Boosting cytotoxicity of adoptive allogeneic NK cell therapy with an oncolytic adenovirus encoding a human vIL-2 cytokine for the treatment of human ovarian cancer

Despite good results in the treatment of hematological malignancies, Natural killer (NK) cells have shown limited effectiveness in solid tumors, such as ovarian cancer (OvCa). Here, we assessed the potential of an oncolytic adenovirus expressing a variant interleukin-2 (vIL-2) cytokine, Ad5/3-E2F-d24-vIL2 (vIL-2 virus), also known as TILT-452, to enhance NK cell therapy efficacy in human OvCa ex vivo. Human OvCa surgical specimens were processed into single-cell suspensions and NK cells were expanded from healthy blood donors. OvCa sample digests were co-cultured ex vivo with NK cells and vIL-2 virus and cancer cell killing potential assessed in real time through cell impedance measurement. Proposed therapeutic combination was evaluated in vivo with an OvCa patient-derived xenograft (PDX) in mice. Addition of vIL-2 virus significantly enhanced NK cell therapy killing potential in treated OvCa co-cultures. Similarly, vIL-2 virus in combination with NK cell therapy promoted the best in vivo OvCa tumor control. Mechanistically, vIL-2 virus induced higher percentages of granzyme B in NK cells, and CD8+ T cells, while T regulatory cell proportions remained comparable to NK cell monotherapy in vivo. Ad5/3-E2F-d24-vIL2 virus treatment represents a promising strategy to boost adoptive NK cell therapeutic effect in human OvCa.

Improving the cytotoxic response of tumor-infiltrating lymphocytes towards advanced stage ovarian cancer with an oncolytic adenovirus expressing a human vIL-2 cytokine

While the presence of tumor-infiltrating lymphocytes (TILs) associates with improved survival prognosis in ovarian cancer (OvCa) patients, TIL therapy benefit is limited. Here, we evaluated an oncolytic adenovirus coding for a human variant IL-2 (vIL-2) cytokine, Ad5/3-E2F-d24-vIL2 (vIL-2 virus), also known as TILT-452, as an immunotherapeutic strategy to enhance TIL responsiveness towards advanced stage OvCa tumors. Fragments of resected human OvCa tumors were processed into single-cell suspensions, and autologous TILs were expanded from said samples. OvCa tumor specimens were co-cultured with TILs plus vIL-2 virus, and cell killing was assessed in real time through cell impedance measurement. Combination therapy was further evaluated in vivo through a patient-derived xenograft (PDX) ovarian cancer murine model. The combination of vIL-2 virus plus TILs had best cancer cell killing ex vivo compared to TILs monotherapy. These results were supported by an in vivo experiment, where the best OvCa tumor control was obtained when vIL-2 virus was added to TIL therapy. Furthermore, the proposed therapy induced a highly cytotoxic phenotype demonstrated by increased granzyme B intensity in NK cells, CD4+ T, and CD8+ T cells in treated tumors. Our results demonstrate that Ad5/3-E2F-d24-vIL2 therapy consistently improved TILs therapy cytotoxicity in treated human OvCa tumors.

Analysis of Lung Cancer Cases Presenting in Outpatient Department of University Hospital of Nepal

Background Lung cancer is one of the leading cause of cancer related death. Most common histopathology of lung cancer is non-small cell carcinoma of which adenocarcinoma is the most common. There are limited number of studies done in Nepal to know different aspects of lung cancer. Objective To know demographic parameters of patients diagnosed as lung cancer in a university hospital. The study also aims to know the different histopathological diagnosis of lung cancer. Method All the patients presenting to outpatient department (Cardio Thoracic and Vascular unit) of Dhulikhel Hospital, if are diagnosed as cancer of lung/bronchus will be included in the study. The duration of the study was January 2017 to December 2021. The details on age, gender, presenting symptoms, histopathology of lung cancer, operability will be included in database and will be analyzed. Result There were total of 127 patients diagnosed as lung cancer. Male:female ratio was 1.7:1. Overall mean age was 63.23 years (SD 13.5 years, Range 19-89 years). Non small cell carcinoma was the most common type of lung cancer with 83.7%. In non small cell carcinoma, most common type was Squamous cell carcinoma followed by undifferentiated and Adenocarcinoma. Only five (3.93%) cases were in operable stage. Conclusion Despite the fact that lung cancer is one of the most common cancer, patients usually present late and moslty are not in operable stage. This study shows that squamous cell carcinoma is the most common histopathology in lung cancer cases.

Clinico-epidemiological Profile of Children with Chronic Kidney Disease in Tertiary Care Referral Center in Nepal: Prospective observational study

Background Chronic kidney disease in children has been increasing over the years and is associated with high degree of morbidity and mortality. The cost of treating children with chronic kidney disease is also substantial. Prevention of this disease is the only long term solution in our context. Till date, there is limited data on chronic kidney disease in Nepalese children. Objective To study the epidemiological, clinical and etiological profile of children with Chronic Kidney Disease from 2 to 16 years of age presenting for the first time in tertiary care hospital. Method This is the prospective observational study carried out at the tertiary care hospital over a period of 3 years. Children between 2-16 years who were first time diagnosed of chronic kidney disease and had estimated glomerular filtration rate < 60 ml/ min/1.73 m2 for last 3 months were enrolled. Result There were total of 124 patients, of whom 78 were male with male to female ratio of 5:3 with mean age of 11.8±2.2 years. Chronic glomerulonephritis (23%), reflux nephropathy (23%) and nephrolithiasis (16%) were the commonest etiological diagnosis. Rapidly progressive glomerulonephritis and systemic lupus erythematous accounted for 85% cases of chronic glomerulonephritis. Vesicoureteric reflux and posterior urethral valve accounted for 85% cases of reflux nephropathy. In 32%, the cause could not be determined. Swelling (45%) and dyspnea (20%) were the chief presenting complaints. Pallor were seen in all cases (100%) followed by hypertension in 68% and short stature in 64%. Majority (60%) of the patients with chronic kidney disease presented in the stage V. Conclusion Chronic glomerulonephritis and reflux nephropathy were the commonest etiologies of chronic kidney disease, majority of them following rapidly progressive glomerulonephritis, systemic lupus erythematosis, vesicoureteric reflux and posterior urethral valve. The commonest clinical features were swelling, dyspnea, pallor and hypertension.

Maternal resources for care are associated with child growth and early childhood development in Bangladesh and Vietnam

BACKGROUND

Suboptimal child growth and development are significant problems in low- and middle-income countries. Maternal resources for care may help to improve growth and development. This study examined the association of maternal resources for care on child length, motor development and language development of children 12-23.9 months old.

