Immunological and molecular diagnostic techniques in fish health: present and future prospectus

Fish health management is critical to aquaculture and fisheries as it directly affects sustainability and productivity. Fish disease diagnosis has taken a massive stride because of advances in immunological and molecular diagnostic tools which provide a sensitive, quick, and accurate means of identifying diseases. This review presents an overview of the main molecular and immunological diagnostic methods for determining the health of fish. The immunological techniques help to diagnose different fish diseases by detecting specific antigens and antibodies. The application of immunological techniques to vaccine development is also examined in this review. The genetic identification of pathogens is made possible by molecular diagnostic techniques that enable the precise identification of bacterial, viral, and parasitic organisms in addition to evaluating host reactions and genetic variation associated with resistance to disease. The combination of molecular and immunological methods has resulted in the creation of novel techniques for thorough evaluation of fish health. These developments improve treatment measures, pathogen identification and provide new information about the variables affecting fish health, such as genetic predispositions and environmental stresses. In the framework of sustainable fish farming and fisheries management, this paper focuses on the importance of these diagnostic techniques that play a crucial role in protecting fish populations and the aquatic habitats. This review also examines the present and potential future directions in immunological and molecular diagnostic techniques in fish health.

In-vivo anti-hyperglycemic effect of herbal extracts Tribulus terrestris (L) and Curcuma amada (R) on streptozotocin-induced diabetic rats and its associated histopathological studies

Dia/betes is a serious health concern in many countries with high blood glucose, obesity, and multiple organ failures in late stages. Treating diabetes with effective drugs is still a challenging issue since most of the available diabetic drugs are not effective in combating diabetes, especially in secondary disease complications like obesity, retinopathy, and nephropathy associated with diabetes. Hence search for effective antidiabetic medication, especially from natural sources is mandatory with no adverse side effects. In the present study, a combined herbal aqueous extract of Tribulus terrestris and Curcuma amada was administered to diabetic-induced rats for 37 days. During experimentation, the mean blood glucose level was estimated and at the end of the experiment on the 37th day, the animal was sacrificed and observed for weight gain, plasma insulin, glycogen, glycated hemoglobin, urea, and creatinine level. The results revealed that TT and CA extract-treated diabetic groups significantly lowered the mean blood glucose level followed by increased glycogen and insulin level. Urea, creatinine, and HbA1c levels were considerably reduced in TT and CA-treated diabetic animals as compared to that of antidiabetic drug Glibenclamide-treated groups. TT and CA-treated diabetic animals showed considerable net body weight gain at the end of the experimental day. A concluding remark of the study shows that TT and CA herbal extract is effective against diabetes and it can be considered as an antidiabetic agent in ayurvedic medicine practice.

In vitro potency of 2-(((2-hydroxyphenyl)amino)methylene)-5,5-dimethylcyclohexane-1,3-dione against drug-resistant and non-replicating persisters of Mycobacterium tuberculosis

OBJECTIVES

New antituberculosis agents active against drug-resistant and non-replicating tubercle bacilli are required. We evaluated a previously identified hit, 2-(((2-hydroxyphenyl)amino)methylene)-5,5-dimethylcyclohexane-1,3-dione (PAMCHD), against several clinical Mycobacterium tuberculosis isolates, including multidrug-resistant (MDR) strains and non-replicating drug-tolerant persisters of M. tuberculosis H37Rv.

METHODS

PAMCHD's potential against drug-resistant M. tuberculosis was investigated by broth microdilution. CFU enumeration was performed to determine PAMCHD's activity against five types of dormant bacilli.

RESULTS

No significant differences in MICs of PAMCHD were observed against M. tuberculosis H37Rv (2.5-5 µg/mL) and eight drug-susceptible strains (1.25-5 µg/mL) as well as drug-resistant strains including six isoniazid (INH)-resistant (2.5-10 µg/mL), one INH + ethambutol (EMB)-resistant (5 µg/mL), one rifampicin (RIF) + EMB-resistant (5 µg/mL) and three MDR (2.5-10 µg/mL) strains. Thus, PAMCHD maintains activity against all kinds of clinical strains, especially MDR. Regarding drug-tolerant persisters, INH and RIF killed, respectively, 0.5 and 5.0 log10 CFU of non-replicating persisters developed by hypoxia and 1.5 and 2.5 log₁₀ CFU developed by nutrient starvation at 64 × of their respective MIC against actively dividing cultures. In contrast, PAMCHD sterilised persister cultures developed by hypoxia (killed 6.5 log10 CFU) or starvation (killed 7.5 log10 CFU). PAMCHD sterilised RIF-tolerant (tolerance level up to 100 µg/mL of RIF) 100-day-old static persisters at 64 × MIC, while moxifloxacin killed only 1.0 log10 CFU of these persisters at 64 × MIC.

