International Journal of BIOLOGICAL AND MEDICAL RESEARCH www.biomedscidirect.com Manuscript submitted at; ISSN: 0976:6685 Editors-in-Chief International Journal of Biological and Medical Research (IJBMR) Web site: http://www.biomedscidirect.com Contact Email: [email protected] BioMedSciDirect Publications Email: [email protected]; [email protected] c Copyright 2023 BioMedSciDirect Publications IJBMR -ISSN: 0976:6685. All rights reserved. Int J Biol Med Res. 2023; 14(4): OCT 2023
BioMedSciDirect Publications Int J Biol Med Res.2023 Contents lists available at BioMedSciDirect Publications Journal homepage: www.biomedscidirect.com International Journal of Biological & Medical Research International Journal of BIOLOGICAL AND MEDICAL RESEARCH Int J Biol Med Res www.biomedscidirect.com Volume 14, Issue 4, Oct 2023 IJBMR-EDITORIAL / ADVISORY BOARD MEMBERS: Dr.P.PASUPATHI – Editor-In-Chief Prof. Dr. Tetsuji Nagata Prof. Dr. Venkat Mani Dr. D. Sankar Dr.V. Rajendran Dr. M. Jayaseelan Prof. Dr. P.Chinnaswamy Prof. Dr. Jombo G T A Dr. G. Saravanan Dr. M. Mohamed Essa Dr. M. K.Banakar Dr. L. Pari Dr. Emeka E. Neboh Dr. Bejoy Baby Prof.Dr. Y.Yagneswara Rao Dr. Mostafa Waly Dr. Kumaraguruparan R Prof. Dr. Zilin Sun Prof. Dr Rachael Adeyanju Akinola Dr. S. Sathiyamoorthy Dr. K. Rohini - INDIA - JAPAN - USA - JAPAN - INDIA - GERMANY - INDIA - NIGERIA - INDIA - OMAN - UNITED KINGDOM - INDIA - NIGERIA - INDIA - INDIA - OMAN - USA - CHINA - NIGERIA - South Korea - MALAYSIA Dr. J. Balakumaran Dr. M.Rahman Prof. Dr.A.V. Ramachandran Prof. Dr. Md. Atiar Rahman Dr. Praveen R Dr. Ebele Joy Ikekpeazu Prof. Dr. Misra. M Prof. Dr. Ahmet Zeki Sengil Prof. Dr. Bechan Sharma Dr. Jawahar Farook Prof.Dr. Emeka E. Neboh Dr. Shashikant R. Pattan Dr. Amanat Ali Dr. Kristie Autry-Mclaurin Dr Rachael Adeyanju Akinola Dr. M.Sharrif Moghaddasi Dr. Ochuko L. Erukainure Dr.Vamseedhar Annam Dr.S.Parthasarathy Dr.Anil Batta Dr. K. Desigamani - INDIA - JAPAN - INDIA - BANGLADESSH - INDIA - NIGERIA - INDIA - TURKEY - INDIA - INDIA - NIGERIA - INDIA - OMAN - USA - NIGERIA - IRAN - NIGERIA - INDIA - INDIA - INDIA - INDIA c Copyright 2023 BioMedSciDirect Publications IJBMR - All rights reserved. BioMedSciDirect Publications Contact: International Journal of Biological and Medical Research [IJBMR] Email: [email protected] | [email protected] | www.biomedscidirect.com | +91 95004 76699
CONTENTS Int J Biol Med Res. Oct- 2023; Volume 14 Issue (4): Page No: 7635 - 7711 EDITORIAL BOARD IJBMR –Contents –Oct 2023 IJBMR-Instructions for authors Int J Biol Med Res. Volume 14; (Issue 4): Oct 2023 IJBMR-Journal office Int J Biol Med Res. Volume 14; (Issue 4): Oct 2023 IJBMR-Journal office Int J Biol Med Res. Volume 14; (Issue 4): Oct 2023 Editor-in-Chief ORIGINAL ARTICLE IJBMR-Journal front page –Oct 2023 Contents lists available at BioMedSciDirect Publications Journal homepage: www.biomedscidirect.com International Journal of Biological & Medical Research BioMedSciDirect Publications ISSN: 0976-6685 International Journal of BIOLOGICAL AND MEDICAL RESEARCH Int J Biol Med Res www.biomedscidirect.com Volume 14, Issue 4, Oct 2023 - - - 01. 02. 03. S.No Page No c Copyright 2023 BioMedSciDirect Publications IJBMR -ISSN: 0976-6685. All rights reserved. 04. 05. 06. 07. 08. Nutritional Status Of Children At Anganwadi Centers In Urban Kolar, A Study In Assessment of Cardiac Histology and Hematological Parameters in Adult Male Wistar Rats Exposed to Exhaust Emissions from Gasoline Generators. Formulation and Evaluation of Herbal nail lacquer for treatment of Onychomycosis Effectiveness Of Professional Image Enhancement Training Programme For B.sc (n) Students And Serum Interleukin - 6 level among Sudanese Patients with Chronic kidney disease Its Impact On Their Perceived Image Among General Public Southern Part Of India After Second Wave Of Covid -19 Pandemic Int J Biol Med Res. 2023; 14(4): 7635-7637 Akshath K S, Srihari Alapati, Balasunder B C, Beere Gowda Y C, Thageeru Mahesh kumar Int J Biol Med Res. 2023; 14(4): 7638-7642 Akinpelu MORONKEJI, Frederick O AKINBO Int J Biol Med Res. 2023 ;14(4):7643-7647 Harshada I. Patil, Aditi S Awati, Dhanashree N Mujumale Int J Biol Med Res. 2023 ;14(4):7648-7651 P.Sagayamary, G.Grace Jebakani Sweety, M.Mary Sasikala, Mrs.N.Gowri Int J Biol Med Res. 2023 ;14(4):7652-7654 Safaa I.A Nasr, Rbab A.M Adam, Hala M.M Ibrahim, Afra S.A Abdelgadir, Ibrahim Alkider, Solomon M. Gamde, Simon P. Abriba 7635 7638 7643 7648 7652
c Copyright 2023 BioMedSciDirect Publications IJBMR -ISSN: 0976-6685. All rights reserved. SHORT REPORT CASE REPORT REVIEW ARTICLE Pharmacognostical identification of leaves of Medicinal Plants Ficus carica Linn. and Prevalence And Associated Risk Factor Of Bovine Calves Coccidiosis In Exploring the Protective Effects of Vitamin C and D against Phosphine-Induced Kidney Damage A Study of Gross Morphological Differences in Appearance of Ligature Mark in Post-Mortem Cases of Effectiveness of knowledge and Utilization of Partograph among midwifery in labour ward at Dicephalus parapagus tribrachius - A rare variety of conjoined twins : A Case Report Eosinophilia Can Serve As a Diagnostic Clues For Helminthic Infestations : A Case Series AN OVERVIEW OF CORONAVIRUS DISEASE (COVID-19) Ashwin hospital , Coimbatore Asphyxial Deaths in a Tertiary Care Centre of Haryana Nekemt City, Oromia, Western Ethiopia Catharanthus roseus (Linn.) G.Don Int J Biol Med Res. 2023 ;14(4):7655-7659 Sumbul Rehman, Sehrish Khan, Ameera Ayyub, Sana Mustaqeem and Aisha Razi Int J Biol Med Res. 2023 ;14(4):7660-7664 Walkite Furgasa, Sosina Dawit, Shibiru Wako and Adisu Dube Int J Biol Med Res. 2023 ;14(4):7665-7668 Akinpelu MORONKEJI, Frederick O AKINBO, Solomon Matthias GAMDE, Temidayo Daniel ADENIYI, Abiodun Abioye OYELEKE, IDOWU-Aiye Faith Int J Biol Med Res. 2023 ;14(4):7669-7672 Kunal Khanna, Jitender Kumar Jakhar, Sandeep Kumar Giri, Naveen Sharma, Gajender Yadav Int J Biol Med Res. 2023 ;14(4):7673-7674 Hatlin Sugi .M, Ph.D Scholar Int J Biol Med Res. 2023 ;14(4):7675-7677 Akshath K S, Balasunder B C, Srihari Alapati, Beeregowda Y C , Thageeru Mahesh kumar Int J Biol Med Res. 2023 ;14(4):7678-7680 G. Vaishnavadevi Int J Biol Med Res. 2023 ;14(4):7687-7691 Emy Jancy Rani J. 09. 10. 11. 12. 13. 14. 15. 16. 7655 7660 7665 7669 7673 7675 7678 7687 Review On Anti-trypanosomial Drug Resistance And Its Status In Ethiopia Int J Biol Med Res. 2023 ;14(4):7692-7698 Walkite Furgasa, and Gedamnesh Asfaw 17. 7692
c Copyright 2023 BioMedSciDirect Publications IJBMR -ISSN: 0976-6685. All rights reserved. Medical Segregation cohort study of Bio – Medical Waste Management Bioremediation and Information Technologies for Sustainable Management Int J Biol Med Res. 2023 ;14(4):7699-7701 Naval Kishor Lodha, Krishna Murari, Biramchand Mewara, Gopal Sharma, Mahendra varma Int J Biol Med Res. 2023 ;14(4):7702-7711 Jyoti Prakash, Aryan Shukla and Ruchi Yadav 18. 19. 7699 7702
IJBMR - Instructions for authors Editor in chief 1. Aim and scope 1.1. Scope of the Article 3. Organization of Manuscript 2. Submission of Manuscript International Journal of Biological and Medical Research (IJBMR) publishes papers describing original research in all areas of contemporary biological and medical fields. Submitted original research papers should represent a novel and important contribution to the understanding of any area of biological and medical research and provide mechanistic insights into the process. All submitted articles should report original, previously unpublished research results, experimental or theoretical, and will be peer-reviewed. Articles submitted to the journal should meet these criteria and must not be under consideration for publication. Manuscripts should follow the style of the journal and are subject to both review and editing. International Journal of biological and medical research is an international peer-reviewed multi disciplinary online journal published in quarterly in the months of January, April, July and October. The journal accepts Original Articles, Short Report, Case Report and Review Articles. All Biological and Medical Sciences like Anesthesiology, Animal Research, Basic medical sciences, Biochemistry, Biotechnology, Bioinformatics, Biophysics, Biology, Cancer biology, Cardiology, Cardio Thoracic Surgery, Dibetology, Dermatology, ENT, Endocrinology, Free radical Biology, General surgery, General Medicine, Genetics, Gastroenterology, Gynecology, Hematology, Herbal Therapy, Human physiology, Immunology, Infertility, Infectious Diseases, Laboratory Medicine & Techniques, Microbiology, Molecular Biology, Nanotechnology, Neonatology, Neurology, Nephrology, Nursing care, Nutrition, Oncology, Orthopedics, Ophthalmology, Pathology, Plant Study, Plant Biotechnology, Pharmacology, Pulmonology, Pediatrics, Psychiatry, Rheumatology, STDs, Stem Cell Research, Toxicology, Urology & Virology etc... Register yourself as an author and submit the manuscript by clicking online submission. Dear author please Register our website (http://www.biomedscidirect.com). After successful registration please check your- mail inbox including (SPAM) also, we have included your username and password in this email, which are needed for all work with this journal through its website. Please login your username and password submits your article through online to the journal for easy review & communication process. Manuscript should be typewritten in 12-font size, 1.5 lines spacing, with margins of at least one inch on all sides. Pages should be numbered consecutively, starting with the title page and the matter arranged in the following orders: In case any problem through the on line submission authors are invited to submit their manuscripts through Journal email address ([email protected]; [email protected]) along with a covering letter preferably by the corresponding author or first author. Each manuscript will be provided with a manuscript ID and all correspondence is done through e-mail. Please always refer to the manuscript ID for any further enquiries. 3.1 Title Page Title page contains title of the manuscript in bold face, title case (font size 14), names of the authors in normal face, title case (font size 12) followed by the address of authors in normal face, lower case (font size 12). Names of the authors should appear as initials followed by surnames. Full names may be given in some instances to avoid confusion. Followed by the author names, please provide the complete postal address or addresses with pin code number of the place(s), where the research work has been carried out. If the publication originates from several institutes, the affiliation of each author should be clearly stated by using superscript Arabic numbers after the name and before the institute. The author to Contents lists available at BioMedSciDirect Publications Journal homepage: www.biomedscidirect.com International Journal of Biological & Medical Research BioMedSciDirect Publications International Journal of BIOLOGICAL AND MEDICAL RESEARCH www.biomedscidirect.com ISSN: 0976:6685 Int J Biol Med Res Int J Biol Med Res. aArticle Type (Original Article, Review Article, Short Report, Case Report) aTitle of the manuscript aNames of authors:- First Name*, Middle & Last Name* (*Authors full name required) aTheir respective Corresponding author addresses Phone No/ E-mail Id aAbstract (not exceeding 300 words) aKey words (Up to 4-6 keywords) aIntroduction aMaterials and Methods aResults aDiscussion aConclusion aAcknowledgments aReferences aFigure ISSN: 0976:6685
whom correspondence should be directed must be indicated with an asterisk. At the bottom left corner of this page, please mention “*For correspondence” and provide a functional e-mail address of the corresponding author to whom all correspondence (including galley proofs) is to be sent. 3.5 Tables Should each be typed on a separate page, numbered in sequence with the body of the text. Tables should be headed with a short, descriptive caption. They should be formatted with horizontal lines only: vertical ruled lines are not required. Footnotes to tables should be indicated with a), b), c) etc. and typed on the same page as the table. 3.6 Figures Should be on separate pages but not inserted with in the text. All figures must be referred to in the text and numbered with Arabic numerals in the sequence in which they are cited. Each figure must be accompanied by a legend explaining in detail the contents of the figure and are to be typed under the figures. Graphs and bar graphs should preferably be prepared using Microsoft Excel and submitted as Excel graph pasted in Word. Alternatively photographs can be submitted as JPEG images. Keys to symbols, abbreviations, arrows, numbers or letters used in the illustrations should not be written on the illustration itself but should be clearly explained in the legend. Avoid inserting a box with key to symbols, in the figure or below the figure. All Tables and Figures captions and legends should be typed on a separate page. 4. Article Proofs Page proofs are sent to the designated author through e-mail. They must be carefully checked and returned the revised manuscript within 48 hours of receipt. 5. Copyright Authors are asked to sign a warranty and copyright agreement upon acceptance of their manuscript, before the manuscript can be published. The Copyright Transfer Agreement can be downloaded here http://www.biomedscidirect.com/instructions. php (in word file & PDF). Submission of your paper to this journal implies that the paper is not under submission for publication elsewhere. Material, which has been previously copyrighted, published, or accepted for publication, will not be considered for publication in this journal. Submission of a manuscript is interpreted as a statement of certification that no part of the manuscript is copyrighted by any other publisher nor is under review by any other formal publication. By submitting your manuscript to us, you agree on BioMedSciDirect Publications copyright guidelines. It is your responsibility to ensure that your manuscript does not cause any copyright infringements, defamation, and other problems. Submitted papers are assumed to contain no proprietary material unprotected by patent or patent application; responsibility for technical content and for protection of proprietary material rests solely with the author(s) and their organizations and is not the 3.2 Sections Manuscripts should be divided into the following section titles (normal face, upper case) and subtitles in each section (bold face, lower case): Abstract An abstract not exceeding 300 words (for Short Communications between 60 and 80 words) should be provided typed on a separate sheet. Abstract should include aims, methods, results and conclusion. Keywords Up to 4-6 keywords must be provided in alphabetical order, preferably taken from Index Medicus. These keywords should be typed at the end of the abstract. Introduction It should be a concise statement of the background to the work presented, including relevant earlier work, suitably referenced. It should be started in a separate page after keywords. Materials and Methods It shall be started as a continuation to introduction on the same page. All-important materials and equipments, the manufacturer's name and, if possible, the location should be provided. The main methods used shall be briefly described, citing references. New methods or substantially modified methods may be described in sufficient detail. The statistical method and the level of significance chosen shall be clearly stated. Results The important results of the work should be clearly stated and illustrated where necessary by tables and figures. The statistical treatment of data and significance level of the factors should be stated wherever necessary. Data that is not statistically significant need only to be mentioned in the text - no illustration is necessary. Discussion This section should deal with the interpretation of results, making the readers to understanding of the problem taken and should be logical. The discussion should state the scope of the results, which need to be further explored. Results and discussion of the work can also be combined under one section, Results and Discussion. Conclusions Concisely summarizes the principal conclusions of the work and highlights the wider implications. This section should not merely duplicate the abstract. 3.3 Acknowledgements: Acknowledgements as well as information regarding funding sources should be provided. 3.4 References Citations of literature within the text must be presented in numerical order and should be set in square brackets, thus [1, 12]. The cited literatures are also collected in numerical order at the end of the manuscript under the heading “References”. Titles of journals should be abbreviated according to the index medicus. Please give the DOI (Digital Object Identifier) if the paper is not yet in print. Please note the following examples. Journals [1] Donald DH. Oxidative stress and vascular disease. Arterioscler Thromb Vasc Biol 2005; 26:689-695. [2] Donne ID, Ranieri R, Roberto C, Daniela G, Aldo M. Biomarkers of oxidative damage in human disease. Clin Chem. 2006; 52:601-623. [3] Liu TS, Wang Y, Chen SY, Sun YH. An updated metaanalysis of adjuvant chemotherapy after curative resection for gastric cancer. EJSO. 2008; 34: 1208-1216. Chapter in a book [1] Goadsby PJ. Pathophysiology of headache. In: Wolff's headache and other head pain. Silberstein SD, Lipton RB, Dalessio DJ (eds). 7th ed. Oxford, England, Oxford University Press, 2001, pp 57-72. Int J Biol Med Res.
