A study on habit of preservation of prescriptions by pregnant women in India

Irrational use of medicine is very common in developing countries like India. Drug or medicine use during pregnancy is an important event for both mother and child. Thalidomide disaster showed the adverse effects of drugs on the unborn child. Knowledge about use of medicines can play a crucial role in rational drug use. Prescription is an important tool to assess the past clinical condition of patients and the use of medicines for them. The present study explored the habit of preservation of previous prescriptions in the pregnant women of villages of Wardha District of Maharashtra state of India. This is an observational cross sectional survey using predesigned, precoded and pretested questionnaire. This study showed an interesting habit of these women. 81% of pregnant women have a habit of preservation of prescription as an important document. It was clear that with increasing level of formal education there is a definite increase in habit of preservation of prescription among the pregnant women in rural areas of India.

Surface modification of liposomes with rhodamine-123-conjugated polymer results in enhanced mitochondrial targeting

A novel mitochondrial-targeted liposomal drug-delivery system was prepared by modification of the liposomal surface with a newly synthesized polymer, rhodamine-123 (Rh123)-PEG-DOPE inserted into the liposomal lipid bilayer. This novel polymer was synthesized by conjugating the mitochondriotropic dye Rh123, with the amphiphilic polyethylene glycol-phosphatidylethanolamine (PEG-PE) conjugate. The modified liposomes showed better uptake by cells (HeLa, B16F10) estimated by fluorescence microscopy and FACS analysis. The co-localization study with stained mitochondria as well as with the isolation of mitochondria of the cultured cells after their treatment with Rh123 liposomes showed a high degree of accumulation of the modified liposomes in the mitochondria. We also prepared mitochondrial-targeted and nontargeted paclitaxel (PCL)-loaded liposomes. Mitochondrial-targeted PCL-loaded liposomes demonstrated enhanced cytotoxicity toward cancer cells compared with nontargeted drug-loaded liposomes or free PCL. Thus, Rh123-modified liposomes target mitochondria efficiently and can facilitate the delivery of a therapeutic payload to mitochondria.

Progress in the Preparation of Aluminum Nitride Substrates from Bulk Crystals

Large (11-mm diameter) single-crystal AlN boules have been prepared using sublimationrecondensation growth. X-ray topography shows that substrates prepared from those boules have a dislocation density of less than 500 cm-2, while the central region of these substrates was nearly dislocation-free. Rocking curves of less than 10 arcsecs have been obtained indicating the high quality of these crystals. The AlN substrates have been used to growth an AlGaN/AlN multiquantum well structure with excellent crystalline quality and with photoluminescence peaked at around 260nm. In addition, a UV LED with emission wavelength at 360nm has been fabricated. This is the first operating opto-electronic device demonstrated on an AlN substrate.

The Hyperdense Internal Carotid Artery Sign: Prevalence and Prognostic Relevance in Stroke Thrombolysis

Introduction. The hyperdense internal carotid artery sign (HICAS) has been suggested as a common marker of terminal internal carotid artery (ICA) thrombus associated with poor outcomes following thrombolysis. We aimed to investigate the prevalence and prognostic significance of the HICAS in an unselected cohort of patients receiving intravenous thrombolysis. Methods. Prethrombolysis NCCTs of 120 patients were examined for the presence of the HICAS and hyperdense middle cerebral artery sign (HMCAS). A poor outcome was defined as a discharge Barthel score <15 or inpatient death. Results. A HICAS was present in 3 patients (2.5%). Prethrombolysis neurological deficits were significantly more severe in patients with a HICAS (P = 0.019). HICAS was not significantly associated with a poor outcome (P = 0.323). HMCAS was significantly associated with severe prethrombolysis neurological deficits (P = 0.0025) and a poor outcome (P = 0.015). Conclusions. This study suggests that the prevalence of the HICAS may be lower than previously reported. The presence of a HICAS was associated with severe prethrombolysis neurological deficits in keeping with terminal ICA occlusion. The role of the HICAS as a prognostic marker in stroke thrombolysis remains unclear.

