ALKAPTONURIA SYNDROME-A REVIEW

Alkaptonuria, also called endogenous ochronosis, and also called as Black Urine Disease, is a rare metabolic autosomal recessive disorder. It occurs by complete inhibition of homogentisic acid oxidase enzyme having its deposition in various tissues. Alkaptonuria is caused due to deficiency of homogentisic acid oxidase involved in the metabolism of tyrosine. Dark discolouration of urine, ochronosis at cartilage and connective tissues, arthritis at the third of fourth decade of life, renal stone disease, spontaneous tendon rupture etc. May be seen in alkaptonuria. Disease severity varies among individual patients, even between siblings, and increase with age because of homogentisic acid accumulation. Usually, life span is not shortened in AKU, but the quality of life is severely effected. Several studies have suggested that Nitisinone may be effective in the treatment of alkaptonuria. Characteristically, the excess HGA means sufferers pass dark urine, which upon standing turns black. This is a feature present from birth. Over time patients develop other manifestations of AKU, due to the deposition of HGA in collagenous tissues, namely ochronosis and ochronotic osteoarthropathy. Although this condition does not reduce life expectancy, it significantly affects the quality of life. The natural history of this condition is becoming better understood, despite gaps in knowledge. Clinical assessment of the condition has also improved along with the development of potentially disease-modifying therapy. Furthermore, recent developments in AKU research have to lead to new understanding of the disease, and further study of the AKU arthropathy has the potential to influence therapy in the management of osteoarthritis

Analysis of vitamin B12 and D deficiency and the effect of supplementation on patients at tertiary care hospital

Vitamins are essential organic compounds for the body and the study aims to understand the extent of deficiency present among the patients tested for deficiency and the effect of supplementation. Our study also aims in understanding the effect of supplementation on treating the deficiency along with its effect on any secondary disease conditions present among the patients such as diabetes, cardiovascular disease, rheumatoid arthritis, osteoporosis and/or hypertension. Assessment was carried out in randomly selected, 500 patients from the patient pool (March 2013 to March 2015) and supplemented with vitamins at KIMS hospital, Secunderabad. Data such as biochemical measures, medications, food supplements and herbal medicines were also taken into consideration. The assessment showed improvement in deficiency symptoms after supplementation. Along with this, the improvement in general health of patients that have secondary conditions was analyzed. The study shows that patients with osteoporosis are benefited by vitamin D supplementation and supplementation seems to also helped patients with pain in case of rheumatoid arthritis. Patients with diabetes and/or cardiovascular disease did not show much improvement with supplementation. Patients with hypertension solely or with other conditions show improvement with this problem compared to other conditions. We observed that supplementation does have a role in general health improvement in patients with some chronic conditions

Ondansetron versus palonosetron: a comparative study on efficacy and safety in prevention of postoperative nausea and vomiting

Background: Postoperative nausea and vomiting (PONV) is a major complication in patients who undergo surgery under general anaesthesia. Various drug regimens and antiemetic interventions have been tried from time-to-time for prevention of PONV but with a variable success rate. This study compares the safety and efficacy of ondansetron and palonosetron in preventing PONV in such patients.Methods: A prospective study was conducted in 60 ASA grades - I and II patients of either sex, aged between 20 to 50 years, scheduled for elective surgery under general anaesthesia, 30 of who received 4 mg ondansetron and the remaining 30 received 0.05 mg palonosetron intravenously 5 minutes before induction of anaesthesia. Postoperatively they were observed for 24 hours for complete response, any episodes of nausea and vomiting, their severity, need for rescue antiemetic and side effects. After the study, results were compiled and the data was analysed using Student’s T test. P value 0.5). Complete antiemetic response was 60% in ondansetron group and 83% in palonosetron group. There was no significant statistical difference between both the groups in causing headache (p >0.5) and dizziness (p >0.05).Conclusions: Our study concludes that the antiemetic efficacy is comparable for both ondansetron and palonosetron in the given doses in preventing PONV and none is superior. Both the study drugs had almost the same adverse effect profile

Diphyllobothriasis in a nine-year-old child in India: a case report

<p>Abstract</p> <p>Introduction</p> <p>The <it>Diphyllobothrium </it>genus belongs to the <it>Diphyllobothridea </it>order of tapeworms. <it>Diphyllobothrium </it>spp., which is commonly known as fish tapeworm, is generally transmitted in humans, but also in other species, such as bears, dogs, cats, foxes, and other terrestrial carnivores. Although worldwide in distribution, the original heartland of <it>Diphyllobothrium </it>spp. spreads across Scandinavia, northern Russia, and western Serbia. We report a rare case that occurred in India.</p> <p>Case presentation</p> <p>A nine-year-old south Indian girl was brought to the casualty at the Prathima Institute of Medical Sciences with complaints of vomiting and loose stools that had started three days earlier. The vomit did not have a foul smell and contained no blood or mucus, but it did contain undigested food particles. The patient described a history of recurrent abdominal pain. She was a non-vegetarian and said she had a history of eating fish.</p> <p>Conclusion</p> <p>The incidence of <it>Diphyllobothrium </it>spp. infection is infrequent in India. Since this is only the fourth reported case in India, and since the previously reported cases also involved observed pediatric patients, we emphasize the need for clinical microbiologists and pediatricians to suspect fish tapeworm infection and recommend epidemiological study of <it>Diphyllobothrium </it>spp. infection.</p