CONCLUSION

PAMCHD offers significant potential against MDR-TB and exhibits notable potency against non-replicating drug-tolerant M. tuberculosis persisters. These findings warrant further studies of PAMCHD for further anti-TB drug development.

Depressive and anxiety symptoms, quality of sleep, and coping during the 2019 coronavirus disease pandemic in general population in Kashmir

Background

With uncertainty surrounding the 2019 coronavirus disease pandemic, there is no knowledge of the psychological impact of this pandemic on the general public from Kashmir. We aimed to understand the psychological impact in the form of depressive symptoms, anxiety symptoms, quality of sleep, and coping during this pandemic.

Methods

This cross-sectional study was conducted using social networking sites. The questionnaire meant for this study was sent as a link to a respondent. Initial part of questionnaire collected the socio-demographic details of the respondents. Depressive and anxiety symptoms were assessed using Hospital Anxiety and Depression Scale. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the quality of sleep. There was also an open-ended question to look for coping skills used.

Results

The majority of our respondents were below 45 years (around 95%) with 54.9% from 18 to 30 years age group. 72.3% were males and 27.7% were females. 58.7% were from rural background. 55.7% were employed, and 32.2% were students. In our respondents, 55% had anxiety symptoms, 55% had depressive symptoms, around 53% had poor quality of sleep, and around 30% of used maladaptive coping skills. Significant depressive symptoms were there in the younger age group, 18–30 years (p = 0.03). Significant depressive symptoms and anxiety symptoms were present in females (p = 0.01 and 0.006, respectively). In urban population, significant anxiety symptoms (p = 0.03) were present. The mean score for anxiety symptoms and depressive symptoms was 8.05 ± 4.53 and 8.07 ± 4.56, respectively. Mean global PSQI score was 6.90 ± 3.82 and was positively correlated with score on depressive symptom scale (p = 0.001) as well as score on anxiety symptom scale (p = 0.001).

Conclusion

Younger people, females, those living in urban conditions, and those using maladaptive coping skills are likely to have anxiety symptoms and depressive symptoms as well as poor quality of sleep.

Thyroid hormone levels and Thyroid Hormone Levels and Ultrasonographic Changes in the Thyroid Gland of Patients on Long-Term Lithium Treatment for Affective Disorders: A Controlled Study

Background:

Although lithium is known to cause thyroid dysfunction and increased thyroid gland volume, clinical examination and biochemical assessment are fundamental to thyroid workup of patients on lithium treatment. We aimed to determine thyroid gland volume and the Thyroid hormone levels of patients who have been receiving lithium treatment for affective disorders in comparison to voluntary healthy controls.

Methods:

This was a cross-sectional, hospital-based observational study which was performed in 43 patients on long-term lithium treatment for bipolar disorder, major depressive and schizoaffective disorders. Patients with documented continuous and adequate serum lithium levels for more than or equal to 6 months recruited consecutively underwent the ultrasonographic examination of the thyroid gland. Ultrasonographic examinations were also done in all gender- and age-matched healthy controls. All cases and controls underwent biochemical thyroid function tests.

Results:

There were no statistically significant differences in gender (P = 0.198; Chi-square = 1.654) of cases and controls. Most of the cases were married, maximum number of them unemployed and belonged to the lower socioeconomic status. Total thyroid volume was significantly greater in the lithium-treated group than the controls (9.40 ± 1.41 vs. 4.79 ± 0.45). Clinical inspection and palpation only detected goiter in six (n = 6, 13.95%) of patients on lithium and none among controls. The mean triiodothyronine, mean thyroxine, and mean scores for thyroid-stimulating hormone were significantly increased in patients receiving lithium therapy as compared to controls.

