Galanin and epilepsy

Neuroanatomical localization and physiological properties of galanin suggest that the peptide may be involved in the regulation of seizures. Indeed, administration of galanin receptor agonists into brain areas pertinent to the initiation and propagation of epileptic activity attenuated seizure responses under conditions of animal models of epilepsy; pharmacological blocking of galanin receptors exerted proconvulsant effects. Functional deletion of both galanin and galanin type 1 receptor genes produced transgenic mice with either spontaneous seizure phenotype, or with enhanced susceptibility to seizure stimuli. At the same time, overexpression of galanin in seizure pathways, using both transgenic and virus vector transfection techniques, hindered the epileptic process. Galanin exerts anticonvulsant effects through both type 1 and type 2 receptors, with distinct downstream signaling cascades. Several synthetic agonists of galanin receptors with optimized bioavailability have been synthesized and inhibited experimental seizures upon systemic administration, thus opening an opportunity for the development of galanin-based antiepileptic drugs.

Identification of putative pheromones in bovine (Bos taurus) faeces in relation to estrus detection

Ten different volatile compounds were detected in bovine faeces using three chromatograms. The chemical profiles of estrus faeces were distinguished significantly from other phases by the presence of three specific substances, viz. acetic acid and propionic acid and 1-iodo undecane. The estrus specific synthetic compounds were rubbed onto the genital region of nonestrus animals (dummy cows), and the bulls were allowed to sniff the genital region and observed sexual behaviours. The statistical significance was higher (P<0.001) in bulls exhibiting repeated flehmen and mounting behaviours towards the mixture of acetic acid, propionic acid and 1-iodo undecane. The bioassay revealed that the fatty acids viz., acetic acid; propionic acid and 1-iodo undecane produced in faeces during estrus appear to be estrus specific. The results suggest that these compounds may be used as estrus indicator in cow, probably involved in bovine biocommunication.

Effect of consumption of micronutrient fortified candies on the iron and vitamin A status of children aged 3-6 years in rural Haryana

OBJECTIVE

To assess the efficacy of micronutrient fortified sugar candies in improving the iron and vitamin A status in children aged 3 to 6 years.

DESIGN

Triple blind randomized controlled trial.

SETTINGS

Anganwadis and preparatory schools in rural Haryana.

METHODS

410 children were randomized in four groups. One group received full dose candy (vitamin A 1000 IU and 14 mg elemental iron) daily, the second group received full dose candy for 3 days a week, the third group received half dose candy (vitamin A 500 IU and 7 mg elemental iron) daily and the fourth received placebo. The candies were provided to children under supervision of field workers. Hemoglobin, S. ferritin, S. retinol and S. retinol binding protein levels were estimated at baseline and after 13 weeks of intervention.

RESULTS

The increase in hemoglobin was least in the placebo group (0.3 g/dL) as compared to the two full dose groups (1.15-1.18 g/dL, P < 0.001). Among anemic children, the increase in hemoglobin was about 2 g/dL in the full dose group and 0.7 g/dL in the placebo group (P < 0.001). S. ferritin levels increased significantly only in the full dose daily group (p < 0.05). The prevalence of anemia decreased from around 50% at baseline to 9.6% in the full dose daily group (p < 0.01). Based on the S. retinol levels, the study area was not vitamin A deficient and the intervention did not result in a significant improvement in the vitamin A status of the children.

CONCLUSION

Micronutrient fortified candies were effective in improving the hemoglobin level and decreasing anemia prevalence. It could serve as a suitable vehicle for micronutrient supplementation in children and other target groups.

Tracking progress towards sustainable elimination of iodine deficiency disorders in Orissa

OBJECTIVE

To assess the status of iodine deficiency in the population of Orissa and track progress of the elimination efforts.

METHODS

A community based field survey was conducted. Data was collected using quantitative and qualitative research methods. Standard internationally recommended protocol and methodology was followed. Thirty clusters were selected using population proportionate to size sampling technique. School children aged 6 to 12 years were selected as target group. Goiter prevalence, urinary iodine excretion in the target group and iodine content of the salt at household were used as outcome variables.

RESULTS

A total of 1200 children were studied. The total goiter rate was found to be 8.0%, of which 7.6% were grade I and 0.4% was grade-II goiter. The median urinary iodine excretion was found to be 85.4 microg/L and 32.2% of the subjects had urinary iodine levels less than 50 microg/L. Estimation of iodine content by titration method revealed that in only 45% of households salt was found to be adequately iodised. (Salt with iodine level 15 ppm).

CONCLUSION

Iodine deficiency continues to be a public health problem in Orissa and the need to accelerate efforts to iodine sufficiency cannot be overemphasized.