responsibility of the BioMedSciDirect Publications or its Editorial Staff. The main author is responsible for ensuring that the article has been seen and approved by all the other authors. It is the responsibility of the author to obtain all necessary copyright release permissions for the use of any copyrighted materials in the manuscript prior to the submission. 6. Page Charges and Re-print The journals published by BioMedSciDirect Publications are Open Access journals, which mean that the publication cost should be covered by the author's institution or research funds. Normal peer-review Process: There is no submission fee. The author's institution or research funds should cover processing and publication fee. Our routine turn around time for submission to decision is around 7 weeks and another 2-3 weeks for publication. Fast-track submission & Process: For new findings of sufficient importance to justify accelerated review and publication, a fast-track submission process for original articles is available. In the submission letter, authors should explicitly request this option. If the editors agree that the manuscript is worthy of fast-track publication, a fee will be charged to the author's / institution or research funds. If accepted for fast-track submission, an article will be reviewed within 10 Days (otherwise, authors will be informed that the paper will be handled within the normal peer-review process). If accepted, a fast-track submission will appear with in 20-25 days published your article through online of the journal. Please Mention The "Fast Track Publication" In Your Manuscript & Covering Letter. With Regards, Editor in Chief International Journal of biological and medical research (IJBMR) Email: [email protected] ; Journal homepage: www.biomedscidirect.com [email protected] c Copyright 2023 BioMedSciDirect Publications IJBMR -ISSN: 0976:6685. All rights reserved. Int J Biol Med Res.
BioMedSciDirect Publications Int J Biol Med Res.2023 ;14(4):7635-7637 Contents lists available at BioMedSciDirect Publications Journal homepage: www.biomedscidirect.com International Journal of Biological & Medical Research International Journal of BIOLOGICAL AND MEDICAL RESEARCH Int J Biol Med Res www.biomedscidirect.com Volume 14, Issue 4, Oct 2023 Copyright 2023 BioMedSciDirect Publications IJBMR - ISSN: 0976:6685. All rights reserved. c ARTICLE INFO ABSTRACT Keywords: Anganwadi nutritional assessment prevalence stunting underweight. 1. Introduction People's health is the wealth of a nation and nutrition is one of the most important prerequisites for good health. A disease created by man is malnutrition. It is a disease of human society. It usually begins in the womb and ends in the grave. A major advantage of treating malnutrition as a human ecological problem is that it enables a range of preventive approaches [1]. Childhood malnutrition is a widespread public health problem with international implications [2]. The nutritional indicators for children under 5 years of age have improved in comparison to NFHS-4 (2015–16), according to a recent report by NFHS-5 (2019–21). Stunting has decreased from 38.4% to 35.5%, wasting from 21.0% to 19.3%, and the prevalence of underweight has decreased from 35.8% to 32.1% [3]. According to Malnutrition in Karnataka, NFHS-5 reveals that more than a third (35%) of Karnataka's children under 5 years of age are stunted, indicating that they are being undernourished. One in five children is wasted and up to 8% of children in this age group are severely wasted, while one-third are chronically or severely underweight [4]. The issue is only made worse by a lack of nutrient-rich food, bad hygiene and sanitary practices in the home, poverty, mothers' illiteracy, and a lack of access to health care. Recovering from poor nutritional status in later life is more challenging for these youngsters because these characteristics are widespread in rural India. Urbanization, female literacy, access to health care, good water, and sanitation all have a positive impact on children's nutrition [5]. The term "protein-energy malnutrition" is used to describe a wide range of clinical conditions, from mild malnutrition presenting with poor growth to severe types of kwashiorkor and marasmus, which have a high mortality rate [6]. Inadequate nutrition, lack of understanding, and undesirable social practices impede a child's early development. Lack of distance and many siblings is the order of the day for low income groups and rural areas. Therefore, this study was carried out to assess the nutritional status of Anganwadi children aged 1 to 5 years old in Kolar town, Karnataka. Aim: To assess the nutritional status of Anganwadi children aged 1 to 5 years old in Kolar town, Karnataka. Background: One of the major causes of death and morbidity in under-five children is malnutrition. The morbidity and mortality from malnutrition can be decreased, and the nutritional condition of children can be improved, by being aware of various risk factors. Objective: To measure the height/length, weight, and mid-upper arm circumference of Anganwadi children. To assess the nutritional status of Anganwadi children aged 1 to 5 years old in Kolar town, Karnataka. Materials and Methods: This cross-sectional study was undertaken among 560 children in the age group of 1 to 5 years in 93 Anganwadi centers (AWCs) of Kolar town a district in Karnataka to determine the nutritional status. Results: In the study, 28.39% belonged to the age group 12-24 months, and the mean age being 34 ± 14. 49.64% were male and 50.36% were female children. 42.68% of mothers & 45.89% of fathers studied till high school. In our study, the overall prevalence of underweight, stunting, and wasting were found to be 13.75%, 14.11%, and 15.89%, respectively. Conclusion: According to this study's findings, compared to NFHS-5 data, the prevalence of moderate acute malnutrition (MAM) is on the lower side, and there is no evidence of severe acute malnutrition (SAM). Greater parental variables, especially the mother's education, occupation and socioeconomic level are helpful in preventing childhood malnutrition. Original article Nutritional Status Of Children At Anganwadi Centers In Urban Kolar, A Study In Southern Part Of India After Second Wave Of Covid -19 Pandemic a b c d e Akshath K S , Srihari Alapati , Balasunder B C , Beere Gowda Y C , Thageeru Mahesh kumar a Junior resident, Sri Narasimharaja district hospital, Kolar, Karnataka bHead of the department, Department of Pediatrics, Sri Narasimharaja district hospital, Kolar, Karnataka c Senior Consultant, Department of Pediatrics, Sri Narasimharaja district hospital, Kolar, Karnataka d Senior Consultant, Department of Pediatri cs, Sri Narasimharaja district hospital, Kolar, Karnataka e Junior resident, Sri Narasimharaja district hospital, Kolar, Karnataka * Corresponding Author : Head of the department, Department of Pediatrics, Sri Narasimharaja district hospital, Kolar, Karnataka, Gmail: [email protected] Dr.Srihari Alapati, c Copyright 2023 BioMedSciDirect Publications IJBMR - All rights reserved.
Objective: To measure the height/length, weight, and mid-upper arm circumference of Anganwadi children aged 1-5 years in Kolar town. Materials and Methods This cross-sectional study was conducted between June 2021 and May 2022 after second wave of Covid-19 pandemic in the Anganwadi centers (AWCs) of Kolar town a district in Karnataka to determine the nutritional status after obtaining ethical committee clearance from MVJ MEDICAL COLLEGE & RESEARCH HOSPITAL, No. MVJMC&RH/PG/Synopsis/01/2021-22. There are 93 Anganwadi centers in total belonging to 35 wards in Kolar Town. Children in the age group of 1 to 5 years enrolled in the Anganwadi centers at Kolar town were the study subjects. Children with chronic ill health, congenital anomalies, chromosomal anomalies, and metabolic diseases were excluded. The cluster sampling method was the sampling method used in the present study. The sample size was calculated considering Karnataka's prevalence of malnutrition at 41% [7] and with a relative error of 10%, and a confidence level of 95% being considered. Sample size = Z2*P*Q/L2 where Z=1.96 = 1.96*1.96*41*59/4.1*4.1 = 9292.83/16.81 = 553 The sample size was calculated to be 553 children between 1-5 age groups enrolled in Anganwadi, Kolar town. However, we included 560 children. Methodology Cluster sampling method was used to select a total of 560 children from 22 randomly selected Anganwadi centers. To gather information on sociodemographic factors, dietary practices, and the health status of the children, pretested questionnaires were used to interview mothers and conduct examinations of a select group of children. In the Anganwadis, anthropometric measurements were recorded. The standard non-stretchable measuring tape was used to measure height, and the digital weighing scale was used to record the weight of the children. The study's purpose was explained to the parents of children aged 1 to 5 years, and each question was used to collect data on their education, occupation, religion, per-capita income, and history of illnesses like diarrhea, measles, and respiratory infections. At the same time, measurements of the subjects' height, weight, head circumference, and mid-upper arm circumference were taken. A digital weighing scale, stadiometer, infantometer, and nonstretchable measuring tape were used. WHO Anthro Software was used to get weight for age, height for age, and weight for height indices using the height and weight of each child [8]. For children between the ages of one and five, the midupper arm circumference was used to classify malnutrition. Children with MUAC between 11.5 cm to 12.5 cm were considered Moderate Acute Malnutrition and those less than 11.5 cm were considered as Severe Acute Malnutrition [9,10]. Statistical analysis Data entry was done in Microsoft Excel 2013 and statistical analysis was performed with the help of SPSS, Version 22. Continuous variables were presented as the mean and standard error of the mean (SEM), while categorical variables are presented as numbers and percentages. The chi-square test was used to compare differences in categorical variables and the independent t-test for continuous variables between boys and girls. Results In the study, 28.39% belonged to the age group 12-24 months, and the mean age being 34 ± 14. 49.64% were male and 50.36% were female children. 42.68% of mothers & 45.89% of fathers studied till high school. 55.54% belonged to nuclear families and only 3.10% to joint families. About 87.86% belonged to the Hindu religion. In our study, the overall prevalence of underweight, stunting, and wasting were found to be 13.75%, 14.11%, and 15.89%, respectively. Table 1: Distribution of children according to their Parents’ Literacy status & Occupation Table 2: Distribution of Children according to Weight for Height, Height for Age, Weight for Age & MUAC as per W.H.O Classification. 7636 Akshath K S et al./Int J Biol Med Res.14(4):7635-7637
Discussion In our study, children aged 12 to 24 months made up the majority (28.39%), whereas those aged 49 to 60 months made up the least number of children (19.29%). This was comparable with the studies were done by Goswami et al.,Tripathi MS et al.,Harishankar et al., and Mittal A et al. 49.64% were males and 50.36% were females. There is no gender preponderance. Findings were in accordance with studies conducted by Das SR et al.,Goswami et al.,Goudappa R Patil et al., and Harishankar et al. None of the mothers were illiterate and most of them (42.68%) had completed High School which is similar to the study by Das SR et al. In the study, among employed fathers, 41.61% were unskilled workers, and among employed mothers, 8.04% were unskilled workers. 83.04% of the mothers were housewives. Findings were in accordance with studies conducted by Hasan I et al., and Mukherjee R et al. Most of the children (41.25%) belonged to Class III which is similar to the study conducted by Hasan I et al. Prevalence of wasting, stunting, and being underweight is 15.89%, 14.11% & 13.75% respectively. In the current study, none of them are under Severe Acute Malnutrition. Findings were in accordance with studies conducted by Safikul Islam et al., and Joseph B et al. As per the recent report of NFHS-5 (2019-21), the prevalence of wasting is 19.3% which is almost similar to our study whereas the prevalence of stunting is 35.5% and underweight is 32.1% which is in contrast to our study findings. Conclusion According to this study's findings, compared to NFHS-5 data, the prevalence of moderate acute malnutrition (MAM) is on the lower side, and there is no evidence of severe acute malnutrition (SAM). There is no gender preponderance related to malnutrition which goes in sync with the latest NFHS-5 report (2019-21).Greater parental variables, especially the mother's education, occupation and socioeconomic level are helpful in preventing childhood malnutrition. Uplifting literacy and socio economic status of the community can definitely eliminate SAM and reduce MAM. Since major population in India lives in rural area where the prevalence of the SAM and MAM is still high, if we can implement the above strategy we can eliminate SAM and reduce MAM. Therefore, in order to prevent malnutrition, it is important to strengthen mothers' literacy, socioeconomic status, providing proper antenatal care and regular immunization to children under Universal Immunization Program. 7637 1. Jelliffe DB. The assessment of the nutritional status of the community, WHO Monograph.1966; Sr.No.53. 2. Mincer Jacob: Schooling experience and earrings, Columbia University press, New York, 1974. 3. M e a s u r e s t o A d d r e s s M a l n u t r i t i o n A v a i l a b l e a t https://pib.gov.in/PressReleasePage.aspx?PRID=1806601 {Cited on 07-08- 2022} 4. Every third kid under 5 is stunted in Karnataka, shows NHFS data Available at: https://www.deccanherald.com/state/every-third-kid-under-5-isstunted-in-karnataka-shows-nhfs-data-1109599.html {Cited on 09-08- 2022} 5. Osmani Siddiq and Alok Bhargava, Health and nutrition in emerging Asia, Asian Development Review, Vol. 16(1), 1998, pp. 31-71. 6. Kariuki FN, Monari JM, Kibui MM et al. Prevalence and risk factors of malnutrition. J Natl Inst Pubic Health 2002;51:44 – 50. 7. Das SR, Prakash J, Krishna C, Iyengar K, Venkatesh P, Rajesh SS. Assessment of nutritional status of children between 6 months and 6 years of age in Anganwadi centers of an urban area in Tumkur, Karnataka, India. Indian J Community Med 2020;45:483-6. 8. World health organization, global database on malnutrition URL http://www.who.int/nutgrowthdb/en/ {cited on 12-12-21} 9. Ghai.O.P, Gupta P, Paul V.K; Essential Pediatrics, 9th edition, New Delhi, Meenaksi Art Printers, 2019. 10. Meharban Singh, Pediatric Clinical Methods, 6th edition New Delhi, Sagar Publications, 2020. REFERENCES All rights reserved. c Copyright 2023 BioMedSciDirect Publications IJBMR - ISSN: 0976:6685. Akshath K S et al./Int J Biol Med Res.14(4):7635-7637
BioMedSciDirect Publications Int J Biol Med Res.2023 ;14(4):7638-7642 Contents lists available at BioMedSciDirect Publications Journal homepage: www.biomedscidirect.com International Journal of Biological & Medical Research International Journal of BIOLOGICAL AND MEDICAL RESEARCH Int J Biol Med Res www.biomedscidirect.com Volume 14, Issue 4, Oct 2023 Copyright 2023 BioMedSciDirect Publications IJBMR - ISSN: 0976:6685. All rights reserved. c ARTICLE INFO ABSTRACT Keywords: Cardiac histology gasoline-generator haematological parameters Nigeria 1. Introduction Exposure to combustion particles may increase the risk of cardiovascular disease (CVD), including atherosclerosis, hypertension, thrombosis, and myocardial infarction [1]. Additionally, the generation of reactive oxygen species (ROS) as a result of particulate matter (PM) components of polluted air plays a role in the development or aggravation of CVD caused by exposure to combustion particles and polycyclic aromatic hydrocarbons (PAHs) [2]. Fossil fuel combustion is the largest driver of air pollution, greenhouse gas emissions, and climate change [3] and remains a primary contributor of nitrogen oxide (NOx)[4]. The epileptic power supply in Nigeria has led to the generation of electricity through the use of gasoline generators. Despite the global transition to cleaner energy sources and less environmental pollution, the rate of gasoline-powered generator importation keeps rising due to the instability of the main power grid [5,6]. The emissions from gasoline generator engines are extremely high and exceed the allowable limits for PM1, PM2.5, and PM10 specified by the US Environmental Protection Agency and the World Health Organization, exposing humans to health hazards [7]. Despite concerted efforts to develop greener and more cost-effective energy sources to replace petroleum, petroleum utilization keeps increasing in both developed and developing countries [8]. Studies have indicated that petroleum fumes lower haematological parameters and these effects worsen with prolonged exposure [9-12]. The cytopathic and haemotoxic effect of gasoline generator exhaust is still been studied. Against this background, we aim to investigate the haematological and histological effects of gasoline generator exhaust exposure. MATERIALS AND METHOD Animal husbandry Adult male wistar rats weighing an average of 180g were obtained from the University of Benin's animal holding facility in Benin City, Nigeria. Before commencing the experiments, the rats were acclimatized for two weeks. The International Humane Animal Care Standards were followed when handling experimental animals . Ethical considerations The Biomedical Research and Ethics Committee of the Ministry of Agriculture, Benin City, Edo State, Nigeria, approved the experimental protocol used in this study and granted it an ethical clearance registration number V.1040/77. Exposure technique to generator exhausts A control group (A) and three test groups, labelled B, C, and D, were split into four groups of mature male wistar rats. Rats in the test groups were exposed to gasoline generator exhaust for 12 weeks at time intervals of 2 hours, 4 hours, and 8 hours respectively, while rats in the control group were not exposed at all. The exposure method was adapted from a study by Henz & Maeder. Experimental animals were placed two meters away res, an AC output of 220 volts, and a DC output of 12 volts/8. Background and Aim: In Nigeria, the lack of a reliable supply of electric power has necessitated the use of gasoline-powered generators to generate electricity. This study investigated the effect of gasoline generator exhaust exposure on the haematological parameters and cardiac histoarchitecture of adult wistar rats. Materials and Methods: Adult male wistar rats subdivided into four groups were exposed to exhaust emissions at time points of 2, 4, and 8 hours for 4, 8, and 12 weeks, respectively. The rats in Group I were the unexposed control rats, while Groups II-IV were the test groups exposed at time points of 2, 4, and 8 hours over a period of 4, 8, and 12 weeks, with haematological and cardiac histopathology performed at the end of the experiment. Results: The results showed that exposed rats had elevated white and red blood cell counts compared to the control, while platelet counts were significantly lower (p-value <0.05), with cardiac histology revealing degenerative myocardial lesions such as inflammatory responses, hemorrhagic intermyocytic spaces, vascular congestion, and fibrosis at various exposure time points. Conclusion: Exposure to gasoline generator exhaust emissions adversely impacts the cardiac tissues, with the most pronounced deleterious effect observed at 12 weeks. Original article Assessment of Cardiac Histology and Hematological Parameters in Adult Male Wistar Rats Exposed to Exhaust Emissions from Gasoline Generators. a,b b Akinpelu MORONKEJI *, Frederick O AKINBO . a Department of Medical Laboratory Science, Faculty of Allied Health Sciences, University of Medical Sciences, PMB 536, Ondo-City, Ondo State, Nigeria. b Department of Medical Laboratory Science, Faculty of Basic Medical Sciences, University of Benin, PMB 1154, Benin-City, Edo State, Nigeria. * Corresponding Author : Lecturer, Faculty of Allied Health Sciences, Department of Medical Laboratory Science, University of Medical Sciences, Ondo City, Ondo State, Nigeria. Tel: +2348166785420 E-mail address: [email protected] ; [email protected] Akinpelu MORONKEJI c Copyright 2023 BioMedSciDirect Publications IJBMR - All rights reserved.