Conclusion:

It would seem wise from a clinical point of view to include ultrasonographic examination of the thyroid gland as part of the standard thyroid workup before initiating lithium treatment.

The Pattern of Psychiatric Morbidity in Chronic Obstructive Pulmonary Disease: A Cross-Sectional, Case-Control Study from a Tertiary Care Hospital in Kashmir, North India

Introduction:

Psychiatric morbidity has an increased prevalence in chronic obstructive pulmonary disease (COPD). Patients overall psychosocial status plays an important role in the development of depression which, when major, is said to occur in 19%–42% of cases of COPD. We aimed to study patterns of psychosocial issues in patients with COPD.

Materials and Methods:

This study was conducted over a period of 6 months in an Outpatient Department of Government Chest Disease Hospital Srinagar. A total of 100 COPD patients and 100 sex- and age-matched controls were included in this study and compared. The diagnosis of COPD was assessed by spirometry. Patterns of psychiatric morbidities were assessed using the Mini-International Neuropsychiatric Interview.

Results:

The frequency of psychiatric comorbidities was significantly higher (P < 0.001) in COPD patients (47%) as compared to controls (12%). The highest frequency of psychiatric morbidities in COPD patients was major depressive episode in 28% in comparison to 9% of controls. Other morbidities include panic disorder, dysthymia, generalized anxiety disorder, and suicidality.

Conclusion:

The frequency of psychiatric morbidities is increased in COPD patients as compared to controls. We recommend that all patients with COPD should be screened for psychiatric morbidity as there is enough scope for psychiatric services to be made available to these patients.

Sociodemographic Profile, Semiology, and Etiology of Patients with Status Epilepticus: A Study from a Tertiary Care Hospital in North India

Background and Objectives:

Despite advance in treatment of status epilepticus (SE), a major neurological emergency, it is still associated with mortality and morbidity. The objective of our study was to estimate sociodemographic profile, semiology, and etiology in the children with SE admitted in pediatric intensive care.

Materials and Methods:

Children between 1 month and 18 years with continuous seizure activity of >5 min or two or more sequential seizures without full recovery of consciousness between seizures, admitted in the Pediatric Intensive Care Unit of the Department of Pediatrics, Government Medical College, Srinagar, were included in the study. A semi-structured tool was designed to record the sociodemographic details. Detailed history, clinical examination, and investigations (including neuroimaging as and when needed) were used to determine the type of seizure and etiology.

Results:

A total of 51 patients were included in our study. Most of the patients were <5 years with 47.10% in 1–5 years’ age group and 43.10% in >1-year age group. Males (60.80%) outnumbered females. Thirty-nine patients (76.47%) belonged to “known” or “symptomatic” group with 35 (68.60%) of them presenting with SE as their fresh seizure. Thirty-nine (76.47%) of our patients had generalized tonic–clonic seizure (GTCS) type of SE.

Conclusion:

Most of the children (90%) were below the age of 5 years with male predominance. Most of the patients had SE as their first seizure without prior history of seizures with GTCSs was the most frequent seizure type.

The Pattern of Psychiatric Morbidity in an Outpatient Child Psychiatry Clinic: A Cross-sectional, Descriptive Study from a Tertiary Care Hospital in Kashmir, North India

BACKGROUND

Psychiatric disorders are ubiquitous and affect not only adults but also children and adolescents. The age factor plays an important role in the pattern of these psychiatric disorders. The objective of our study was to find the pattern of psychiatric morbidity in children and adolescents at the child and adolescent outpatient service of a tertiary care hospital.

MATERIALS AND METHODS

A semi-structured questionnaire was used to record the sociodemographic status. The state of mental health and psychiatric morbidity was assessed after a thorough clinical assessment. Intelligence quotient was assessed by a clinical psychologist as and when needed. All the diagnoses were made on the basis of Diagnostic and Statistical Manual of Mental Disorders, 4^th Edition, Text Revision criteria.

