Nutritional Problems Among Special Needs Children in a Rural Special Needs Children Home Near Chennai

Background Special needs children have various health problems, and the most common problems are nutritional deficiency and malnourishment which leads to increased morbidity affecting their quality of life. This study aims to assess the nutritional status and health-seeking behaviour of special needs children. Methods The study was conducted among 46 special needs children at a special needs children's home. After collecting basic sociodemographic details, they were assessed for nutritional status and health-seeking behaviour using a semi-structured questionnaire followed by general and clinical examination. Results Out of these 46 special needs children, 69.6% were male and 30.4% were female. The mean age was 11.69±4.62 years. In this study, 65.22% were underweight; 6.52% were overweight; 10.87% were obese I; 4.35% were obese III; 13.04% were normal. Among them, 37% seek Government healthcare facilities for their healthcare needs. Referral advice was provided to all required children. Conclusion A high proportion of the special needs children were screened positive for nutritional deficiency and malnourishment which needs to be addressed. Interventions should be aimed at correcting the nutritional deficiency and malnourishment by involving the caretakers, mainly mothers of these children.

Satellite Epidemic of Covid-19 Associated Mucormycosis in India: A Multi-Site Observational Study

BACKGROUND

Sudden upsurge in cases of COVID-19 Associated Mucormycosis (CAM) following the second wave of the COVID-19 pandemic was recorded in India. This study describes the clinical characteristics, management and outcomes of CAM cases, and factors associated with mortality.

METHODS

Microbiologically confirmed CAM cases were enrolled from April 2021 to September 2021 from ten diverse geographical locations in India. Data were collected using a structured questionnaire and entered into a web portal designed specifically for this investigation. Bivariate analyses and logistic regression were conducted using R version 4.0.2.

RESULTS

A total of 336 CAM patients were enrolled; the majority were male (n = 232, 69.1%), literate (n = 261, 77.7%), and employed (n = 224, 66.7%). The commonest presenting symptoms in our cohort of patients were oro-facial and ophthalmological in nature. The median (Interquartile Range; IQR) interval between COVID diagnosis and admission due to mucormycosis was 31 (18, 47) days, whereas the median duration of symptoms of CAM before hospitalization was 10 (5, 20) days. All CAM cases received antifungal treatment, and debridement (either surgical or endoscopic or both) was carried out in the majority of them (326, 97.02%). Twenty-three (6.9%) of the enrolled CAM cases expired. The odds of death in CAM patients increased with an increase in HbA1c level (aOR: 1.34, 95%CI: 1.05, 1.72) following adjustment for age, gender, education and employment status.

CONCLUSION

A longer vigil of around 4-6 weeks post-COVID-19 diagnosis is suggested for earlier diagnosis of CAM. Better glycemic control may avert mortality in admitted CAM cases.

Unravelling the room temperature growth of two-dimensional h-BN nanosheets for multifunctional applications

The room temperature growth of two-dimensional van der Waals (2D-vdW) materials is indispensable for state-of-the-art nanotechnology. Low temperature growth supersedes the requirement of elevated growth temperatures accompanied with high thermal budgets. Moreover, for electronic applications, low or room temperature growth reduces the possibility of intrinsic film-substrate interfacial thermal diffusion related deterioration of the functional properties and the consequent deterioration of the device performance. Here, we demonstrated the growth of ultrawide-bandgap boron nitride (BN) at room temperature by using the pulsed laser deposition (PLD) process, which exhibited various functional properties for potential applications. Comprehensive chemical, spectroscopic and microscopic characterizations confirmed the growth of ordered nanosheet-like hexagonal BN (h-BN). Functionally, the nanosheets show hydrophobicity, high lubricity (low coefficient of friction), and a low refractive index within the visible to near-infrared wavelength range, and room temperature single-photon quantum emission. Our work unveils an important step that brings a plethora of potential applications for these room temperature grown h-BN nanosheets as the synthesis can be feasible on any given substrate, thus creating a scenario for "h-BN on demand" under a frugal thermal budget.

Barriers of community pharmacists in identification and referral of presumptive tuberculosis cases in Tiruvallur district of Tamil Nadu

BACKGROUND

Tuberculosis (TB) still continues to be a major public health threat. Early diagnosis is the cornerstone in combating TB. Community pharmacists are the front line health care providers among the health care system. The present study aimed to identify the barriers of community pharmacists in the identification and referral of presumptive pulmonary tuberculosis cases.