METHODS

We used baseline data from the Alive & Thrive household surveys collected in Bangladesh (n = 803) and Vietnam (n = 635). Resources for care were represented by maternal education, knowledge, height, well-nourishment, mental well-being, decision-making, employment, support in chores and perceived support. The regression analyses were adjusted for household wealth and other covariates on households, children and parents and accounted for geographical clustering.

RESULTS

Maternal height (Bangladesh β = 0.150 p < 0.001, Vietnam β = 0.156 p < 0.001), well-nourishment (Vietnam β = 0.882 p = 0.007) and mental well-being (Bangladesh β = 0.0649 p = 0.008, Vietnam β = 0.0742 p = 0.039) were associated with child length. Well-nourishment (Vietnam β = 0.670 p = 0.042) and support in chores (Bangladesh β = 0.0983 p = 0.021) were associated with child motor development. Mental well-being (Vietnam β = 0.0735 p = 0.013), decision-making autonomy (Bangladesh β = 0.0886 p = 0.029) and perceived support (Vietnam β = 0.445 p = 0.003) were associated with child language development.

CONCLUSION

Maternal height, well-nourishment, mental well-being, decision-making, support in chores and perceived social support were associated with child outcomes. Interventions that help to improve resources among mothers have potential to foster child growth and development.

Sydenham's Chorea with Silent Cardiac Lesions, Mimicking

Sydenham's chorea is an uncommon neurological manifestation of rheumatic fever and has many and varied differential diagnosis. It may mimic encephalitis when presents as an isolated feature even when silent cardiac lesions are present. Early diagnosis, treatment and penicillin prophylaxis prevents recurrence and progression of cardiac lesions. Prompt symptomatic relief and alleviation of distress is obtained with therapeutic intervention. A case of rheumatic chorea with silent cardiac valve lesions which mimicked herpes simplex encephalitis with choreoathetosis, in a 13 year old girl is presented along with review of literature.

Ruling out Color Transparency in Quasielastic ^{12}C(e,e^{'}p) up to Q^{2} of 14.2 (GeV/c)^{2}

Quasielastic ^{12}C(e,e^{'}p) scattering was measured at spacelike 4-momentum transfer squared Q^{2}=8, 9.4, 11.4, and 14.2  (GeV/c)^{2}, the highest ever achieved to date. Nuclear transparency for this reaction was extracted by comparing the measured yield to that expected from a plane-wave impulse approximation calculation without any final state interactions. The measured transparency was consistent with no Q^{2} dependence, up to proton momenta of 8.5  GeV/c, ruling out the quantum chromodynamics effect of color transparency at the measured Q^{2} scales in exclusive (e,e^{'}p) reactions. These results impose strict constraints on models of color transparency for protons.

Knowledge, Attitude, and Practices Related to COVID-19 among Healthcare Personnel in a Tertiary Care Hospital in Nepal: A Cross-sectional Survey

Background COVID-19 is significantly affecting the healthcare system globally. As a result, healthcare workers need to be updated on the best practices for the proper management of the disease. Objective The purpose of this study was to assess the knowledge, attitude, and practices (KAP) related to COVID-19 among healthcare personnel. Method This was a cross-sectional study conducted among medical personnel at Dhulikhel Hospital Kathmandu University Hospital using a semi-structured questionnaire on KAP related to COVID-19 from May 8th to June 8th, 2020. We analyzed survey data by using descriptive statistics. Spearman rank correlation, chi-square test and binary logistic analysis were used to examine the association between sociodemographic characteristics with KAP related to COVID-19. Result Among 220 participants, the majority were nurses (60%) followed by doctors (27.7%), paramedics (10%) and technicians (2.3%). The results showed that 68.6% of healthcare personnel had a good knowledge with appropriate practices (98.5%) and negative attitude (59.3%). In the multivariate binary logistic analysis, the healthcare workers with the clinical experience level of one to five years (OR:.42, 95% CI:.19- .96) and more than 5 years (OR: .16, 95% CI: .04-.63) were significantly associated with negative attitude. The confidence score for managing COVID-19 (OR:1.16, 95% CI:1.02-1.34) was significantly associated with an optimistic attitude. Conclusion Healthcare workers are knowledgeable about COVID-19 and proactively practising to minimize the spread of infection but lack optimistic attitudes. Hence, the constantly updated educational programmes related to COVID-19 for targeted groups will contribute to improving healthcare workers' attitude and practices.

First Reported Death of a Postpartum Woman Due to Coronavirus Disease 2019 in Nepal: A Lesson Learnt

The first case of coronavirus disease 2019 was reported on December 31, 2019 in Wuhan, China where the average case fatality rate was 6.1 ± 2.9%. There are 453 deaths as of September 24, 2020 in Nepal. We report the first death of a 29-years-old postpartum woman due to COVID-19 in Nepal who was referred from a rural health center to Dhulikhel Hospital. On arrival, she was taken to the acute respiratory zone of the emergency department to provide immediate lifesaving procedures. Despite the repeated resuscitative measures, return of spontaneous circulation could not be achieved. The real time polymerase chain reaction test was positive. Our case report highlights the importance of early clinical suspicion, importance of "safety first" in healthcare settings, and the chain of management in such patients. We consider the fact that a postpartum woman registered as the first case of COVID-19 related death in Nepal to be an area of further study.

Probing the Deuteron at Very Large Internal Momenta

We measure ^{2}H(e,e^{'}p)n cross sections at 4-momentum transfers of Q^{2}=4.5±0.5  (GeV/c)^{2} over a range of neutron recoil momenta p_{r}, reaching up to ∼1.0  GeV/c. We obtain data at fixed neutron recoil angles θ_{nq}=35°, 45°, and 75° with respect to the 3-momentum transfer q[over →]. The new data agree well with previous data, which reached p_{r}∼500  MeV/c. At θ_{nq}=35° and 45°, final state interactions, meson exchange currents, and isobar currents are suppressed and the plane wave impulse approximation provides the dominant cross section contribution. We compare the new data to recent theoretical calculations, where we observe a significant discrepancy for recoil momenta p_{r}>700  MeV/c.

