A CROSS-SECTIONAL STUDY OF USING DENVER DEVELOPMENTAL SCREENING TEST II FOR DETECTING CEREBRAL PALSY EARLY IN YOUNG CHILDREN AND NEONATES AT PATNA MEDICAL COLLEGE AND HOSPITAL, PATNA, BIHAR.

Objectives This study aimed to assess and identify developmental delays in infants using the Denver Developmental Screening Test (DDST-II), examining potential contributing factors and offering recommendations for effective interventions. Methods The study employed a prospective cross-sectional design, enrolling 111 infants aged 0 months to 2 years attending a tertiary care center for 2 years. Denver Developmental Screening Test (DDST-II) was administered, and infants were followed up for three consecutive months to assess developmental milestones and potential contributing factors. Results In the study encompassing 111 infants, 6.4% demonstrated delayed development, 7.8% exhibited doubtful delays, and 85.8% were considered normal. Notably, 25% of cases with developmental concerns had a history of preterm birth, 35% were of low birth weight, and 30% were delivered via cesarean section. Furthermore, 100% detection rates for delayed development were observed in infants aged 13-24 months. Conclusion The current study underscores a notable prevalence of developmental delays among infants, emphasizing the critical importance of early detection and intervention. The multifactorial nature of contributing elements, including preterm birth and low birth weight, highlights the complexity of developmental challenges. The study's findings contribute valuable insights into developmental patterns, supporting the need for broader research and targeted interventions. Recommendation The study recommends further research with larger and more diverse samples to enhance generalizability. Additionally, exploring the effectiveness of tailored interventions for developmental delays is crucial for optimizing infant development

Etiological study of bone marrow aspiration cytology in children in a tertiary care government hospital in India with a special focus on adolescent females

Background: Bone marrow aspiration (BMA) cytology is a common and cheap technique which reveals the marrow cellularity, its structure, and stages of differentiation of different blood cells. Objectives: The objectives of the study were to study the etiology and the common presentation in patients undergoing BMA in pediatric age group with special focus on the adolescent females. Materials and Methods: This cross-sectional descriptive study was carried out in the Department of Pediatrics and Pathology of a Medical College Hospital of Bihar, India. The study was done from May 1, 2018, to April 31, 2019, on 259 cases. BMA was carried out and relevant clinical history, physical examination, and laboratory data were retrieved. Results: Out of 259 cases, 1 case was excluded from the final analysis due to inadequate marrow. Male-to-female ratio was 1.16:1. The most common indication was unexplained anemia (46.5%) and pancytopenia (26.7%). The most common etiological diagnosis was nutritional anemia (27.5%) followed by hypoplastic anemia (22%). Among adolescents (>11–18 years), male:female ratio decreased to 1:1 where nutritional anemia was the most common cause followed by hypoplastic anemia. Conclusion: The common hematological disorders prevailing in our community in pediatric age group are nutritional anemia, hypoplastic anemia, and acute leukemia

PREDICTING MORTALITY OUTCOME IN NEONATES DIAGNOSED WITH HYPOXIC ISCHEMIC ENCEPHALOPATHY: A CROSS-SECTIONAL STUDY.

Objectives This study aimed to explore the relationship between varying HIE grades in newborns and levels of reduced glutathione and superoxide dismutase in cerebrospinal fluid, investigating their potential as predictive markers for mortality. The goal was to assess the utility of CSF-based free radical scavengers and antioxidants in predicting mortality in newborns with HIE.  Methods A 3-year cross-sectional study at Patna Medical Collage and Hospital in Patna, Bihar, India included 86 newborns with hypoxic ischemic encephalopathy. Standard treatments were administered, and CSF analysis for superoxide dismutase and reduced glutathione followed exclusion criteria.  Results  In the study of 140 neonates, 54 were excluded due to consent issues, leaving 86 examined by Sarnat staging. Cerebrospinal fluid superoxide dismutase significantly decreased with HIE severity (81.8, 53.2, 31.6 U/ml, P < 0.001). Reduced glutathione exhibited a negative correlation (1354.6, 1041.9, 692.7 ng/ml, P < 0.001). Deceased neonates showed significantly lower SOD (61.43 U/ml, P < 0.001) and GSH (22.45 U/ml, P < 0.001) compared to survivors (1104.32 ng/ml, 584.68 ng/ml, respectively).  Conclusion The current study reveals that diminished levels of reduced glutathione (GSH) and superoxide dismutase (SOD) in cerebrospinal fluid indicate the intensity of hypoxic ischemic encephalopathy (HIE) and correlate with newborn mortality, highlighting the critical role of oxidative stress. Establishing cut-off values for these antioxidants in CSF may serve as markers for HIE staging and prognosis, guiding the development of targeted neuroprotective therapies for neonates.  Recommendation  The study recommends conducting larger, prospective investigations to address limitations like the small sample size and retrospective design. Furthermore, exploring interventions targeting oxidative stress is advised to enhance outcomes in newborns with HIE

Morbidity Profile and Seasonal Variation of Diseases in a Primary Health Center in Kanpur District: A Tool for the Health Planners