METHODS

Prospective, cross-sectional study was conducted among the community pharmacists in Tiruvallur district of Tamil Nadu. One pharmacist from each pharmacy was interviewed using semi-structured questionnaire. Knowledge component, practice and barriers of identification and referral in presumptive TB cases were captured.

RESULTS

A total of 143 pharmacists were included in the study. Barriers in identification and referral by pharmacists' perception were patient volume (32%), pharmacy workload (22%), difficulty in identifying the cases (16%), etc. Research team also identified few barriers such as pharmacists do not have adequate knowledge about TB (34%), pharmacists are not trained enough to identify and refer presumptive TB cases (26%), etc. All the pharmacists (100%) refer the presumptive TB cases, if they come across for OTC medications. Pharmacists also provided health education to their community (45.7%).

CONCLUSION

Adequate training of community pharmacists and a follow-up system for the presumptive TB cases identified by the community pharmacist are essential in reducing the barriers of pharmacists in TB case detection.

Is child undernutrition associated with antenatal care attendance in Madhya Pradesh, India?

Context

There is a paucity of research investigating the association between antenatal care (ANC) attendance and child undernutrition in Madhya Pradesh, India.

Aim

To determine whether body weight status in children under the age of 5 years is associated with ANC attendance in Madhya Pradesh.

Methods

A cross-sectional study was carried out using data from India's National Family Health Survey (2005-2006). Bodyweight status (an indicator of undernutrition) was determined using weight-for-age. Descriptive statistics and logistic regression were used to estimate prevalence and obtain adjusted odds ratios (AOR) to investigate associations between ANC indicators and weight-for-age.

Results

Majority of children were underweight (55.1%). ANC attendance was inadequate, with only 36.8% of women having four or more visits. None of the ANC indicators were associated with body weight status. Increased child age especially an age of 2 years (AOR 2.29; 1.66-3.15), belonging to a scheduled tribe [ST] (AOR 2.36; CI 1.64-3.39), scheduled caste [SC] (AOR 1.75; CI 1.25-2.45) or other backward caste [OBC] (AOR 1.43; CI 1.08-1.89) were associated with being underweight; a birth weight of ≥2.5 kg was associated with lower relative odds of being underweight (AOR 0.43; CI 0.29-0.64). Mothers who had a normal BMI (AOR 0.66; CI 0.53-0.82) or were overweight (AOR 0.42; CI 0.25-0.69) were less likely to have underweight children.

Conclusions

ANC attendance was not associated with body weight status. Increased child age, low birth weight, poor maternal nutrition status and belonging to SCs, STs or OBCs increased the odds of child undernutrition.

EEG for children with complex febrile seizures

BACKGROUND

Febrile seizures can be classified as simple or complex. Complex febrile seizures are associated with fever that lasts longer than 15 minutes, occur more than once within 24 hours, and are confined to one side of the child's body. It is common in some countries for doctors to recommend an electroencephalograph (EEG) for children with complex febrile seizures. A limited evidence base is available to support the use of EEG and its timing after complex febrile seizures among children.

OBJECTIVES

To assess the use of EEG and its timing after complex febrile seizures in children younger than five years of age.

SEARCH METHODS

For the latest update of this review, we searched the following databases on 12 March 2019: Cochrane Register of Studies (CRS Web), which includes the Cochrane Epilepsy Group Specialized Register and the Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE (Ovid, 1946 to 11 March 2019); and ClinicalTrials.gov. We applied no language restrictions.

SELECTION CRITERIA

All randomised controlled trials (RCTs) that examined the utility of an EEG and its timing after complex febrile seizures in children.

DATA COLLECTION AND ANALYSIS

The review authors selected and retrieved the articles and independently assessed which articles should be included. Any disagreements were resolved by discussion and by consultation with the Cochrane Epilepsy Group. We applied standard methodological procedures expected by Cochrane.

MAIN RESULTS

Of 48 potentially eligible studies, no RCTs met the inclusion criteria.