from the exhaust of a brand-new gasoline generator set (Elepaq Yaofeng constant 1.5KVA model SV2500) with a dimension of (L x W x H) mm 460 x 380 x 330, and a noise level of 7 meters 66 dB, fuel capacity of 6.0 lit Grouping and animal exposure Four adult male Wistar rats in Group A served as controls; they were not exposed to gasoline generator emissions and were euthanised after the experiments. Group B comprised 12 adult Wistar rats divided into three subgroups of four rats each, who were exposed to gasoline generator exhaust for 2, 4, and 8 hours daily for one month before being euthanised. Twelve adult Wistar rats from Group C were divided into three groups of four and exposed to gasoline generator exhaust fumes for 2 hours, 4 hours, and 8 hours daily for two months before being euthanized. Twelve adult Wistar rats from Group D were divided into three groups of four and exposed to gasoline generator fumes for 2 hours, 4 hours, and 8 hours daily for three months before being euthanized. Tissue Preparation and Histopathological Analysis The hearts of rats euthanized by cervical dislocation were removed and immediately placed in 10% neutral-buffered formalin for 24 hours, while blood samples were collected through cardiac puncture and put into an ethylenediaminetetraacetic (EDTA) anticoagulant bottle for haematological analysis. The tissues were histologically processed as described by Bancroft et al. while the Hematoxylin and Eosin (H and E) stained sections were examined for histopathological changes using an Olympus CX33 trinocular microscope, and photomicrographs were obtained with a Kodak PIXPRO A2527. Haematological analysis At 12 weeks, the haematological parameters were evaluated using an automated Sysmex XN-350 five-part differential haematology analyzer. Additionally, the red blood cell count (RBC), haematocrit (HCT), haemoglobin (Hb), platelet levels, and red blood cell indices such as mean cell volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC) were also measured. Statistical analysis. The Statistical Package for Social Science (SPSS, Cary, NC, USA). Version 25 was used to perform one-way analysis of variance on the acquired haematological data. A student t-test was used to compare the effects of exposure at different time points at 12 weeks. All quantitative data were reported as mean standard deviation (mean SD). The data from the various exposure periods were statistically compared to the unexposed control, and differences in mean values were evaluated using the least significant difference test, with pvalues < 0.05 considered statistically significant. RESULTS Histopathological findings Histoarchitectural evaluation of the cardiac tissues across the exposed groups at varying time points revealed cytopathic features ranging from congestion and inflammation evident by the presence of mononuclear inflammatory infiltrate in the exposed rats. The cardiac histology of the control rats was devoid of pathological lesions. However, 2 hours of daily exposure for 4 weeks revealed a haemmoragic intermyocytic space while 4 hours of daily exposure showed vascular congestion within the epicardial and myocardial layers, as well as mild fibrosis in the myocardium. Daily exposure for 8 hours at 4 weeks revealed congested epicardial and myocardial layers (Figure 1) while exposure at 8 weeks resulted in myocardial congestion and inflammatory response evident by the presence of infiltrating inflammatory cells at the 2-hour exposure period. The features in the 2-hour time point at 8 weeks were consistent with the 4-hour exposed group while exposure at 8 hours revealed a severely congested myocardial layer (Figure 2). The 12-week exposure revealed varying cytopathic features across the various time points of exposure. While the rats exposed for 2 hours daily had congested myocardium, exposure at 4-hour time points revealed a severely congested myocardium with a focal area of inflammation. The features exhibited in the rats exposed for 8 hours were consistent with the 4-hour exposed group at 12 weeks (Figure 3). Figure 1. H and E-stained section of rat cardiac tissue a) Normal epicardial layer (white arrow) and myocardial layer (black arrow) of the unexposed control rats (mag=x100). b). In the unexposed control, higher magnification revealed a normal epicardium (white arrow) and myocardium consisting of central nuclei with perinuclear cytoplasm (black arrow), (mag=x400). c) A normal myocardium (black arrow) and epicardium (white arrow) are seen in rats exposed for 2 hours daily at 4 weeks. The inter myocytic spaces appear haemorrhagic (slender arrow) (mag=x100). d) Higher magnification reveals the epicardial layer (white arrow), myocardium with perinuclear cytoplasm and central nuclei (black arrow), hemorrhagic intermyocytic spaces (slender arrow) is evident (mag=x400). e) The epicardial layer of the rats exposed for 4 hours daily for 4 weeks, shows vascular congestion (white arrow), and some areas of the myocardium are congested (yellow arrow) while some regions also exhibit mild fibrosis (black arrow) (mag=x100). f) A higher magnification reveals the epicardial layer with vascular congestion (white arrow), the myocardium consisting of central nuclei with perinuclei cytoplasm (black arrow) appear congested in selected regions (yellow arrow) while some areas appear mildly fibrosed (black arrow) (mag=X400). g) 4 weeks of exposure for 8 hours daily resulted in a congested epicardial layer (white arrow) and a moderately congested myocardial layer (black arrow) (mag=X100). h) A moderately congested myocardium (black arrow) was evident at a higher magnification, and the myocytes appeared normal (blue arrow) (mag=X400). Figure 2 H and E-stained section of rat cardiac tissue exposed daily at 8 weeks a) Exposure for 2 hours daily for 8 weeks resulted in congestion in the myocardial layer (white arrow), some regions of the myocardium are mildly infiltrated by mononuclear cells (slender arrow) (mag=X100). b) Higher magnification revealed the congested myocardium (white arrow), with a mild mononuclear infiltration (slender arrow), (mag =x400). c) Exposure for 4 hours daily at 8 weeks revealed a congested myocardia layer (white arrow) with a normal appearing myocyte (blue arrow) (mag =x100). d) Higher magnification reveals a focal area of inflammation and mild congestion within the myocardium (black arrow) (mag= x400). e) the myocardium was moderately congested (white arrow) after 8-hour daily exposure at 8 weeks (mag=x100) f) Higher magnification of 8-hour daily exposure at 8 weeks revealed a severely congested myocardial layer (white arrow), with apparently normal myocytes (blue arrow) (mag =x400). 7639 Akinpelu MORONKEJI and Frederick O AKINBO/Int J Biol Med Res.14(4):7638-7642
Figure 3. H and E-stained section of rat cardiac tissue exposed daily at 12 weeks a) 12 weeks of exposure for 2 hours daily revealed a normal epicardium (white arrow), a mildly congested myocardium (black arrow), and normal-looking myocytes (blue arrow) (mag= x100). b) At a higher magnification, note the congested myocardial layer (slender arrow) containing normal appearing myocytes (blue arrow) (mag = x400). c) exposure for 4 hr daily at 12 weeks reveals mild congestion within the myocardial layer (white arrow), note the focal area of inflammation (black arrow), with the myocytes appearing normal (blue arrow). d) The myocardial layer is congested (black arrow) with the myocytes appearing normal (blue arrow). e) mild congestion within the myocardial layer (white arrow) and focal area of inflammatory cell infiltration (black arrow), are seen at a higher magnification with the myocytes appearing normal (blue arrow) (mag= x400). f) Exposure for 8 hours daily for 12 weeks resulted in mild congestion of the myocardial layer (white arrow) and a focal area of inflammation (black arrow), although the myocytes appear normal (blue arrow) (mag = x100). g) Higher magnification reveals the presence of inflammatory mononuclear infiltrate within the myocardium (black arrow), normal-appearing myocytes (blue arrow), and myocardial congestion (white arrow) (mag= x400). Table 4. Comparative analysis of the red blood cell parameters/indices and platelet values at 12 weeks. Table 1. Mean and Standard deviation of Heamatology parameters at twelve (12) weeks. Table 2 Comparative analysis of the white blood cell parameters across the various groups at 12 weeks. Data expressed as mean value ± SD. *Mean values were significantly different compared to the unexposed control group at p-value <0.05. Data expressed as mean value ± SD. *Mean values were significantly different compared to the unexposed control group at p-value <0.05. #Mean values were significantly different across the exposure time points at p-value < 0.05. DISCUSSION The toxic impact of air pollutants and the heterogeneous, complex mixture of gases, liquids, and PM has demonstrated a consistently increased risk for cardiovascular events in both chronic and acute exposure . We observed that gasoline generator exhaust had a deleterious impact on heart tissue, causing congestion, inflammation and fibrotic changes in the epicardial and myocardial layers of the experimental animal with the most severe cytopathic features evident at 12 weeks of exposure. Additionally, haematological changes in the blood of exposed adult wistar rats were detected. The processes by which inhaled PM2.5 causes a deleterious cardiovascular effect are unknown . Endothelial dysfunction and systemic inflammation, however, remain the leading causes of CVD. PAH(s) are widespread environmental pollutants that are mostly produced by human activities such as the incomplete burning of fossil fuels and organic materials and death associated with gasoline-fueled generators and diesel exhaust engines have been reported . In this study, observation at 4 weeks across the various time points of exposure revealed hemorrhagic intermyocytic spaces, along with vascular congestion and fibrotic changes. The pathophysiology of CO which is a component of the product of fossil fuel combustion can be toxic to the heart due to Data expressed as mean value ± SD. *Mean values were significantly different compared to the unexposed control group at P<0.05. #Mean values were significantly different across the exposure time points at P < 0.05. 7640 Akinpelu MORONKEJI and Frederick O AKINBO/Int J Biol Med Res.14(4):7638-7642
7641 rapid diffusion into the bloodstream and binding to haemoglobin. It can also modify platelet function to boost nitric oxide (NO) production, which interacts with oxygen free radicals to form peroxynitrite (ONOO-), inhibiting mitochondrial function and activating platelets and neutrophils further . Several possible molecular mechanisms have also been proposed, including platelet activation, endothelial dysfunction, a proclivity for coagulation/thrombosis, an inclination for arrhythmias, acute arterial vasoconstriction, systemic inflammatory responses, and chronic promotion of atherosclerosis. Except for fibrotic changes, the cytopathic characteristics detected at week 4 were still evident at 8 weeks. Anakwue & Otamiri, documented histological abnormalities associated with gasoline exposure to include cellular degradation, congested myocardium, and varied degrees of mononuclear myocardial infiltration in exposed rats. In our study, inflammation was most prominent in the 12th week of exposure, implying that chronic exposure consistently elicits inflammatory responses within cardiomyocytes. According to Krishnan et al., there is a strong correlation between long-term residential PM2.5 concentration and NO-mediated endothelial dysfunction, which has been linked to the development of CVD. It is worth noting that the exhaust from fossil fuel combustion contains hundreds of proinflammatory and hazardous substances such as hydrocarbons, carbon particles, SOX, and NOX, all of which can exacerbate cardiac tissue survival and function . A congested epicardial and myocardial layer was observed at 12 weeks, in addition to the substantial mononuclear infiltration reported across the exposure time points. Chu et al. earlier indicated that hypoxia-induced as a result of carboxyhemoglobin (COHb) formation and the generation of ONOOinhibits cytochrome enzymes thus leading to myocardial injury. The haematotoxic effect of gasoline generator exhaust has been reported We observed elevated WBC values across the various time points of exposure compared to the control. Anyiam et al documented a decrease in RBC, MCH, MCHC, and HCT levels among gasolinestationed workers while Okoro et al. reported that exposure to petroleum fumes lowers RBC in a time-dependent manner. These reports contradict the findings of this study; however, our findings are consistent with Sirdah et al. who reported increased RBCs in individuals exposed to gasoline vapour. The increase in the inflammatory cell counts in the exposed rats could be attributed to the inflammatory response induced by oxidative stress with reports by Bai et al. , indicating that PM-induced vascular cytotoxicity and elevates ROS generation . Additionally, Choi et al. also documented the adverse effects of PM and their role in disease development coupled with alteration in the oxidant-antioxidant homeostasis and elevated proinflammatory indicators . Elevated RBC parameters across the various time points of exposure were observed in this study with significant platelet reduction when compared to the control which aligns with the reports of Anyiam et al. who documented a significant reduction in the platelet count in gasoline stationed workers in Anambra state, Nigeria. Ajugwo et al. reported that RBC, Hb, MCH and MCHC are more reduced in fuel attendants than in auto mechanics further suggesting this could be due to the effects of benzene and xylene, as reported by d'Azevedo et al. . While Opute et al. observed no significant variation in the MCH values of exposed individuals, a significant increase in the MCH was observed in our study. We observed that the RBC was significantly elevated at 2, 4, and 8-hour time points of exposure relative to the control which is also consistent with other parameters such as HGB and HCT and other red cell indices (MCV, MCH and MCHC). Our findings further align with Onyeka et al. Who reported a significant increase in the PCV, HB, MCV and MCH of rats exposed to gasoline vapour. Elevated Hb levels were observed in the experimental groups compared to the control. The increase in the red cell indices, Hb and HCT values observed in this study may be due to dysfunction in the secretion of erythropoietin caused by the exposure to the noxious elements and PM content of the gasoline generator exhaust. Comparative analysis of the platelet values revealed a significant reduction at various time points of exposure relative to the control thus agreeing with the reports of Elnabi et al. Conclusively, exposure to gasoline generator exhaust negatively impacts the cardiac tissue with the most pronounced damage occurring at 12 weeks. CONCLUSION This study provides insight into the deleterious effects of gasoline generator exhaust exposure. The findings revealed the negative impacts on the cardiac tissue evident with a focal area of inflammation, congestion and fibrosis across various time points of exposure. Additionally, elevated WBC, RBC, and red cell indices were observed with the platelet considerably decreased across the experimental group. It is pertinent that awareness to further enlighten people about the potential hazards associated with gasoline generator exhaust exposure be encouraged. Acknowledgement The authors appreciate Prof. Dickson Olayanju of the Medical Laboratory Science Department of Afe Babalola University, AdoEkiti, Nigeria, and Otegbade S. of the Histopathology Department, University College Hospital, Ibadan for their support and expertise throughout this study. Conflict of Interest- Authors declare no conflict of interest. Funding Sources -nil 1. Jokinen MP, Lieuallen WG, Johnson CL, Dunnick J, Nyska A. Characterization of spontaneous and chemically induced cardiac lesions in rodent model systems: the national toxicology program experience. Cardiovascular toxicology. 2005; 5:227-44. 2. Holme JA, Brinchmann BC, Refsnes M, Låg M, Øvrevik J. Potential role of polycyclic aromatic hydrocarbons as mediators of cardiovascular effects from combustion particles. Environmental Health. 2019;18:1-8. 3. Sayin Kul B, Kahraman A. Energy and exergy analyses of a diesel engine fuelled with biodiesel-diesel blends containing 5% bioethanol. Entropy. 2016; 31;18(11):387. 4. Blakemore FB, Davies C, Isaac JG. Effects of changes in the UK energydemand and environmental legislation on atmospheric pollution by oxides of nitrogen and black smoke. Appl Energy. 2001;68:83–117. 5. Akinbami JF. Renewable energy resources and technologies in Nigeria: present situation, future prospects and policy framework. Mitigation and adaptation strategies for global change. 2001;6:155-82. 6. Kurawa MI. Acute Inhalation of Generator Exhaust-Fumes May Impair Learning and Memory in Mice. Dutse J Pure Appl Sci. 2021;7(3):84–93. 7. Ahmed WK, Salam AQ, Mahdiy MT, Chaichan MT. Environmental Impact of Using Generators in the University of Technology in Baghdad, Iraq. Journal of Thermal Engineering. 2020 Jan 12;6(6):272-81. REFERENCES Akinpelu MORONKEJI and Frederick O AKINBO/Int J Biol Med Res.14(4):7638-7642