Associations of maternal resources with care behaviours differ by resource and behaviour

Care is important for children's growth and development, but lack or inadequacy of resources for care can constrain appropriate caregiving. The objectives of this study were to examine whether maternal resources for care are associated with care behaviours specifically infant and young child feeding, hygiene, health-seeking, and family care behaviours. The study also examined if some resources for care are more important than others. This study used baseline Alive & Thrive household surveys from Bangladesh, Vietnam, and Ethiopia. Measures of resources for care were maternal education, knowledge, height, nourishment, mental well-being, decision-making autonomy, employment, support in chores, and perceived instrumental support. Multiple regression analyses were conducted to examine the associations of resources for care with child-feeding practices (exclusive breastfeeding, minimum meal frequency, dietary and diversity), hygiene practices (improved drinking water source, improved sanitation, and cleanliness), health-seeking (full immunization), and family care (psychosocial stimulation and availability of adequate caregiver). The models were adjusted for covariates at child, parents, and household levels and accounted for geographic clustering. All measures of resources for care had positive associations with care behaviours; in a few instances, however, the associations between the resources for care and care behaviours were in the negative direction. Improving education, knowledge, nutritional status, mental well-being, autonomy, and social support among mothers would facilitate provision of optimal care for children.

Understanding the relationship between Food Insecurity, Excess Body Weight, and Mental Health among Latinos in California. 2014

Objectives: 1) To determine the association between food insecurity and excess body weight among Latinos in California, and whether it differs by gender. 2) To examine the role of psychological distress as a mediator in this relationship. Material and Methods: A cross-sectional analysis was conducted in adults participating in the California Health Interview Survey in 2014, who self-reported as Latinos (n=3779). Using logistic regression, we examined the associations of interest while controlling for key covariates. Results: Food insecurity was positive and significantly associated with excess body weight in Latino women, but not men. Psychological distress was positively associated with food insecurity, but not with excess body weight. Conclusions: Psychological distress did not appear to be a mediator in the food insecurity-body weight association in this sample. More studies are needed to fully understand the relationships among mental health, obesity and food insecurity.

Paths Linking Maternal Resources for Care to Child Growth and Early Childhood Development in Bangladesh (P11-125-19)

Objectives

The study aimed to determine the paths through which resources for care were associated with child growth and development. We hypothesized that resources could have been directly associated with child outcomes or indirectly through care behaviors. Child growth could also have mediated the association between care resources and development.

Methods

We used the baseline Alive & Thrive data from Bangladesh (n = 803 mothers and their 12–23.9-month children). Child outcomes were height-for-age z score (HAZ) and motor and language development. Care resources were maternal education, knowledge, height, body mass index (BMI), mental well-being, decision-making autonomy, employment, support in chores, and perceived support. Care included dietary diversity, cleanliness, immunization, stimulation, and adequate care. Path analyses accounting for potential confounders and clustering were used.

Results

Education, knowledge, health, autonomy and support were associated with child outcomes. Height (β = 0.054), BMI (β = 0.033), and mental well-being (β = 0.024) had direct associations with child HAZ. Knowledge (β = 0.0038) and perceived support (β = 0.013) were associated HAZ via immunization. Height (β = 0.034) and mental well-being (β = 0.015) were associated with motor development via HAZ. Knowledge (β = 0.0024) and perceived support (β = 0.0075) were associated with motor development via immunization and then HAZ. Autonomy (β = 0.085) and perceived support (β = -0.24) had a direct association with language. Education was associated with language via cleanliness (β = 0.011). Knowledge and perceived support had associations with language via cleanliness, and immunization and then HAZ. Height (β = 0.016), BMI (β = 0.0094), and mental well-being (β = 0.0070) were associated with language via HAZ.

Conclusions

Care resources were associated with growth and development directly and via care. Child growth mediated the associations between resources and child development. Strengthening various maternal resources and integration of growth and development interventions may improve child outcomes.

Funding Sources

Bill & Melinda Gates Foundation and the governments of Canada and Ireland through Alive & Thrive, managed by FHI 360, and the Patrice L. Engle Dissertation Grant in Global Early Child Development.

Integrating nutrition into health systems at community level: Impact evaluation of the community-based maternal and neonatal health and nutrition projects in Ethiopia, Kenya, and Senegal

Maternal undernutrition and mortality remain high in several African countries. Key nutrition and health interventions improve maternal and birth outcomes. Evidence is scarce on how to strengthen health systems to ensure pregnant women and newborns are reached with these interventions. We conducted three quasi-experimental nonrandomized Community Based Maternal and Neonatal Health and Nutrition projects in regions of Ethiopia, Senegal, and Kenya to demonstrate how proven nutrition interventions could be integrated into health programs to improve knowledge and practices during pregnancy, birth, and postpartum. We evaluated impact on knowledge and practices related to maternal and neonatal care using logistic regression and repeated-measures models with districts as a fixed variable and adjusted for covariates. Combined country analyses show significant positive effects of the intervention on women receiving first antenatal care visit (ANC) during first trimester (OR = 1.44; p < .001), those consuming any iron and folic acid supplement during their latest pregnancy (OR = 1.60; p = .005), those whose <6 months infants were exclusively breastfed (OR = 2.01; p=.003), those whose delivery was facility based (OR = 1.48; p=.031), and those whose postnatal care was facility based (OR = 2.15; p<.001). There was no significant differences between intervention and control groups regarding one or more and four or more ANC visits, women consuming iron and folic acid for ≥90 days, and early initiation of breastfeeding. We conclude that integrating proven nutrition interventions into health programs at community level improved components of access to and use of ANC, delivery services, and postnatal care by women in three African countries.

Sonographic Assessment of the Normal Dimensions of Liver, Spleen, and Kidney in Healthy Children at Tertiary Care Hospital

Background Ultrasonography is one of the most common imaging modality to measure dimensions of visceral organs in children. However, the normal limit of size of visceral organs according to age and body habitus has not been specified in the standard textbooks. This might result in under detection of organomegaly in pediatrics population. Objective The objective of this study was to determine the normal range of dimensions for the liver, spleen, and kidney in healthy children. Method This is prospective cross-sectional, hospital-based study done at Tertiary-care teaching hospital. Participants included 272 pediatric subjects (152 male and 120 female) with normal physical or sonographic findings who were examined because of problems unrelated to the measured organs. The subjects were one month to 15 year (180 months) old. All measured organs were sonographically normal. Relationships of the dimensions of these organs with sex, age, body weight and height were investigated. Limits of normal dimensions of these organs were defined. Result Normal length of liver, kidneys and spleen were obtained sonographically for 272 children (152 male [55.9%] and 120 female [44.1%]) in the age group from 1 months to 15 (180 months) years. The mean age was 45.78 months (SD, 44.73). The measured dimensions of all these organs showed highest correlation with height and age so the descriptive analysis of the organ dimensions (mean, minimum, and maximum values, SD and 5th and 95th percentiles) were expressed in 10 age groups along with height range of the included children. The mean length of right kidney was shorter than the left kidney length, and the difference was statistically significant (p = 0.001). Conclusion This study provides practical and comprehensive guide to the normal visceral organ dimension in pediatric population. The normal range limit of the liver, spleen, and kidney determined in this study could be used as a reference in daily practice in local radiology clinics.