AUTHORS' CONCLUSIONS

We found no RCTs as evidence to support or refute the use of EEG and its timing after complex febrile seizures among children under the age of five. An RCT can be planned in such a way that participants are randomly assigned to the EEG group and to the non-EEG group with sufficient sample size. Since the last version of this review, we have found no new studies.

Thermally Stable, High Performance Transfer Doping of Diamond using Transition Metal Oxides

We report on optimisation of the environmental stability and high temperature operation of surface transfer doping in hydrogen-terminated diamond using MoO3 and V2O5 surface acceptor layers. In-situ annealing of the hydrogenated diamond surface at 400 °C was found to be crucial to enhance long-term doping stability. High temperature sheet resistance measurements up to 300 °C were performed to examine doping thermal stability. Exposure of MoO3 and V2O5 transfer-doped hydrogen-terminated diamond samples up to a temperature of 300 °C in ambient air showed significant and irreversible loss in surface conductivity. Thermal stability was found to improve dramatically however when similar thermal treatment was performed in vacuum or in ambient air when the oxide layers were encapsulated with a protective layer of hydrogen silsesquioxane (HSQ). Inspection of the films by X-ray diffraction revealed greater crystallisation of the MoO3 layers following thermal treatment in ambient air compared to the V2O5 films which appeared to remain amorphous. These results suggest that proper encapsulation and passivation of these oxide materials as surface acceptor layers on hydrogen-terminated diamond is essential to maximise their environmental and thermal stability.

Social impact of menstrual problems among adolescent school girls in rural Tamil Nadu

Background Adolescence is a period of physiological, psychological and social transition between childhood and adulthood and is characterized by the onset of menstruation in girls. A adolescent girls are naïve about menstruation and they take time to adapt to these changes both socially and psychologically. This study was carried out to assess the psychosocial impact of menstrual problems among schoolgoing adolescent girls. Methods This study is a cross-sectional study carried out in 350 schoolgoing adolescent girls in the year 2012 in the Thiruvallur district of Tamil Nadu. Girls who attained menarche 1 year prior to the data collection were included in the study. Data regarding background characteristics and psychosocial impact of menstrual problems were collected. Data was analyzed using SPSS ver. 15 software. The χ2-test was carried out to assess the statistical significance at the 95% level of significance. Results The mean age of the participants was 14.7 years. In this study, 87.7% of the girls had at least one menstrual problem. Among these, 78.5% could not attend school during menstruation, 51.1% were unable to perform household/sports activities (p < 0.001). It was observed that dysmenorrhea and menorrhagia were at increased risk of absenting the girls from school (p < 0.05). Conclusion The key to a sound adolescent health programme is a holistic approach which also focuses on the psychological and social domain of health. This could be achieved by involving all the stakeholders like parents, teachers, etc. to work as a team. It is also essential to develop adolescent friendly health services at the grass root level.

EEG for children with complex febrile seizures

BACKGROUND

Febrile seizures can be classified as simple or complex. Complex febrile seizures are associated with fever that lasts longer than 15 minutes, occur more than once within 24 hours, and are confined to one side of the child's body. It is common in some countries for doctors to recommend an electroencephalograph (EEG) for children with complex febrile seizures. A limited evidence base is available to support the use of EEG and its timing after complex febrile seizures among children.

OBJECTIVES

To assess the use of EEG and its timing after complex febrile seizures in children younger than five years of age.

SEARCH METHODS

For the latest update of this review, we searched the Cochrane Epilepsy Group Specialized Register (23 January 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) via the Cochrane Register of Studies Online (CRSO, 23 January 2017), MEDLINE (Ovid, 23 January 2017), and ClinicalTrials.gov (23 January 2017). We applied no language restrictions.

SELECTION CRITERIA

All randomised controlled trials (RCTs) that examined the utility of an EEG and its timing after complex febrile seizures in children.

DATA COLLECTION AND ANALYSIS

The review authors selected and retrieved the articles and independently assessed which articles should be included. Any disagreements were resolved by discussion and by consultation with the Cochrane Epilepsy Group. We applied standard methodological procedures expected by Cochrane.

MAIN RESULTS

Of 41 potentially eligible studies, no RCTs met the inclusion criteria.