7642 25. Umahi-Ottah G, Ireneh RU, Adejumo BI, Oyakhire FO, Aiyegbusi OV, Dimkpa U, Abdulrahman ON, Akhaumere EO, Aiyesoro FO. Effects of Carbon Monoxide on Haematological and Haemostatic Parameters among the Exposed Workers at Generator Servicing Centres in Benin City. Health. 2022;14(7):737-50. 26. Anyiam A.F, Obi E, Ifeanyichukwu MO, & Elochukwu CI. Effects of Gasoline on Haematological Parameters Effects of Gasoline on Haematological Parameters of Gasoline Station Workers in Onitsha, Anambra State, Nigeria. Pet Technol Dev Journal. 2019;9(1). 27. Sirdah M, Al Laham NA, Al Madhoun R. Possible health effects of liquefied petroleum gas on workers at filling and distribution stations of Gaza governorates. EMHJ. 2013;19:289–94. 28. Bai Y, Suzuki AK, Sagai M. The cytotoxic effects of diesel exhaust particles on human pulmonary artery endothelial cells in vitro: Role of active oxygen species. Free Radic Biol Med. 2001;30(5):555–62. 29. Okayama Y, Kuwahara M, Suzuki A, Tsubone H. Role of reactive oxygen species on diesel exhaust particle-induced cytotoxicity in rat cardiac myocyte s . J Tox i col Envi ron He a l - Pa r t A Cur r I s sue s . 2006;69(18):1699–710. 30. Zuo L, Youtz DJ, Wold LE. Particulate matter exposure exacerbates high glucose-induced cardiomyocyte dysfunction through ROS generation. PloS one. 2011;6(8):e23116. 31. Choi JK, Choi IS, Cho KK, Lee SH. Harmfulness of Particulate Matter in Disease Progression. J Life Sci. 2020;30(2):191–201. 32. Meo SA, Suraya F. Effect of environmental air pollution. Eur Rev Med Pharmacol Sci. 2015;19:4890–7. 33. Ajugwo AO, Adias TC, Aghatise K, Fadairo JK, Nyenke CU. Reduced Haematological Indices in Auto-Mechanics and Fuel Attendants in Elele Nigeria. Am J Med Biol Res. 2014;2(1):1–4. 34. d'Azevedo PA, Tannhauser M , Tannhauser SL BH (1996). Hematological alterations in rats from xylene and benzene. Veterinary and Human Toxicology. Vet Hum Toxicol. 1996;38(5):1996. 35. Opute P, Oghortaire BC, Osazee EN, Tawari-Fufeyin P. Comparative Haematology and Urinary Analysis of Passive Inhalers of Petrol Fumes (Petrol Station Attendants) in Benin City, Nigeria. EIJST 4(3), 1–8. 36. Okonkwo CO, Ehileboh AD, Nwobodo E, Dike CC. The effects of acute gasoline vapour inhalation on some haematological indices of albino Wistar rats. J Acute Dis. 2016;5(2):123-5. 37. Onyeka C, Okonkwo J, Ehileboh AD, Nwobodo E, Dike CC. The effects of acute gasoline vapour inhalation on some haematological indices of albino Wistar rats. J Acute Dis. 2016;5(2):123–5. 8. Environmental Protection Agency (EPA). Light-Duty Automotive Technology, Carbon Dioxide Emissions, and Fuel Economy Trends: 1975 Through 2016 - Executive Summary (EPA-420-S-16-001, November 2016). 2 0 1 6 ; ( N o v e m b e r ) : 1 – 1 1 . A v a i l a b l e f r o m : h t t p s : / / w w w. e p a . g o v / s i t e s / p r o d u c t i o n / f i l e s / 2 0 1 6 - 11/documents/420s16001.pdf 9. Okoro AM, Ani EJ, Ibu JO, Akpogomeh BA. Effect of petroleum products inhalation on some haematological indices of fuel attendants in Calabar metropolis, Nigeria. Nigerian Journal of Physiological Sciences. 2006;21(1- 2). 10. Ukaejiofo EO, Nubila T, Ike SO. Biochemical and haematological assessment of workers exposed to some petroleum products in Enugu Urban, Enugu State, Nigeria. Nigerian Journal of Medicine. 2006;15(3):318-24. 11. Udonwa NE, Uko EK, Ikpeme BM, Ibanga IA, Okon BO. Exposure of petrol station attendants and auto mechanics to premium motor spirit fumes in Calabar, Nigeria. Journal of Environmental and Public Health. 2009; 23;2009. 12. Adienbo OM, Nwafor A. Effect of Prolong Exposure to Gas Flaring on some Haematological Parameters of Humans in the Niger Delta Region of Nigeria. Journal of Applied Sciences and Environmental Management. 2010;14(1). 13. Hau J, Van Hoosier G. Handbook of laboratory animal science; Essential principles and practices. Vol. 2, Second Edition. USA: CRC Press; 2002. pp:1–40. 14. Henz S, Maeder M. Prospective study of accidental carbon monoxide poisoning in 38 Swiss soldiers. Swiss Medical Weekly. 2005;135(27- 28):398-406. 15. John D. Bancroft., S. Kim Suvarna. CL. Bancroft's Theory and Practice of Histological Techniques. Vol. 24, Issue 4 Eight Edition Elsevier Limited, United Kingdom 2019. pp: 573. 16. Brook RD, Franklin B, Cascio W, Hong Y, Howard G, Lipsett M, & Tager I. Air pollution and cardiovascular disease: A statement for healthcare professionals from the expert panel on population and prevention science of the American Heart Association. Circulation. 2004;109(21):2655–71. 17. Pope CA, Bhatnagar A, McCracken JP, Abplanalp W, Conklin DJ, O'Toole T. Exposure to fine particulate air pollution is associated with endothelial injury and systemic inflammation. Circ Res. 2016;119(11):1204–14. 18. Unger N, Heyes C. Global Climate and Human Health Effects of the Gasoline and Diesel Vehicle Fleets GeoHealth. 2020;1–13. 19. Chu LM, Shaefi S, Byrne JD, Alves RW, Souza D, Otterbein LE. Carbon monoxide and a change of heart. Redox Biol 2021;48:102183. 20. Brook RD, Rajagopalan S, Pope III CA, Brook JR, Bhatnagar A, Diez-Roux AV, Holguin F, Hong Y, Luepker RV, Mittleman MA, Peters A. Particulate matter air pollution and cardiovascular disease: an update to the scientific statement from the American Heart Association. Circulation. 2010 1;121(21):2331-78. 21. Kuan Ken Lee, Mark R. Miller ASVSB. Air pollution and stroke. J stroke. 2018;20(1):2–11. 22. Anakwue RC, Otamiri C. Petroleum Products Induced-Cardiac Enzymes and Histological Changes in Wistar Rat Model: Is there any Implications for Cardiovascular Disease in Nigeria?. Ann Med Health Sci Res. 2018;8(5):279- 84. 23. Krishnan RM, Adar SD, Szpiro AA, Jorgensen NW, Van Hee VC, Barr RG, et al. Vascular responses to long- and short-term exposure to fine particulate matter: MESA Air (Multi-Ethnic Study of Atherosclerosis and Air Pollution). J Am Coll Cardiol. 2012;60(21):2158–66. 24. Elnabi HM, Mohamed S, Wafa AE, Khalaf H, & Allam W. Assessment of hematological parameters, liver and kidney functions among fuel station workers in Sohag governorate, Egypt. Ain Shams J Forensic Med Clin Toxicol. 2021;37:57–66. All rights reserved. c Copyright 2023 BioMedSciDirect Publications IJBMR - ISSN: 0976:6685. Akinpelu MORONKEJI and Frederick O AKINBO/Int J Biol Med Res.14(4):7638-7642
BioMedSciDirect Publications Int J Biol Med Res.2023 ;14(4):7643-7647 Contents lists available at BioMedSciDirect Publications Journal homepage: www.biomedscidirect.com International Journal of Biological & Medical Research International Journal of BIOLOGICAL AND MEDICAL RESEARCH Int J Biol Med Res www.biomedscidirect.com Volume 14, Issue 4, Oct 2023 Copyright 2023 BioMedSciDirect Publications IJBMR - ISSN: 0976:6685. All rights reserved. c ARTICLE INFO ABSTRACT Keywords: Neem oil Castor oil Ethyl cellulose sustained release nail lacquer Onychomycosis 1. Introduction Nails are the hard coverings located on the extremities of fingers and toes. They are prone to various nail infections such as leukonychia, onychatrophia, onychogryposis, onychomycosis, green nail syndrome, sub-ungual hyperkeratosis, etc [1]. The elderly and people with impaired immune systems are particularly susceptible to these nail conditions. Due to its non-invasiveness, medication targeting to the site of action, reduction of side effects associated with systemic therapy, increased patient compliance, and reduced treatment costs, topical therapy is a desirable choice [2]. The poor permeability of the nail plates to the topically administered drugs was the main reason why topical therapy had little success. Enhancing ungual drug penetration is necessary for topical therapy across the nail plate to be successful [3]. However, gel, cream, or liquid formulations are not adequate for the transungual delivery since they are easily removed by washing or rubbing. This phenomenon at the site of application accounts for their inefficacy. Few days lasting drug delivery is considered as essential requirement for pharmaceutical formulations applied topically on the nail. Film-forming systems for transungual drug delivery are used in clinical practice, but their ability to deliver therapeutic doses of active substances remains critical for efficient onychomycosis treatment. Mechanical characteristics and water resistance make nail lacquers a promising alternative for onychomycosis topical treatment. Lacquer film is formed during solvents evaporation after lacquer application. Films formed by nail lacquers must establish attachment to the nail surface which is a necessary prerequisite of efficient drug delivery [4]. The medicated nail lacquers are modification of the cosmetic nail lacquers by addition of rate controlling polymers into it which will sustain the drug release into the nail bed. The nail lacquer once applied will leave a film on the nail plate wherein the polymers will act as a depot of drug and release it slowly from the film into the ungual space [5]. Currently available nail lacquer reported in literature include ciclopirox, Naftifine hydrochloride, terbinafine, ketoconazole, luliconazole [6]. Apart from above antifungal agents, castor oil and neem oil has promising anti fungal activity [7, 8,9]. It functions as an anti-fungal agent in nail lacquer. Neem oil softens cuticles while penetrating the nail to strengthen and torment it. It serves as a repellant and lessens insect feeding. Castor oil works as an antiinflammatory in nail lacquer. Benefits comprise strengthening, moisturizing, nurturing brittle nails, relieving nail grooves, and healing leukonychia punctate. A fungal infection of the fingernails or toenails called onychomycosis results in thickening, detachment from the nail bed, and discoloration of the nails. Although it affects everyone, older people, kids, and patients with compromised immune systems are more likely to contract it. The goal of the current study was to create and formulate a therapeutic nail lacquer using the Neem oil to treat the condition of onychomycosis. Neem oil, an antifungal agent, was combined with castor oil, an established anti-inflammatory drug, in this study. Nail lacquer was made using a simple mixing process. Application frequency was decreased to twice a week by using polymers such ethyl cellulose to sustain medication release for up to 20 hours. Along with a bad odour, the infection is accompanied by pain and swelling around the nail. Ethyl acetate will therefore aid in masking the unpleasant aroma while also having an anti-inflammatory impact to increase patient compliance and acceptability. Additionally, it will function as a permeation enhancer, increasing the drug's ability to permeate the nail bed. Drying time, non-volatile content, viscosity, water resistance test, and research were taken into consideration when optimizing the formulation. The ideal drug viscosity for the optimized formulation was around 131 cp, and the drying period was 3 min. As a result, neem oil's nail lacquer was effectively created. Original article Formulation and Evaluation of Herbal nail lacquer for treatment of Onychomycosis Harshada I. Patil, Aditi S Awati, Dhanashree N Mujumale *Assistant Professor, Department of Pharmaceutics Dr. Shivairao Kadam College of Pharmacy, Kasbe Digraj, 416 305 Sangli, Mahrashtra, India. * Corresponding Author : Department of Pharmaceutics, Dr. Shivajirao Kadam College of Pharmacy, Kasbe Digraj, 416 305, Sangli, Maharashtra, India. E-mail: [email protected] c Copyright 2023 BioMedSciDirect Publications IJBMR - All rights reserved. Harshada I. Patil,
It is reported, when castor oil is applied once or twice a week, there is significant reduction in fungal infection [10]. Topical application of oils on nails is troublesome leading to poor patient compliance. The goal of this work is to improve the permeation of castor oil and neem oil along with prolonging the release. Materials and Methods: Materials Ethyl cellulose, ethyl acetate, propylene glycol, salicylic acid, polyvinylpyrrolidone (PVP) and glycerin were purchased from research lab, India. Neem oil and castor oil was procured from market. The solvents ethanol, ethyl acetate was of analytical grade. Methods: Preparation of nail lacquer The medicated nail lacquer was prepared by simple mixing method, Table 1. The film forming polymer ethyl cellulose was dissolved in ethyl acetate using stirring. The polymer was allowed to dissolved completely, then plasticizer (propylene glycol) and PVP was added to the solution while stirring [11]. Castor oil and neem oil were added into the polymer solution. Further, salicylic acid and glycerin were added in the desired amount and mixed properly using magnetic stirrer. The formulation was then filled in the narrow mouth containers and sealed with liner and cap. The developed nail lacquer was further optimized to arrive at the final formulation containing desired levels of film former and release retardant. Formulation development Initially, a solvent system was screened for the polymer (ethyl cellulose). Various solvent system such as ethanol, acetone and ethyl acetate were studied. After selection of solvent, the polymer concentration was optimized. Nail lacquer formulation was developed by considering different concentration of ethyl cellulose, salicylic acid, propylene glycol, PVP and glycerin. Optimization of formulation was done by preparing six different batches. As, shown in Table 2, formulation F1 to F6 were formulated. The aim was to achieve desired level of film forming ability by the nail lacquer. Table 1: Formulation of Medicated Nail lacquer Table 2: Optimization of formulation of medicated nail lacquer Characterization and evaluation of developed formulation: Drying time: The drying time is the primary test used for the nail lacquer. 2 Briefly a brush applicator was used to spread the lacquer on a 2 cm area on a glass slide at room temperature and let to dry. After every 15 sec, a gloved finger was used to touch the film. The time required to obtain dry to touch condition was recorded [12]. Smoothness to flow: The sample was spread on the glass slide. The glass slide was then raised vertically [13]. Gloss: The sample covered the nail in an even layer. The gloss and the marketed cosmetic nail lacquer were visually compared. Non- volatile content: A glass petri plate was used for the sample measurement, and the 0 weight was recorded. The plate was then heated for one hour at 105 C. After an hour, the plate's weight was recorded. The difference between initial and final weight was calculated. The percentage nonvolatile content was determined by formula: Viscosity: Viscosity of formulation was determined using Brookfield Viscometer, model DV E-5, at room temperature with spindle No. 61 running at 10 rpm. Water resistance test: A glass plate was used to apply the sample. After being weighed, the glass plate containing the fully dried sample was submerged in water. The sample was examined visually for discoloration, turbidity, blistering, and weight change. Drug Content Estimation: About 200 mg of nail lacquer was dissolved in 50 ml phosphate buffer of pH 7.4. The solution was ultrasonicated for 15 minutes. The resulting solution was filtered and volume was made up to 100 ml with phosphate buffer solution of pH 7.4. The diluted solution was estimated spectrophotometrically at wavelength of 223 nm and determined the drug content. In-vitro release studies through artificial membrane: The in-vitro release from medicated nail lacquer was conducted 0 using Franz diffusion cell at 37 C. Cellophane membrane was used as artificial membrane for diffusion studies. The membrane was soaked in phosphate buffer pH 7.4 containing ethanol 30 % for 24 hrs. The formulation was applied on the cellophane membrane and was allowed to dry. The prepared membrane was placed on the cell, between donor and receptor chamber of Franz diffusion cell. 20 ml of Phosphate buffer pH 7.4 was taken in receptor compartment. Entire 0 setup was kept under stirring at 37 C. Aliquots measuring 1ml was withdrawn through sampling arm of the Franz diffusion cell followed by immediate replenishment with the same volume of fresh receptor media. UV spectrophotometric method was used to determine the drug content in each sample, and cumulative drug contents were plotted against the time to obtain the release profile. 7644 Harshada I. Patil et al. /Int J Biol Med Res.14(4):7643-7647