Productivity enhancement and improved livelihoods through participatory soil fertility management in Tribal Districts of Andhra Pradesh

Under the National Agricultural Innovation Project (NAIP) , three tribal-dominated districts (Adilabad, Khammam and Nalgonda) in Andhra Pradesh were selected to study the role of Site Specific Nutrient Management (SSNM) and balanced nutrition to enhancing income and livelihood security. By adopting a toposequence approach, 720 surface soil samples were collected from 39 villages with the participation of farmers. The soil sampling was based on stratified random sampling. Generally, it is believed that soils in the tribal region are rich in organic carbon and high in soil fertility because of relatively low intensity cropping. Contrary to this belief, the results of soil analyses showed that most of the soils are low to medium in organic carbon, low in available N and P, and low to high in available K. Among the secondary and micronutrients, S, B and Zn are the emerging nutritional constraints. By adopting SSNMand balanced nutrition approach, increase in yield ranged from 13 to 53% in cotton, 15 to 58% in chickpea, 18 to 44% in groundnut, 33 to 47% in green gram; and in vegetable crops, the increase in yield varied from 25 to 54% in tomato and 7-10% in Bhindi (Ladies fmger) over the farmer's practice (FP). Net income and return per Re investment also increased by balanced nutrition. In cotton, net income obtained ranged between Rs. 30783 and 55533 ha-1 in Adilabad, Rs. 15,030 and 70,533 ha-1 in Khammam under balanced nutrient management. In other crops, the net return was Rs. 5564-14214 ha-! in chickpea, . Rs. 8380-13840 ha-1 in groundnut, Rs. 4207-8995 ha'! in green gram, Rs. 47526-78329 ha-! in tomato and Rs. 15570-38370 ha-1 in Bhindi under balanced nutrition. Mean value of return per Re investment was 2.97-3.05, 1.78, 1.60, 1.55,2.09 Ind 1.78 in cotton, chickpea, groundnut, green gram, tomato and Bhindi, respectively under balanced nutrition

The antioxidant and antiproliferative activities of methanolic extracts from Njavara rice bran

<p>Abstract</p> <p>Background</p> <p>Free radical-induced oxidative stress is the root cause for many human diseases. Naturally occurring antioxidant supplements from plants are vital to counter the oxidative damage in cells. The main objective of the present study was to characterize the antioxidant and antiproliferative potential of rice bran extracted from an important Indian rice variety, Njavara and to compare the same with two commercially available basmati rice varieties: Vasumathi, Yamini and a non medicinal variety, Jyothi.</p> <p>Methods</p> <p>Methanolic extracts of rice bran from four varieties; Vasumathi, Yamini, Jyothi and Njavara were used to study their total phenolic and flavonoid contents, <it>in vitro </it>antioxidant activities including total antioxidant activity, scavenging of nitric oxide and 1,1-Diphenyl-2-picrylhydrazyl (DPPH) radical, reducing power and cytotoxic activity in C6 glioma cells. Correlation coefficient and regression analysis were done by using Sigmastat version 3.1 and Stata statistical package respectively.</p> <p>Results</p> <p>Rice bran methanolic extract from Njavara showed the highest antioxidant and cell cytotoxic properties compared to the other three rice varieties. IC₅₀values for scavenging DPPH and nitric oxide were in the range of 30.85-87.72 μg/ml and 52.25-107.18 μg/ml respectively. Total antioxidant activity and reducing power were increased with increasing amounts of the extract. Total phenolic and flavonoid contents were in the range of 3.2-12.4 mg gallic acid-equivalent (GAE)/g bran and 1.68-8.5 mg quercetin-equivalent (QEE)/g bran respectively. IC₅₀values of cytotoxic assay (MTT assay) were 17.53-57.78 μg/ml. Correlation coefficient and regression analysis of phenolic content with DPPH and NO scavenging, MTT (-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide) assay, total antioxidant assay and reducing power showed a highly significant correlation coefficient values (96-99%) and regression values (91-98%).</p> <p>Conclusion</p> <p>The results of the present study show that the crude methanolic extract from Njavara rice bran contains significantly high polyphenolic compounds with superior antioxidant activity as evidenced by scavenging of free radicals including DPPH and NO. Njavara extracts also showed highest reducing power activity, anti-proliferative property in C6 glioma cells. In conclusion, it is conceivable that the Njavara rice variety could be exploited as one of the potential sources for plant - based pharmaceutical products.</p