AUTHORS' CONCLUSIONS

We found no RCTs as evidence to support or refute the use of EEG and its timing after complex febrile seizures among children. An RCT can be planned in such a way that participants are randomly assigned to the EEG group and to the non-EEG group with sufficient sample size. Since the last version of this review, we have found no new studies.

Charge Trapping Analysis of High Speed Diamond FETs

Charge carrier trapping in diamond surface conduction field effect transistors (FETs) has been analyzed. For these devices two methods were used to obtain a negative electron affinity diamond surface; either plasma hydrogenation or annealing in an H2 environment. In both cases the Al2O3 gate dielectric can trap both electrons and holes in deep energy levels with emission timescales of seconds, while the diamond – Al2O3 interface traps exhibit much shorter time scales in the microsecond range. Capacitance-Voltage (CV) analysis indicates that these interface traps exhibit acceptor-like characteristics. Correlation with CV based free hole density measurements indicates that the conductance based interface trap analysis provides a method to quantify surface characteristics that lead to surface conduction in hydrogenated diamond where atmospheric adsorbates provide the acceptor states for transfer doping of the surface.

APOL1 Polymorphisms in a Deceased Donor and Early Presentation of Collapsing Glomerulopathy and Focal Segmental Glomerulosclerosis in Two Recipients

Two common polymorphisms in APOL1 (G1 and G2) are conserved in persons of African ancestry, and the presence of two polymorphisms (commonly referred to as risk variants) has been identified as a risk factor for chronic kidney disease and focal seg-mental glomerulosclerosis. In kidney transplantation, deceased donors with two APOL1 risk variants carry an increased risk of renal allograft failure in the recipient. An emerging question is whether these data should influence deceased donor assessment or be used to refine prediction of allograft survival. We present the first detailed report of two cases of recipient glomerular disease in the first year following transplant from a deceased donor later defined as carrying two APOL1 risk variants. A possible "second hit" predisposing to renal disease in these recipients is discussed, one with active cytomegalovirus infection concurrent with collapsing glomerulopathy and renal failure and the other with chronic, slowly healing wound infection and focal segmental glomeru-losclerosis but stable renal function. In retrospect, awareness of the donor APOL1 risk alleles would not have influenced donor selection and ultimately did not influence posttransplant management. These case reports inform further discussion of the value of APOL1 testing for deceased donors.

Vertical 2D/3D Semiconductor Heterostructures Based on Epitaxial Molybdenum Disulfide and Gallium Nitride

When designing semiconductor heterostructures, it is expected that epitaxial alignment will facilitate low-defect interfaces and efficient vertical transport. Here, we report lattice-matched epitaxial growth of molybdenum disulfide (MoS2) directly on gallium nitride (GaN), resulting in high-quality, unstrained, single-layer MoS2 with strict registry to the GaN lattice. These results present a promising path toward the implementation of high-performance electronic devices based on 2D/3D vertical heterostructures, where each of the 3D and 2D semiconductors is both a template for subsequent epitaxial growth and an active component of the device. The MoS2 monolayer triangles average 1 μm along each side, with monolayer blankets (merged triangles) exhibiting properties similar to that of single-crystal MoS2 sheets. Photoluminescence, Raman, atomic force microscopy, and X-ray photoelectron spectroscopy analyses identified monolayer MoS2 with a prominent 20-fold enhancement of photoluminescence in the center regions of larger triangles. The MoS2/GaN structures are shown to electrically conduct in the out-of-plane direction, confirming the potential of directly synthesized 2D/3D semiconductor heterostructures for vertical current flow. Finally, we estimate a MoS2/GaN contact resistivity to be less than 4 Ω·cm(2) and current spreading in the MoS2 monolayer of approximately 1 μm in diameter.

EEG for children with complex febrile seizures

BACKGROUND

This is an updated version of original Cochrane review published in Issue 1, 2014.Febrile seizures can be classified as simple or complex. Complex febrile seizures are associated with fever that lasts longer than 15 minutes, occur more than once within 24 hours and are confined to one side of the child's body. It is common in some countries for doctors to recommend an electroencephalograph (EEG) for children with complex febrile seizures. A limited evidence base is available to support the use of EEG and its timing after complex febrile seizures among children.

OBJECTIVES

To assess the use of EEG and its timing after complex febrile seizures in children younger than five years of age.

