Implications of zinc on fetal neural tube defects

Zinc is essential for normal growth and differentiation in all mammalian species and it is reported that folic acid supplementation has reduced the incidence of neural tube defects (NTD). It is still considered one of the important congenital malformations having wide implications. Zinc deficiency has been reported to produce NTD in animals. The present study was undertaken to evaluate zinc status of newborn babies with NTD and their mothers. Blood samples were taken from 287 mothers and their babies having NTD and from 110 controls visiting hospitals and health clinics. Zinc level as μg/ml for blood and serum and μg/g for cell mass were determined on GBC 932 atomic absorption spectrophotometer (Australia) by fluorometery. The mean maternal blood, serum and cell mass concentration in NTD group (14.56 ± 1.34 μg/ml, 0.6 ± 0.01 μg/ml, 5.64 ± 0.35 μg/gm respectively) were significantly lower than those of the control mothers (24.15 ± 2.95 μg/ml, 0.72 ± 0.03 μg/ml, 7.37 ± 0.44 μg/gm respectively). There is a significant decrease in the concentration of Zinc in newborns having NTD (15.65 ± 3.18 μg/ml, 0.56 ± 0.08 μg/ml, 5.11 ± 0.18 μg/gm respectively) as compared with normal newborns (28.04 ± 1.1 μg/ml, 0.59 ± 0.08 μg/ml and 6.08 ± 0.29 μg/gm respectively). Maternal nutritional zinc deficiency in newborns and their mothers is thought to be one of the factors responsible for NTD. However, the lowered zinc concentration may be influencing the causation of NTD. More investigations on zinc status in mothers during antenatal period, especially in the prenatal development and antenatal zinc status including normal babies and NTD babies are required at population level.Keywords: Neural Tube Defect; Trace Element; ZincInternet Journal of Medical Update 2012 July;7(2):19-2

ANTIMICROBIAL-RELATED ADVERSE DRUG REACTION IN A TERTIARY CARE HOSPITAL

  Objective: The objective of the study was to evaluate the adverse drug reaction (ADR) related to commonly used antimicrobials in a tertiary care hospital.Methods: A prospective spontaneous reporting study involving, active methods (pharmacist actively looking for suspected ADRs) and passive methods (stimulating prescribers to report suspected ADRs) was carried out in all departments of a tertiary care hospital, for 1 year. Patients of all age groups were included in the study. The data for the study were taken from case sheets, investigation reports of patients who had experienced an ADR, personal interviews with reporting persons or clinicians, personal interviews with patient or patient's attendant, past history of medication use, which were generally obtained from, prescriptions from the past, reports of medical and surgical interventions, referral letters, ADR reporting forms. Collected data were then analyze for causality assessment by Naranjo's scale and severity assessment by Hartwig and Siegel's scale.Result: During 1 year of study period, 75 ADRs related to antimicrobial were reported among 1354 patients who were given antibiotic for the treatment. The incidence rate of antibiotic was found to be 5.53%. The department that reported ADR was medicine (10.16%), ENT (4.6%), pediatric (8.12%), orthopedics (06.9%), surgery (06.9%), chest and tuberculosis (04.6%), obstetrics and gynecology (06.9%), dentistry (02.3%), and skin (10.16%). The most common ADRs were related to gastrointestinal tract; dermatological reactions were second in the list of antimicrobial drugs causing ADR. In this study, among antimicrobials, fluoroquinolones, and beta-lactam antibiotics were the most common drugs causing gastrointestinal and dermatological ADRs. There was no unknown ADR reported that may need to be further investigated through active monitoring. All patients recovered from ADRs without any complications. The causality was assessed by Naranjo's scale and it revealed that out of 75 antibiotics related ADR 48 (64%) were possible, 27 (36%) were probable, 3 (4.00%) were definate, and 0% were unlikely. According to the Hartwig and Siegel's scale, most of ADR were mild 45 (60%) and moderate 30 (40%) in nature.Conclusion: ADRs related to antimicrobials occurs frequently. Among antimicrobials, fluoroquinolones, and beta-lactam antibiotics were the most common drugs causing gastrointestinal and dermatological ADRs. The health-care system can promote the spontaneous reporting of antimicrobial ADR to pharmacovigilance center for ensuring safe drug use and patient care

Calibration for measurements of droplet size distributions of ground based clouds - a laboratory investigation

Water droplets of varying sizes, released through an atomizer, were collected on glass slides coated with uniform layers of magnesium oxide or carbon soot and silicone oil. Assuming that the droplets retain their original shapes in the oil film, calibrations were obtained for their spreading on oxide and soot layers of known thickness. The calibrations have been further applied to evaluate droplet size distributions of ground-based clouds

Design and Evaluation of an Oral Floating Matrix Tablet of Salbutamol Sulphate

Purpose: To develop floating matrix tablets of salbutamol sulphate using ethyl cellulose and acrycoat S-100 as polymers, and sodium bicarbonate, citric acid and tartaric acid as gas generating agents. Methods: Twenty four formulations were prepared and segregated into four major categories, A to D. The floating tablets were prepared by wet granulation technique, and the granules were compressed at a pressure of 50 kg/cm2. The tablets contained drug, ethyl cellulose and Acrycoat S-100 (as releaseretarding polymers), sodium bicarbonate, citric acid and tartaric acid (as gas formers) as well as various additives. The tablets were made by wet granulation technique. The formulations were evaluated for in vitro buoyancy, dissolution and in vitro drug release. Results: All the formulations fulfilled the essential requirements for good floating systems. Formulation F8, containing citric acid and sodium bicarbonate, showed lower lag time and longer floating duration than the formulations containing only sodium bicarbonate. Formulation F8.2 (which contained citric and tartaric acid at a ratio of 1:1) showed longer floating duration (9 h) than F8. As the concentration of sodium bicarbonate increased in formulation F8.2, drug release decreased while floating duration increased.Conclusion: Of all the 24 formulations, the one containing tartaric acid and citric acid in ratio 1:3 and 12 mg sodium bicarbonate showed the highest floating duration and least lag time.Keywords: Salbutamol sulphate, Ethyl cellulose, Acrycoat S-100, Sodium bicarbonate, Citric acid, Tartaric aci