The Utility of a New Index for Adiposity among Pre-school Children

Obesity in children is a cause for concern because it may predict adult obesity and increased risk of coronary heart disease in adult life. Adiposity in preschool children is measured by different conventional indices. The aim of the present study was to measure the indicators of abdominal adiposity - waist circumference (WC), waist-hip ratio (WHR), waist-height ratio (WHTR), conicity index (CI) and a newly proposed body mass abdominal index (BMAI), and to assess the relationship of these with overall adiposity as measured by body mass index (BMI). The study was conducted on 2,016 rural pre-school children (930 boys and 1,086 girls), aged 3-5 years from randomly selected 66 Integrated Child Development Services (ICDS) centres in the Nadia District of West Bengal, India. Results showed significant correlations for all adiposity measures with BMI in both sexes. A noteworthy point was that the correlations were strongest (p< 0.01) with BMAI (boys: r = 0.856, girls: r = 0.868, sex-combined: r = 0.863). Results of linear regression of adiposity measures with BMI revealed that BMAI had the strongest significant impact (t = 76.729) on BMI. Moreover, this new index accounted for 74.5% of variations in BMI. In conclusion, our results provide evidence for the use of body mass abdominal index (BMAI) as a good indicator of overall adiposity (BMI). More studies should be undertaken including its validation with other direct measures of adiposity.

Inhibition of TGF-β signaling by 1D11 antibody treatment increases bone mass and quality in vivo

Transforming growth factor β (TGF-β) is an abundant bone matrix protein that influences osteoblast and osteoclast interactions to control bone remodeling. As such, TGF-β represents an obvious pharmacologic target with the potential to regulate both bone formation and resorption to improve bone volume and strength. To investigate the skeletal effect of TGF-β inhibition in vivo, we used an antibody (1D11) specifically directed at all three isoforms of TGF-β. Normal mice were treated with 1D11 or control antibody (4 weeks), and cortical and trabecular bone was assessed by micro-computed tomographic (µCT) scanning. Bone volume and cellular distribution were determined by histomorphometric analysis of vertebrae and long bones. Also, whole-bone strength was assessed biomechanically by three-point bend testing, and tissue-level modulus and composition were analyzed by nanoindentation and Raman microspectroscopy, respectively. TGF-β blockade by 1D11 increased bone mineral density (BMD), trabecular thickness, and bone volume by up to 54%, accompanied by elevated osteoblast numbers and decreased osteoclasts. Biomechanical properties of bone also were enhanced significantly by 1D11 treatment, with increased bending strength and tissue-level modulus. In addition, Raman microspectroscopy demonstrated that 1D11-mediated TGF-β inhibition in the bone environment led to an 11% increase in the mineral-to-collagen ratio of trabecular bone. Together these studies demonstrate that neutralizing TGF-β with 1D11 increases osteoblast numbers while simultaneously decreasing active osteoclasts in the marrow, resulting in a profound increase in bone volume and quality, similar to that seen in parathyroid hormone (PTH)-treated rodent studies.

Novel D3 dopamine receptor-preferring agonist D-264: Evidence of neuroprotective property in Parkinson's disease animal models induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and lactacystin

Parkinson's disease (PD), a progressive neurodegenerative movement disorder, is known to be caused by diverse pathological conditions resulting from dysfunction of the ubiquitin-proteasome system (UPS), mitochondria, and oxidative stress leading to preferential nigral dopamine (DA) neuron degeneration in the substantia nigra. In the present study, we evaluated the novel D3 receptor-preferring agonist D-264 in a mouse model of PD to evaluate its neuroprotective properties against both the nigrostriatal dopaminergic toxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)- and the proteasome inhibitor lactacystin-induced dopaminergic degeneration. C57BL/6 male mice either were given MPTP by intraperitoneal injection twice per day for 2 successive days at a dose 20 mg/kg or were microinjected with lactacystin bilaterally (1.25 microg/side) into the medial forebrain bundle (MFB). Pretreatment with D-264 (1 mg/kg and 5 mg/kg, intraperitoneally, once per day), started 7 days before administration of MPTP or lactacystin. We found that D-264 significantly improved behavioral performance, attenuated both MPTP- and lactacystin-induced DA neuron loss, and blocked proteasomal inhibition and microglial activation in the substantia nigra (SN). Furthermore, D-264 treatment was shown to increase the levels of brain-derived neurotrophic factor (BDNF) and glial cell line-derived factor (GDNF) in MPTP- and lactacystin-treated mice, possibly indicating, at least in part, the mechanism of neuroprotection by D-264. Furthermore, pretreatment with the D3 receptor antagonist U99194 significantly altered the effect of neuroprotection conferred by D-264. Collectively, our study demonstrates that D-264 can prevent neurodegeneration induced by the selective neurotoxin MPTP and the UPS inhibitor lactacystin. The results indicate that D-264 could potentially serve as a symptomatic and neuroprotective treatment agent for PD.

