Fall in Vitamin D Levels during Hospitalization in Children

Plasma levels of 25-hydroxyvitamin D [25(OH)D] were measured by competitive Electrochemiluminescence Immunoassay (ECLIA) in 92 children (67 boys, 25 girls) aged 3 months to 12 years at admission to hospital (timepoint 1, T1) and at discharge (timepoint 2, T2). There was a significant fall in the mean 25(OH)D from T1 (71.87 ± 27.25 nmol/L) to T2 (49.03 ± 22.25 nmol/L) (mean change = 22.84 nmol/L, P value = 0.0004). Proportion of patients having VDD (levels <50 nmol/L) at admission (25%, 23/92) increased significantly at the time of discharge (51.09%, 47/92) (P=0.0004). There was a trend towards longer duration of hospital stay, requirement of ventilation and inotropes, development of healthcare-associated infection, and mortality in vitamin D deficient as compared to nondeficient patients though the difference was statistically insignificant. In conclusion, vitamin D levels fall significantly and should be monitored during hospital stay in children. Large clinical studies are needed to prospectively evaluate the effect of vitamin D supplementation in vitamin D deficient hospitalized children on various disease outcome parameters

Associations between Body Mass Index and Breast Cancer Markers

Body mass index (BMI) and breast cancer biomarkers (BCBs) such asresistin, leptin adiponectin, monocyte chemoattractant protein-1 (MCP-1)and homeostasis model assessment of insulin resistance (HOMA-IR) arehighly associated with each other. The report has focused the inter-relationship between BMI and BCBs based on probabilistic modeling. It hasbeen shown that mean BMI is directly associated with leptin (P<0.0001)and MCP-1 (P=0.0002), while it is inversely associated with adiponectin(P=0.0003), HOMA-IR (P<0.0001), and it is higher for healthy women(P=0.0116) than breast cancer women. In addition, variance of BMIis inversely associated with resistin (P=0.1450). On the other hand,mean MCP-1 is directly associated with BMI (P<0.0001). Mean resistin is directly associated with the interaction effect of BMI and leptin(BMI*Leptin) (P=0.0415), while its variance is directly associated withBMI (P=0.0942), and it is inversely associated with BMI*Adiponectin(P=0.1518). Leptin is directly associated with BMI (P<0.0001). Alsoadiponectin is inversely associated with BMI (P<0.0001), BMI*Leptin(P=0.1729), while it is directly associated with Age*BMI (P=0.0017)and BMI*Resistin (P=0.0615). It can be concluded that BMI and BCBsare strongly associated with each other. Care should be taken on BMI forbreast cancer women

Fabrication of Custom Ocular Prosthesis Using a Graph Grid: A Case Report

Patients&nbsp; requiring&nbsp; treatment&nbsp; with&nbsp; custom&nbsp; ocular&nbsp; prosthesis&nbsp; are&nbsp; those&nbsp; who&nbsp; have&nbsp; lost&nbsp; ocular&nbsp; structures through orbital evisceration or orbital enucleation which was necessary as a surgical intervention for a congenital&nbsp; defect,&nbsp; pathology&nbsp; or&nbsp; an&nbsp; accident.&nbsp; The&nbsp; disfigurement&nbsp; associated&nbsp; with&nbsp; eye&nbsp; loss&nbsp; can&nbsp; cause significant&nbsp; physical&nbsp; and&nbsp; emotional&nbsp; disturbance.&nbsp; As&nbsp; iris&nbsp; placement&nbsp; is&nbsp; a&nbsp; technique&nbsp; sensitive&nbsp; procedure, visual assessment alone may not be accurate.The&nbsp; present article&nbsp; is an illustration of a case report&nbsp; of&nbsp; a lady chosen for a custom ocular prosthesis. The method described here uses a transparent grid template from which the iris is traced. An attempt is also made to mimick the shade and colour of the sclera in the wax&nbsp; pattern&nbsp; itself;&nbsp; using&nbsp; white&nbsp; paraffin&nbsp; wax.&nbsp; This&nbsp; gives&nbsp; an&nbsp; accurate&nbsp; registration&nbsp; of&nbsp; the&nbsp; position&nbsp; and&nbsp; alignment of iris disc assembly, giving a natural look. &nbsp;Key&nbsp; words: Custom&nbsp; ocular&nbsp; prosthesis,&nbsp; graph&nbsp; grid. &nbsp

Antiviral and Neuroprotective Role of Octaguanidinium Dendrimer-Conjugated Morpholino Oligomers in Japanese Encephalitis

Japanese encephalitis (JE) is caused by a flavivirus that is transmitted to humans by mosquitoes belonging to the Culex sp. The threat of JE looms over a vast geographical realm, encompassing approximately 10 billion people. The disease is feared because currently there are no specific antiviral drugs available. There have been reports where other investigators have shown that agents that block viral replication can be used as effective therapeutic countermeasures. Vivo-Morpholinos (MOs) are synthetically produced analogs of DNA or RNA that can be modified to bind with specific targeted regions in a genome. In this study the authors propose that in an animal model of JE, MOs specifically designed to bind with specific region of JE virus (JEV) genome, blocks virus production in cells of living organisms. This results in reduced mortality of infected animals. As the major target of JEV is the nerve cells, analysis of brain of experimental animals, post treatment with MOs, showed neuroprotection. Studies in cultured cells were also supportive of the antiviral role of the MOs. The potent anti-sense effect in animals and lack of obvious toxicity at the effective dosage make these MOs good research reagents with future therapeutic applications in JE