7645 Stability Studies: Stability studies of nail lacquers were carried out as per ICH guidelines. The optimized formulation was stored at 25±2 °C/60 ± 5% RH for 3 months and 40 ± 2°C/75 ± 5% RH for 1 month. Then the samples were analyzed for non-volatile content, drying time, drug content, diffusion across artificial membrane. Smoothness to flow and gloss Optimized formulation F5 when poured onto the glass plate was found to have ssatisfactory flow property and result in a uniform smooth film, as compared to other formulation batches. Non- Volatile Content of Nail Lacquer The increase in polymer concentration from 0.5 % to 3 % causes increase in non-volatile content of nail lacquer. Non- Volatile Content depends on polymer content. Thus, higher the polymer concentration higher is the non-volatile content of nail Lacquer. Viscosity The viscosity of the sample varied from 114 to 131 centipoise (cp). This viscosity range provided good adherence and flow property. The viscosity of various formulation batches is given in Table 4. Water Resistance Test As shown in, Table 5 increase in polymer concentration increases the water resistance. Formulation F1, F2, F3 and F4 shows lower water resistance than F5 and F6. Table 3: Drying time of various batches Table 4: Viscosity of formulated batches The objective of the present study was to formulate a nail lacquer for preventing fungal growth on toe nails or finger nails so that the appearance of the nails is improved. Hence utilizing neem oil and castor oil as anti- inflammatory and anti-fungal a medicated nail lacquer is formulated to provide the requisite sustained medication release, better drug permeation, and desirable anti-fungal effectiveness. The prepared formulation included salicylic acid as keratolytic agent and permeation enhancer, propylene as plasticizer, PVP as film former, glycerin as humectant, release modifying polymers (Ethyl cellulose), and ethyl acetate as a solvent system. Initially, a solvent system was selected for optimization of formulation. Selection of Solvent Film formation is influenced by solvent system used which should efficiently dissolve the film-forming components and drug substance. The trial experiments were performed to screen solvent system. It is essential that the resultant lacquer has capacity to hydrate the nail with the hydrophobic component while achieving desirable physical characteristics of the lacquer such as resistance and adhesion with the hydrophobic component. Solvent system consisting of ethanol, acetone and ethyl acetate were used for formulation of nail lacquer, as shown in Table 2. From the trials, it was observed that the polymer aggregates in the nail lacquer containing ethanol. Further, when acetone was used as solvent, it produce clear solution with the polymer. However, it cannot be used as it rapidly evaporates leaving behind the polymer. The solvent system ethanol and acetone was not suitable for this formulation. Therefore, ethyl acetate was used as the solvent to formulate the nail lacquer. A linear increase in viscosity was observed when ethyl acetate was used as the solvent for dissolving the polymer (ethyl cellulose). Evaluation of Nail lacquer: Formulated nail lacquers were subjected to preliminary evaluation tests. a) Drying Time Drying time for formulations F1 to F4 was found between 30 seconds to 80 seconds. It was found that as the polymer concentration increases from 0.5 % w/v to 2 % w/v the drying time increases respectively. The time required for the solvent to evaporate from the more viscous solution is more than the less viscous solution. Formulation F5 showed optimum drying time of about 100 sec. Formulation F6 showed maximum drying time as it contained higher amount of polymer. Result and Discussion: Harshada I. Patil et al. /Int J Biol Med Res.14(4):7643-7647
7646 Table 5: Water resistance test formulated batches aW1 and bW2 - Weight of glass slide along with nail lacquer before and after dipping in water. Figure 1: In-vitro diffusion studies Figure 2: Mechanism of permeation of nail lacquer References Drug Content Estimation Percentage drug content for all the formulation batches were found to be satisfactory and in between 80.0 %- 96.0 % which is reported in Table 6. Highest % of drug content was found to be 96% (F5) and the lowest 80% of drug content (F1). If the drug content is more than 90 % the formulation shows high amount of drug present in it. This, ensure better therapeutic response. Conclusion: As a chronic, recurrent fungal nail infection, onychomycosis necessitates long-term management and regular adherence to the advised therapy. The goal of the current study was to create a patient-friendly nail lacquer formulation using neem oil, a known anti-inflammatory agent with the potential to increase penetration. The prolonged drug release up to 20 hours was achieved with the addition of rate-modifying polymer, namely ethyl cellulose, making it acceptable for twice-weekly application. The best formulation out of the six was F4, with good gloss, flowability, and consistency. The proposed formulation can therefore be a prospective replacement for current onychomycosis therapy. In vitro diffusion study Franz diffusion cell was used to conduct diffusion experiments with a artificial membrane (cellophane). On the membrane's surface, an optimised nail lacquer formulation (F5) was evenly applied. Similar study was performed using castor oil and neem oil only. The diffusion study was continued upto 20 hours, as shown in Fig.1. Nail lacquer formulation (F5) showed the highest release of 94.48 %. It was found that due to presence of permeation enhancer (salicylic acid), the release of drug increases. Moreover, ethyl cellulose sustains the release of castor oil and neem oil upto 20 hours. The expected mechanism of permeation of nail lacquer is shown in Fig.2. Stability Study The results of the stability analysis showed that when the medicated nail lacquer was kept at a temperature of 37°C for a month, it exhibited good stability. Colour, non-volatile content, viscosity, drying time, and smoothness have not changed significantly. Table 6: Drug content estimation of formulated batches 1. Bhowmik D (2013) Nail drug delivery system- a novel approaches for drug delivery system. Pharma Innov 1: 3–16. 2. Manish V. Saner, Abhijeet D. Kulkarni & Chandrakantsing V. Pardeshi (2014) Insights into drug delivery across the nail plate barrier, Journal of Drug Targeting, 22:9, 769-789, DOI: 10.3109/1061186X.2014.929138 3. Murdan S. Enhancing the nail permeability of topically applied drugs. Expert Opin Drug Deliv 2008;5:1–16. 4. Indrė Šveikauskaitė, Vitalis Briedis, "Effect of Film-Forming Polymers on Release of Naftifine Hydrochloride from Nail Lacquers", International Journal of Polymer Science, vol. 2017, Article ID 1476270, 7 pages, 2017. https://doi.org/10.1155/2017/1476270 5. Shrihari SS (2021) Sustained Release Nail Lacquer Formulation Containing Combination of Luliconazole and Methyl Salicylate for the Treatment of Onychomycosis. Int J Drug Dev and Res Vol.13 No.3. Harshada I. Patil et al. /Int J Biol Med Res.14(4):7643-7647
7647 6. Vikas, A., Rashmin, P., Mrunali, P. et al. Mechanistic Insights of Formulation Approaches for the Treatment of Nail Infection: Conventional and Novel Drug Delivery Approaches. AAPS PharmSciTech 21, 67 (2020). https://doi.org/10.1208/s12249-019-1591-9 7. h tt p s : / / w w w. o n l i n e a t h e n s . c o m / s t o r y / l i f e s t y l e / h e a lt h - fitness/2019/02/04/peoples pharmacy-castor-oil-got-rid-of-persistenttoenail-fungus/6112133007/ 8. Saadaoui E, Martín JJ, Tlili N, Cervantes E. Castor bean (Ricinus communis L.) Diversity, seed oil and uses. Oilseed Crops: Yield and Adaptations under Environmental Stress. 2017 Feb 17:19-33. 9. Adepoju, Adeyinka & Femi-Adepoju, Abiola & OGUNKUNLE, Tunde. (2014). ANTIFUNGAL ACTIVITIES OF SEED OIL OF NEEM (Azadirachta indica A. Juss.). Vol.3(1):106-109. 106-109. 10. https://www.chron.com/life/article/Castor-oil-cleared-up-toenailfungus-13090236.php 11. Shrihari SS (2021) Sustained Release Nail Lacquer Formulation Containing Combination of Luliconazole and Methyl Salicylate for the Treatment of Onychomycosis. Int J Drug Dev and Res Vol.13 No.3. 12. Puri, V.; Savla, R.; Chen, K.; Robinson, K.; Virani, A.; Michniak-Kohn, B. Antifungal Nail Lacquer for Enhanced Transungual Delivery of Econazole Nitrate. Pharmaceutics 2022, 14, 2204. https://doi.org/10.3390/ pharmaceutics14102204 13. Farsana. P, Baby Shahanas, Anu Sebastian & Ashly Merin George Formulation and Evaluation of Medicated Tolnaftate Nail Lacquer Global Journal of Medical Research: B Pharma, Drug Discovery, Toxicology & Medicine Volume 18 Issue 5 Version 1.0 Year 2018 All rights reserved. c Copyright 2023 BioMedSciDirect Publications IJBMR - ISSN: 0976:6685. Harshada I. Patil et al. /Int J Biol Med Res.14(4):7643-7647
BioMedSciDirect Publications Int J Biol Med Res.2023 ;14(4):7648-7651 Contents lists available at BioMedSciDirect Publications Journal homepage: www.biomedscidirect.com International Journal of Biological & Medical Research International Journal of BIOLOGICAL AND MEDICAL RESEARCH Int J Biol Med Res www.biomedscidirect.com Volume 14, Issue 4, Oct 2023 Copyright 2023 BioMedSciDirect Publications IJBMR - ISSN: 0976:6685. All rights reserved. c ARTICLE INFO ABSTRACT Keywords: Professional image nursing students perceived image general public 1. Introduction NEED FOR THE STUDY Nursing is perceived as a healthcare profession dedicated to caring of individuals. Raising awareness of the competencies that make up this professional profile is crucial for the development of a professional identity. The perception that nurses have on profession's reputation may influence their decisions to enter nursing, stay in nursing, promote nursing, and advance a career in nursing. There haven't been any recent studies on how public view the nursing profession1. Clinical performance, job happiness, and the standard of care are all influenced by the nurse's image, which is directly linked to her function and identity. The cultural setting in which nursing is done has a significant impact on how nurses are portrayed2. Nursing students have become into highly knowledgeable healthcare specialists in their own way. The public, however, does not always respect the abilities and talents that nurses have developed through training and invention 3. The worldwide shortage of nurses has focused political and professional discourse on the current shortfall in the number of individuals who are pursuing nursing as a career and those who are leaving the profession. To attract more individuals to the nursing profession, a positive image of nursingamong the general population needs to be improved so that the public acknowledge the nursing students in both clinical and community settings when they go for the postings. The projection of a positive image of nurses and nursing has been a principal concern of the profession with resultant changes through the creation of a graduate profession in many jurisdictions and efforts to enhance the clinical nursing career pathway 4. Nursing students are the developing healthcare professionals in their own right who possess a great deal of knowledge. However, the public does not always value the skills and competences of the nursing students in some occasions3. SIGNIFICANCE IN NURSING Depending upon the perception of the nursing image among the general population, the nursing students will try to improve their work performance and manage their overload, by balancing the study and clinical experience to work hard to improve the public's trust in the health system. It has been shown that decision to become a nurse and remain in the profession over time, is significantly related to the profession's image from both the nurses and the public's perspective. When the nursing students believe that their public image is positive, they work better and display more interest to remain in the profession. Otherwise, the nursing studentsmay not be motivated to sustain in nursing profession. Thus, the investigator selected this study to improve the image of nursing profession among general public. STATEMENT OF THE PROBLEM Effectiveness of professional image enhancement training programme on professional image for BSc(N) II year students and its impact on their perceived image among general public. Nurses are perceived in different domains by the public and the nursing students are solely responsible for the creation of the positive image of nurses. To increase this image, a study was conducted to assess the eeffectiveness of professional image enhancement training programme on professional image for BSc(N) students and its impact on their perceived image among general public. The study was conducted in two phases. Phase 1 consisted of the assessment of the professional image enhancement training on the practice of professional image of nursing students and phase 2 was to assess the perceived image of the nursing students among general public. 100 students in phase 1 and 100 persons in general public were selected by using purposive sampling technique. The data collection period was 15 days in each phase. After statistical analysis, the professional image among nursing students and perceived image of the general public were improved after the professional image enhancement training programme. Original article Effectiveness Of Professional Image Enhancement Training Programme For B.sc (n) Students And Its Impact On Their Perceived Image Among General Public *Prof.Dr.P.Sagayamary,**Prof.Dr.G.Grace Jebakani Sweety,***Mrs.M.Mary Sasikala, ****Prof.Mrs.N.Gowri *Principal,**Professor,***Assistant Professor,****Vice Principal, Our Lady of Health College of Nursing, Thanjavur Affilitated to The Tamil Nadu Dr MGR Medical University, Chennai, Tamil Nadu,India. * Corresponding Author : Professor, Our Lady of Health College of Nursing, Thanjavur, Tamil Nadu,India [email protected] c Copyright 2023 BioMedSciDirect Publications IJBMR - All rights reserved. Dr. G. Grace Jebakani Sweety, Ph.D(N),
OBJECTIVES ü To evaluate the effectiveness of professional image enhancement training programme for B.Sc (N) II year students. ü To assess the impact of professional image enhancement training programme on the perceived image of nursing students HYPOTHESES ü There will be a significant difference between the pretest and posttest level of expressed practice of professional image among BSc(N) II year students ü There will be a significant difference between the pretest and posttest level of perceived image of nursing students among the general public REVIEW OF LITERATURE There has been a tremendous growth in the nursing profession over the past 100 years and the attitude of the society towards the nursing has transformed significantly. The general public attitude can be viewed as positive or negative.This study was aimed to assess the attitude of general public towards nursing profession. In spite of favourable attitude, still public have undesirable attitude in certain point towards this profession5. Nursing students' perception towards the image of the nursing profession has an apparent impact on their self-concept, selfesteem, recruitment, retention and performance. Thus, nurses who have professional images will have more and stronger relations with their patients, peers and community as a whole. Although there is an enormous advancement in the nursing profession, nurses still face multiple challenges in relation to a professional image6. The image of nursing plays a vital part in determining the history and future of nursing. It forms the framework of guidelines and protocols for promoting and improving the role of nurses in the modern world. There is not much research studies had been done till now to assess any training module to improve their professional image among the general population. Thus, the investigator took this approach to evaluate the effectiveness of professional image enhancement training on the practice of B.Sc (N) II year students and its impact on the perceived image of the nursing students among general public. RESEARCH METHODOLOGY Research approach Quantitative research approach. Research design Pre experimental one group pretest and posttest research design Variables Phase I: - Independent variable: Professional image enhancement training. - Dependent variable: Practice of B.Sc (N) II years. - Demographic variables: Education of the father, education of the mother, residential area. Phase II: - Independant variable:Practice of B.Sc (N) II years. - Dependant variable: Perceived image of the nursing students. - Demographic variables: Age in years, gender, education, occupation, history of hospitalization, any family history or relative in nursing profession and previous source of information. Setting of the study Phase I was conducted in the Our Lady of Health College of Nursing, Thanjavur. Phase II was conducted in the urban area, Anna Nagar, Thanjavur. Anna Nagar covers the population of 10021with 2529 houses. Population Phase I-B.Sc (N) students. Phase II -General public. Sample Phase I- B.Sc (N) II year students of Our Lady of Health College of Nursing, Thanjavur. Phase II -General public, Anna Nagar, Thanjavur. Sample size Phase I – 100 B.Sc (N) II year students Phase II – 100 persons of general public Sampling technique The samples were selected using purposive sampling technique. Criteria for sample selection Phase II: Inclusion criteria: General public - Who were willing to participate in the study. Who could understand either Tamil or English. Description and interpretation of the tool Phase I: - Part 1: Demographic variables: Education of the father, education of the mother, residential area. - Part 2: Checklist to assess the effectiveness of professional image enhancement training programme on professional image Scoring procedure Phase II: - Part 1: Demographic variables: Age in years, gender, education, and occupation, history of hospitalization, any family history or relative in nursing profession and previous source of information. - Part 2: Rating scale to assess the perceived image of the nursing students among general public. The rating scale had four sections and each section had ten questions. 7649 P.Sagayamary et al. /Int J Biol Med Res.14(4):7648-7651