SEARCH METHODS

For the latest update of this review, we searched the Cochrane Epilepsy Group Specialized Register (6 July 2015), the Cochrane Central Register of Controlled Trials (CENTRAL, 2005, Issue 6), MEDLINE (6 July 2015) and ClinicalTrials.gov (6 July 2015). We applied no language restrictions.

SELECTION CRITERIA

All randomised controlled trials (RCTs) that examined the utility of an EEG and its timing after complex febrile seizures in children.

DATA COLLECTION AND ANALYSIS

Review authors selected and retrieved the articles and independently assessed which articles should be included. We resolved disagreements by discussion and by consultation with the Cochrane Epilepsy Group. We applied standard methodological procedures expected by Cochrane.

MAIN RESULTS

Of 37 potentially eligible studies, no RCTs met the inclusion criteria.

AUTHORS' CONCLUSIONS

We found no RCTs as evidence to support or refute the use of EEG and its timing after complex febrile seizures among children. An RCT can be planned in such a way that participants are randomly assigned to the EEG group and to the non-EEG group with sufficient sample size. Since the last version of this review, we found no new studies.

Electrical transport and low-frequency noise in chemical vapor deposited single-layer MoS2 devices

We have studied temperature-dependent (77-300 K) electrical characteristics and low-frequency noise (LFN) in chemical vapor deposited (CVD) single-layer molybdenum disulfide (MoS2) based back-gated field-effect transistors (FETs). Electrical characterization and LFN measurements were conducted on MoS2 FETs with Al2O3 top-surface passivation. We also studied the effect of top-surface passivation etching on the electrical characteristics of the device. Significant decrease in channel current and transconductance was observed in these devices after the Al2O3 passivation etching. For passivated devices, the two-terminal resistance variation with temperature showed a good fit to the activation energy model, whereas for the etched devices the trend indicated a hopping transport mechanism. A significant increase in the normalized drain current noise power spectral density (PSD) was observed after the etching of the top passivation layer. The observed channel current noise was explained using a standard unified model incorporating carrier number fluctuation and correlated surface mobility fluctuation mechanisms. Detailed analysis of the gate-referred noise voltage PSD indicated the presence of different trapping states in passivated devices when compared to the etched devices. Etched devices showed weak temperature dependence of the channel current noise, whereas passivated devices exhibited near-linear temperature dependence.

EEG for children with complex febrile seizures

BACKGROUND

Febrile seizures can be classified as simple or complex. Complex febrile seizures are associated with fever that lasts longer than 15 minutes, occur more than once within 24 hours and are confined to one side of the child's body. It is common in some countries for doctors to recommend an electroencephalograph (EEG) for children with complex febrile seizures. A limited evidence base is available to support the use of EEG and its timing after complex febrile seizures among children.

OBJECTIVES

To assess the use of EEG and its timing after complex febrile seizures in children younger than five years of age.

SEARCH METHODS

We searched the Cochrane Epilepsy Group Specialised Register (17 October 2013), the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 9, 2013), MEDLINE (17 October 2013) and the Clinical Trial Registry (ClinicalTrials.gov (17 October 2013)). We applied no language restrictions.

SELECTION CRITERIA

All randomised controlled trials (RCTs) that examined the utility of an EEG and its timing after complex febrile seizures in children.

DATA COLLECTION AND ANALYSIS

Review authors selected and retrieved the articles and independently assessed which articles should be included. Disagreements were resolved by discussion and by consultation with the Cochrane Epilepsy Group. We applied standard methodological procedures expected by The Cochrane Colloboration.

MAIN RESULTS

Of 33 potentially eligible studies, no RCTs met the inclusion criteria.

AUTHORS' CONCLUSIONS

We found no RCTs as evidence to support or refute the use of EEG and its timing after complex febrile seizures among children. A randomised controlled trial can be planned in such a way that participants are randomly assigned to the EEG group and to the non-EEG group with sufficient sample size.