Genotype V Japanese Encephalitis Virus Is Emerging

Japanese encephalitis (JE) is a global public health issue that has spread widely to more than 20 countries in Asia and has extended its geographic range to the south Pacific region including Australia. JE has become the most important cause of viral encephalitis in the world. Japanese encephalitis viruses (JEV) are divided into five genotypes, based on the nucleotide sequence of the envelope (E) gene. The Muar strain, isolated from patient in Malaya in 1952, is the sole example of genotype V JEV. Here, the XZ0934 strain of JEV was isolated from Culex tritaeniorhynchus, collected in China. The complete nucleotide and amino acid sequence of XZ0934 strain have been determined. The nucleotide divergence ranged from 20.3% to 21.4% and amino acid divergence ranged from 8.4% to 10.0% when compared with the 62 known JEV isolates that belong to genotype I–IV. It reveals low similarity between XZ0934 and genotype I–IV JEVs. Phylogenetic analysis using both complete genome and structural gene nucleotide sequences demonstrates that XZ0934 belongs to genotype V. This, in turn, suggests that genotype V JEV is emerging in JEV endemic areas. Thus, increased surveillance and diagnosis of viral encephalitis caused by genotype V JEV is an issue of great concern to nations in which JEV is endemic

Correlation of Serotype-Specific Dengue Virus Infection with Clinical Manifestations

Dengue virus (DENV) causes disease in millions of people annually and disproportionately affects those in the developing world. DENVs may be divided into four serotypes (DENV-1, DENV-2, DENV-3, and DENV-4) and a geographical region may be affected by one or more DENV serotypes simultaneously. Infection with DENV may cause life-threatening disease such as dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS), but more often causes less severe manifestations affecting a wide range of organs. Although many previous reports have explored the role of the different DENV serotypes in the development of severe manifestations, little attention has focused on the relative role of each DENV serotype in the development of cutaneous, respiratory, gastrointestinal, musculoskeletal, and neurological manifestations. We recruited a large group of participants from four countries in South America to compare the prevalence of more than 30 manifestations among the four different DENV serotypes. We found that certain DENV serotypes were often associated with a higher prevalence of a certain manifestation (e.g., DENV-3 and diarrhea) or manifestation group (e.g., DENV-4 and cutaneous manifestations)

Comparison of Argentinean Saint Louis Encephalitis Virus Non-Epidemic and Epidemic Strain Infections in an Avian Model

St. Louis encephalitis virus (SLEV, Flavivirus, Flaviviridae) is an emerging mosquito-borne pathogen in South America, with human SLEV encephalitis cases reported in Argentina and Brazil. Genotype III strains of SLEV were isolated from Culex quinquefasciatus mosquitoes in Cordoba, Argentina in 2005, during the largest SLEV outbreak ever reported in South America. The present study tested the hypothesis that the recent, epidemic SLEV strain exhibits greater virulence in birds as compared with a non-epidemic genotype III strain isolated from mosquitoes in Santa Fe Province 27 years earlier. The observed differences in infection parameters between adult House sparrows (Passer domesticus) that were needle-inoculated with either the epidemic or historic SLEV strain were not statistically significant. However, only the House sparrows that were infected with the epidemic strain achieved infectious-level viremia titers sufficient to infect Cx. spp. mosquitoes vectors. Furthermore, the vertebrate reservoir competence index values indicated an approximately 3-fold increase in amplification potential of House sparrows infected with the epidemic strain when pre-existing flavivirus-reactive antibodies were present, suggesting the possibility that antibody-dependent enhancement may increase the risk of avian-amplified transmission of SLEV in South America

Viral Etiology of Encephalitis in Children in Southern Vietnam: Results of a One-Year Prospective Descriptive Study

Viral encephalitis is associated with high morbidity and mortality in Vietnam. However little is known about the causes of the disease due to a lack of diagnostic facilities in this relatively resource-poor setting. Knowledge about the etiologies and clinical outcome of viral encephalitis is necessary for future design of intervention studies targeted at improvement of clinical management, treatment and prevention of the disease. We report the viral agents, clinical outcome and prognostic factors of mortality of encephalitis in children admitted to a referral hospital for children in southern Vietnam. We show that about one third of the enrolled patients die acutely, and that mortality is independently associated with patient age and Glasgow Coma Scale on admission. Japanese encephalitis, dengue virus and enterovirus (including enterovirus 71) are the major viruses detected in our patients. However, more than half of the patients remain undiagnosed, while mortality in this group is as high as in the diagnosed group. This study will benefit clinicians and public health in terms of clinical management and prevention of childhood encephalitis in Vietnam