Teratogenicity of antiepileptic drugs: role of drug metabolism and pharmacogenomics

The approach to clinical decision-making pertaining to the use of antiepileptic drugs (AEDs) during pregnancy has relied on previous accumulated experience and, since the 1990s, on data from pregnancy registries. The limitations of this process are that no information regarding the chemical attributes of the AED under consideration, nor the role of a number of enzyme systems that are known to interact with foreign compounds to modify their potential for harm, are included. The role of the hepatic mixed function oxidase system may be especially important in conferring teratogenic risk. However, systems such as epoxide hydrolase, glutathione reductase, superoxide dismutase and other toxin-scavenging systems may be important modifiers that lower the risk. Knowledge is also accumulating on the interactions of AEDs with molecular targets such as histone deacetylase and peroxisome proliferator-activated receptors that may play important roles in teratogenesis. While our knowledge of these factors are incomplete, progress can be achieved by beginning to include these concepts in our discussion on the topic and by promoting research that may improve our ability to individualize the analysis of risk for a specific patient with regards to specific AEDs.

Inflammation contributes to seizure-induced hippocampal injury in the neonatal rat brain

OBJECTIVE

The extent of neuronal injury in the hippocampus produced by experimental status epilepticus (SE) is age dependent and is not readily demonstrable in many models of neonatal seizures. Neonatal seizures often occur in clinical settings that include an inflammatory component. We examined the potential contributory role of pre-existing inflammation as an important variable in mediating neuronal injury.

MATERIALS AND METHODS

Postnatal day 7 (P7) and P14 rat pups were injected with lipopolysaccharide (LPS), 2 h prior to SE induced by lithium-pilocarpine (LiPC). Neuronal injury was assessed by well-described histologic methods.

RESULTS

While LPS by itself did not produce any discernible cell injury at either age, this treatment exacerbated hippocampal damage induced by LiPC-SE. The effect was highly selective for the CA1 subfield.

CONCLUSIONS

Inflammation can contribute substantially to the vulnerability of immature hippocampus to seizure-induced neuronal injury. The combined effects of inflammation and prolonged seizures in early life may impact long-term outcomes of neonatal seizures.

Inflammation contributes to seizure-induced hippocampal injury in the neonatal rat brain

OBJECTIVE

The extent of neuronal injury in the hippocampus produced by experimental status epilepticus (SE) is age dependent and is not readily demonstrable in many models of neonatal seizures. Neonatal seizures often occur in clinical settings that include an inflammatory component. We examined the potential contributory role of pre-existing inflammation as an important variable in mediating neuronal injury.

MATERIALS AND METHODS

Postnatal day 7 (P7) and P14 rat pups were injected with lipopolysaccharide (LPS), 2 h prior to SE induced by lithium-pilocarpine (LiPC). Neuronal injury was assessed by well-described histologic methods.

RESULTS

While LPS by itself did not produce any discernible cell injury at either age, this treatment exacerbated hippocampal damage induced by LiPC-SE. The effect was highly selective for the CA1 subfield.

CONCLUSIONS

Inflammation can contribute substantially to the vulnerability of immature hippocampus to seizure-induced neuronal injury. The combined effects of inflammation and prolonged seizures in early life may impact long-term outcomes of neonatal seizures.

Tracking progress towards sustainable elimination of iodine deficiency disorders in Bihar

OBJECTIVES

To assess the status of the iodine deficiency in the population of Bihar and track progress of the elimination efforts.

METHODS

A community based field survey was conducted. Using quantitative and qualitative research methods, data was collected by following internationally recommended protocol and methodology. Thirty clusters were selected using population proportionate to size technique. School age children (6 to 12 years) were the target group studied. Urinary iodine in target children and iodine content of salt at households were the indicators used.

RESULTS

Total of 1169 children were studied. The median urinary iodine concentration was found to be 85.6 microg/L. Urinary iodine concentration was less than 50 microg/L in 31.5% of the subjects. Only 40.1% of the household salt samples were found to be adequately iodised as determined by titration method (> or =15 ppm iodine).

CONCLUSIONS

Study results show existence of iodine deficiency in the state. There is need to accelerate our efforts to achieve iodine sufficiency and this should be done on a war-footing.

Magnetic source imaging localizes epileptogenic zone in children with tuberous sclerosis complex

The authors assessed whether magnetoencephalography/magnetic source imaging (MEG/MSI) identified epileptogenic zones in patients with tuberous sclerosis complex (TSC). In six TSC children with focal seizures, ictal video-EEG predicted the region of resection with 56% sensitivity, 80% specificity, and 77% accuracy (p = 0.02), whereas interictal MEG/MSI fared better (100%, 94%, and 95%, respectively; p < 0.0001). Interictal MEG/MSI seems to identify epileptogenic zones more accurately in children with TSC and focal intractable epilepsy.

