Is Rivastigmine Effective in the Treatment of Alzheimer’s Disease?

OBJECTIVE: The objective of this selective EBM review is to determine whether or not rivastigmine is effective for the treatment of Alzheimer’s Disease. STUDY DESIGN: Review of two trials in the English language published in 2007 and 2010, and an open-label, singlearm, multi-center study from 2008. DATA SOURCES: Randomized, double-blind, placebo-controlled trials comparing rivastigmine to a visually-matched capsule (placebo) was found using PubMed and Cochrane databases. OUTCOMES MEASURED: Overall global performance using the Alzheimer’s Disease Assessment Scale (ADAS-cog), ability to perform activities of daily living, cognitive function using the mini mental status exam (MMSE), and neuropsychiatric symptoms using BEHAVE-AD. RESULTS: The two RCTs included in the review along with the open-label study showed that rivastigmine did help improve symptoms, but usually in patients with a more severe or progressive form of dementia. Rivastigmine was also shown to be more effective in preventing cognitive decline when given at higher doses and to participants who did not have other confounding symptoms, such as hallucinations. CONCLUSIONS: The results of the RCTs and open-label study show that rivastigmine for the treatment of Alzheimer’s disease is safe and effective

Raeleen Kao Interview

BIO: Raeleen Kao is a drawer, printmaker, and amateur competitive eater aka glutton residing in Chicago with a Charles Brand etching press, a red tabby, and forty plants. Her prints and drawings have been exhibited in museums and galleries across the country most notably at the International Museum of Surgical Science, the Monmouth Museum of Art, Bert Green Fine Art, the Smith College Museum of Art, Tory Folliard Gallery, Firecat Projects, and Normal Editions Workshop. Her work has been represented at SELECT Fair New York, the Editions and Artist Books Fair in New York, the Cleveland Fine Print Fair, the LA Art Show, and Aqua Art Miami. Her work has been published in four volumes of Art In Print and featured in Printed Editions: Online catalog of the Print World. http://frozencharlottepress.com

One step pre-hardening micropropagation of Bambusa balcooa Roxb.

Bamboo’s fast growth and ability to sequester atmospheric carbon consequently mitigate climate change.Abellon’s mission is to reduce CO2 from the environment by growing bamboo on marginal land and using this biomass for bioenergy. Bambusa balcooa Roxb. micropropagation protocol is established for a consistent supply of quality plantlets. Surface sterilization of nodal explants using 0.1% mercuric chloride followed by initiation in liquid and solid media with and without Gentamycin (3.0-8.0 mg/L) containing Murashige and Skoog (MS) media supplemented with 0.01% myo-inositol, 3% sugar, 25 mg/L citrate 50 mg/L ascorbate, and 3.5 mg/L 6-benzylaminopurine (BAP) as growth regulator. Shoots were multiplied using MS medium augmented with 3% sugar, 6% agar, 0.01% myo-inositol with 3 mg/L BAP and 0.5 mg/L naphthalene acetic acid (NAA). Shoot clusters were rooted in MS supplemented with 4 mg/L NAA, pre-hardened in half MS, acclimatized using coco peat, and vermicompost while at net house using vermicompost, soil, sand, and vesicular arbuscular mycorrhiza (VAM) culture. 97% bud break was achieved from initiation while overall success ratio for establishment was 85%. Sub-culturing shoots showed proliferation rate of 3.5-fold. Rooting was successfully achieved with 83% rate.Acclimatization rate at primary and secondary hardening was 72%. The uniqueness of the study lies as bamboo confines to tropical region, however; we have described B. balcooa mass multiplication protocol using explants from arid region with one step pre-hardening process. The protocol achieved multiplication rate of 3.5-fold, overall survival rate 74.66% using vermicompost and VAM for acclimatization of B. balcooa

Antidepressant Use During Pregnancy

There are no studies that have shown any antidepressant to be absolutely safe for use during any stage of pregnancy. The use of selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants (TCAs) during pregnancy does not increase the risk of congenital malformations or miscarriage. (Strength of Recommendation [SOR]: B, based on limited-quality, patient-oriented evidence.) The use of SSRIs or TCAs during pregnancy may increase the risk of preterm birth, low birth weight, respiratory distress, and neonatal convulsions, without obvious subsequent adverse neurodevelopmental outcomes. (SOR: B, based on limited-quality, patient-oriented evidence.