RESULTS

A total of 529 patients were included. Most patients belonged to the age group of 6-16 years (70.5%). Boys (67.9%) outnumbered girls. Most of the patients were from rural background (56.7%) and from nuclear families (53%). Attention-deficit hyperactivity disorder (31%) and mental retardation (29%) were the most frequent diagnoses, followed by pervasive developmental disorders (10%). Comorbidity was present in about 18% of our patients.

CONCLUSION

The child psychiatry is gaining acceptance, and children and adolescents with minor mental health issues are being identified and referred for specialized services.

Distribution of Helminth Parasites in Intestines and Their Seasonal Rate of Infestation in Three Freshwater Fishes of Kashmir

The present study was undertaken to determine the incidence of helminth parasites in fishes with special reference to water quality parameters in Dal Lake and River Jhelum and correlate the observations. Water, fish, and parasite samples were collected during different seasons from various sites and processed. Three fish species, namely, Schizothorax niger Heckel 1838, Schizothorax esocinus Heckel 1838, and Schizothorax curvifrons Heckel 1838, were recovered from these water bodies. The physicochemical parameters temperature, dissolved oxygen, pH, and free carbon dioxide showed variation vis-à-vis the season and location of the stations in water bodies. Acanthocephalan parasite Pomphorhynchus kashmirensis Kaw 1941 (27.47%) and two intestinal cestodes Bothriocephalus acheilognathi Yamaguti 1934 (30.63%) and Adenoscolex oreini Fotedar 1958 (32.43%) were recovered from all the three species of Schizothorax. All the three parasites showed higher prevalence during summer and the least prevalence during winter. Parasitic infections were prevalent more in male fishes compared to females. The presence of the parasites had reduced the condition coefficient of the infected fishes in both water bodies. The study also showed that some of the physicochemical features showed a significant positive correlation with the prevalence.

Role of substrate effects on the morphological, structural, electrical and thermoelectrical properties of V2O5thin films

The present work focuses on the influence of different substrates on the morphological, compositional, phase purity, structural and transport properties of vanadium pentaoxide (V₂O₅) thin films.

Mitochondrial DNA variability to explore the relationship complexity of Schizothoracine (Teleostei: Cyprinidae)

Despite numerous studies on the taxonomy of a highly complex group of schizothoracine (snow trouts), with over five recognized species from Kashmir, India (Schizothorax niger, Schizothorax esocinus, Schizothorax plagiostomus, Schizothorax curvifrons and Schizothorax labiatus) based on traditional morphological data, the relationships between these species is poorly understood and the taxonomic validity is still under debate. To resolve the evolutionary relationships among these species, we sequenced mitochondrial fragments, including 16Sr RNA, Cytb and the D-loop. Separate analyses of 16S and Cytb showed intermixing of the species and 16S was found more conserved than Cytb. The D-loop was found highly variable and showed length variation between and within species. Length variation was observed in di-nucleotide (TA)n microsatellite repeats with a variable number of repeat units (n = 7-14) that did not show heteroplasmy. Central conserved sequence blocks (CSBs) in D-loop sequences were found comparable to other vertebrate species. All phylogenetic reconstructions recovered the focal taxa as a monophyletic clade within the schizothoracines. Analyses with combined mitochondrial data sets showed close genetic relationships of all the five species. In addition to a close relationship between S. niger and S. curvifrons, two distinct groupings of S. ecoscinus and S. plagiostomus were supported by all the analyses. This study gives an insight into molecular phylogeny of the species and improves our understanding of historical and taxonomic relationships derived from morphological and ecological studies.

Length variation and sequence divergence in mitochondrial control region of Schizothoracine (Teleostei: Cyperinidae) species