Correlation of Fine Needle Aspiration Cytology and Histopathology of the Neck Swellings Presenting at National Academy of Medical Sciences, Kathmandu, Nepal

IntroductionNeck masses are frequently found in clinical practice. A spectrum of pathological lesions ranging from inflammation to benign and highly malignant manifestation is observed. Fine needle aspiration cytology (FNAC) of neck masses is a quick, easy, safe and cheap technique in the diagnosis which has been a well-accepted procedure in diagnosing various swellings. Histopathology is a gold standard technique in diagnosing any swelling which also provide detail architecture, however it also requires OT setings, more manpower, expensive, time consuming, more traumatic and can sometimes become difficult.ObjectiveThe objective of our study was to evaluate the frequencies of neck swellings and how efficacy FNAC is in diagnosing neck masses by correlating the gold standard histopathological examination.MethodologyA Hospital based descriptive cross sectional prospective study was conducted in 50 patients with neck swellings presenting in the surgery OPD and admitied patient for some other reasons. FNAC and histopathological examinations were done from those lesions and were compared. The sensitivity, specificity and accuracy rates were calculated. Data entry and analysis was performed using SPSS.ResultsA total of 50 patient were subjected to both FNAC and histopathology examination (HPE). Out of 50 cases, 25 were male and 25 were female. The age ranged from 16 to 82 years. Lymph nodes 22 (44%) was the most common case, followed by thyroid 17 (34%), salivary glands 10 (20%) and soft issue 1 (2%).Among all Tubercular lymphadenitis (18%) followed by papillary carcinoma of thyroid (14%),metastatic carcinoma of lymph node, NHL, and pleomorphic adenoma 10% each. The sensitivity of FNAC in diagnosing neck masses is 90.08%, specificity is of 98.53%, and diagnostic accuracy is of 87.64%.ConclusionFNAC is a simple, fast, inexpensive, and minimally invasive technique which can be used as the first line investigation in diagnosing neck swellings.Birat Journal of Health SciencesVol.2/No.1/Issue 2/ Jan - April 2017, page: 206-210

Substitute for the Breast Milk (Sale, Distribution and Control) Act 2049: Revisited

No abstract availableJ Nepal Paediatr Soc 2016;36(3):219-221

Clinicopathological study of gall bladder cancer and its relationship with gall stones

Introduction: Gall bladder cancer is the most common cancer of the biliary tree and one of the highly malignant tumors with poor prognosis. Although its incidence is low in west, it is common in our part of the world. There are very few studies regarding gall bladder cancer in Nepal. The incidence of gallstones in patients with gall bladder cancer is high. The aim of the study was to evaluate the clinicopathological aspect of the disease in patients with gallbladder cancer and to Asses the incidence of gallstones in patients with gall bladder cancer.Material and Methods: This was a retrospective study carried out in GI Surgery unit of National Academy of Medical Science, Bir Hospital, Kathmandu, Nepal. All patients diagnosed as gallbladder carcinomas during 12 years period from 2002 to 2014 were included in this study. Their clinical characteristics, laboratory data, tumor histopathology reports were obtained and analyzed using SPSS17.Results: Total of 47 patients who met inclusion criteria were included in the study. Male to Female ratio was 1:1.8. Age ranged from 32 to 72 years with mean age of 54. Most common presenting symptom was Pain abdomen (93.6%) followed by weight loss (51.1%) and Jaundice (46.8%). Most common finding on examination was Icterus (42.6%) followed by palpable gall bladder (34%) and Hepatomegaly (29.8%). Gall Stones were seen in 37 (72.3%) patients. Most common histopathology was Adenocarcinoma (93.6%).Conclusion: Most of the patient with gall bladder cancer remained asymptomatic until late. Pain abdomen was most common presenting symptom and icterus was most common findings. There was strong association between gall bladder cancer and gallstones. There should be high index of suspicion if patient with gallstones has constant pain in right hypochondrium and has jaundice.

Seasonal affective disorder associate with common chronic diseases and symptoms in a population-based study

Background

Seasonal affective disorder (SAD) is a recurrent mood disorder with 22%–42% of the patients experiencing symptoms even after 5–11 years after diagnosis, and 33%–44% developing non-seasonal symptoms. The purpose of this study was to assess how seasonality is associated with some of the most common non-communicable diseases in the general Finnish population.

Methods

The global seasonality score (GSS) and the experiences of problems due to the seasonal variations from FINNRISK 2012 dataset were used to measure the seasonality in 4689 Finns aged 25–74 years living in five geographical regions in Finland, and assess their association with common non-communicable diseases (NCDs). The regression models and odds ratios were adopted to analyze the associations adjusted for covariates.

Results

The prevalence of SAD in the Finnish general population is 21%. Seventy percent of the participants had seasonal variations in sleep duration, social activity, mood and energy level, while 40% had seasonal variations is weight and appetite. Angina pectoris and depression were significantly associated with seasonality, including seasonal variations in sleep duration, mood, weight, appetite, social activity and energy level. Depression was significantly associated with the increased odds for experiencing a problem due to the seasonal variations (OR = 4.851, P < 0.0001) and SAD symptoms (OR = 4.075, P < 0.0001), and with the GSS (P < 0.0001).