Stability of rifampicin in dissolution medium in presence of isoniazid

Rifampicin (RIF) hydrolyzes in acidic medium to form insoluble and poorly absorbed 3-Formyl rifamycin SV (3-FRSV). This study describes development of two principally different methods, Dual Wavelength UV-Vis. spectrophotometry (DW spectrophotometry) and HPTLC, to determine 3-FRSV in presence of RIF. Using DW spectrophotometry, RIF was estimated by using wavelengths 475.0 and 507.0 nm and 3-FRSV was estimated using 457.0 and 492.0 nm. In HPTLC method, a mixture of chloroform:methanol:water (80:20:2.5 v/v) was used as the mobile phase to resolve 3-FRSV from RIF and 3-FRSV was quantified at 333 nm. The linearity range for 3-FRSV was 2-10 microg/ml and 50-250 ng/spot for DW spectrophotometric method and HPTLC method, respectively, and 5-50 microg/ml for RIF using DW spectrophotometric method. Both the methods were found to be specific, accurate and reproducible. The proposed methods were successfully applied to determine the rate of degradation of RIF to 3-FRSV in dissolution medium (0.1 N HCl) and also in presence of isoniazid (INH). The rate of degradation of RIF in presence of INH was almost two times more than that of RIF alone. These methods were utilized to study the stability of RIF in market formulations of RIF and RIF with INH in dissolution medium. It has been observed that RIF degrades by 12.4% to form 3-FRSV (RIF formulations) while in presence of INH the degradation is catalyzed to about 21.5% (RIF+INH formulations), in 45 min. Thus, lower concentration of RIF may be available for absorption leading to poor bioavailability of RIF from combination dosage forms (RIF+INH) as compared to formulations containing only RIF. It is proposed that specific analytical method should be used to measure RIF in presence of 3-FRSV in a dissolution study.

The human bone morphogenetic protein 4 (BMP-4) gene: molecular structure and transcriptional regulation

Bone morphogenetic protein 4 (BMP-4) is a vital regulatory molecule that functions throughout human development in mesoderm induction, tooth development, limb formation, bone induction, and fracture repair and is overexpressed in patients who have fibrodysplasia ossificans progressiva. The human gene encoding bone morphogenetic protein 4 (BMP-4) has been isolated and its structural organization characterized. The complete DNA sequence of an 11.2 kb region has been determined. BMP-4 mRNA is transcribed from four exons, although there is evidence that alternate first exons may be used. Transcript initiation occurs at variable positions within a GA-rich region of the DNA. The promoter region is GC-rich with no obvious TATA or CAAT consensus sequences, and contains both positive and negative transcriptional regulatory elements within the 3 kb 5' flanking region of the RNA start site. Comparison of the human and murine BMP-4 genes reveals highly conserved sequences not only in the exon-coding regions but also within the introns and 5' flanking regions. BMP-4 localizes to human chromosome 14q21 by fluorescence in situ hybridization, a location more centromeric than that recently reported. These studies provide a foundation for understanding the genetic regulation of this important gene in human development.

Bivalirudin compared with heparin during coronary angioplasty for thrombus-containing lesions

OBJECTIVES

We investigated whether bivalirudin is more effective than heparin in preventing ischemic complications in high risk patients undergoing coronary angioplasty for thrombus-containing lesions detected by angiography.

BACKGROUND

Heparin is administered during coronary angioplasty to prevent closure of the dilated vessel. Bivalirudin (Hirulog) is a direct thrombin inhibitor that can be safely substituted for heparin during angioplasty. Bivalirudin has several theoretic advantages over heparin as an anticoagulant agent.

METHODS

We performed an observational analysis of the Hirulog Angioplasty Study in which 4,098 patients with unstable or postinfarction angina were randomized to receive either bivalirudin or heparin during coronary angioplasty. The study group for this analysis consisted of 567 patients who had thrombus-containing lesions on angiography. The primary end point was death, myocardial infarction, emergency coronary artery bypass graft surgery or abrupt vessel closure before hospital discharge.

RESULTS

Patients with thrombus-containing lesions had a higher incidence of myocardial infarction (5.1% vs. 3.2%, p = 0.03) and abrupt vessel closure (13.6% vs. 8.3%, p < 0.001) than those without thrombus. In patients with thrombus-containing lesions, however, the incidence of the primary end point was not different between the bivalirudin and heparin treatment groups. Furthermore, no difference in the incidence of ischemic events at 6 months was seen between the treatment groups.