Objective: The objective of this study was to determine the morbidity profile of patients being treated at the Primary Health Center, their distribution according to gender, and the seasonal trend of diseases. Materials and Methods: The study was done retrospectively using secondary data, over a period of 1 year from June 2007 to July 2008, at the OPD of the Primary Health Center at Patara in Kanpur District, India. The study was aimed to study the pattern of diseases according to the classification provided by the Government of India. The data were collected from the OPD registers of the consultant medical officer, and the diagnosis was classified into communicable diseases, nutritional and metabolic disorders, infectious diseases, obstetric complications, and other diseases including injuries. Results: A total of 6838 patients had been treated at the OPD, which included 2707 males and 4131 females. It was observed that, while communicable diseases constituted about half of the total burden of the diseases with skin infections being the commonest; the non-communicable diseases constituted about one-fifth of the total disease burden. Significant gender differences were evident in the prevalence of certain diseases such as worm infestation, acute respiratory tract infection, urinary tract infection, reproductive tract infection, chronic obstructive pulmonary disease, gastritis, arthritis/gout, falls/injuries/fractures, anemia, pyrexia of unknown origin, and snake bite. Most of the diseases were observed to have a seasonal variation, with the communicable and infectious diseases peaking in the monsoon months. Surprisingly, the non-communicable diseases such as gastritis and falls and injuries also showed a seasonal variation. Conclusion: Many diseases have a seasonal variation and the burden of these diseases could be reduced if we devise measures to detect the changes in their trend through the implementation of surveillance programs in this part of the world, as has been carried out in other countries. The knowledge of the burden of the diseases would also assist the health administrators in judicious allocation of the resources

Human Beta Casein Fragment (54–59) Modulates <em>M. bovis</em> BCG Survival and Basic Transcription Factor 3 (BTF3) Expression in THP-1 Cell Line

<div><p>Immunostimulatory peptides potentiate the immune system of the host and are being used as a viable adjunct to established therapeutic modalities in treatment of cancer and microbial infections. Several peptides derived from milk protein have been reported to induce immunostimulatory activity. Human β -casein fragment (54–59), natural sequence peptide (NS) carrying the Val-Glu-Pro-Ile-Pro-Tyr amino acid residues, was reported to activate the macrophages and impart potent immunostimulatory activity. In present study, we found that this peptide increases the clearance of <em>M. bovis</em> BCG from THP-1 cell line in vitro. The key biomolecules, involved in the clearance of BCG from macrophage like, nitric oxide, pro-inflammatory cytokines and chemokines, were not found to be significantly altered after peptide treatment in comparison to the untreated control. Using proteomic approach we found that BTF3a, an isoform of the Basic Transcription Factor, BTF3, was down regulated in THP-1 cell line after peptide treatment. This was reconfirmed by real time RT-PCR and western blotting. We report the BTF3a as a novel target of this hexapeptide. Based on the earlier findings and the results from the present studies, we suggest that the down regulation of BTF3a following the peptide treatment may augment the <em>M. bovis</em> BCG mediated apoptosis resulting in enhanced clearance of <em>M. bovis</em> BCG from THP-1 cell line.</p> </div

BTF3a is down regulated after NS treatment.

<p>Real Time RT-PCR (a) and western blotting (b) was performed to analyse the expression of BTF3. BTF3a expression was down regulated after NS and LPS treatment. Fold change in expression during treated conditions is presented in respect to control. The values and error bars represent average and standard deviations of three independent set of experiments. Student T test was performed to find out significant difference between control and treated conditions and comparisons were considered significantly different at P<0.01 (**). In western, two different isoforms of BTF3 were detected as shown in figure (Lanes: a - control, b - NS-20 µM, c - LPS-1 µg/ml). Lower panel depicts the equal level of actin protein which was taken as loading control.</p

Clearance of <i>M. bovis</i> BCG from THP-1.

<p>PMA differentiated THP-1 cells were treated with NS at 10 µM and 20 µM and infected with bioluminescent recombinant BCG. RLU was measured at 0, 24 and 48 hrs time point of infection. The percent decrease in RLU reading after 24 hrs and 48 hrs of infection was considered as percent clearance of bacilli from THP-1 over this time period of infection. Percent increase in clearance in treated cells was calculated in reference to control cells. Lipopolysaccharide (LPS) was taken as positive control for the study. The values and error bars represent average and standard deviations of three independent set of experiments.</p

Nitric oxide production from THP-1 after <i>M. bovis</i> BCG infection.

<p>PMA differentiated THP-1 cells pretreated with NS at 10 µM and 20 µM were infected with recombinant BCG. Infection was continued in the presence of peptide for 24 and 48 hrs. Nitric oxide produced in cell culture after 24 and 48 hrs of infection was measured as described in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0045905#s4" target="_blank">materials and methods</a>. Lipopolysaccharide (LPS) was taken as a positive control. The values and error bars represent average and standard deviations of three independent set of experiments. Student T test was performed to find out significant difference between control and treated group at P<0.01–0.05.</p

Change in pro-inflammatory cytokine and Chemokine expression from THP-1 upon peptide treatment.

<p>PMA differentiated THP-1 cells were treated with NS at 10 µM and 20 µM, Lipopolysaccharide (LPS) at 1 µg/ml concentration for 6 hrs. Change in TNF-α, IL-8, MIP-1beta, MCP-1 & Rantes expression level was quantified by real-time RT-PCR and expressed as fold change in expression of cytokines and cytokines in treated cells verses control cells. LPS was taken as a positive control. Bar shows the mean fold change ± SEM from three different experiments. The difference in cytokine expression between experimental group and control group was assessed by Student’s t-test and comparisons were considered significantly different at P≤0.05 (*) and at P<0.01 (**).</p