Schizothoracine fish commonly called snow trouts inhibit the entire network of snow and spring fed cool waters of Kashmir, India. Over 10 species reported earlier, only five species have been found, these include Schizothorax niger, Schizothorax esocinus, Schizothorax plagiostomus, Schizothorax curvifrons and Schizothorax labiatus. The relationship between these species is contradicting. To understand the evolutionary relation of these species, we examined the sequence information of mitochondrial D-loop of 25 individuals representing five species. Sequence alignment showed D-loop region highly variable and length variation was observed in di-nucleotide (TA)n microsatellite between and within species. Interestingly, all these species have (TA)n microsatellite not associated with longer tandem repeats at the 3' end of the mitochondrial control region and do not show heteroplasmy. Our analysis also indicates the presence of four conserved sequence blocks (CSB), CSB-D, CSB-1, CSB-II and CSB-III, four (Termination Associated Sequence) TAS motifs and 15bp pyrimidine block within the mitochondrial control region, that are highly conserved within genus Schizothorax when compared with other species. The phylogenetic analysis carried by Maximum likelihood (ML), Neighbor Joining (NJ) and Bayesian inference (BI) generated almost identical results. The resultant BI tree showed a close genetic relationship of all the five species and supports two distinct grouping of S. esocinus species. Besides the species relation, the presence of length variation in tandem repeats is attributed to differences in predicting the stability of secondary structures. The role of CSBs and TASs, reported so far as main regulatory signals, would explain the conservation of these elements in evolution.

Metal free stereoselective synthesis of functionalized enamides

An efficient and expeditious DABCO-mediated synthesis of functionalized enamides from alkenes is delineated. The reaction proceeds through an unprecedented cascade involving an Aza-Michael addition/α-bromination/elimination and a Morita-Baylis-Hillman type reaction to generate functionalized enamides in a regio- & stereoselective fashion.

Synthesis and biological evaluation of ursolic acid-triazolyl derivatives as potential anti-cancer agents

A series of ursolic acid-1-phenyl-1H-[1,2,3]triazol-4-ylmethylester congeners have been designed and synthesized in an attempt to develop potent antitumor agents. A regioselective approach using Huisgen 1,3-dipolar cycloaddition reaction of ursolic acid-alkyne derivative with various aromatic azides was employed to target an array of triazolyl derivatives in an efficient manner. Their structures were confirmed by using (1)H NMR, (13)C NMR, IR and MS analysis. All the compounds were evaluated for anti-cancer activity against a panel of four human cancer cell lines including A-549 (lung), MCF-7 (breast), HCT-116 (colon), THP-1 (leukemia) and a normal human epithelial cell line (FR-2) using sulforhodamine-B assay. The pharmacological results showed that most of the compounds displayed high level of antitumor activities against the tested cancer cell lines compared with ursolic acid. Compounds 7b, 7g, 7p and 7r were found to be the most potent compounds in this study.

Neuroendocrine control of water content and calcium concentration in the crab Ocypode macrocera (H. Milne-Edwards 1852) (Brachyura, Ocypodae)

The present study is focused to see the effect of crustacean neuroendocrine organs on the water and calcium metabolism which is very much important for the osmoregulatory functions. Since the experiments were carried out to investigate the control of water contents and calcium concentration in the crab, Ocypode macrocera. The animals were collected from the shore of the Bay of the Bengal near Annan Koil one among the biggest landing centers of south east coast of Tamil Nadu, India. The data revealed that water content in the hepatopancreas and thoracic muscle of the control crab were 70.16 and 79.86%, respectively, whereas in the experimental ones, the values were 80.32 and 87.44% after eyestalk removal and 54.52 and 66.98% after eyestalk extract injection. Calcium concentration in both the hepatopancreas and thoracic muscle of the control crab were 2.16 and 2.14 mg g(-1), respectively, whereas in the experimental animals the values were 2.76 and 3.52 mg g(-1) in the eyestalkless crabs and 1.52 and 1.57 mg g(-1) after eyestalk extract injection, respectively. Hence it was observed the % of water content is more in eyestalk less crabs as compared to that of control and injected. The roles of neurosecretory secretions, which control these parameters, were discussed. The ability for Ocypode macrocera to adapt rapidly and maintain homeostasis in a wide range of abnormality supports the fact that Ocypode macrocera are a suitable species for land-based aquaculture in ponds as well as critical condition where rapid fluctuation in salinity can occur.

Hormonal regulatory role of eyestalk factors on growth of heart in mud crab, Scylla serrata

The present study was attempted to know the growth regulation of eyestalk factors on the growth of heart in Scylla serrata using eyestalk extractions and bilateral eyestalk ablations. The bilateral eyestalk ablation led to the maximum growth indices of the heart ((H) indices) to 0.162 and 0.158 in ablated male and female, respectively, in comparison to 0.153 and 0.167 in the control male and female and 0.147 and 0.157 in injected male and female, respectively. The data have shown that the heart of male crabs grows faster than female crabs. The study has also shown that bilateral eyestalk ablation resulted in a significant increase in the heart indices in males and has least effect on the growth of the female heart. The results presented strongly support a potential role of the eyestalk factors and molting hormone regulating the growth of the heart in S. serrata.

