Sleeping with the enemy: the United Nations Development Programme and its position on the non‐communicable disease epidemic

The United Nations Development Programme's (UNDP) position on non‐communicable diseases (NCDs) is undermined by a key issue at the global institutional level. Fundamentally, the nature of the relationship between international development agencies and the tobacco industry is at odds with the professed public health priorities of the former. At its core, the business model of the tobacco industry is premised on the sale of addictive and disease‐causing substances that fuel NCDs in the first place. The role of the United Nations system and, in particular, UNDP is to ‘build nations that can withstand crisis’, not to collaborate with entities that profit from crises. This simple and well‐established fact cannot be overlooked. We outline an array of conflict of interests. If the effects of NCDs are ever to be reversed, then international agencies such as the UNDP ought to adhere to ethical standards in choosing partners and avoid conflict of interests. In the absence of this, the UNDP may well compromise its own agenda and proliferate NCDs rather than containing them.     

VP6 capsid protein of chicken rotavirus strain CH2: sequence, phylogeny and in silico antigenic analyses

The inner capsid protein VP6 of group A rotavirus possesses group and subgroup epitope specificities. Avian rotaviruses have a unique VP6 that is antigenically different from its mammalian counterpart. The lack of information on the VP6 protein of chicken rotavirus strain, CH2, at the genetic and antigenic level was a major motivation for this work. Sequencing of the complete cDNA of the VP6 gene of CH2, revealed a nucleotide (amino acid) identity that varied from 78.3 to 98.5% (86.4-98.2%) when compared with other avian rotaviruses. Regardless of its host origin dissimilarity, CH2 VP6 showed a close sequence homology (97.4-98.2%) with turkey and pigeon rotaviruses. Homology-based modeling of the CH2 VP6 from the corresponding crystal structure of the bovine rotavirus, RF strain, demonstrated that the hypervariable region (residue 228-240) does have a critical role in strain specific antigenic characteristics of avian and mammalian rotaviruses. A predicted conformational epitope encompasses experimentally characterized group and subgroup epitopes suggesting that it is a major antibody binding site on the VP6 protein. The VP6 structure modeling and conformational epitope prediction together with enzyme immuno assay of SG MAbs placed CH2 in SGI/II. The study may be helpful in designing peptides for group A rotavirus diagnostic assays and to achieve heterotypic protection against rotavirus serotypes.     

Coinfection of Japanese encephalitis with neurocysticercosis: an imaging study

BACKGROUND AND PURPOSE: Coinfection of neurocysticercosis (NCC) and Japanese encephalitis (JE) has been advocated as more than a chance occurrence resulting in poor outcome. We undertook this study to determine whether the association of the 2 infections is more than a chance occurrence, to define the imaging characteristics of coinfections, and to explore the synergistic effect of NCC in JE.MATERIALS AND METHODS: Sixty-two patients with JE were studied by MR imaging and CT. CT was done in 53 and MR imaging in 53 patients. The diagnosis of JE was established by CSF JE virus immunoglobulin M capture (MAC) enzyme-linked immunosorbent assay (ELISA). NCC was diagnosed from imaging. A control group of 385 patients was evaluated by imaging for prevalence of NCC in the general population.RESULTS: A significantly high association of NCC with JE (19.3%) was observed in comparison with prevalence of NCC in control subjects (1.04%; P = .0003). JE lesions in coinfection were significantly asymmetric with lateralization to the side of the brain having the maximum NCC or a cyst with edema. The JE lesions in coinfections were more florid, with a significantly higher proportion of abnormal CT scans and more abnormal MR imaging. Coinfections were significantly more common in children. Significantly lower CSF MAC-ELISA units in patients with coinfection reflected low CSF IgM levels, suggesting altered immune status.CONCLUSION: In our series, there was a strong association between JE and NCC, and, thus, this coinfection was more than a chance occurrence.