Flehmen response in bull: role of vaginal mucus and other body fluids of bovine with special reference to estrus

The present investigation was carried out with a view to evaluate the frequency of Flehmen behaviour in bull in response to body fluids of cows in various stages of the estrous cycle, in the context of estrus detection. The study was performed on free moving bulls under natural conditions. Samples of vaginal mucus, saliva, faeces and milk of pro-estrus, estrus and di-estrus stages collected from donor cows were rubbed individually onto the genital regions of non-estrus animals (dummy cows) and the bulls were observed for 30 min for assessment of Flehmen behaviour. The duration of Flehmen behaviour shown by bulls was maximum towards the dummy cows receiving estrus sample. Such Flehmen behaviour, however, did not occur in bulls in response to the cows receiving samples of other stages. The statistical significance was higher (P < 0.001) in exhibiting repeated Flehmen behaviour towards estrus as compared to those of pro-estrus and di-estrus. Among the various body fluids tested, the exhibition of Flehmen behaviour was significantly higher (P < 0.01) in response to estrus vaginal fluid. No response was observed on dummy cows (control) to which only water was applied on the genital region. The results suggest that vaginal mucus may act as an additional/secondary source along with urine in eliciting copulatary behaviour and executing coitus in bulls during estrus. The results further suggest that in addition to vaginal mucus, other body fluids like saliva, faeces and milk have estrus-related odours and are probably involved in bovine bio-communication.

Radioactive iodine therapy in Graves' hyperthyroidism: a prospective study from a tertiary referral centre in north India

BACKGROUND

Radioactive iodine has gained widespread acceptance as the first-line therapy for Graves' hyperthyroidism and is the preferred treatment option in most situations.

OBJECTIVE

A prospective study was conducted to look at the therapeutic practice of use of radioactive iodine in the treatment of Graves' hyperthyroidism, to determine whether the expected or desired therapeutic outcome is achieved.

SETTINGS

A tertiary referral centre in north India, Delhi that caters to patients with thyroid disorders.

METHODS

One hundred and seventy four consecutive subjects with Graves' hyperthyroidism, who were given radioactive iodine were followed up.

RESULTS

There were 59 (33.9%) males and 115 (66.1%) females. The mean age was 41.8 +/- 9 years. The dose of radioactive iodine ranged from 2 mCi to 15 mCi and the mean dose administered was 5.2 +/- 1.9 mCi. After one year following radioactive iodine therapy, 29 (16.7%) subjects were euthyroid, 51 (29.3%) were hypothyroid and the remaining 94 (54%) had persisting hyperthyroidism. Those subjects with persisting hyperthyroidism at one year after radioactive iodine had received a significantly lower dose compared to the groups who had achieved cure (either euthyroidism or hypothyroidism).

CONCLUSION

The study shows that the current practice of empirical low dose radioactive iodine therapy to avoid hypothyroidism results in majority of patients having persisting hyperthyroidism. There is a need to take a new look at the current practice to increase the cure rate.

Surgery for symptomatic infant-onset epileptic encephalopathy with and without infantile spasms

Children undergoing surgery with infant-onset epilepsy were classified into those with medically refractory infantile spasms (IS), successfully treated IS, and no IS history, and the groups were compared for pre- and postsurgery clinical and Vineland Adaptive Behavior Scale (VABS) developmental quotients (DQ). Children without an IS history were older at surgery and had longer epilepsy durations than those with IS despite similar substrates, surgeries, and seizure frequencies. In all groups, better postsurgery VABS-DQ scores were associated with early surgical intervention indicating that infant-onset epilepsy patients with or without IS are at risk for seizure-induced encephalopathy.

Micronutrient fortification of foods--rationale, application and impact

Deficiencies in intake of essential vitamins and minerals (commonly referred to as micronutrients) that are essential for efficient energy metabolism and other functions of the human body (commonly termed as micronutrients) are severe and widespread in many parts of the world. They cause an immeasurable burden on individuals, on health services, education systems and families caring for children who are disabled or mentally impaired. Studies by World Bank have shown that countries whose populations suffer from micronutrient deficiencies encounter economic losses as high as 5% of gross domestic product (GDP). The solution to control and prevent micronutrient deficiencies is available and affordable. At a national level, micronutrient malnutrition can be addressed by implementing programmes designed to educate people to diversify their diets (where appropriate foods are available), or by fortifying commonly eaten foods with the missing micronutrients or providing nutrient supplements through targeted distribution programmes. Food fortification is increasingly recognized as an effective means of delivering micronutrients. Fortification of foods can provide meaningful amounts of the nutrient at normal consumption of the food vehicle. Proper choice of fortificant and processing methods could ensure the stability and bioavailability of the nutrient. The level of fortification should take into account variations in food consumption to ensure safety for those at the higher end of the scale and impact for those at the lower end. Fortification needs to be supported by adequate food regulations and labeling, quality assurance and monitoring to ensure compliance and desired impact. In industrialized countries food fortification has played a major role in the substantial reduction and elimination of a number of micronutrient deficiencies. Although a growing number of large scale fortification programmes in different parts of the world are beginning to demonstrate impact at the biochemical level and are leading to the elimination of several nutrient deficiencies, food fortification remains an underutilized opportunity in many developing countries where micronutrient malnutrition remains a public health problem.