Implementing a Public Private Partnership Model for Managing Urban Health in Ahmedabad

Governments in many developing countries acknowledge they are facing difficulties in their attempt to meet the basic health needs of their populations. They rely on contracting out to private (for-profit and not-for-profit) organizations as a strategy to meet the needs of underserved populations. For the most part, the public sector chooses to contract out primary healthcare services to the private sector to expand access, increase the availability of medicines and medical supplies, and improve the quality of care. In both urban and rural settings, private for-profit and non-profit health service providers serve both the rich and the poor. Communities often recognize private sector healthcare providers to be more responsive to their healthcare needs and preferences in terms of services available, suitable timings and geographical access etc. Private sector has always played a significant role in the delivery of health services in developing countries. Public-private-partnership (PPP) is an approach under which services are delivered by the private sector, while the responsibility for providing the resources rests with the government. Establishing a PPP requires a legal framework acceptable to all the partners, clarity on the commitment of resources, roles and responsibilities of each partner, as well as accountability to provide a given set of services at a desired level of quality and affordable user charges. Formalizing such an arrangement between partners requires conceptualising a framework for Public Private Partnership (PPP) to manage the delivery of health services. In this paper, we describe the design, development and implementation of a PPP for managing urban health services in Ahmedabad city, Gujarat. Our model has succeeded in bringing together compatible public and private partners to plan and deliver quality healthcare services to meet the community needs of Vasna ward, in Ahmedabad. The new Vasna Urban Health centre was inaugurated on July 23, by the Chief Minister of Guajarat. This new centre now serves about 120 outpatients everyday as against an average of 10 outpatients daily earlier.

Awareness, Knowledge and Perception Towards Denture Marking in Kheda District

Even though labeled dentures are a relatively new idea and a developing practice in urban areas, few individuals in Kheda's rural areas are aware of them. Thus, the purpose of the study was to evaluate the sample of rural Kheda population's awareness and perception of denture marking

Assessment of Ear Nose and Throat morbidities prevalent in the school going children aged 5-14 years in rural area of Jamnagar

Background: India is home to more than 400 million children forming about 35% of its total population. Upper respiratory tract infections predispose a child to complications such as otitis media, tonsillitis, and sinusitis that further contribute to morbidity leading to hearing impairment and learning disability & even RHD. Unfortunately these morbidities are either not detected or remain untreated making situation worse. Aims and objectives:1. To assess the prevalence of common Ear Nose and Throat symptoms among children aged 5-14 years and to study its relationship with socio-demographic factors 2. To know regarding health seeking behavior in relations to Ear Nose and Throat morbidities. Materials and method: A cross-sectional study was done over a period of 2 months among 300 school children aged 5-14 years of six government schools of Jamnagar district. Assessment was done through clinical examination and oral questioners. Results: Prevalence of Ear Nose and Throat morbidity was 46.66%; Ear (14.33%), Nose(28.66%) and Throat(10%).Common Ear Nose and Throat problems were– common cold(23%), cough(9.67%), sore throat(8.34%) and ear ache(8.67%). Associations of Ear Nose and Throat morbidity with age and religion were statistically significant. Only 31.40% of children had taken treatment for the problems. Mother’s education had statistically significant association on health seeking behavior of school children. Conclusion: Prevalence of Ear Nose and Throat morbidity was very high among school children, only 1/3 children had taken treatment, indicating negligence towards problems on the part of parents as well as teachers suggesting strong need for sensitization of parents and teachers

Knowledge & Awareness Of Dental Implants Among Undergraduate Dental Students In Nadiad

Introduction: Since dental graduates will inevitably become dentists, it is imperative that they possess a comprehensive understanding of the most recent advancements in dental technology, particularly in relation to tooth replacement. These aspiring dentists have a duty to inform the public about emerging dental technologies. In order to determine how many dental students are aware of dental implants, this study was conducted. Materials and Methods: In order to determine how many dental students in their first and second years at a Faculty of Dental Science in Nadiad, were aware of dental implants, we conducted a cross-sectional study. The study comprised 200 dentistry students in total. Five questions about implants were included in self-explanatory questionnaire forms that were utilized for evaluation. The results were displayed as a percentage of various responses. Results: This study provides data on the knowledge and awareness of first- and second-year dental undergraduates regarding dental implants as a means of treating missing teeth. 187 of the 200 students who took part in the survey returned it fully completed. Of these, just 11 (5.88%) were ignorant of implants, while the remaining 176 (94.12%) were. The remaining questions were asked of these 176 subjects, and the percentage was computed. Conclusion: This study suggests that in order to ensure that future dentists are well-informed and self-assured when it comes to dental implant therapy, there should be more instruction on dental implants taught to first- and second-year dental students

Probiotic Amelioration of Azotemia in 5/6th Nephrectomized Sprague-Dawley Rats

The present study was to test the hypothesis that selected bacteria instilled into the gastrointestinal tract could help in converting nitrogenous wastes accumulated due to renal insufficiency into nontoxic compounds; thereby, ameliorating the biochemical imbalance. Herein we describe a prospective, blinded, placebo-controlled pilot study, using 5/6th nephrectomized Sprague Dawley rat as a chronic renal failure model. The study group consisted of 36 nephrectomized and 7 non-nephrectomized (control) rats. After two-week nephrectomy stabilization, cohorts of six nephrectomized rats were fed casein-based diet plus one of the following regimens: (A) Control, (B) Placebo (casein-based diet without probiotics), (C) Bacillus pasteurii, (D) Sporolac®, (E) Kibow cocktail, (F) CHR Hansen Cocktail, and (G) ECONORMTM. Subsequently, blood (retro-orbital) and urine (collected for measurements of blood urea-nitrogen and creatinine respectively), body weight and bacterial counts (feces) were obtained at regular intervals. The study end-points were to determine if any of the probiotic dietary supplements facilitated, (1) decreased blood concentrations of uremic toxins, (2) altered renal function, and (3) prolonged survival. After 16 weeks of treatment, regimens C and D significantly prolonged the life span of uremic rats, in addition to showing a reduction in blood urea-nitrogen levels, concluding that supplementation of probiotic formulation to uremic rats slows the progression of azotemia, which may correlate with prolonged life span of uremic rats. Derivative trials of probiotic treatment of larger animals and humans will further assess the potential role of probiotic formulations in delaying the onset and clinical severity of clinical illness at different stages of renal failure