Japanese encephalitis (JE) is a mosquito-borne viral encephalitis that is endemic to several tropical and semitropical countries in Asia. A total of 50,000 new cases occur annually across the endemic regions of the world, of which 10,000 people die. JE is endemic in India, with outbreaks reported in several Indian states in the past decades. Pigs act as amplifier of the JE virus (JEV). Epidemics occur in the summer rainy season in India when mosquitoes are abundant. Clinically, the disease manifests as fever, headache, and altered sensorium with or without focal neurologic symptoms.¹ On CT and MR imaging, JE lesions are most commonly seen in the thalami. Other areas involved are the substantia nigra, basal ganglia, cerebral cortex, hippocampus, pons, midbrain, medulla, cerebellum, and white matter.^2–4Neurocysticercosis (NCC) is caused by the larval stage of the pork tapeworm, Taenia solium and results from the ingestion of the eggs of the adult tapeworm by the fecal-oral route. It is endemic to and a public health problem in India. Neuroimaging by CT or MR imaging is useful for establishing the diagnosis.⁵Coinfection of JE and NCC has been reported in China and India.^6–8 Although both diseases have common epidemiologic and sociodemographic factors like pig rearing, poor socioeconomic status, hygienic conditions, malnutrition, and so forth, more than a casual association of the 2 conditions has been suggested. The presence of NCC has been advocated as a prognosticator of poor outcome in JE.^6,7 Few imaging studies have studied this coinfection.^9,10 These have drawn conflicting conclusions. Singh et al⁹ reported the imaging features in coinfection but did not compare with a cohort of JE patients without coinfection. Azad et al¹⁰ found an increased prevalence of NCC in patients with JE but did not find any statistically significant difference from the prevalence of NCC in control subjects. We undertook this study to find out if there is a significant association of JE with NCC, to define the imaging characteristics of coinfection of JE and NCC, to compare them with a cohort of JE subjects without coinfections, and to explore the synergistic effect of NCC in JE.     

Analgesic and anti-nociceptive activity of hydroethanolic extract of Drymaria cordata Willd

Objectives:

To study the analgesic and anti-nociceptive activity of hydroethanolic extract of Drymaria cordata Willd.

Materials and Methods:

Wistar rats and Swiss albino mice were used for studying analgesic and anti-nociceptive activity of Drymaria cordata hydroethanolic extract (DCHE) at doses 50, 100 and 200 mg/kg p.o. Various models viz. acetic acid induced writhing model (female mice), Eddy''s hot plate (mice) and tail flick model (rat) for analgesic study and formalin-induced paw licking model (mice) were used for anti-nociceptive study.

Results:

In acetic acid induced writhing model, effect of DCHE was better than the standard drug- indomethacin 10 mg/kg (p.o.). In the hot plate model, the maximum effect was observed at 60 min at a dose of 200 mg/kg p.o., which was higher than the standard drug morphine sulfate (1.5 mg/kg i.p.), whereas in the tail flick model, effect was comparable with morphine sulfate. In formalin-induced paw licking model, administration of DCHE completely abolished the early phase at 100 and 200 mg/kg p.o. and in the late phase, the effect of DCHE (200 mg/kg p.o.) was higher than indomethacin (10 mg/kg p.o.).

Conclusion:

DCHE was effective in both non-narcotic and narcotic models of nociception, suggesting its possible action via peripheral and central mechanism. It also abolished the early phase in formalin-induced paw licking model, suggesting complete inactivation of C-fiber at higher dose. The activity can be attributed to the phyto-constituents viz tannins, diterpenes, triterpenes and steroids present in the DCHE extract. In conclusion, DCHE can be developed as a potent analgesic and anti-nociceptive agent in future.     

Indirect optic nerve injury in two-wheeler riders in northeast India

Purpose:

To investigate the association of posterior indirect traumatic optic neuropathy and superior temporal orbital rim injury in two-wheeler riders and documentation of the clinical profile of such cases.

Design:

Retrospective observational study.

Materials and Methods:

Records of all patients reporting with cranio-orbital injury and vision loss following road traffic accidents between October 1994 and April 2006 were reviewed and from them cases with vision loss solely from indirect optic nerve injury were taken up for study. The prognostic significance of different presenting features, role of intravenous methyl prednisolone (IVMP) and relative risk of superior orbital rim injury to posterior indirect traumatic optic neuropathy (at 95% confidence interval) was calculated.

Results:

Out of 129 consecutive cases of cranio-orbital injury, 35 had posterior indirect traumatic optic neuropathy with minor ipsilateral superior temporal orbital rim trauma and none used any protective headwear. Presenting clinical features like relative afferent pupillary defect (P= 0.365), optic disc status (P= 0.518) and visual evoked potential (VEP) (P= 0.366) were disproportionate to visual loss. Only VEP had prognostic significance. The IVMP did not provide any added therapeutic benefit. The remaining 94 cases sustained direct blinding ocular trauma and 28 of them had associated intracranial pathology. The relative risk of superior temporal orbital rim injury to posterior indirect optic nerve trauma was 2.25.