Comparative study of different surface decontaminants on chicken quality

(1) A comparative study on the effect of different surface decontaminants: hot water at 70 degrees C for one minute; 2% lactic acid for 30 s; 1200 p.p.m. acidified sodium chlorite (ASC) solution for 5 s and 50 p.p.m. chlorine solution for 5 min in the form of dips and sprays on the surface of dressed broilers for 0, 24 and 48 h of storage was conducted. (2) The variables studied were, total plate count (TPC), presumptive coliform count (PCC), pH and extract release volume (ERV). All treatments reduced TPC and PCC. (3) Lactic acid dip and hot water dip were the most effective for reducing TPC (1.36 and 1.28 log/cm2, respectively) with no significant difference between them. (4) ASC and hot water in dip could diminish PCC (1.37 and 1.34 log/cm2, respectively) and did not vary significantly. (5) No treatment affected muscle pH, water holding capacity (WHC), ERV, appearance, smell, tenderness and overall acceptability of treated broilers significantly. (6) Hot water treatment is the cheapest, most convenient and simplest decontamination technique for hygienic and wholesome poultry production.

An audit on assessment and management of pain at the time of acute hospital admission in older people

BACKGROUND

Pain management is fundamental to good clinical care. All patients who are admitted into hospital with any acute condition should be assessed about the presence or absence of pain and managed appropriately at the time of admission. As the prevalence of pain is high in older people, we examined how well it is assessed and managed in the older people in a typical medical emergency setting in the UK.

METHODS

We performed a retrospective audit in a district general hospital with catchment population of 250,000 in West Norfolk, UK. We included all patients admitted to care of the elderly wards during October-November 2007. We evaluated management of pain within the first 24 h of acute hospital admission.

RESULTS

Of the 140 patients admitted, 74 (53%) were male and their median age was 84 years (range = 56-99; = < 70, n = 8). Only 93 (66%) were asked about the presence or absence of pain on admission. Of those who complained of pain (n = 45), severity of pain was documented in 5 (11%) and the management was documented in 17 (38%). Of 17 with documented pain management, only 4 (23%) had further assessment of effectiveness of pain management. Only 70 (50%) of the patients had their mental state assessed by the abbreviated mental test score (AMTS). Among those who complained of pain and AMTS < or = 8 (n = 51), only 4 (8%) had objective documentation.

CONCLUSIONS

Our findings suggest that pain management may be sub-optimal in older people in the acute medical settings. Regular monitoring and education may have potential to improve assessment and management of pain in these vulnerable older adults.

Blood stream infections in cancer patients: a single center experience of isolates and sensitivity pattern

BACKGROUND

Up to 10% of patients who develop a nosocomial blood stream infection (BSI) in the hospital have an underlying malignancy. The treatment of infections in patients with malignancy often relies on the use of established guidelines along with the consideration of the local microbiology and antibiotic sensitivity patterns of possible etiologic agents.

AIMS

This study attempts to identify the likely etiologic agents and the antibiotic sensitivity profile of BSIs in cancer patients.

SETTINGS AND DESIGN

This was a retrospective study.

METHODS AND MATERIAL

The study was conducted at a tertiary care center for cancer patients, in which samples representing blood stream infections sent from the Medical Oncology services of the hospital during the year of 2007 were analysed. The microbiological profile and antibiotic sensitivity pattern of these isolates was studied.

RESULTS

There were 484 isolates that represented BSIs. The most common bacterial isolates from patients with cancer were Pseudomonas spp. (30.37%), Staphylococcus aureus (12.6%) and Acinetobacter spp. (11.57%). Meropenem was the most effective antibiotic with 71.2% sensitivity to the bacterial isolates it was tested against. Oxacillin resistance was seen in 18% of S. aureus isolates.

CONCLUSION

Gram-negative bacteria were more common as etiologic agents of BSIs in cancer patients. The poor activity of the primary empirical agents for infections in cancer namely ceftazidime and piperacillin-tazobactam is alarming.Strict regulation of vancomycin use should be considered in areas where there is a low prevalence of methicillin-resistant S. aureus (MRSA).