Promoting school climate and health outcomes with the SEHER multi-component secondary school intervention in Bihar, India: a cluster-randomised controlled trial.

BACKGROUND: School environments affect health and academic outcomes. With increasing secondary school retention in low-income and middle-income countries, promoting quality school social environments could offer a scalable opportunity to improve adolescent health and wellbeing. METHODS: We did a cluster-randomised trial to assess the effectiveness of a multi-component whole-school health promotion intervention (SEHER) with integrated economic and process evaluations in grade 9 students (aged 13-14 years) at government-run secondary schools in the Nalanda district of Bihar state, India. Schools were randomly assigned (1:1:1) to three groups: the SEHER intervention delivered by a lay counsellor (the SEHER Mitra [SM] group), the SEHER intervention delivered by a teacher (teacher as SEHER Mitra [TSM] group), and a control group in which only the standard government-run classroom-based life-skills Adolescence Education Program was implemented. The primary outcome was school climate measured with the Beyond Blue School Climate Questionnaire (BBSCQ). Students were assessed at the start of the academic year (June, 2015) and again 8 months later at the end of the academic year (March, 2016) via self-completed questionnaires. This study is registered with ClinicalTrials.gov, number NCT02484014. FINDINGS: Of the 112 eligible schools in the Nalanda district, 75 were randomly selected to participate in the trial. We randomly assigned 25 schools to each of the three groups. One school subsequently dropped out of the TSM group, leaving 24 schools in this group. The baseline survey included a total of 13 035 participants, and the endpoint survey included 14 414 participants. Participants in the SM-delivered intervention schools had substantially higher school climate scores at endpoint survey than those in the control group (BBSCQ baseline-adjusted mean difference [aMD] 7·57 [95% CI 6·11-9·03]; effect size 1·88 [95% CI 1·44-2·32], p<0·0001) and the TSM-delivered intervention (aMD 7·57 [95% CI 6·06-9·08]; effect size 1·88 [95% CI 1·43-2·34], p<0·0001). There was no effect of the TSM-delivered intervention compared with control (aMD -0·009 [95% CI -1·53 to 1·51], effect size 0·00 [95% CI -0·45 to 0·44], p=0·99). Compared with the control group, participants in the SM-delivered intervention schools had moderate to large improvements in the secondary outcomes of depression (aMD -1·23 [95% CI -1·89 to -0·57]), bullying (aMD -0·91 [95% CI -1·15 to -0·66]), violence victimisation (odds ratio [OR] 0·62 [95% CI 0·46-0·84]), violence perpetration (OR 0·68 [95% CI 0·48-0·96]), attitude towards gender equity (aMD 0·41 [95% CI 0·21-0·61]), and knowledge of reproductive and sexual health (aMD 0·29 [95% CI 0·06-0·53]). Similar results for these secondary outcomes were noted for the comparison between SM-delivered intervention schools and TSM-delivered intervention schools (depression: aMD -1·23 [95% CI -1·91 to -0·55]; bullying: aMD -0·83 [95% CI -1·08 to -0·57]; violence victimisation: OR 0·49 [95% CI 0·35-0·67]; violence perpetration: OR 0·49 [95% CI 0·34-0·71]; attitude towards gender equity: aMD 0·23 [95% CI 0·02-0·44]; and knowledge of reproductive and sexual health: aMD 0·22 [95% CI -0·02 to 0·47]). However, no effects on these secondary outcomes were observed for the TSM-delivered intervention schools compared with the control group (depression: aMD -0·03 [95% CI -0·70 to 0·65]; bullying: aMD -0·08 [95% CI -0·34 to 0·18]; violence victimisation: OR 1·27 [95% CI 0·93-1·73]; violence perpetration: OR 1·37 [95% CI 0·95-1·95]; attitude towards gender equity: aMD 0·17 [95% CI -0·09 to 0·38]; and knowledge of reproductive and sexual health: aMD 0·06 [95% CI -0·18 to 0·32]). INTERPRETATION: The multi-component whole-school SEHER health promotion intervention had substantial beneficial effects on school climate and health-related outcomes when delivered by lay counsellors, but no effects when delivered by teachers. Future research should focus on the evaluation of the scaling up of the SEHER intervention in diverse contexts and delivery agents. FUNDING: John D. and Catherine T. MacArthur Foundation, USA and the United Nations Population Fund India Office