Conclusion:

Superior temporal orbital rim injury, even when minor, carries a potential risk for development of blindness from indirect posterior indirect traumatic optic neuropathy in two-wheeler drivers. Presenting signs do not correlate with visual status. Only VEP has prognostic significance and the condition is untreatable.     

Delayed postoperative opacification of three hydrophobic acrylic intraocular lens: A scanning electron microscopic and energy dispersive spectroscopic study

Purpose:The aim of this study was to report scanning electron microscopic (SEM) and energy dispersive spectroscopic (EDS) findings of three specimens of opaque hydrophobic acrylic intraocular lens (IOL) explanted in delayed postoperative period for visual indications.Methods:Clinical data and photographs from each subject were obtained. Explanted IOLs were examined under gross and light microscopy followed by SEM coupled with EDS.Results:All three subjects underwent IOL implantation following senile cataract extraction at an average age of 64.3 ± 0.3 years, and the IOLs were in situ for a duration of 11.3 ± 4.04 years. The IOL explantation and exchange were done due to late postoperative opacification of the IOL and significant visual deterioration. The milky iridescent opacity affected the full thickness of IOL optics in the first two specimens and in the third only two surfaces were involved. SEM detected surface cracks in the first specimen, typical conglumated surface, pores and accumulation of crystals with surface deposit of nano-particles on the second specimen and uneven surface erosion in the third specimen. SEM detected mainly sodium (Na) and chloride (Cl) spikes. All patients recovered normal vision following IOL exchange.Conclusion:SEM features of the IOL optics and absence of calcium and phosphate spikes in EDS and other findings were consistent and suggestive of hydrolytic biodegradation of hydrophobic acrylic IOL polymer in ocular media and was responsible for delayed postoperative opacification of the hydrophobic IOLs and visual loss.     

Studies on the anti-inflammatory properties of Plantago erosa leaf extract in rodents

Ethnopharmacological relevance

Leaves of Plantago erosa ex Roxb are used traditionally in Northeast India in different illnesses which include wounds, cuts, bruises, insect bites, poison-ivy rashes, minor sores and snakebite, etc.

Aim of the study

Plantago erosa is one of the commonly used medicinal plants in various inflammatory conditions in this region; however, due to paucity of scientific literature on its anti-inflammatory property, the present study was aimed at evaluating its anti-inflammatory activity in the leaves using in vivo models of inflammation.

Materials and methods

Different models like carageenan induced paw edema in rat and mice, formalin induced paw licking in rats and cotton pellet induced granuloma in rats were used for studying the anti-inflammatory activity in methanol extract of Plantago erosa (PEME) leaves.

Results

The PEME at the oral doses from 300 to 600 mg/kg showed anti-inflammatory activity in various models. The extract (PEME) reduced carageenan induced paw edema in rat and mice, inhibited the formation of granulomatous tissue in cotton pellet induced granuloma after treatment and also decreased the reaction time in both early and late phases in formalin induced paw licking in rats.

Conclusion

The study evidently confirmed anti-inflammatory activity of PEME and thus supported the traditional claim. The anti-inflammatory activity could be attributed to the phytoconstituent (flavonoids, alkaloids and steroid) present in the methanol extract of the plant.     

Synthesis of curcumin-loaded chitosan phosphate nanoparticle and study of its cytotoxicity and antimicrobial activity

Curcumin has acquired an important position in the treatment of various diseases. But its use, as a chemotherapeutic agent, is limited due to its low water solubility, poor bioavailability, and its sensitive nature at the physiological pH. To overcome this, curcumin was loaded into chitosan phosphate nanoparticles (CPNs). The loading efficiency was found to be 84%. DLS studies revealed the average particle size of CPNs and curcumin-loaded CPNs as 53 and 91 nm, respectively, and TEM results supplemented these values. A sustained release pattern was noticed and the amount of curcumin released in acidic pH was higher than at physiological pH. The curcumin nanoformulation exhibited proficient activity against both Gram-positive and Gram-negative bacteria as well as fungus. Cytocompatibility of the nanoformulations against peripheral blood mononuclear cells (PBMCs) and murine monocyte–macrophage cell line was confirmed by incubating with PBMCs and murine monocyte–macrophage cell line.