TP53 Pro47Ser and Arg72Pro polymorphisms and colorectal cancer predisposition in an ethnic Kashmiri population

Two TP53 gene polymorphisms at codon 47 (TP53 Pro47Ser) and at codon 72 (TP53 Arg72Pro) have been associated with susceptibility to various cancers. We carried out a case-control study and examined the genotype distribution of TP53 Pro47Ser and Arg72Pro single nucleotide polymorphisms (SNPs), using a PCR-RFLP approach, to determine if these two SNPs are risk factors for colorectal cancer (CRC) development and to look for a possible correlation of these two SNPs with clinicopathological variables of CRC. We investigated the genotype distribution of these SNPs in 86 CRC cases in comparison with 160 healthy subjects in an ethnic Kashmiri population. TP53 Arg72Pro SNP genotype frequencies differed significantly (P = 0.000001) between the groups; the frequency of the Pro/Pro mutant was almost 20% in the general population. We also found significant association of the Pro/Pro mutant with tumor location, nodal status/higher tumor grade and bleeding per rectum/constipation. We conclude that Arg72Pro SNP is associated with susceptibility to developing CRC in this ethnic Kashmiri population.

Two new coumarins from Euonymus hamiltonianus

Two new coumarins, named Euonidiol (1) and Euoniside (2) were isolated from the aerial parts of Euonymus hamiltonianus.

Chemotherapy of leishmaniasis. Part VII: synthesis and bioevaluation of substituted terpenyl pyrimidines

Some novel 4-N-substituted terpenyl pyrimidines 5(a-d) and 7(a-g) have been synthesized using novel synthetic methods. The compounds were screened for in vivo antileishmanial screening. When compared to 4-thiomethoxy substituted pyrimidine 2 4-N-substituted terpenyl pyrimidines 5(a-d) and 7(a-g) were found inactive.

Characterization of Two Epimers, 4 and 4 , of a Novel Podophyllotoxin--4-O-(D)-6-Acetylglucopyranoside from Podophyllum hexandrum by LC--ESI-MS--MS

High-performance liquid chromatography (HPLC) with diode array detection interfaced to electrospray ionization (ESI) mass spectrometry (MS) is applied to identify the two epimers of a novel and minor constituent, podophyllotoxin-4-O-(D)-6-acetylglucopyraniside from high-altitude Podophyllum hexandrum for the first time. This is done by matching the structural information from the tandem MS data with the reported lignan markers. The results show that LC-MS-MS is the method of choice for fast detection and detailed chemical analysis of mixtures in the crude extracts of Podophyllum. The method can be employed in the absence of reference standards for the markers and is particularly useful in view of the scarcity of these rare chemical standards.

Isolation, characterization and biological evaluation of datura lactones as potential immunomodulators

Phytochemical investigation of Datura quercifolia (Solanaceae) plant yielded a new datura lactone, 1beta,5alpha,12alpha-trihydroxy-6alpha,7alpha,24alpha,25alpha-diepoxy-20S,22R with-2-enolide (1), along with two known compounds, 2 and 3. The structure of 1 was established on the basis of spectral analysis, as well as by its chemical transformation into known datura lactones. These compounds have been evaluated for immunomodulatory activity by observing their effect on antibody production, T-cell and B-cell activation, and cytokine production from splenocytes. Compound 2 was found to be the most promising immunostimulator in the present study.

Synthesis and biological evaluation of chalcones and their derived pyrazoles as potential cytotoxic agents

A series of substituted chalcones and their corresponding pyrazoles were synthesized and evaluated for in vitro cytotoxic activity against a panel of human cancer cell lines. Out of 93 compounds screened, 8 compounds, 1s, 3i,j,n, 4i,j,n and 4s, showed marked activity. Compounds 4j,n and 4s were found to be the most promising in this study. SAR is also discussed.

