Efficacy and safety of racecadotril as an adjunct to oral rehydration therapy for acute watery diarrhea in children

Background: Racecadotril, an enkephalinase inhibitor with antisecretory action is a safe and effective treatment for acute diarrheafor children and adults. As an adjunct to oral rehydration therapy (ORT) in Indian children, its efficacy and safety data are scarce.Methods: A total of 117 children with acute watery diarrhea for not more than 7 days were randomized into two groups. Group A(control group) received ORT and zinc only while Group B (study group) received a combination of racecadotril (1.5 mg/kg q8 h),zinc and ORT. Primary end point was the number of loose stools during first 48 h of treatment. Time to cure as well as total volumeof oral rehydration solution (ORS) consumed was also measured. Results: Baseline characteristics were not significantly differentbetween the groups. Mean 48 h stool frequency in the study group was 10.47±3.2 episodes and that in control group was 15.87±4.6episodes indicating a significant reduction of 34.1% with racecadotril (p=0.00016). The mean time for recovery in the study groupwas 37.98±6.1 h and 51.02±9.4 h in control group indicating a significant reduction of 25.6% with racecadotril (p=0.002). Themean volume of ORS consumed before recovery in the study group was 162.72 ml as compared to 232.68 ml in control grouppointing to a significant reduction of 30.1% in the study group. Conclusions: Racecadotril is effective as an adjunct to ORT andearly continued feeding in infants and children with acute watery diarrhea

Study of biochemical and nutritional indicators in severe acute malnutrition: A prospective observational study

Background: Malnutrition in children is widely prevalent in developing countries including India. More than 33% of thedeaths in 0-5 years are associated with malnutrition. Children with severe acute malnutrition (SAM) are in danger of death fromhypoglycemia, hypothermia, fluid overload, electrolyte mismanagement, and undetected infections. Hence, biochemical andnutritional indicators in these children are important for management. Objectives: To study the biochemical and nutritional indicatorsin children with SAM. Methods: This hospital based prospective study was conducted on children aged 6-59 months admitted atNutrition Rehabilitation Center attached to a tertiary care teaching institution. 100 consecutive SAM children admitted during2013-2015 were studied. Children were tested for biochemical and nutritional status like complete blood picture with peripheralsmear, liver function tests, renal function tests, serum electrolytes, calcium, phosphorus, and alkaline phosphatase. Results: A totalof 100 cases were included, of these 57 were male and female were 43. Mean age of presentation was 18.45±2.37 months. A lack ofexclusive breastfeeding was seen in 67% of these children and in 78% children complimentary feeds were initiated either early orlater than 6 months. Hypoglycemia was seen in 15% cases, hypokalemia in 22%, and hypocalcemia in 35% of cases. Hyponatremiawas seen in 14% and hypernatremia in 19% of the children. The most common type of anemia was microcytic hypochromictype (55%). Conclusion: The observations in this study confirm a significant association between SAM and faulty feeding andearly introduction of complementary feeds. It was observed that these children have significant alterations in nutritional indicatorsat admission

Comparative study of Pap smear abnormalities in HIV infected and HIV non-infected women

Background: HIV positive women are more likely than HIV negative women to have cervical dysplasia. Incidence of HPV-related dysplasia increases as immune function declines. To analyse the prevalence of cervical dysplasia on papsmear among women affected with HIV and to compare with that of HIV negative women.Methods: The study period was of 6 months duration from December 2010 to May 2011. Cervical cytology specimen from HIV positive and HIV negative women who attended the OPD of Institute of Maternal and Child Health, Government Medical College, Kozhikode. Were collected after excluding known case of carcinoma cervix, post hysterectomy patients, patients with bleeding per vagina and also those with active genital tract infections.Results: A prospective study of 200 females (100 HIV positive and 100 HIV negative) was done in our hospital. Age range was between 36 and 50 years. PAP smear abnormality was obtained in 35% of the study group. Out of which 21% was seen in HIV positive patients and 14% in HIV negative patients. Prevalence of LSIL (low grade squamous intraepithelial lesion) was significantly higher among HIV positive patients. Abnormality was not associated with CD4 count, HIV status of husband or addictions of husband, not associated with number of partners of husband both in HIV positive and negative patients.Conclusions: PAP smear abnormality (overall), prevalence of LSIL was significantly higher among HIV positive patients. It was not associated with SES, age of first intercourse, number of partners of wife and other immunosuppressive status