7650 Scoring procedure Table 2: Effectiveness of professional image enhancement training on the practice of professional image among the nursing students. Phase II: Table 3: Demographic variables of the general public. The above table reveals that the mean score of pretest and posttest level on the practice of professional image of B.Sc (N) II year students were 107.14 with SD 9.5 and 158.6 with SD 5.12 respectively with the paired t test value 34.3 which was significant at 0.05 level. The scoring of the rating scale was given as below: 3- Agree, 2- Neutral, 1- Disagree Reliability and validity of the tool Phase I: Reliability- Reliability of the tool was done by inter rater method and the tool was found to be practicable and feasible, r= 0.6546 (Karl Pearson Co efficient formula). Validity- The data collection tool was validated by the experts of nursing and peer evaluation. Phase II: Reliability- Reliability of the tool was done by split half method and the tool was found to be practicable and feasible, r= 0.8438 (Karl Pearson Co efficient formula). Validity- The data collection tool was validated by the experts of nursing and peer evaluation. Method of data collection Phase I: Day 1: Collection of demographic variables and pretest for B.Sc (N) II years. Day 2: Professional image enhancement training programme. Day 17: Posttest Phase II: Day 18: Collection of demographic variables and pretest for general public. Day 19- 34: Practice of B.Sc (N) II year students in the community area. Day 35: Posttest. Plan for data analysis The collected data was tabulated and analyzed by using descriptive and inferential statistics. P.Sagayamary et al. /Int J Biol Med Res.14(4):7648-7651
7651 References CONCLUSION Although nurses are more visible during the pandemic period and there are still some negative impact in the public perception of the nursing profession. Nursing students should maintain the professional decorum in their profession. It is also recommended that nursing students in the profession should be made aware of the important role they play in changing their image and in re-branding the profession as a service and knowledge based career for all age groups. Table 4: Effectiveness of the practice of the professional image and its impact on the perceived image of the nursing students among general public. N=100 The above table reveals that the mean score of pretest and posttest level on the perceived image of the nursing students among general public were 82.1 with SD 16.41 and 122.1 with SD 14.83 respectively with the paired t test value 17.7 which was significant at 0.05 level. RECOMMENDATIONS The above table reveals that the mean score of pretest and posttest level on the perceived image of the nursing students among general public were 82.1 with SD 16.41 and 122.1 with SD 14.83 respectively with the paired t test value 17.7 which was significant at 0.05 level. RECOMMENDATIONS A correlational study can be conducted to assess the relationship between the perceived nursing image and quality of care among general public. A comparative study can be conducted on the perceived nursing image between the general population and the caregivers of the patients. An experimental study can be conducted to develop a module on the outlook of nursing profession to create a positive image of nurses among general population. A study to assess the role of the media in fostering the image of nurses among general public. 1. Emeghebo L (2012). The image of nursing as perceived by nurses. Nurse Education Today. 32(6): e49-e53. 2. Shokoh et al (2012). Iranian nurses self-perception- factors influencing nursing image. Journal of nursing management.20(4): 551-60. 3. Yvonne et al (2014). The nursing profession: public image, self-concept and professional identity. A discussion paper. Journal of advanced nursing. 70(2): 295-309 4. Edgar et al(2012). A triangulation study: Bahraini nursing students' perceptions of nursing as a carrier. Journal of NurseEducation and Practice. 2(3). 5. Mohanasundari K et al (2021). A descriptive cross-sectional survey on public attitude towards nursing profession in India. Asian Journal of Nursing Education and Research. 11(4): October- December, 2021. 6. Chauke M E et al (2014). Transforming student nurses' image of nursing: an appreciative inquiry approach. A dissertation presented in partial fulfillment of the requirements for the degree doctor of literature and philosophy, University of South Africa. 1-38. All rights reserved. c Copyright 2023 BioMedSciDirect Publications IJBMR - ISSN: 0976:6685. P.Sagayamary et al. /Int J Biol Med Res.14(4):7648-7651
BioMedSciDirect Publications Int J Biol Med Res.2023 ;14(4):7652-7654 Contents lists available at BioMedSciDirect Publications Journal homepage: www.biomedscidirect.com International Journal of Biological & Medical Research International Journal of BIOLOGICAL AND MEDICAL RESEARCH Int J Biol Med Res www.biomedscidirect.com Volume 14, Issue 4, Oct 2023 Copyright 2023 BioMedSciDirect Publications IJBMR - ISSN: 0976:6685. All rights reserved. c ARTICLE INFO ABSTRACT Keywords: Interleukin-6 Chronic Kidney Disease Inflammation, and Hemoglobin. 1. Introduction Chronic Kidney Disease (CKD) is an irreversible loss of the kidney functions which is fatal in the absence of prescribed dialysis or kidney transplant (1,2). Nowadays, there are increasing evidences that associate CKD to the disruption in immune responses. CKD affects over 800 million individual worldwide and it is fast becoming a public health concern due to the high mortality and growing number of patients who required renal replacement therapy (3). Numerous systemic and local insults, including infections, hypoxemia, nephrotoxin, immune complexes dysregulation, advanced glycation end products are known to stimulate the kidney to produce systemic interleukin-6 (IL-6) (4,5). Some studies (6,7) have reported high plasma IL-6 level in CKD patients. Interleukin-6 accelerates the progression of CKD not only by aggravating kidney injury as described above but also by initiating its complications, especially the chronic vascular disease (CVD). MATERIALS AND METHOD Study design and Population This was a cross-sectional laboratory-based study conducted in August- September 2020 consisting of a control group of fortyfour apparently healthy participants, 27 (61.4%) were male, and a test group of forty-four CKD patients, 17 (38.64%) were female, proved by hemodialysis in Alrebat hospital Khartoum, Sudan. The study participants were recruited from the Alrebat hospital Khartoum, Sudan. The apparently healthy volunteers for the control without CKD, diabetes mellitus, hypertension, viral infections (HIV, HBV, and HCV) or other known risk factors for CKD were included for the study. Personal data was obtained by standard questionnaire designed for dialysis patients. Ethical clearance The study received ethical clearance from both the ethical review committees at the Faculty of Medical Laboratory Science, Sudan International University and Alrbat hospital, Khartoum, Sudan. Inform consent was obtained from all the study participants. Background: High plasma interleukin-6 is common in chronic kidney disease patients due to chronic stress, prolonged inflammation, and fluid overload. However, conflicting opinions still exist. Moreover, the effects of age, sex, and ethnicity on interleukin-6 level in chronic kidney disease is not known. Aim: This study aimed to determine interleukin-6 level in chronic kidney disease patients in Khartum, Sudan.Methods: This is a cross-sectional laboratory based study. A total of 88 participants consisting of 44 chronic kidney disease patients and 44 apparently healthy control. Of the 44 chronic kidney disease patients, 27 (61%) were male and 17 (39%) female. According to their age, 15 (34%) ≤ 40 years and 29 (66%) ˃ 40 years old. Concerning the duration of disease, 31 (70%) were ≤ 2 years and 13 (30%) were ˃ 2 years. Hemoglobin and interleukin-6 concentration were determined using enzyme linked immunosorbent assay. Results: Plasma interleukin -6 levels was significantly (p= 0.011) elevated in chronic kidney disease (Mean ± SD = 51.72 ± 9.63) compared to control group (Mean ± SD = 24.77±3.27). When hemoglobin was considered, interleukin -6 correlates negatively with significant difference (Correlation coefficient = -0.0364, p = 0.033). However, there was no statistical significant difference among the sex, age, and duration of the disease.Conclusion: Interleukin -6 level was significantly elevated in chronic kidney disease. There was no significant difference in the interleukin -6 level among the sex, age, and duration of the disease. When hemoglobin was considered, there was a negative correlation with interleukin -6 Original article Serum Interleukin - 6 level among Sudanese Patients with Chronic kidney disease a a a a a b b Safaa I.A Nasr , Rbab A.M Adam , Hala M.M Ibrahim , Afra S.A Abdelgadir , Ibrahim Alkider , Solomon M. Gamde , Simon P. Abriba a Department of Hematology and Immunohematology, Faculty of Medical Laboratory Science, Sudan International University. b Department of Medical Laboratory Science, Faculty of Health Sciences, Bingham University Karu, Nigeria * Corresponding Author : email; [email protected]. ORCID; http://orcid/0000-0002-7631-8782 c Copyright 2023 BioMedSciDirect Publications IJBMR - All rights reserved. Solomon Matthias Gamde
Sample Preparation and Procedure On a 5 ml EDTA container, venous blood was collected by single non traumatic venipuncture. Haemoglobin was measured by automatic blood counter (Sysmex KX-21N) for both CKD patients and control group. The centrifuged plasma was harvested into a plain container for IL-6 estimation using enzyme linked immunosorbent assay (ELISA). Principle of Enzyme Linked Immunosorbent Assay This involves the reaction of an antibody with an antigen and a detection system to determine if a reaction has occurred which involve Binding of the test molecule or organism to a solid support e.g. micro titer plate. Statistical analysis The data obtained were categorized into different groups and analyzed by statistical using computer program statistical package for social science (SPSS), used F- test (ANOVA) and T- test. Analyzed data was represented in tables and figures. RESULT Our data (Table 1) showed that IL-6 was significantly (p value 0.011) increased in CKD group (Mean±SD =51.72±9.63) compared to control (Mean±SD=24.77±3.27). However, there was no statistical significant (P ˃ 0.05) difference in IL-6 levels among the age groups, gender, and duration of the disease (Table 2). The characteristics of the demographic data and mean hemoglobin (Hb) concentration in CKD are given in Table 3. Hb Mean ± SD = 10.5±1.29, age group Mean ± SD = 46.5±13.7, and Mean ± SD = 1.97±0.74. Figure 1 showed the percentages of the age groups, gender, and duration of disease. In figure 2, hemoglobin correlates negatively with IL-6 level (correlation coefficient = - 0.0364, P value 0.033). DISCUSSION Mortality due to CKD is a global problem due to high prevalence of CKD risk factors. The present study investigated the possible effect of Interleukin (IL)-6 in CKD patients on hemodialysis. Our result showed that the plasma IL-6 was significantly (P =0.011) elevated in CKD patients (Mean±SD=51.72±9.63) compared to control (Mean±SD=24.77±3.27). Our finding is in tandem with previous study that documented interleukin-6 as a proinflammatory and antiinflammatory cytokines which is elevated in chronic kidney disease (10). Similarly, some clinical and experimental studies have reported that IL-6 enhanced the progression of CKD and its related complications (10). Raised IL-6 expression in the urine of patients with mesangial proliferative glomerulonephritis is often associated with poor outcome (16). Moreover, high plasma IL-6 level is commonly observed in CKD patients (6). It is evident from the previous reports that IL-6 level is significantly higher in CKD patients compared with the apparently healthy group. Furthermore, Interleukin-6 enhances the progression of CKD not only by inciting kidney damage as described above but also by instigating its complications, particularly the chronic vascular disease (CVD). Increasing evidences abound that IL-6 initiates endothelial injury essentially by reducing endothelial nitric oxide synthase and an anti-atherogenic adipocyte expression, and the inoculation of recombinant IL-6 exacerbates atherosclerosis. These mechanisms also suggests that IL-6 contributes to the increased incidence of CVD in CKD patients. Nonetheless, the elevated plasma IL-6 is not only a consequence of CKD, it also acts as a stimulant for the progression of CKD and its related complications (17). However, the present study is the first that demonstrated there was no significant association in IL-6 among the age groups, gender, and duration of the disease. CONCLUSION Based on these finding, interleukin-6 level was significantly raised in Chronic Kidney Disease. there was no significant association in IL-6 among the age groups, gender, and duration of the disease. Our data also showed a negatively significant association between Hb and interleukin -6 level in the study population. ACKNOWLEDGEMENT Our gratitude goes to the Staff in Alrebat Hospital who supported in the sample collection and Khartoum University Institute of Endemic Disease. Conflict of interest: None declared. Funding: Nothing to declare Figure 1: Percentages of the age groups, gender, and duration of the disease Figure 2: Correlation of IL-6 and Hb levels in CKD 7653 Safaa I.A Nasr et al. /Int J Biol Med Res.14(4):7652-7654