Expression, purification and characterization of allelic variants of MSP-1(42) from Indian Plasmodium falciparum isolates

The C-terminal 19 and 42 kDa fragments of Plasmodium falciparum merozoite surface protein 1 (MSP-1) have shown to be protective in animals against lethal parasite challenge. The MSP-1(19) being highly conserved may lack sufficient number of T-cell epitopes in order to elicit a broader response in genetically diverse populations. The inclusion of additional epitopes from the N-terminal MSP-1(42) has shown to enhance the protective efficacy of MSP-1(19) vaccine. In an attempt to examine the strain specific immunogenicity to MSP-1, we have cloned and expressed three diverse allelic variants of MSP-1(42) from Indian P. falciparum isolates in bacteria. Among three alleles, one was extremely rare and not been found before. These purified and refolded recombinant products were recognized by conformation specific monoclonal antibodies and hyper-immune sera. Immunization of mice and rabbits with the purified proteins generated high titer biologically active polyclonal antibodies supporting further development of this vaccine candidate antigen.

Targeting the Transforming Growth Factor-beta pathway inhibits human basal-like breast cancer metastasis

Background

Transforming Growth Factor β (TGF-β) plays an important role in tumor invasion and metastasis. We set out to investigate the possible clinical utility of TGF-β antagonists in a human metastatic basal-like breast cancer model. We examined the effects of two types of the TGF-β pathway antagonists (1D11, a mouse monoclonal pan-TGF-β neutralizing antibody and LY2109761, a chemical inhibitor of TGF-β type I and II receptor kinases) on sublines of basal cell-like MDA-MB-231 human breast carcinoma cells that preferentially metastasize to lungs (4175TR, 4173) or bones (SCP2TR, SCP25TR, 2860TR, 3847TR).

Results

Both 1D11 and LY2109761 effectively blocked TGF-β-induced phosphorylation of receptor-associated Smads in all MDA-MB-231 subclones in vitro. Moreover, both antagonists inhibited TGF-β stimulated in vitro migration and invasiveness of MDA-MB-231 subclones, indicating that these processes are partly driven by TGF-β. In addition, both antagonists significantly reduced the metastatic burden to either lungs or bones in vivo, seemingly independently of intrinsic differences between the individual tumor cell clones. Besides inhibiting metastasis in a tumor cell autonomous manner, the TGF-β antagonists inhibited angiogenesis associated with lung metastases and osteoclast number and activity associated with lytic bone metastases. In aggregate, these studies support the notion that TGF-β plays an important role in both bone-and lung metastases of basal-like breast cancer, and that inhibiting TGF-β signaling results in a therapeutic effect independently of the tissue-tropism of the metastatic cells. Targeting the TGF-β pathway holds promise as a novel therapeutic approach for metastatic basal-like breast cancer.

Conclusions

In aggregate, these studies support the notion that TGF-β plays an important role in both bone-and lung metastases of basal-like breast cancer, and that inhibiting TGF-β signaling results in a therapeutic effect independently of the tissue-tropism of the metastatic cells. Targeting the TGF-β pathway holds promise as a novel therapeutic approach for metastatic basal-like breast cancer.

Accounting for disease model uncertainty in mapping heterogeneous traits--a Bayesian model averaging approach

BACKGROUND

Locus heterogeneity, wherein a disease can be caused in different individuals by different genes and/or environmental factors, is a ubiquitous feature of complex traits. A Bayesian approach has been proposed to account for variable rates of heterogeneity across families in a parametric linkage analysis setup [Biswas and Lin: J Am Stat Assoc 2006;101:1341-1351]. As with any parametric approach, its application requires specification of the disease model, which limits its practical utility.

METHODS

We address this limitation by proposing a Bayesian model averaging (BMA) approach. We consider a finite number of disease models and treat the model as an unknown parameter. In practice, we use simple single-locus disease models as various categories for model.

RESULTS

Our simulations as well as analysis of Genetic Analysis Workshop 13 simulated data show that BMA retains at least 80% of the power that is obtained by analyzing under the true disease model. The coverage probability of interval for disease gene is maintained around the nominal level. Finally, we apply BMA to a Late-Onset Alzheimer's Disease dataset and find evidence for linkage on chromosomes 19, 9, and 21.