Conclusion

Our data suggest that seasonality is associated with depression and angina pectoris. The co-occurrence of the seasonal variations in mood and behavior with common NCDs warrants the need for future research to have insights into the etiology and potentially shared pathways and mechanisms of action.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Seasonality and Distribution Pattern of Brown Marmorated Stink Bug (Hemiptera: Pentatomidae) in Virginia Vineyards

Brown marmorated stink bug, Halyomorpha halys (Stål) (Hemiptera: Pentatomidae), is a highly polyphagous invasive insect pest from eastern Asia that feeds on numerous fruit, vegetable, and field crops. Four commercial vineyards in Virginia were sampled in 2012 and 2013 to study the basic biology, seasonality, and distribution pattern of H. halys in vineyards. At each vineyard, two blocks were selected. Weekly 3-min timed count visual samplings were performed in border and interior sections from late May until mid-September. Overwintering adult bugs were first detected in vineyards in May; however, the timing of first detection differed among vineyards. Egg masses were found primarily in June and July, and were usually found on the lower surface of grape leaves, although they were occasionally on the upper leaf surface, on the berry, or on the rachis. All developmental stages of H. halys were found in vineyards, suggesting that grape can serve as a reproductive host for H. halys. Substantial variation in H. halys densities was found among vineyards and throughout the growing season. The first instars were found on egg masses and after molting, dispersed throughout the grape vines. The date on which the first egg mass was collected was considered as a biofix. Based on a degree-day model, there were sufficient degree-days for completion of a generation in Virginia vineyards. Significantly higher numbers of H. halys were collected in border sections compared with interior sections. These results are discussed in relation to the potential pest status of H. halys in vineyards and implications for possible control strategies.

Postinfective Glomerulonephritis (PIGN) in Children Attending a Tertiary Care Centre in Nepal

Introduction: Post infectious glomerulonephritis (PIGN) is one of the common paediatric kidney disease in developing countries. This study was undertaken to describe the common clinical features, biochemical findings and complications in children with PIGN. Materials and Methods: This was a retrospective descriptive study in which 30 patients admitted with a diagnosis of PIGN at Tribhuvan University Teaching Hospital (TUTH) in a six month period (July 2014 to Dec 2014) were included. Hospital medical records were reviewed for the data collection. Results: Out of 30 patients, 24 (80%) were between 5 to 15 years of age (mean age of 11.5±3.3) with male to female ratio of 2.3:1. Pedal oedema and hypertension were the clinical features seen in 29 (97%) and 28 (93%) patients respectively. Hypocomplementemia was found in 29 (97%) patients. Recent past history of sore throat seen in 10 (33%) patients and skin lesions in 12 (40%). The complications noted were congestive cardiac failure in 5 (17%) patients, rapidly proliferative glomerulonephritis in 3 (10%) and encephalopathy in 1(3%). Conclusion: The most important clinical and biochemical profile observed in nepalese children with PIGN are the hypertension, pedal edema and hypocomplementemia. J Nepal Paediatr Soc 2014;34(3):221-224 DOI: http://dx.doi.org/10.3126/jnps.v34i3.10707  

Extra - Intestinal Gastrointestinal Stromal Tumor of Omentum

Gastrointestinal stromal tumors are rare tumors, constituting less than 3% of all gastrointestinal malignant neoplasms but are the most common mesenchymal tumors of the gastrointestinal tract. Approximately 10% of gastrointestinal stromal tumors are extraintestinal and mostly arise from the mesentery or omentum. Here we report a rare case of an extraintestinal gastrointestinal stromal tumor of mesentery. Morphological and immunohistochemical features led to a diagnosis of extra-gastrointestinal stromal tumor.DOI: http://dx.doi.org/10.3126/jpn.v4i8.11610 Journal of Pathology of Nepal; Vol.4,No. 8 (2014) 682-684

A myelopoiesis gene signature during remission in anti-neutrophil cytoplasm antibody-associated vasculitis does not predict relapses but seems to reflect ongoing prednisolone therapy

A myelopoiesis gene signature in circulating leucocytes, exemplified by increased myeloperoxidase (MPO) and proteinase 3 (PR3) mRNA levels, has been reported in patients with active anti-neutrophil cytoplasm antibody-associated vasculitis (AAV), and to a lesser extent during remission. We hypothesized that this signature could predict disease relapse. mRNA levels of PR3, MPO, selected myelopoiesis transcription factors [CCAAT/enhancer binding protein α (CEBP-α), CCAAT/enhancer binding protein β (CEBP-β), SPI1/PU.1-related transcription factor (SPIB), spleen focus forming virus proviral integration oncogene, PU.1 homologue (SPI1)] and microRNAs (miRNAs) from patient and control peripheral blood mononuclear cells (PBMC) and polymorphonuclear cells (PMN) were analysed and associated with clinical data. Patients in stable remission had higher mRNA levels for PR3 (PBMC, PMN) and MPO (PBMC). PR3 and SPIB mRNA correlated positively in controls but negatively in patient PBMC. Statistically significant correlations existed between PR3 mRNA and several miRNAs in controls, but not in patients. PR3/MPO mRNA levels were not associated with previous or future relapses, but correlated with steroid treatment. Prednisolone doses were negatively linked to SPIB and miR-155-5p, miR-339-5p (PBMC) and to miR-221, miR-361 and miR-505 (PMN). PR3 mRNA in PBMC correlated with time since last flare, blood leucocyte count and estimated glomerular filtration rate. Our results show that elevated leucocyte PR3 mRNA levels in AAV patients in remission do not predict relapse. The origin seems multi-factorial, but to an important extent explainable by prednisolone action. Gene signatures in patients with AAV undergoing steroid treatment should therefore be interpreted accordingly.

Turner Syndrome, Uncommonly Diagnosed Cause of Short Stature: Case Report and Review of Literature

Many children are frequently brought to the paediatric clinic for evaluation of short stature. Evaluation for these children does not go beyond x-ray for bone age estimation and growth hormone analysis. Most of them are considered having constitutional or genetic cause for their short stature. However, shuttle dysmorphic features could be missed in many of them. Hence, many children might be having chromosomal anomaly as an underlying cause. We report a case of 40 months who had been evaluated several times in the past for pneumonia, otitis media and short stature is finally diagnosed to have Turner syndrome. DOI: http://dx.doi.org/10.3126/jnps.v33i1.8174 J Nepal Paediatr Soc. 2013;33(1):74-76

Incidence of gastric cancer, its subtypes, and correlation with Helicobacter Pylori