Authors' Contribution: All authors were equally involved in data collection, analysis, manuscript preparation, revision and finalization. 7654 References 1. National Insttitute of Diabetes and Digestive and Kidney Diseases ''Kidney Failure'' . Retrieved 11 November, 2017. 2. ”What is renal failure?”. Johns Hopkins Medicine. Archived from the original on 18 June 2017. Retrieved 18 December, 2017. 3. Marwa Osman, Mazin Shigidi, Haider Ahmed, Ihab Abdelrahman, Wieam Karrar, Elhussein Elhassan, Hussam Shwaib, Rayyan Ibrahim, Marwa Abdalla. Pattern and outcome of acute kidney injury among Sudanese adults admitted to a tertiary level hospital: a retrospective cohort study. Pan African Medical Journal. 2017; 28:90:1-7.doi:10.11604/pamj.2017.28.90.11054 4. Su H, Lei C-T and Zhang C. Interleukin-6 Signaling Pathway and Its Role in Kidney Disease: An Update. Front. Immunol. 2017: 8:405. doi: 10.3389/fimmu.2017.00405. 5 .Yung S, Tsang RC, Sun Y, Leung JK, Chan TM. Effect of human anti-DNA antibodies on proximal renal tubular epithelial cell cytokine expression: implications on tubulointerstitial inflammation in lupus nephritis. J Am Soc Nephrol, 2005; 16:3281–94. doi:10.1681/ASN.2004110917. 6. Pecoits-Filho R, Heimburger O, Barany P, Suliman M, Fehrman-Ekholm I, Lindholm B, et al. Associations between circulating inflammatory markers and residual renal function in CRF patients. Am J Kidney Dis, 2003: 41:1212–8. Doi: 10.1016/S0272-6386(03)00353-6. 7. Akhtar Atiya, Taghreed Majrashi, Safia Akhtar, Arshad Ali Khan ,Afnan Mohammad Sultan Asiri, Hanan Jamaan Al-Zahrania, Raghad Sameer Alnami, Sara Abdulrahman Alsharif, Taef Amer, Zainah Abdullah Faiz, Shimaa Ahmad M AlYahya, Shahad Saeedhabtar. The value of Genus Acacia in arid and semi-arid environments for the treatment of chronic inflammatory d i s e a s e s . . P h y t o m e d i c i n e P l u s 2 ; 2 0 2 2 : 1 0 0 3 1 5 . https://doi.org/10.1016/j.phyplu.2022.100315. 1-39. 8. . Bruun JM, Lihn AS, Verdich C, Pedersen SB, Toubro S, Astrup A, et al. Regulation of adiponectin by adipose tissue-derived cytokines: in vivo and in vitro investigations in humans. Am J Physiol Endocrinol Metab, 2003: 285:E527–33. doi:10.1152/ajpendo.00110.2003. 9. Huber SA, Sakkinen P, Conze D, Hardin N, and Tracy R. Interleukin-6 exacerbates early atherosclerosis in mice. Arterioscler Thromb Vasc Biol, 1999; 19:2364–7. doi:10.1161/01.ATV.19.10.2364. 10. Amdur, R.L. et al. interleukin-6 is arisk factor for atrial fibrillation in chronic kidney disease: findings from the CRIC study. PLOS ONE, 2016. http://dx.doi.org/doi:10.1371/journal.pone.0148189 . 11. Takahashi T, Kubota M, Nakamura T, Ebihara I, Koide H. Interleukin-6 gene expression in peripheral blood mononuclear cells from patients undergoing hemodialysis or continuous ambulatory peritoneal dialysis. Ren Fail , 2000; 22:345–54. Doi: 10.1081/JDI-100100878. 12. Caglar K, Peng Y, Pupim LB, Flakoll PJ, Levenhagen D, Hakim RM, et al. Inflammatory signals associated with hemodialysis. Kidney Int, 2002; 62:1408–16. doi:10.1111/j.1523-1755.2002.kid556.x. 13. Ranganathan P, Jayakumar C, Ramesh G. Proximal tubule-specific overexpression of netrin-1 suppresses acute kidney injury-induced interstitial fibrosis and glomerulosclerosis through suppression of IL6/STAT3 signaling. Am J Physiol Renal Physiol, 2013; 304:F1054–65. Doi: 10.1152/ajprenal. 00650.2012. 14. Kielar ML, John R, Bennett M, Richardson JA, Shelton JM, Chen L. Maladaptive role of IL-6 in ischemic acute renal failure. J Am Soc Nephrol, 2005; 16:3315–25. doi:10.1681/ASN.2003090757 15. Harcourt BE, Forbes JM, Matthews VB. Obesity-induced renal impairment is exacerbated in interleukin-6-knockout mice. Nephrology (Carlton), 2012; 17:257–62. doi:10.1111/j.1440-1797.2011.01547.x. 16. Nephrology Dialysis Transplantation, 2015 30(4): 564–574, https://doi.org/10.1093/ndt/gfu233 ( 2014). 17. Su H, Lei C-T and Zhang C (2017) Interleukin-6 Signaling Pathway and Its Role in Kidney Disease: An Update. Front. Immunol. 8:405. doi: 10.3389/fimmu.2017.00405. All rights reserved. c Copyright 2023 BioMedSciDirect Publications IJBMR - ISSN: 0976:6685. Safaa I.A Nasr et al. /Int J Biol Med Res.14(4):7652-7654
BioMedSciDirect Publications Int J Biol Med Res.2023 ;14(4):7655-7659 Contents lists available at BioMedSciDirect Publications Journal homepage: www.biomedscidirect.com International Journal of Biological & Medical Research International Journal of BIOLOGICAL AND MEDICAL RESEARCH Int J Biol Med Res www.biomedscidirect.com Volume 14, Issue 4, Oct 2023 Copyright 2023 BioMedSciDirect Publications IJBMR - ISSN: 0976:6685. All rights reserved. c ARTICLE INFO ABSTRACT Keywords: Pharmacognostical Identification Catharanthus roseus (Linn.) G.Don. and Ficus carica Linn. 1. Introduction Plants have served humans for centuries as a natural source of cures for a variety of diseases. Recent years have witnessed an explosion of research into estimating the medicinal potential of plants. A significant portion of the community and conventional practitioners continue to rely on traditional herbal remedies as their primary health care. Misidentification of pharmaceuticals may also result in catastrophes, so it is essential to identify the drug to be administered. There is a renewed interest in drugs of natural origin because they are regarded as green medicine, which is always assumed to be secure. Instances of synthetic drugs with a detrimental nature, which are deemed to be hazardous to humans and the environment, are another factor that accentuates this focus. The advantage of natural drugs is that they are easily accessible, inexpensive, and have few or no adverse effects, but the disadvantage is that they are frequently adulterated. The natural medication is easily contaminated with low-grade ingredients to satisfy the rising demand. Adulteration or substitution is the replacement of the original plant with another plant material or the purposeful addition of a foreign substance to raise the product's weight, potency, or cost. The therapeutic effectiveness of medicinal plants is contingent upon the quality and quantity of their chemical constituents. The improper utilization of herbal medicine or natural products often The identification of medicinal plants is an essential step in ensuring their purity and authenticity, particularly before leading any phytochemical or biological studies. This process helps to prevent adulteration or substitution. The current study presents the standard pharmacognostical analysis of two leaves of two medicinal plants, namely Ficus carica Linn. and Catharanthus roseus (Linn.) G. Don. Additionally, it highlights the significance and necessity of conducting pharmacognostical studies. F. carica Linn. (Moraceae) commonly known as 'Fig' is native to Asia and is cultivated in all tropical and subtropical nations, its dried fleshy receptacles-fruits are used as laxatives, emollient, demulcent, diuretic, used to treat piles, gout, arthritis and jaundice. Latex is also reported to be used as anthelminthic and for treating mouth ulcers. Another commonly used medicinal plant selected for the study was C. roseus (Linn.) G. Don of the Apocynaceae family, formerly known as 'Vinca rosea' and commonly known as 'Madagaskar periwinkle' is extensively distributed in India. It is the main source of vinca alkaloids used for the treatment of cancer and diabetes, also used as antiseptic, antipyretic, leaves are used in menorrhagia, blood dysentery etc. Both plants are extensively commonly used for different ailments, and plethora of research work has been done; but pharmacognostical identification of its leaves is limited. Therefore, In the present study pharmacognostical evaluation of macro and micro-morphological character along with the organoleptic characters (shape, size, color, odor, texture etc.), morphological features, macroscopic study of part used like leaf type, phyllotaxy, venation, vein islet number, lamina, base, apex etc.; microscopic study of transverse section of leaf (stomatal number, epidermal no, shape and type of trichome, palisade ratio etc.) was done. In terms of pharmacognostical identification, the present study can make a significant contribution, as the findings may contribute to the future determination of the integrity and identity of the aforementioned plants. Original article Pharmacognostical identification of leaves of Medicinal Plants Ficus carica Linn. and Catharanthus roseus (Linn.) G.Don a b b b b Sumbul Rehman , Sehrish Khan *, Ameera Ayyub , Sana Mustaqeem and Aisha Razi a b Assistant Professor, P.G. Scholar, Department of Ilmul Advia, Faculty of Unani Medicine, Aligarh Muslim University, Aligarh, (U.P) INDIA * Corresponding Author : P.G. Scholar (Ilmul Advia) Department of Ilmul Advia Faculty of Unani Medicine Aligarh Muslim University, Aligarh Email id: [email protected] c Copyright 2023 BioMedSciDirect Publications IJBMR - All rights reserved. Sehrish Khan
originates from incorrect identification. One prevalent mistake observed is the attribution of a single vernacular name to multiple distinct species. The resolution of these issues can be achieved through the implementation of pharmacognostical investigations pertaining to medicinal plants. Establishing identification specifications for medicinal plants used in pharmaceuticals is of utmost importance and indeed indispensable. Pharmacognosy is an academic discipline that focuses on the investigation and analysis of medicinal substances that are sourced from natural origins, with a primary emphasis on plant-derived compounds. This field primarily encompasses the processes of standardization, authentication, and investigation of natural pharmaceutical substances. The majority of research conducted in the field of pharmacognosy has focused on the identification of contentious plant species and the authentication of frequently utilized traditional medicinal plants using methods such as morphological, phytochemical, and physicochemical analysis. The significance of pharmacognosy has been widely recognized in contemporary times. In contrast to taxonomic identification, pharmacognostical study incorporates parameters that facilitate the detection of adulteration in dry powder form as well (Chanda, 2014). This process is deemed essential due to the fact that once the plant undergoes dehydration and is transformed into a powdered state, it forfeits its distinct morphological characteristics and becomes highly susceptible to adulteration. Pharmacognostical studies play a crucial role in establishing the identity of plants, establishing standardization parameters, and preventing adulterations. These studies will contribute to the authentication of plants and the establishment of consistent quality standards for herbal products, thereby enhancing the safety and effectiveness of natural products. In the current study, two medicinal plants that are frequently utilized in traditional systems of medicine were chosen for pharmacognostical exploration. Ficus carica Linn. commonly known as fig from Moraceae family widely used as laxative (Fig.1). It is the tree of moderate size 5-9 m high, bearing latex, which is a native of Asia minor, and is cultivated in many parts of Northern India, Andhra Pradesh, Karnataka and Maharashtra (Anonymous, 2006; R. Bercu and Popoviciu, 2014). It bears fruits after second or third year of planting in most of the cases; though if planted through root cuttings or layered planting it may start fruiting in the first year. They continue to grow until 12 or 15 years, after which there is marked decline. Two or sometime three crops of figs can be obtained in a year first in July-October another in January to May. Ficus leaves contain 4.3 protein, crude fat 1.7; crude fiber 4.7%, ash 5.3%, N-free extractives 16.4%, moisture 67.6 %and pentosans 3.6%. It also contains 0.002% carotene, ficusin, bergaptine, stigmasterol, sitosterol and tyrosine. It is also a good source of Calcium, silica and potassium minerals (Anonymous, 1992). It is reported to be diuretic, demulcent, emollient, anti-pyretic and has high nutritive property. Its roots are used in the treatment of piles, leukoderma and ringworms and sweet fruits have antipyretic, purgative, aphrodisiac properties useful to treat inflammations, gout, piles and paralysis, in liver and spleen disorders. Locally the leaves are being used in the treatment of jaundice. In ayurvedic literature, it is claimed that Charka used to apply the paste of figs for emaciation and debility, and used it as a diuretic in urinary stones. Shushruta also included the fruit in a medicated clarified butter for internal use in fever, consumption, asthma, epilepsy and insanity (Patil and Patil 2011; Baby and Justin 2011). Catharanthus roseus (Linn.) G. Don, commonly known as Madagascar periwinkle, formerly known as Vinca rosea (Apocynaceae) is highly explored annual herb (Fig.2) for its efficacy in significant ailments including its oncolytic property to the presence of active alkaloids like vinca alkaloids like vincristine, vinblastine etc. This is an erect, ever blooming, 40-90 cm much branched, indigenous, glabrous annual herb widely distributed in tropical regions; probably native to Malagasy and cultivated as an ornamental plant in West Bengal, Southern Florida, Africa, India, Thailand, Taiwan, Eastern Europe and Australia (Anonymous 1992; Mohd. Ali 2000). The physiologically important alkaloids are antineoplastic dimeric alkaloids, vinblastine, vincristine in its aerial parts and ajmalicine, serpentine in the roots (Perez, 2015). Among more than 130 types of alkaloids (mostly monoterpene indole alkaloids), found many are reported to be proved effective in treating various types of cancers like breast and lung cancer, uterine cancer, melanomas. Vincristine, vinblasticine are used specifically for multidrug resistant tumor types like Hodgkin's lymphoma and childhood leukemia, chorion epitheloma. Vinflunine, not universally accepted except in Europe is also said to possess anti-tumor activity. The newer semisynthetic chemotherapeutic agent vinorelbine is used to deal with non-small-cell lung cancer, can be prepared either from vindoline and catharanthine or from the vinca alkaloid leurosine in both cases via anhydrovinblastine. Rosinidin is an anthocyanidin pigment found in the flowers of C. roseus. It is also reported to cure diabetes (Anonymous 1992; Evans, 2009). Medicinally important both the plants have been searched a lot for their biological efficacy, but still pharmacognostical characterization of leaves of F. carica is very limited (Patil and Patil, 2011), though fruit being mostly used has been characterized (Anonymous, 1992). Similarly leaves of C. roseus was also identified (Anonymous, 2007) but few parameters on standard pharmacognostical guidelines was lacking which can be used for future reference in their identification. In the present study macromicroscopical exploration along with the leaf surface anatomy and its microscopic characterization was done. It included the understanding the various anatomical characters of the leaves as Figure 1: Plant and Leaf Ficus carica Linn. Figure 2: Plant and Leaves of Catharanthus roseus (Linn.) G.Don 7656 Sumbul Rehman et al. /Int J Biol Med Res.14(4):7655-7659
well as the identification of the various diagnostic characteristics related to the leaves. Leaf constants, such as the Stomatal index, Stomatal number, Palisade ratio, vein-islet, and vein termination numbers, were also determined. Material and methods Collection and authentication of selected medicinal plants Fresh leaves of Ficus carica Linn. and Catharanthus roseus(Linn.) G. Don were collected from herbal garden, department of Ilmul Advia (Unani pharmacology), Aligarh Muslim University, Aligarh. It was identified in the pharmacognosy lab of the department and on the basis of literature available and the sample was preserved in the lab for future reference. Preparation for test samples of leaves of selected test drugs Samples of fresh leaves were washed with water and foreign material and other contaminants was removed from it. Microscopic examination was done using standard method as per the guidelines. Macroscopic analysis Fresh leaves of both plants were evaluated for various thorough morphological and organoleptic parameters such as shape, size, color, odor, taste, leaf margin, apex, texture, presence or absence of petiole, phyllotaxy etc. were recorded in accordance of standard textbooks (Anonymous, 2006; Mohd. Ali, 2000; Evans, 2009). Microscopic analysis For preparing the transverse section of the leaves, mature fresh leaves were collected and washed with water. Thin section of leaves was cut from the center of the lamina across the midrib and kept in water, so that they retain moisture. It was boiled in a test tube containing chloral hydrate solution for 5-6 minutes, to avoid the presence of chlorophyll. Fine, thin and intact transverse section of leave were shifted to watch glass containing water and then shifted to watch glass holding 2-3 drops of safranin. After sometime, section was taken and rinsed with water. Excess stain was removed by ethanol. Section of leave were transferred to slide, covered with cover slip and observed under microscope. Staining agent like Safranin, Fast green along with glycerin, DPX were used of analytical grade. Microphotographs were taken by OPTIKA binocular digital microscope B-290 using appropriate magnification as required. Leaf constants were recorded with the help of camera lucida, stage micrometer and epidermal cells, structure, distribution and type of stomata, structure and distribution of trichome on the fresh leaveswasdone observed as identification parameter. Leaf surface study · Stomatal number: Stomatal number (SN) or stomatal density is defined as the average number of stomata count in 1 mm square of the leaf within both upper and lower epidermises. · Stomatal length and Osteolar length: It were measured with the help of software available OPTIKA B-290 microscope software. Total stomatal and total osteolar length was measured accordingly. · Stomatal index: Percentage of number of stomata to the total number of epidermal cell (where each stomata is also considered to be a single epidermal cell (Evans 2009; Khandelwal and Vrundasethi, 2021). Procedure: For determination of stomatal number and stomatal index within both upper and lower epidermises were peeled off from fresh young leaves using a pair of forceps, razor and by