Multisite Microprobes for Electrochemical Recordings in Biological Dynamics

For over 30 years, techniques have been developed that allow for the microscale (10-30 /mum) measurement of chemical signals with high temporal resolution (1-200 Hz). Such measurements, called in vivo electrochemical recordings, allow for the direct determination of neurotransmitter molecules and related compounds in biological systems. Multiple recordings, simultaneously performed at different, closely spaced, well defined locations throughout a three-dimensional tissue volume in the brain, are of interest in neuroscience. Developments in microelectronic techniques enable the fabrication of multi-electrode microprobes for recording extracellular action potentials generated by individual neurons simultaneously. A high-yield microfabrication process has been successfully developed for the fabrication of a novel semiconductor based, four-site silicon microprobe that involves a three-mask process and standard UV photolithography. A plasma process has been developed for dry etching of the gold electrodes and conducting lines. The electrochemical behavior of the microprobe is investigated by a high-speed computer-based in vitro electrochemical recording system. The electrochemical signals are measured at 5 Hz and varying gain. It is found that a selectivity of over 500:1 is achieved, and the signal to noise ratio of the recorded signal is particularly suitable for in vivo recordings

Multisite Microprobes for Electrochemical Recordings in Biological Dynamics

For over 30 years, techniques have been developed that allow for the microscale (10-30 /mum) measurement of chemical signals with high temporal resolution (1-200 Hz). Such measurements, called in vivo electrochemical recordings, allow for the direct determination of neurotransmitter molecules and related compounds in biological systems. Multiple recordings, simultaneously performed at different, closely spaced, well defined locations throughout a three-dimensional tissue volume in the brain, are of interest in neuroscience. Developments in microelectronic techniques enable the fabrication of multi-electrode microprobes for recording extracellular action potentials generated by individual neurons simultaneously. A high-yield microfabrication process has been successfully developed for the fabrication of a novel semiconductor based, four-site silicon microprobe that involves a three-mask process and standard UV photolithography. A plasma process has been developed for dry etching of the gold electrodes and conducting lines. The electrochemical behavior of the microprobe is investigated by a high-speed computer-based in vitro electrochemical recording system. The electrochemical signals are measured at 5 Hz and varying gain. It is found that a selectivity of over 500:1 is achieved, and the signal to noise ratio of the recorded signal is particularly suitable for in vivo recordings

Next-generation modelling approaches for sustainable crop protection

The combined pre and post-harvest insect-pest and disease infestation causes an annual estimated 40-50% of total produce loss. Overall loss of attainable yield is more severe in the Asian and African continents because of transboundary insect pests, inconsistent access to crop protection products and lack of preparedness. Solicit innovative, digitally enabled lowcost climate smart pest management technologies for real-time pest forecasting and decision support systems (DSSs) are of great significance and inevitable. Considering this, efforts have been made to develop weather based forewarning models for pests in Chickpea and Pigeonpea (Helicoverpa, Phytophthora blight) and Cotton (Aphid, Leaf hopper, thrips, whitefly) for forewarning time of first appearance of pest, maximum severity/pest population vis-à-vis’ crop age. Using weather indices, models were obtained through stepwise regression technique and machine learning (artificial neural network and Bayesian network) techniques. In general, the models fitted well for all the available data and have good agreement between forecasts and observed status. The predictive ability and accuracy of models will be further validated through cross-location and cross-year models. Further, development of Hybrid Mobile App with Microsoft Azure and promoting e/m-participation will help in dissemination of information to end users for real-time pest monitoring, prediction and crop protection advisory

Use of Xpert MTB/RIF in Decentralized Public Health Settings and Its Effect on Pulmonary TB and DR-TB Case Finding in India

Background Xpert MTB/RIF, the first automated molecular test for tuberculosis, is transforming the diagnostic landscape in high-burden settings. This study assessed the impact of up-front Xpert MTB/RIF testing on detection of pulmonary tuberculosis (PTB) and rifampicin-resistant PTB (DR-TB) cases in India. Methods This demonstration study was implemented in 18 sub-district level TB programme units (TUs) in India in diverse geographic and demographic settings covering a population of 8.8 million. A baseline phase in 14 TUs captured programmatic baseline data, and an intervention phase in 18 TUs had Xpert MTB/RIF offered to all presumptive TB patients. We estimated changes in detection of TB and DR-TB, the former using binomial regression models to adjust for clustering and covariates. Results In the 14 study TUs, which participated in both phases, 10,675 and 70,556 presumptive TB patients were enrolled in the baseline and intervention phase, respectively, and 1,532 (14.4%) and 14,299 (20.3%) bacteriologically confirmed PTB cases were detected. The implementation of Xpert MTB/RIF was associated with increases in both notification rates of bacteriologically confirmed TB cases (adjusted incidence rate ratio [aIRR] 1.39; CI 1.18-1.64), and proportion of bacteriological confirmed TB cases among presumptive TB cases (adjusted risk ratio (aRR) 1.33; CI 1.6-1.52). Compared with the baseline strategy of selective drug-susceptibility testing only for PTB cases at high risk of drug-resistant TB, Xpert MTB/RIF implementation increased rifampicin resistant TB case detection by over fivefold. Among, 2765 rifampicin resistance cases detected, 1055 were retested with conventional drug susceptibility testing (DST). Positive predictive value (PPV) of rifampicin resistance detected by Xpert MTB/RIF was 94.7% (CI 91.3-98.1), in comparison to conventional DST. Conclusion Introduction of Xpert MTB/RIF as initial diagnostic test for TB in public health facilities significantly increased case-notification rates of all bacteriologically confirmed TB by 39% and rifampicin-resistant TB case notification by fivefold

