharing patterns in families making them socially and biologically vulnerable

Unraveling Prostaglandin and NLRP3 Inflammasomemediated Pathways of Primary Dysmenorrhea and the Role of Mefenamic Acid and Its Combinations

Painful menstrual cramps during or around the time of the monthly cycle are known as dysmenorrhea. The estimated global prevalence in women of reproductive age ranges from 45% to 95%. It has a significant negative impact on regular activities and productivity at work. However, despite the severe consequences on quality of life, primary dysmenorrhea (PD) is underdiagnosed. Dysmenorrhea has complex pathogenesis. It involves the release of prostaglandins and activation of the nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome and also includes the involvement of other mediators such as bradykinin, histamine and acetylcholine. Even though nonsteroidal anti-inflammatory drugs (NSAIDs) remain the most common type of pain medication, the question of which one should be the most preferred is still open to debate. The current review examines the existing evidence for the pathogenesis of PD and makes evidence based and clinical experience based recommendations for the use of mefenamic acid and its combination in the treatment of dysmenorrhea. Mefenamic acid alleviates PD by inhibiting endometrial prostaglandin formation, restoring normal uterine activity, and reducing the inflammatory response by inhibiting the NLRP3 inflammasome and reducing the release of cytokines such as interleukin (IL)-1β. It is also known to have bradykinin antagonist activity. Dicyclomine has a dual action of blocking the muscarinic action of acetylcholine in postganglionic parasympathetic effect or regions and acting directly on uterine smooth muscle by blocking bradykinin and histamine receptors to relieve spasms. According to the experts, mefenamic acid and dicyclomine act synergistically by acting on the different pathways of dysmenorrhea by blocking multifactorial agents attributed to the cause of dysmenorrhea. Hence, the combination of mefenamic acid and dicyclomine should be the preferred treatment option for dysmenorrhea

Aqueous Cinnamon Extract (ACE-c) from the bark of Cinnamomum cassia causes apoptosis in human cervical cancer cell line (SiHa) through loss of mitochondrial membrane potential

<p>Abstract</p> <p>Background</p> <p>Chemoprevention, which includes the use of synthetic or natural agents (alone or in combination) to block the development of cancer in human beings, is an extremely promising strategy for cancer prevention. Cinnamon is one of the most widely used herbal medicines with diverse biological activities including anti-tumor activity. In the present study, we have reported the anti-neoplastic activity of cinnamon in cervical cancer cell line, SiHa.</p> <p>Methods</p> <p>The aqueous cinnamon extract (ACE-<it>c</it>) was analyzed for its cinnamaldehyde content by HPTLC analysis. The polyphenol content of ACE-<it>c </it>was measured by Folin-Ciocalteau method. Cytotoxicity analysis was performed by MTT assay. We studied the effect of cinnamon on growth kinetics by performing growth curve, colony formation and soft agar assays. The cells treated with ACE-<it>c </it>were analyzed for wound healing assay as well as for matrix metalloproteinase-2 (MMP-2) expression at mRNA and protein level by RT-PCR and zymography, respectively. Her-2 protein expression was analyzed in the control and ACE-<it>c </it>treated samples by immunoblotting as well as confocal microscopy. Apoptosis studies and calcium signaling assays were analyzed by FACS. Loss of mitochondrial membrane potential (Δψ_m) in cinnamon treated cells was studied by JC-1 staining and analyzed by confocal microscopy as well as FACS.</p> <p>Results</p> <p>Cinnamon alters the growth kinetics of SiHa cells in a dose-dependent manner. Cells treated with ACE-<it>c </it>exhibited reduced number of colonies compared to the control cells. The treated cells exhibited reduced migration potential that could be explained due to downregulation of MMP-2 expression. Interestingly, the expression of Her-2 oncoprotein was significantly reduced in the presence of ACE-<it>c</it>. Cinnamon extract induced apoptosis in the cervical cancer cells through increase in intracellular calcium signaling as well as loss of mitochondrial membrane potential.</p> <p>Conclusion</p> <p>Cinnamon could be used as a potent chemopreventive drug in cervical cancer.</p

Evaluation of Acute Kidney Injury and Its Risk Factors in Children Admitted with Diagnosis of Nephrotic Syndrome: Acute Kidney Injury in Nephrotic Syndrome

Background and Aim: Acute Kidney Injury (AKI) is an important complication of Nephrotic Syndrome (NS) associated with adverse outcomes. The frequency of AKI has increased to almost double in the last decade. This study was conducted to determine the incidence of AKI, risk factors, and its association with outcomes in hospitalized children with NS. Methods: All children aged 1-18 years with a diagnosis of NS from 01 November 2018 to 31 May 2020 were enrolled in the study. AKI was diagnosed using the KIDIGO 2012 guidelines and classified according to the pediatric RIFLE definition. Results: The mean age of the children was 4.7± 2.8 years. Complications were observed in 67% of the cases. The most frequent complication was anemia (25%) followed by infection (21%). The incidence of AKI was 18.6% in hospitalized children with NS.&nbsp; According to the pRIFLE criteria, 11.6% of the children met stage 1 (risk) criteria, 4.6% met stage 2 (injury) criteria, and 2.3% met stage 3 (failure) criteria. Among all NS children, 53% received nephrotoxic drugs during the hospital stay. On applying multivariate logistic regression analysis, only male gender, associated anemia, and vancomycin use were significant independent risk factor for AKI in nephrotic syndrome patients. Conclusion: AKI is more frequent in the first episode of NS rather than in any type of relapses. Although nephrotoxic drugs and male gender are known independent risk factors for development of AKI, associated anemia is still not considered as an independent risk factor for AKI in children with NS

Synthesis, crystal structure, DFT/HF, Hirshfeld surface, and molecular docking analysis of 4-(tert-butyl)-4-nitro-1,1-biphenyl

4-(tert-Butyl)-4-nitro-1,1-biphenyl has been synthesized, and its structure has been characterized by using some spectroscopic and single-crystal X-ray diffraction techniques. It crystallizes in a monoclinic crystal system with space group P21/n and unit cell parameters: a = 6.4478(3) Å, b = 9.2477(4) Å, c = 23.4572(9) Å, β = 95.114(4)°, V = 1393.11(10) Å3, Z = 4. The molecular structure has been solved by using the intrinsic phasing method. The crystal structure is stabilized by C-H···O interactions. Computational studies were performed using density functional theory (DFT) and Hartree-Fock (HF) methods. The optimized geometry obtained from DFT and HF in the gas phase was compared with solid-phase experimental data retrieved from single-crystal X-ray diffraction results. Frontier molecular orbitals, such as the HOMO/LUMO energy gap, the molecular electrostatic potential, and Mulliken atomic charges, have been investigated. The HOMO LUMO energy gap of 3.97 eV indicates that the molecule is soft and highly reactive. The Hirshfeld surface analysis and their associated fingerprint plots have been used to quantitatively validate the interactions. Further insilico molecular docking studies have been performed with the molecular target Type-II topoisomerase (PDB ID: 1JIJ) and their results suggest that 4-(tert-butyl)-4-nitro-1,1-biphenyl could be considered an anticancer drug