CONCLUSION

We conclude that the BMA approach utilizing simple single-locus models for averaging is effective for mapping heterogeneous traits.

Bivalent phenethylamines as novel dopamine transporter inhibitors: evidence for multiple substrate-binding sites in a single transporter

Bivalent ligands--compounds incorporating two receptor-interacting moieties linked by a flexible chain--often exhibit profoundly enhanced binding affinity compared with their monovalent components, implying concurrent binding to multiple sites on the target protein. It is generally assumed that neurotransmitter sodium symporter (NSS) proteins, such as the dopamine transporter (DAT), contain a single domain responsible for recognition of substrate molecules. In this report, we show that molecules possessing two substrate-like phenylalkylamine moieties linked by a progressively longer aliphatic spacer act as progressively more potent DAT inhibitors (rather than substrates). One compound bearing two dopamine (DA)-like pharmacophoric 'heads' separated by an 8-carbon linker achieved an 82-fold gain in inhibition of [(3)H] 2beta-carbomethoxy-3beta-(4-fluorophenyl)-tropane (CFT) binding compared with DA itself; bivalent compounds with a 6-carbon linker and heterologous combinations of DA-, amphetamine- and beta-phenethylamine-like heads all resulted in considerable and comparable gains in DAT affinity. A series of short-chain bivalent-like compounds with a single N-linkage was also identified, the most potent of which displayed a 74-fold gain in binding affinity. Computational modelling of the DAT protein and docking of the two most potent bivalent (-like) ligands suggested simultaneous occupancy of two discrete substrate-binding domains. Assays with the DAT mutants W84L and D313N--previously employed by our laboratory to probe conformation-specific binding of different structural classes of DAT inhibitors--indicated a bias of the bivalent ligands for inward-facing transporters. Our results strongly indicate the existence of multiple DAT substrate-interaction sites, implying that it is possible to design novel types of DAT inhibitors based upon the 'multivalent ligand' strategy.

Vessels in femoral triangle in a rare relationship

The femoral region of the thigh is utilised for various clinical procedures, both open and closed, particularly in respect to arterial and venous cannulations. A rare vascular pattern was observed during the dissection of the femoral region on both sides of the intact formaldehyde-preserved cadaver of a 42-year-old Indian man from West Bengal. The relationships and patterns found were contrary to the belief that the femoral vein is always medial to the artery, just below the inguinal ligament and the common femoral artery. The femoral artery crossed the vein just deep to the inguinal ligament so that the femoral vein was lying deep to the artery at the base of the femoral triangle. Just deep to the inguinal ligament, the profunda femoris artery (deep femoral artery) arose from the femoral artery, and the long saphenous vein drained into the femoral vein. The embryological and clinical correlations are discussed.

Aberrant DNA methylation occurs in colon neoplasms arising in the azoxymethane colon cancer model

Mouse models of intestinal tumors have advanced our understanding of the role of gene mutations in colorectal malignancy. However, the utility of these systems for studying the role of epigenetic alterations in intestinal neoplasms remains to be defined. Consequently, we assessed the role of aberrant DNA methylation in the azoxymethane (AOM) rodent model of colon cancer. AOM induced tumors display global DNA hypomethylation, which is similar to human colorectal cancer. We next assessed the methylation status of a panel of candidate genes previously shown to be aberrantly methylated in human cancer or in mouse models of malignant neoplasms. This analysis revealed different patterns of DNA methylation that were gene specific. Zik1 and Gja9 demonstrated cancer-specific aberrant DNA methylation, whereas, Cdkn2a/p16, Igfbp3, Mgmt, Id4, and Cxcr4 were methylated in both the AOM tumors and normal colon mucosa. No aberrant methylation of Dapk1 or Mlt1 was detected in the neoplasms, but normal colon mucosa samples displayed methylation of these genes. Finally, p19(Arf), Tslc1, Hltf, and Mlh1 were unmethylated in both the AOM tumors and normal colon mucosa. Thus, aberrant DNA methylation does occur in AOM tumors, although the frequency of aberrantly methylated genes appears to be less common than in human colorectal cancer. Additional studies are necessary to further characterize the patterns of aberrantly methylated genes in AOM tumors.