Background: Gastric cancer is the fourth most commonly diagnosed cancer and the second most common cause of cancer related death worldwide. It is the common cause of cancer related death in Nepal. Helicobacter Pylori has been classified as a definite carcinogen along with other factors. The aim of this study was to fi nd the incidence of gastric cancer among the patients undergoing upper gastroscopy, its various subtypes and association with Helicobacter Pylori. Materials and Methods: This is a retrospective and prospective study carried out at GRP Polyclinic and Kist Medical College Teaching Hospital. All the patients undergoing upper gastrointestinal endoscopy were included in this study. Data of all the gastric endoscopic biopsies done from June 2011 to January 2013 were collected and analyzed. All the biopsy specimens were processed routinely in histopathology laboratory. Specimens showing carcinoma were enrolled in this study and all the relevant demographic data were collected. Results: Out of 3395 biopsy cases; 49 cases (1.44%) were diagnosed as adenocarcinoma stomach. The overall mean age for carcinoma was 47.6 years with a mild male preponderance. Thirty cases (61.2%) were of intestinal type, (n=11; 22.4%) were of diffuse type and (n=8; 16.3%) were mixed type of adenocarcinoma. According to WHO classifi cation the most common subtype was tubular adenocarcinoma (n=35; 71.5%) followed by signet ring type (11 cases; 22.4%). Out of 49 cases of adenocarcinoma stomach 39 cases (79.5%) were Helicobacter Pylori positive. Conclusion: This study shows that gastric carcinoma is a male predominant neoplasm usually of old age but can occur at younger ages. It predominantly occurs in Helicobacter Pylori infected patients and H. Pylori eradication will help to decrease the incidence rate and mortality of stomach cancer. Journal of Pathology of Nepal (2013) Vol. 3, No.1, Issue 5, 403-407 DOI: http://dx.doi.org/10.3126/jpn.v3i5.7869

Trends in Perinatal Mortality in Tribhuvan University Teaching Hospital: 13 Years Review

Introduction: The perinatal mortality rate (PMR) in Nepal is still very high. In major hospitals of Nepal, it is still ranging from 20-30 per thousand births. This study was carried out with the objective to review PMR and classifying it according to Wigglesworth classification to identify the causes of perinatal deaths at Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal over the past 13 years and assess need for improvement in care. Material and Methods: It was a retrospective study carried out in TUTH. Data of all stillbirths from 28 weeks of pregnancy and neonatal deaths within first seven days of life in the hospital was taken from monthly perinatal audit and annual mortality review. All the perinatal deaths were then classified according to Wigglesworth classification. Results: Over a 13 year period, there were total 42,746 births and 921 perinatal deaths giving a perinatal mortality of 21.5 per thousand births. Over this period PMR has decreased from 31 to 18 per thousand births. Still births contributed almost 50% of the perinatal deaths; deaths related to prematurity show an increasing trend and have increased by almost 70% in past 5 years. Deaths due to perinatal asphyxia were static. Conclusion: PMR over the years has shown declining trend at TUTH. There is need to improve antenatal, obstetric as well as intrapartum services to further reduce the still birth as well as deaths due to prematurity and perinatal asphyxia. J. Nepal Paediatr. Soc. 32(2) 2012 150-153 doi: http://dx.doi.org/10.3126/jnps.v32i2.6898

Role of cell block preparation in neoplastic lesions

Background: Fine needle aspiration cytology of superficial lesion or deep anatomical site is an increasingly common procedure in diagnosis of neoplastic lesions. Sometimes fine needle aspiration does not yield sufficient information for precise diagnosis and the risk of false negative or intermediate diagnosis always exists. In order to overcome these problems, cell block technique has been resorted to make the best use of available material.Materials and Methods:This was a prospective hospital based study conducted in the department of pathology, Manipal Teaching Hospital, Pokhara, Nepal over a period of 2 years from the year 2009 October to 2011. There were total of 49 cases included in the study of which fine needle aspiration cytology smears, cell block and biopsy specimens were available.Results: A total of 49 such cases were included in the study of which fine needle aspiration cytology smears, cell block and biopsy specimens were available. Of all the malignant cases, 12 cases were from lungs aspirate, 10 were from breast, 15 from lymph node and 12 from thyroid. With the combined use of smear and cell block, the diagnostic accuracy of the tumors approaches 100% and also significantly improves diagnostic and sub typing accuracy of malignancies. Cell blocks were found superior in diagnosing neoplasm than smears with diagnostic accuracy of 95.91% and 91.8% respectively.Conclusion: Cell block method allows the recovery and processing of minute amounts of cellular material and facilitates the better classification of tumor when reviewed along with cytological smears. The method is simple to perform and no expertise is required to handle the specimen. Therefore the routine preparation of the cell block improves the accuracy of fine needle aspiration cytology diagnosis.Journal of Pathology of Nepal (2012) Vol. 2, 272-276DOI: http://dx.doi.org/10.3126/jpn.v2i4.6876

Violence against women by their husband and postpartum depression

BACKGROUND

Violence against women in developing countries is very high with very little to choose between the cities and provinces. In Nepal too, violence against women is very rampant. This occurs despite physical violence against women being ascribed as criminal act by Domestic Violence Act. The main objective of the study was to see the association between postpartum depression and violence against women.

METHODS

A prospective cohort study was conducted among pregnant women of reproductive age group in two centers. Standard questionnaires were used to collect data regarding violence and for detecting postpartum depression. Three interviews one in antenatal and two in postnatal period were taken.

RESULTS

The incidence of postpartum depression was found to be 19.4 % (95% CI = 14.73 - 24.06) and 22.22% (95% CI = 17.30 - 27.09) during first (6 week postpartum ) and second (10th week) postpartum interview respectively. The incidence of physical, psychological and sexual violence was found to be 20.8% (95%CI= 16.01 - 25.58), 19.4% (95%CI= 14.73 - 24.06) and 13.9% (95% CI= 9.82 - 17.97) respectively. No statistically significant relationship could be found between different forms of violence and postpartum depression .The study showed that all the women with bad communication or conversation with the husband had postpartum depression while only 17.1% of women with good conversation had postpartum depression.

CONCLUSIONS

No form of violence against women had statistically significant association with development of postpartum depression among Nepalese population.

Variability of presentations and CT-scan findings in children with neurocysticercosis

BACKGROUND

Neurocysticercosis is one of the common neurological morbidities in childhood.

OBJECTIVES

To find the commonest mode of presentation of this disorder in children. The study also aims to find out the age at which it commonly occurs, commonest site affected in the brain and the ethnic group and region most commonly affected in Western Nepal.

METHODS

Retrospective hospital based study carried out in the Department of Pediatrics, Manipal Teaching Hospital, Pokhara from June 2004 to June 2009.

RESULTS

Over the period of five years, 678 patients were admitted for seizures; out of which 109 patients were diagnosed as having neurocysticercosis (16%). Out of them, 66 (60.5%) were males and 43 (39.4%) were females. The age of presentation varied from 18 months to 16 years, with mean age 9.77 years. The most common age of presentation was between 6-10 years (n=47; 43.1%) and 11-15 years (n=47; 43.1%). Maximum number of patients were from Kaski district (n=41; 37.6%) followed by Syangja (n=34; 31.1%).The commonest presentation was with seizures (n=85; 77.9 %); generalised seizures was present in 45 patients (52%). Psychiatric manifestations were present in 3 patients (2.7%). The lesions were found mostly in the parietal region (n=65; 59.6 %). Most of the lesions were single (n=89; 81.6%). Out of 109 patients, 74 patients (67.8%) improved without any recurrence of symptoms on two years follow-up.