CONCLUSIONS

Bivalirudin is not more effective than heparin in preventing ischemic complications in patients undergoing coronary angioplasty for thrombus-containing lesions detected by angiography. Other approaches, perhaps involving potent anti-platelet agents, should be considered for patients with thrombus-containing lesions.

Water dynamics and population pressure in the Nepalese Himalayas

The authors investigate the impact of water shortages, especially water for irrigation, on development in Nepal. "The problems associated with hydropower development will be illustrated by using the Kulekhani watershed project as a case study." The possible future effects on food supplies and health are discussed.

Rabbit complement lyses tumor cells without massive C3 deposition

These experiments were performed to determine why rabbit complement lyses tumor cells very efficiently, while not having particularly strong activity in hemolytic assays or in any other complement assay. The target cells used were human tumor cells coated with three different mouse IgG(2a) monoclonal antibodies, and complement from 5 mammalian species were tested. In antibody titration experiments, rabbit complement was found to lyse target cells at a relatively low antibody concentration, insufficient to allow lysis by complement of other species. Since this result was still observed after absorption of rabbit serum with target cells, the potency of rabbit complement cannot be attributed to the presence of natural antibodies. We then assayed C3 deposition on target cells, using two types of (125)I-labeled anti-C3 Abs to measure C3 deposition: goat antibodies specific for C3 of the human, guinea pig, rabbit, rat or mouse, and chicken antibodies to human C3 which cross-react with C3 of other mammals. Unexpectedly, complement of the human, rat, guinea pig, and BUB mouse deposited large amounts of C3 on the surface of target cells, while rabbit complement deposited 100-1,000 fold less. We discuss the possible reasons that C3 deposition does not correlate with cytotoxicity, and may indeed be inversely related. These data indicate that there is a fundamental difference in the complement cascade between rabbits and the other species tested. The potent lytic activity of rabbit complement is likely to be related to this difference, although the mechanism is not yet understood.

Spinal deformity in patients who have fibrodysplasia ossificans progressiva

We reviewed roentgenograms and clinical records in order to characterize the spinal deformity in forty patients who had an established diagnosis of fibrodysplasia ossificans progressiva. Twenty-six (65 per cent) of the patients had scoliosis, which, according to the clinical records and the recollection of the patients, had been present during childhood. Twenty-three (88 per cent) of the twenty-six curves were unbalanced c-shaped curves, while the remaining three (12 per cent) were balanced s-shaped curves. Twenty-one (91 per cent) of the twenty-three c-shaped curves involved the thoraco-lumbar or lumbar spine. The c-shaped curves ranged in magnitude from 15 to more than 80 degrees. Curves became rigid by early adulthood and many resulted in severe pelvic obliquity with impaired sitting or standing balance. An osseous bridge developed between the posterolateral aspect of the iliac crest and the posterolateral aspect of the rib cage in twenty-two (55 per cent) of the forty patients. Nineteen (86 per cent) of these twenty-two patients had scoliosis; there was a significant association between the development of scoliosis and the presence of the osseous bridge (p < 0.005). Ossification of the paravertebral muscles and fascia during the first decade of life limited the development of a normal thoracic kyphosis in ten (42 per cent) of twenty-four patients for whom lateral roentgenograms of the spine were available. A spinal orthosis was used to treat the scoliosis in two patients, but this method resulted in breakdown of the skin and failed to halt progression of the curve.(ABSTRACT TRUNCATED AT 250 WORDS)

Correlation between dissolution characteristics and absorption of methaqualone from solid dosage forms

A methaqualone tablet in two strengths, 150 and 300 mg, was developed. The dissolution rate of an experimental formulation in pH 7.0 phosphate buffer, measured by the resin flask method, was shown to correlate with bioavailability in humans. The dissolution rate criterion was used to develop the final tablet formulation. Bioavailability of this formulation in two strengths was compared with a commercial capsule formulation and a slowly dissolving tablet formulation. Correlation between dissolution rate and bioavailability was shown in freshly prepared methaqualone tablet formulations. Bioavailability of tablets under accelerated stability testing conditions remained unaltered, whereas the dissolution rates in pH 7 phosphate buffer decreased, using the resin flask method. A rotating-flask method was developed, and dissolution in 0.1 N HCl at 2 rpm correlated with the bioavailability of both new and aged tablet formulations.