Separation of 9-Methoxycamptothecin and Camptothecin from Nothapodytes foetida by Semipreparative HPLC

The present work describes the isolation of camptothecin and 9-methoxycamptothecin from the aerial parts of Nothapodytes foetida by semipreparative high-performance liquid chromatography because the separation of compounds by conventional procedures is tedious and cumbersome. The purity of the isolates is determined by physicochemical data and liquid chromatography-mass spectrometry.

X-linked myotubular myopathy with probable germline mosaicism

X-linked myotubular myopathy is a disorder characterized by severe neonatal hypotonia and respiratory insufficiency. The mutation of MTMI gene results in a defective production of myotubularin, which is responsible for the maturational arrest of muscle development. An identical mutation in the carrier mother and the diseased child establishes the inheritance. We report the disease in a neonate with a mutation on exon 6 of the MTMI gene. Surprisingly, the mother was healthy and did not carry this mutation, she is likely to have germline mosaicism.

Effects of human milk fortification on morbidity factors in very low birth weights infants

BACKGROUND

The use of human milk as a sole source of nutrients for preterm infants has been the subject of debate in recent years. We studied the morbidity factors associated with hospitalization of very low birth weight (VLBW) infants fed human milk with and without fortification.

PATIENTS AND METHODS

One hundred VLBW infants were randomly assigned to two groups with stratification for gestation and weight. The control group (n=50; mean birth weight 1239+/-186 g and mean gestation 29.3+/-2.1 wks) was fed human milk only, and in the fortifier group (n=50; mean birth weight 1245+/-191 g and mean gestation 29.5+/-2.1 wks), human milk was enriched with a fortifier after the babies reached a volume of 140 mL/kg/day by the enteral route. Weight was measured twice weekly, biochemical indices of nutritional and bone status and serum electrolytes were obtained weekly, and clinical evidence for sepsis, necrotizing enterocolitis and feeding intolerance was assessed regularly until infants were discharged.

RESULT

Hospital stay was less than 45 days in the majority (94%) of the babies in the fortifier group, whereas the majority (66%) of the babies in the control group stayed for more than 45 days (P<0.01). Low serum phosphorus and raised alkaline phosphatase levels were seen more frequently in the control group without fortification (P<0.01), as well as hyponatremia (P<0.01), late metabolic acidosis of prematurity (P<0.01) and culture-proven sepsis (P<0.05). There was no significant difference in the occurrence of necrotizing enterocolitis between the two groups (P>0.05).

CONCLUSION

Human milk fortification has beneficial effects on the growth of VLBW infants and decreases hospital stay and morbidity associated with prematurity and very low birth weight, with economic and psychological benefits for the parents.

Collision-induced dissociation of MCl(+) adducts (M = Mg, Mn, Zn, Co, Ni and Cu) and Cu(+) and Ag(+) adducts of dithioalkyl ketene acetals

Electrospray ionization mass spectra of equimolar solutions of dithioalkyl ketene acetals 1 and 2 and metal chlorides (MgCl(2), MnCl(2), ZnCl(2), CoCl(2), NiCl(2) and CuCl(2)) produced abundant ligated metal ion adducts [1 + MCl](+) and [2 + MCl](+). In addition, CuCl(2) also gave rise to Cu(+) adducts. The ligated metal ion adducts upon collision-induced dissociation (CID) showed characteristic fragmentation pathways reflecting the favoured site of coordination. The results show that MgCl(+) prefers oxygen over sulfur, whereas the reverse is true for ZnCl(+) adducts, exemplified by the preferred fragmentation of [1 + MgCl](+) as elimination of MgCl(OH), while that of [1 + ZnCl](+) is expulsion of ZnCl(SCH(3)). Co and Ni chloride adducts tend to give stable metal coordinated species. Cleavage of the dithiolane ring followed by elimination of C(2)H(4)S is the preferred pathway during the CID of [2 + MCl](+) adducts. The CuCl(+) adducts of 1 and 2 showed reduction of Cu((I)) to Cu((0)) resulting in the M(+)(*)ions of 1 and 2. Abstraction of *CH(3) resulting in elimination of CuCH(3) was observed during CID of Cu(+) adducts of 1 and 2. A comparative study of the corresponding Ag(+) adducts revealed a similar behaviour.