CONCLUSION

Neurocysticercosis is a preventable zoonotic disease which results in significant morbidity in children where sanitary measures are inadequate. Any child presenting with a first episode, afebrile seizure should be screened for neurocysticercosis provided other common causes are ruled out.

Anthropometric Measurements in Different Ethnic groups of Nepalese New Borns

Introduction: There is a wide variation in normal birth weight, length and head circumference of newborns. The standards formulated by Western workers may not be very reliable to this part of world because of wide variations in normal range of length, weight and head circumference in different ethnic groups. This study aims to determine the anthropometric values – birth weight, length and head circumference in Term and Preterm newborns of different ethnic groups in this region of the country and to see if this can be used as a standard for taking the anthropometric measurements.Materials and Methods: A prospective study of 600 newborns born in Manipal Teaching Hospital, Pokhara from July 2009–June 2010. A detailed anthropometric measurement (weight, length, and head circumference) of all newborns was taken on 3rd day of life. Results: Six major Ethnic groups were noted Brahmin, Gurung, Dalit, Chettri, Magar and Newar. There were 54 % males and 46% females among which 18.16% were preterms, 20.66% small for gestation age, 81.50% term and 0.33% posterm. The mean weight, length and head circumference of term babies were 2.817±0.61 gms, 47.68±2.48 cm, 33.56±2.02 cm and for preterm babies it was 2.215± 0.41 gms, 46.36±2.39 cm, 32.23±2.03 cm respectively. There were 25% low birth weight (n=151, highest number in Brahmins-27%), 74.16% normal weight (n=445) and 0.66% over weight (n=4, all were gurungs) babies. In Term newborns weight, length and head circumference was noted to be highest in Gurungs (3.3004gms, 49.35cm, 34.72cm) and was statistically significant (p<0.000). Weight and length of Brahmins was lowest (2.578 gms, 45.49cm) and head circumference was lowest in Dalits (30.88cm, statistically significant<0.000). In case of preterms highest weight and length was seen in Magars (2.387gms, 47.90cm) but head circumference was highest in Gurungs (34.18cm) whereas weight was lowest in chettri (2.1609gms), length in Brahmin (44.61cm) and OFC in Dalits (29.92cm). These parameters were directly proportion with gestation age and was statistically significant (p<0.000).Conclusion: The present study highlights the mean weight, length and head circumference of term and preterm newborns in different ethnic groups and gestation age. These parameters were directly proportion to gestation age but were variable in different Ethnic groups. Therefore a study in larger population could give us a different standard for anthropometric measurements in Nepalese newborns.Key words: Anthropometry Measurements; Newborn; NepalDOI: http://dx.doi.org/10.3126/jnps.v32i1.4880 J. Nepal Paediatr. Soc. Vol.32(1) 2012 1-8

Infant Feeding Practices in Kaski District, Pokhara

Background: Children in developing countries are prone to infectious diseases due to insufficient and inappropriate feeding practices. Socio-demographic and socio-economic factors directly and indirectly play a role in influencing infant feeding practices.  This study was conducted to assess the socio-demographic and economic factors associated with initiation of breastfeeding, complimentary feeding, and the various prelacteal feeds practiced in Kaski, Pokhara. Materials and Methods: In this prospective study, interviews were conducted to 500 mothers at Manipal Teaching Hospital who brought their child for treatment. The interviews were conducted in a questionnaire format relating to their demographic and financial statuses. Results: A total of 500 mothers were questioned, out of which 86.6% gave their child breastmilk as its first food. 47% initiated breastfeeding within half an hour of child’s birth. 86% gave Jaulo as the first complementary food to their children. About 26% of the mothers gave complementary feeding to their children before the recommended time of 6 months. Conclusion: Initiation of breastfeeding after life and complementary feeding practices overall has improved from previous studies. There is still need of making awareness campaigns and such in order to further improve this trend. Key words: Breastfeeding; Complimentary feeding; Malnourishment DOI: http://dx.doi.org/10.3126/jnps.v32i1.5339     J. Nepal Paediatr. Soc. Vol.32(1) 2012 23-27

Antibacterial photodynamic therapy on Staphylococcus aureus and Pseudomonas aeruginosa in-vitro

Photodynamic therapy (PDT) involves the use of drugs or dyes known as photosensitizers, and light source which induces cell death by the production of cytotoxic reactive oxygen species (ROS). This principle of cell death can be utilized to kill bacteria in vitro. We propose the use of blue light emitting diodes (LEDs) and Riboflavin as the light source and photosensitizer for in vitro killing of Staphylococcus aureus and Pseudomonas aeruginosa. Circularly arranged 65-blue LED array was designed as the light source to fit exactly over 7cm culture plate. Riboflavin having non-toxic properties and nucleic acid specificity was used as a photosensitizer. Clinical isolates of Staphylococcus aureus and Pseudomonas aeruginosa were used in our study. Effect of PDT on viability on these species of bacteria was compared with control samples that included: control untreated, control treated with light only and control treated with riboflavin only. Statistical analysis was done using one-way ANOVA test. PDT against Pseudomonas aeruginosa and Staphylococcus aureus was significantly (p < 0.05) effective compared to all control samples. Combination of blue LEDs and Riboflavin in PDT against these bacterial species has been successfully demonstrated in-vitro. Therefore, PDT has promising applications in the process of treating superficial wound infections.