Therapeutic Considerations for Docetaxel and Paclitaxel in Metastatic Breast Cancer

Breast cancer is the main source of death among women. Currently, 77% of women diagnosed with breast cancer are age 50 and older; however, it is projected that approximately 66% of the new cases diagnosed will occur in women younger than 65. Several clinical trials have assessed the wellbeing and adequacy of taxanes along with their tolerability in patients with metastatic cancer (MBC) The overview of these Paclitaxel and Docetaxel, the mechanism of action, pharmacokinetics and pharmacodynamics, dose and administration, adverse effects, clinical potency, and sufferable profiles combination therapies, the pathological complete response of these taxanes are included. The different novel formulations of taxanes are formulated from nanoparticles, polyglutamate, liposomes to improve the wellbeing and adequacy taxanes to reduce their toxicities. Single-agent research located with docetaxel and paclitaxel in metastatic breast most cancers show clinically huge antitumor motion even in the advanced stage, heavily pretreated, safe, as properly as in refractory diseases. This action is likewise clear with taxane-based combination regimens. Serious hematologic and nonhematologic toxicities are incompatible, with different toxicities noted dependent on the portion and weekly regimen selected.  Weekly docetaxel and paclitaxel regimens speak to important helpful treatment options for women suffering from metastatic breast cancer and have entered assessment as a major aspect of adjuvant treatment for this disease Toxicity associated with taxanes chemotherapy are based totally on the dose schedules and weekly regimen selected and the most frequent toxicities related with these marketers include myalgia, peripheral neuropathy, neutropenia, etc Docetaxel retains in tumor cells for longer duration when compared to paclitaxel because of its slow efflux and large amounts of uptake into the cell which explains its more benefits when compared to paclitaxel. Clinical studies conducted so far suggested a more benefit to risk ratio for docetaxel when compared to paclitaxel. This article reviews mainly different actions exhibited by taxanes in the therapy of metastatic breast cancer and others on stages of cancer along with the toxicities associated with these agents. &nbsp

Language in tuberculosis services: can we change to patient-centred terminology and stop the paradigm of blaming the patients?

The words 'defaulter', 'suspect' and 'control' have been part of the language of tuberculosis (TB) services for many decades, and they continue to be used in international guidelines and in published literature. From a patient perspective, it is our opinion that these terms are at best inappropriate, coercive and disempowering, and at worst they could be perceived as judgmental and criminalising, tending to place the blame of the disease or responsibility for adverse treatment outcomes on one side-that of the patients. In this article, which brings together a wide range of authors and institutions from Africa, Asia, Latin America, Europe and the Pacific, we discuss the use of the words 'defaulter', 'suspect' and 'control' and argue why it is detrimental to continue using them in the context of TB. We propose that 'defaulter' be replaced with 'person lost to follow-up'; that 'TB suspect' be replaced by 'person with presumptive TB' or 'person to be evaluated for TB'; and that the term 'control' be replaced with 'prevention and care' or simply deleted. These terms are non-judgmental and patient-centred. We appeal to the global Stop TB Partnership to lead discussions on this issue and to make concrete steps towards changing the current paradigm

Distribution and Severity of Dry Root Rot of Chickpea Caused by Rhizoctonia bataticola in Parts of North Karnataka

Chickpea (Cicer arietinum L.) is one of the most important food legumes and India accounts for approximately 75% of world’s chickpea production. Despite the high total production, yields of chickpea are low due to many biotic and abiotic constraints. Among the biotic constraints more than 50 diseases have so far been reported on chickpea. Among them soil borne disease dry root rot caused by Rhizoctonia bataticola, is the major limiting factor in chickpea production. The survey on the incidence of dry root rot of chickpea was carried out to know the prevalence and distribution of the disease in eight districts of North Karnataka viz., Bidar, Kalaburgi, Yadgir, Raichur, Koppal, Ballari, Dharawad and Vijaypura representing chickpea growing rainfed situations during rabi, 2015-16