BIO-CONTROL OF MULTIPLE DRUG-RESISTANT UROPATHOGENS USING MEDICINAL PLANT EXTRACTS

Objective: The present study was conducted to evaluate the potential of some medicinal plants used in Ayurveda in treating multiple drug-resistant human pathogens causing urinary tract infections (UTIs). Methods: Dried parts of six medicinal plants used in Ayurveda for treating UTI were Soxhlet extracted, and the extract was concentrated in vacuo. Various concentrations of the extract were tested for antimicrobial activity against three clinical isolates of multiple drug-resistant bacteria causing UTI. Results: Preliminary results showed the promising antibacterial effect of plant extracts. Escherichia coli, the most common pathogen associated with UTI, was susceptible to aqueous extracts of all the six medicinal plants. Conclusion: This study concluded that the medicinal plants used in Ayurveda to treat UTIs are effective against multiple drug-resistant uropathogens. Further study in this regard may lead to the identification of novel antimicrobial agent for treating multiple drug-resistant urinary tract pathogens

Antimicrobial Activity of Actinomycetes Against Multidrug Resistant Staphylococcus aureus, E. coli and Various Other Pathogens

Purpose: The rapid emergence of drug resistance among pathogenic bacteria, especially multidrugresistant bacteria, underlines the need to look for new antibiotics.Methods: In the present study, 134 different actinomycetes, isolated from the soil samples collected from different localities of Punjab and Himachal Pradesh, were screened for antimicrobial activity against various test organisms including multidrug-resistant methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli in order to identify potential antibiotic producers.Results: Among these isolates, 51 (38 %) showed antimicrobial activity against one or more test organisms and six exhibited promising broad-spectrum activity against all the tested organisms. The observed cultural, morphological, physiological and biochemical characteristics confirmed that these isolates are species of the genus, Streptomyces.Conclusion: Further studies on the bioactive metabolites from these cultures will be useful for discovering novel compounds of clinical and agricultural use.Keywords: Actinomycetes, Broad spectrum antibiotics, Multidrug-resistant Staphylococcus aureus, Streptomyces

Operating Manifold Services in Hospitals: A costly affair?

Manifold services form an important cost centre in hospitals. Most public sector hospitals do not have standard cost accounting system and therefore budget allocation is often difficult for support services such as the manifold. The study was conducted in a 1045 bedded tertiary care hospital in New Delhi, India with the objective of identifying the cost incurred in delivery of manifold services.This traditional costing exercise was conducted from 01 July to 30 Sept 2010 and included classification of costs, identification of the cost centres in the hospital, cost allocation and apportioning. Direct and indirect costs as well as capital and operational costs were calculated. The process of manifold services from delivery to the operational aspects was studied. Tender documents and supply orders were perused to arrive at expenditure on manifold gas pipeline system, equipment & accessories. Total annual cost of manifold services at the hospital was calculated to be $333,676 and per day cost was calculated to be$ 941 .Annual cost per manifold terminal unit was $207.3. The daily cost of manifold system was calculated to be$ 0.56. The annual and daily cost per bed was deduced to be $320 and$ 0.87 respectively.While manifold is a vital support service, the fact remains that it is cost intensive and underutilized and often poorly planned in terms of cost effectiveness. The focus on technology in manifold services needs to be sustained

Clinical characteristics of epilepsy in resource‐limited communities in Punjab, Northwest India

Objectives: To describe clinical characteristics of a community‐based epilepsy cohort from resource‐limited communities in Punjab, Northwest India. / Methods: The cohort was gathered following a two‐stage screening survey. We cross‐sectionally examined and followed up the cohort for one year. A panel of neurologists assigned seizure types, syndromes, and putative etiologies and categorized drug responsiveness. / Results: The cohort of 240 included 161 (67.1%) men, 109 (45.4%) illiterates and 149 (62.1%) unemployed. Current age was >18 years in 155 (64.6%) but age at epilepsy onset was <18 years in 173 (72.1%). Epilepsies due to structural and metabolic causes were diagnosed in 99 (41.3%), but syndromic assignments were not possible in 97 (40.4%). After one year, drug‐resistant epilepsy was established in 74 (30.8%). Perinatal events (n = 35; 14.6%) followed by CNS infections (n = 32; 13.3%) and traumatic brain injury (n = 12; 5.0%) were common risk factors. Most of those with CNS infections (n = 19; 63.3%), perinatal antecedents (n = 23; 76.7%), and other acquired risk factors (n = 27; 90.0%) presented with epilepsy due to structural and metabolic causes. Perinatal events were the putative etiology for nearly 40.7% of generalized epilepsies due to structural and metabolic causes and 28.2% of all epilepsies with onset <10 years. / Significance: Existing classifications schemes should be better suited to field conditions in resource‐limited communities in low‐ and middle‐income countries. The finding of drug‐resistant epilepsy in nearly at least a third in a community‐based sample underscores an unmet need for enhancing services for this segment within healthcare systems. Perinatal events, CNS infections, and head injury account for a third of all epilepsies and hence preventative interventions focusing on these epilepsy risk factors should be stepped up