Isolation and evolutionary analysis of Australasian topotype of bluetongue virus serotype 4 from India

Bluetongue (BT) is a Culicoides-borne disease caused by several serotypes of bluetongue virus (BTV). Similar to other insect-borne viral diseases, distribution of BT is limited to distribution of Culicoides species competent to transmit BTV. In the tropics, vector activity is almost year long, and hence, the disease is endemic, with the circulation of several serotypes of BTV, whereas in temperate areas, seasonal incursions of a limited number of serotypes of BTV from neighbouring tropical areas are observed. Although BTV is endemic in all the three major tropical regions (parts of Africa, America and Asia) of the world, the distribution of serotypes is not alike. Apart from serological diversity, geography-based diversity of BTV genome has been observed, and this is the basis for proposal of topotypes. However, evolution of these topotypes is not well understood. In this study, we report the isolation and characterization of several BTV-4 isolates from India. These isolates are distinct from BTV-4 isolates from other geographical regions. Analysis of available BTV seg-2 sequences indicated that the Australasian BTV-4 diverged from African viruses around 3,500 years ago, whereas the American viruses diverged relatively recently (1,684 CE). Unlike Australasia and America, BTV-4 strains of the Mediterranean area evolved through several independent incursions. We speculate that independent evolution of BTV in different geographical areas over long periods of time might have led to the diversity observed in the current virus population

Embryology and bony malformations of the craniovertebral junction

BACKGROUND: The embryology of the bony craniovertebral junction (CVJ) is reviewed with the purpose of explaining the genesis and unusual configurations of the numerous congenital malformations in this region. Functionally, the bony CVJ can be divided into a central pillar consisting of the basiocciput and dental pivot and a two-tiered ring revolving round the central pivot, comprising the foramen magnum rim and occipital condyles above and the atlantal ring below. Embryologically, the central pillar and the surrounding rings descend from different primordia, and accordingly, developmental anomalies at the CVJ can also be segregated into those affecting the central pillar and those affecting the surrounding rings, respectively. DISCUSSION: A logical classification of this seemingly unwieldy group of malformations is thus possible based on their ontogenetic lineage, morbid anatomy, and clinical relevance. Representative examples of the main constituents of this classification scheme are given, and their surgical treatments are selectively discussed

The dominant Anopheles vectors of human malaria in the Asia-Pacific region: occurrence data, distribution maps and bionomic précis

<p>Abstract</p> <p>Background</p> <p>The final article in a series of three publications examining the global distribution of 41 dominant vector species (DVS) of malaria is presented here. The first publication examined the DVS from the Americas, with the second covering those species present in Africa, Europe and the Middle East. Here we discuss the 19 DVS of the Asian-Pacific region. This region experiences a high diversity of vector species, many occurring sympatrically, which, combined with the occurrence of a high number of species complexes and suspected species complexes, and behavioural plasticity of many of these major vectors, adds a level of entomological complexity not comparable elsewhere globally. To try and untangle the intricacy of the vectors of this region and to increase the effectiveness of vector control interventions, an understanding of the contemporary distribution of each species, combined with a synthesis of the current knowledge of their behaviour and ecology is needed.</p> <p>Results</p> <p>Expert opinion (EO) range maps, created with the most up-to-date expert knowledge of each DVS distribution, were combined with a contemporary database of occurrence data and a suite of open access, environmental and climatic variables. Using the Boosted Regression Tree (BRT) modelling method, distribution maps of each DVS were produced. The occurrence data were abstracted from the formal, published literature, plus other relevant sources, resulting in the collation of DVS occurrence at 10116 locations across 31 countries, of which 8853 were successfully geo-referenced and 7430 were resolved to spatial areas that could be included in the BRT model. A detailed summary of the information on the bionomics of each species and species complex is also presented.</p> <p>Conclusions</p> <p>This article concludes a project aimed to establish the contemporary global distribution of the DVS of malaria. The three articles produced are intended as a detailed reference for scientists continuing research into the aspects of taxonomy, biology and ecology relevant to species-specific vector control. This research is particularly relevant to help unravel the complicated taxonomic status, ecology and epidemiology of the vectors of the Asia-Pacific region. All the occurrence data, predictive maps and EO-shape files generated during the production of these publications will be made available in the public domain. We hope that this will encourage data sharing to improve future iterations of the distribution maps.</p