Morquio Syndrome in Two Siblings: A Case Report

Morquio syndrome is a rare inherited autosomal recessive disorder characterized by the accumulation of mucopolysaccharides (glycosaminoglycans) in various body tissues. It is rare cause of dwarfism. Many pediatricians therefore are unlikely to see this case hence may miss the diagnosis due to lack of experience. With this view we report two siblings with this dwarfism highlighting the classical clinical and radiological presentation. Key words: Mucopolysaccharidosis; Morquio syndrome DOI: 10.3126/jnps.v31i1.3541J Nep Paedtr Soc 2010;31(1):68-71

Microalbuminuria among type-2 diabetes mellitus patients in Pokhara, Nepal

Microalbuminuria is considered to be an early stage of diabetic nephropathy as well as a marker of cardiovascular disease. The aim of this study was to see the prevalence of microalbuminuria in type 2 diabetic patients and assess its association with cardiovascular risk factors among them. A total of 143 type 2 diabetic patients with the mean age of 56.06 +/- 1.08 years were analysed. The prevalence of microalbuminuria and overt proteinuria was 45.5% and 11.2%, respectively. Prevalence of microalbuminuria in female was marginally higher than in male (p > 0.05). Subjects with microalbuminuria had significantly higher blood pressure (p < 0.001) and duration of diabetes (p < 0.05) compared with normoalbuminuric subjects. High density lipoprotein was found to be significantly lower (p < 0.05) in subjects with microalbuminuria whereas fasting blood sugar, triglyceride, total cholesterol and very low density lipoprotein were marginally higher in microalbuminuric than in normoalbuminuric subjects (p > 0.05). High prevalence of microalbuminuria in diabetic patients and its positive association with blood pressure and altered lipid profile suggests that screening for microalbuminuria is essential for intervention and prevent further complications like end stage renal disease and cardiovascular diseases.

Epidemiology of Typhoid and Paratyphoid Fever in Kathmandu : Two Years Study and Trends of Antimicrobial Resistance

Enteric fever is prevalent in developing countries including Nepal, where it still remains as a major healthproblem. Appropriate antibiotics are essential for the treatment of typhoid and paratyphoid fever. Aprospective study was carried out to characterize the epidemiological features of enteric fever in Kathmandu,Nepal and to analyse the recent trend of antimicrobial resistance pattern of the Salmonella isolated from thecases of enteric fever from different hospitals in Kathmandu during June, 2002 to June, 2004. A total of 1469Salmonella typhi and Salmonella paratyphi ‘A’ isolates collected during this period from five different hospitallaboratories situated in Kathmandu were studied. The antimicrobial susceptibilities of the isolates towardsAmpicillin (10mcg), Chloramphenicol (30mcg), Cotrimoxazole (25mcg), Ciprofloxacin (5mcg) and Ceftriaxone(5mcg) were determined by standard disc diffusion technique and Agar dilution technique were used todetermine the minimum inhibitory concentration (MIC) for Ampicillin, Ciprofloxacin, Chloramphenicoland Ceftriaxone. All the isolates tested were found to be sensitive to Ceftriaxone and Ciprofloxacin, the mostcommonly used antibiotic for treatment of enteric fever in Nepal. Of the total isolates studied, 15.5% from2002, 8% from 2003 and 3.45% from 2004 were found to be multidrug resistant (exhibiting resistance towardsAmpicillin, Chloramphenicol and Cotrimoxazole). Of the total multi drug resistant Salmonella isolates, 92%were Salmonella typhi. All the multidrug resistant isolates were also further tested for susceptibilities towardsTetracycline (30mcg), Nalidixic acid (30 mcg), Streptomycin (10units), Gentamycin (25mcg), Azithromycin(15mcg), Kanamycin (30mcg), Neomycin (30mcg). 50% of the multi drug resistant Salmonella typhi werealso resistant to Tetracycline. Plasmid analysis revealed that all of the Mutidrug resistant Salmonella typhiisolates with Tetracycline resistance harbored a large molecular weight (147 Kb) plasmid.Key Words: Enteric fever, Salmonella, Antibiotic, Plasmid, Multidrugresistant

Epidemiology of typhoid and paratyphoid fever in Kathmandu: two years study and trends of antimicrobial resistance

Enteric fever is prevalent in developing countries including Nepal, where it still remains as a major health problem. Appropriate antibiotics are essential for the treatment of typhoid and paratyphoid fever. A prospective study was carried out to characterize the epidemiological features of enteric fever in Kathmandu, Nepal and to analyse the recent trend of antimicrobial resistance pattern of the Salmonella isolated from the cases of enteric fever from different hospitals in Kathmandu during June, 2002 to June, 2004. A total of 1469 Salmonella typhi and Salmonella paratyphi 'A' isolates collected during this period from five different hospital laboratories situated in Kathmandu were studied. The antimicrobial susceptibilities of the isolates towards Ampicillin (10 mcg), Chloramphenicol (30 mcg), Cotrimoxazole (25 mcg), Ciprofloxacin (5 mcg) and Ceftriaxone (5 mcg) were determined by standard disc diffusion technique and Agar dilution technique were used to determine the minimum inhibitory concentration (MIC) for Ampicillin, Ciprofloxacin, Chloramphenicol and Ceftriaxone. All the isolates tested were found to be sensitive to Ceftriaxone and Ciprofloxacin, the most commonly used antibiotic for treatment of enteric fever in Nepal. Of the total isolates studied, 15.5% from 2002, 8% from 2003 and 3.45% from 2004 were found to be multidrug resistant (exhibiting resistance towards Ampicillin, Chloramphenicol and Cotrimoxazole). Of the total multi drug resistant Salmonella isolates, 92% were Salmonella typhi. All the multidrug resistant isolates were also further tested for susceptibilities towards Tetracycline (30 mcg), Nalidixic acid (30 mcg), Streptomycin (10 units), Gentamycin (25 mcg), Azithromycin (15 mcg), Kanamycin (30 mcg), Neomycin (30 mcg). 50% of the multi drug resistant Salmonella typhi were also resistant to Tetracycline. Plasmid analysis revealed that all of the multidrug resistant Salmonella typhi isolates with Tetracycline resistance harbored a large molecular weight (147 Kb) plasmid.

Accelerated stability of sulphamethoxazole microcapsules coated with Eudragit RS 100 and Eudragit RL 100

Eudragit is being used as coating material in Microencapsulation technique for sustained release microcapsule formulation. In the present study, we have concentrated in evaluating the stability parameters of the Sulphamethoxazole microcapsules coated with Eudragit RS 100 and RL 100. Two sets of sample were studied, the first set was stored at room temperature for ten years and the second set is freshly prepared one. The second set of samples was subjected to various storage conditions for a period of six months. The samples were analyzed for drug content, dissolution, surface properties and physical properties. It was found that 70% of the core material is still intact in the ten year old sample. Similarly, dissolution studies of the ten year old sample of sustained release microcapsule showed that the drug release ranges from 4% in the first hour to 65% at the end of 8th hour. Whereas, the drug release from the freshly prepared microcapsule (keeping the manufacturing parameters same as that followed for old sample) ranged from 25% in the first hour to 98% at the end of 8th hour. IR spectra of the freshly prepared microcapsules and that of the ten year old microcapsules were found to be identical which shows that no interaction has occurred between the coating polymer and core substance even after ten years.