sticking transparent cotton tape. The peeled section was fixed on slide by glycerin and examined under OPTIKA binocular digital microscope B-290 using 40X magnification. Numbers of stomata per mm square were recorded for stomatal number. To calculate exact, accurate and standard values five readings were taken for each, and the slides were photographed. Stomatal Index was calculated as per following formulae: · Vein islet number: It is the average number of vein islet enclosing small green area in 1 sq. mm leaf surface · Veinlet termination number: It is the determination of average number of terminated veinlet in 1 mm square of leaf surface area taken from region of midrib to margin of the leaf Veinlet termination the ultimate free end of veinlet. Procedure: To determine vein islet and vein termination number, lamina of leaf between midrib and margin was cut into small pieces about 1-3 mm square and boiled in a concentrated solution of chloral hydrate for 15 minutes till the discoloration of pieces. The transparent fragments were transferred into glass slide and observed under microscope at magnification of 10X. Vein islets were counted in 1mm sq area. Along with veins-islets the veinlet terminations were also, counted which were inside the square only. To calculate exact, accurate and standard values five readings were taken for each vein islet and vein termination number, and the slides were photographed. · Palisade ratio: Palisade ratio is defined as the average number of Palisade cells below single upper epidermal cell (Evans 2009). It is an important parameter for determination and characterization of leafy drugs (Barkatullah et al., 2016). Procedure: Small pieces (1-2mm) of leaf grown in full sun light were taken and cleared by boiling in 200% chloral hydrate solution. The cleared pieces were mounted and examined under microscope. A number of groups of each of four upper epidermal cells were first focused. Then by minor rotation of the fine adjustment, the under lying palisade cells were focused within the area of four epidermal cells. Palisade ratio was then obtained by dividing the number of palisade cells by 4. Five readings were taken from different pieces in order to obtain accurate average (Evans 2009; Kokate 2020). Result and Discussion Morphological characters of leaf: In the present study it was found that its simple broad leaves of F. carica L. was found to be of an average 5-10 length and 3-6 inches width. Their shape is mostly found to be ovate or nearly orbicular, and more or less deeply 3-5 lobes with alternate phyllotaxy. Mature leaves are large up-to 10 x 7 inches, of bright shining green color with cordate base, obovate lobes, obtuse and sometime broadly acuminate at the apex, irregularly toothed, finely serrated margins, S=Quantity of stomata per unit area E=Number of ordinary epidermal cell in same unit area 7657 Sumbul Rehman et al. /Int J Biol Med Res.14(4):7655-7659
dark green above, rough texture due to the presence of stout, stiff hairs which are more on dorsal side, while ventral side is comparatively soft, pubescent. Petiole is 2-5 cm long while stipule was found to be absent, venation is arcuate (Fig.1 and 3; Table-1). Findings were found to be similar and which were also found in one of the preliminary studies by Shamkant (2014). Leaves of annual everblooming C. roseus herb were found to be simple, opposite, petiolate, with long and thick petiole (1.5 x 0.5 cm), glabrous or softly pubescent, elliptic lamina, shape oblong- elliptic or obovate, acutely rounded apex, cuneate or sub cuneate base with entire margin. Upper surface is was found to be glabrescent of dark shining green while lower surface is was pubescent or nearly glabrous comparatively light green in color, main lateral nerves rather close (Fig.2 & 4; Table:1). Findings were found to be in appropriate manner as texted in different books (Mohd Ali 2000; Anonymous, 2007; Kokate 2020; Padma Paarakh, 2019). Veins are found to be more prominent at lowersurface. trichomes were found on both the surface which were more around midrib and on upper surface as compared to lower. Beneath the thin cuticular lining elliptical, thick walled epidermal cells, numerous palisade tissues were found to be filled with numerous calcium oxalate crystals along with the chloroplast. Fewer number of starch grains were also observed. Micro-morphology of C. roseus leaves also revealed anomocytic (ranunculaceous) stomata of kidney shape present around 3-4 subsidiary cells. At 40 X magnification, average stomatal number from five subsequent readings was found to be 52-54, stomatal index 12.03-12.05, epidermal cells 380-390, stomatal length 0.03 µm, osteolar length 0.02 µm, vein islet number as 2.5-3, while vein termination number as 3-4. Palisade ratio was found to be within the range of 2.75 (Table-2). Table2-Quantitative microscopic parameters of selected test drugs Microscopic characters Leaf surface anatomy: In F. carica leaves, numerous kidney shaped, anomocytic stomata surrounded by five to six subsidiary cells were found. At 40 X magnification average stomatal number was found to be 28-30, epidermal cells in four subsequent regions was found to be 236, stomatal index 10.6-11.2m stomatal length 0.03 µm, osteolar length 0.02 µm, vein islet number as 3.8-4.2 while vein termination number as 2-3. Palisade ratio was found to be within the range of 3-5 (Table2). It was found to be similar as in anatomical study done by R. Bercu and Popoviciu (2014). Transverse section of F. carica leaf demonstrated various nonglandular, unicellular, uniseriate non-glandular, unbranched Fig.3 Micro morphology of Ficus carica Linn. Fig.4 Micromorphology of Catharanthus roseus (Linn) G.Don 7658 Sumbul Rehman et al. /Int J Biol Med Res.14(4):7655-7659 Table1- Leaf constants and its organoleptic characters
7659 All rights reserved. c Copyright 2023 BioMedSciDirect Publications IJBMR - ISSN: 0976:6685. Transverse section of C. roseus leaf demonstrated various T.S of leaf showed cuticular lining above thin-walled elliptical epidermal cells. In lower epidermal surface sinuous wall surface was found wile in upper epidermis slightly curved or sinusoid walls were found. Beneath the epidermal cells numerous parallel palisade cells were found which were filled with chloroplast. It was found to be similar as mentioned in textbooks Anonymous (2007) and research work done by Padma Paarakh in 2019. Unicellular, septate, uniseriate, non-glandular, unbranched trichomes were found on both the surface. CONCLUSION Pharmacognostical identification in terms of macro and micromorphological characters of the leaves of Ficus carica Linn. and Catharanthus roseus (Linn.) G. Don done in the present study can be useful in future, for the authentication of raw material of respective drugs before using it in clinical study or human welfare. Various parameters studied during the present analysis will also be helpful in quality assessment and detection of adulterants in the herbal drugs or that can be used as principal component of herbal medicine formulation. References 1. Sumitra Chanda. Importance of Pharmacognostic study of medicinal plants: An overview. Journal of Pharmacognosy and Phytochemistry 2014;2 (5):69- 73. 2. Anonymous. Standardization of Single drugs of unani medicine, CCRUM. Ministry of health and family welfare, Govt. of India, New Delhi, Part I 2006;7-11. 3. R.Bercu, D.R. Popoviciu. Anatomical study of Ficus carica L. leaf. Annals of the Romanian society for cell biology 2014; 19 (1):33-36. 4. Anonymous. The wealth of India (A Dictionary of Raw material and Industrial products). Publications and Information directorate, CSIR, New Delhi,India.1992;3:388 5. Vikas V. Patil, Vijay R. Patil. Ficus carica Linn.- an overview. Research Journal of Medicinal Plants 2011; 5 (3):246-253. 6. Baby Joseph, S.Justin Raj. Pharmacognostic and phytochemical properties of Ficus carica Linn.-An overview. International Journal of Pharm Tech Research 2011;3 (1):8- 12. 7. Francisco Fernandez-Perez, Lorena Almagro, Maria Angeles Pedreno, et al. Indole Alkaloids from Catharanthus roseus: Bioproduction and Their Effects on Human Health. Molecules 2015;20:2973-3000. 8. Anonymous. Reviews of Indian Medicinal Plants. Medicinal Plants Unit, Indian council of medical research, New Delhi.2007;5:816 9. Shafqat Ali Khan, Muhammad Ibrar, Barkatullah, et al . Pharmacognostic evaluation of the leaf of Rhus succedanea Var. Himalaica. J. D. Hooker. African journal of Traditional, Complementary and Alternative medicines 2016;13 (6):107-120. 10. C.K. Kokate, S.B.Gokhale, Dr.S.J.Surana, Dr.M.G.Kalaskar. Pharmacogosy. Nirali Prakashan 2020;8.79-8.81 11. Shamkant B. Badgujar, Vainav V.Patel, Atmaram H. Bandivdekar, Raghunath T.Mahajan, et al .Traditional uses, phytochemistry and pharmacology of Ficus carica: A review. Pharmaceutical Biology 2014;52 (11):1487-1503. 12. M Padmaa Paarakh, S Swathi, Tasneem Taj, V Tejashwini, B Tejashwini. Catharanthus roseus Linn.-A Review. Acta Scientific Pharmaceutical Sciences 2019;3 (10):19-24. 13. Evans W.C. Trease and Evan's Pharmacognosy. W B Saunder 2009; 16:423- 424. 14. K.R Khandelwal, Vrunda Sethi. Practical Pharmacognosy. Nirali Prakashan 2021;12.33-12.35 15. Mohammed Ali. Textbook of Pharmacognosy. CBS Publishers and Distributors 2000;332-334 Sumbul Rehman et al. /Int J Biol Med Res.14(4):7655-7659
BioMedSciDirect Publications Int J Biol Med Res.2023 ;14(4):7660-7664 Contents lists available at BioMedSciDirect Publications Journal homepage: www.biomedscidirect.com International Journal of Biological & Medical Research International Journal of BIOLOGICAL AND MEDICAL RESEARCH Int J Biol Med Res www.biomedscidirect.com Volume 14, Issue 4, Oct 2023 Copyright 2023 BioMedSciDirect Publications IJBMR - ISSN: 0976:6685. All rights reserved. c ARTICLE INFO ABSTRACT Keywords: Bovine calf Coccidiosis Nekemte Oocyst Prevalence Risk factor 1. Introduction Parasitic diseases are a major constraint in animal health and production throughout the tropic and sub- tropical countries of the world (Bruhn et al., 2011). Parasitic disease caused by helminthes, protozoa and arthropods can cause more economic losses than disease caused by bacteria and viruses but their impact is not clear to animal owners (Juyal and Single, 2011). Bovine coccidiosis occurs worldwide and usually affects cattle under one year old, but it occasionally seen in yearlings and adults. Bovine coccidiosis has been observed in almost all areas where cattle are raised and is usually most common and important in calves younger than one year (Daugschies and Najdrowsk, 2005). Coccidiosis spreads from one animal to another by contact with infected feces and is one of the most alarming problems for calf rearing industry. The development of clinical coccidiosis in cattle mainly depends on factors like species of Eimeria, age of infected animal, number of oocysts ingested, presence of concurrent infections and type of production system and management practices (Daugschies and Najdrowsk, 2005). Eimeria infections are one of the most common and important diseases of cattle worldwide. It is a protozoan disease that has a special place among the many parasite species for different reasons caused by various species of Eimeria, widespread distribution regardless of the climatic conditions, results major economic losses in animal husbandry worldwide (Almeida et al., 2011; Nisar-Khan et al.,2013). About 11 species of Eimeria have been identified and documented to cause disease in cattle (Coetzer and Justin, 2004) and the most common pathogenic species in cattle are E. bovis and E. zuernii (Maas, 2007). The other species have been shown experimentally to be mildly or moderately pathogenic, but they are not considered important pathogens. All calves kept under traditional management systems are exposed and become infected early in life. As coccidiosis spreads from one animal to another by contact with infected feces, it is one of the serious problems for calf rearing industry (Lucas et al., 2006). Adult animals are usually asymptomatic carriers that often serve as a source of infection for juvenile animals, which are more susceptible to infection. In association with other enteropathogens, coccidia have been indicated as an important Coccidiosis is a parasitic disease caused by a small, single celled parasite, called a protozoa, that lives inside the cells of an infected animal's intestinal tract and is one of the most common and important disease of calves in the world. A Cross-sectional study was conducted in and around nekemt town from January 2022 up to September 2022 to determine the prevalence and associated risk factors of infection in calves. Faecal samples were collected from a total of 384 calves less than 24 month of age and examined for the oocysts of coccidian. Detailed information of the age, sex, breed, management system and hygienic status were considered as risk factors. Centrifugal faecal floatation technique using sugar solution was used to detect coccidian oocyst. From the total calves included, 176 calves were demonstrated for the presence of coccidian infection. The most of diarrheic calves show a positive result for Eimeria infection .Coccidian oocyst was detected in calves from 1 to 2 year of age but greater prevalence was observed in age categories less than 6 month of age. Statistically significant association (p<0.05) between prevalence of coccidiosis and age, breeds and husbandry system was observed in the study. There was a statistically significant association (P<0.05) between prevalence of coccidiosis and the hygienic status of the calf. Accordingly, calves with poor hygienic condition showed significantly higher prevalence than calves which have relatively better hygienic condition However, there was no statistically significant association (p>0.05) with sex. In conclusion, the study revealed that calf coccidiosis was prevalent in and around nekemte town and consequently affects the productivity of the sector. Hence, appropriate disease prevention and control measures are required to be undertaken to reduce its effect. Original article PREVALENCE AND ASSOCIATED RISK FACTOR OF BOVINE CALVES COCCIDIOSIS IN NEKEMT CITY, OROMIA, WESTERN ETHIOPIA a a b b Walkite Furgasa , Sosina Dawit , Shibiru Wako and Adisu Dube * Corresponding Author : Wollega University, School of Veterinary Medicine Email: [email protected] c Copyright 2023 BioMedSciDirect Publications IJBMR - All rights reserved. Walkite Furgasa aWollega University, school of veterinary Medicine b East wollega Agricultural office, Guto Gida Veterinary Clinc
cause of diarrhea in calves on the first few months of their age (Abebe et al., 2008). They develop only in the intestinal epithelial cells, leading to mucosa damage and the appearance of clinical signs, malnutrition, weakness, anaemia, diarrhoea and haemorrhagic faeces (Yu et al., 2011). The development of clinical coccidiosis in cattle mainly depends on factors like species of Eimeria, age of infected animal, number of oocysts ingested, presence of concurrent infections and type of production system and management practice (Alula et al., 2013). Diagnosis of coccidiosis depends on the discovery of oocysts on faecal examination using direct smear, flotation or McMaster's techniques. Studies have demonstrated that the prevalence of Eimeria species in cattle varies between different regions and age of animal (Alemayehu et al., 2013). The prevalence, species composition, and importance of bovine coccidiosis have been documented in various countries of the world. In Ethiopia, different finding reported that young age and poor hygienic status of the farms were strongly associated with infection of coccidiosis in dairy farms., However, in another study by Alula agreed that age was a significant factor but breed, body condition, sex, and management system were not significantly associated with the disease (Dawid et al., 2012). According to Dawid et al 2012), although coccidiosis is an important cause of calf morbidity and mortality in Ethiopia and very little attention has been given to this disease. Nekemte is one of the cities of Oromia where urban and periurban dairy farms dwell to provide milk for population of the city. Reports on coccidiosis are scarce to assess the magnitude of this disease and no original information about the disease in the present study. In view of the lack of authentic information available regarding the prevalence of Coccidiosis affecting calves in the study area. Therefore the objectives of the present study were: To estimate the prevalence of coccidiosis affecting calves in Nekemte city and to estimate the associated risk factors of coccidiosis in dairy calves MATERIALS AND METHODS Study Area The study was conducted in Nekemte town, East Wollega zone, Oromia regional state, Western Ethiopia from January 2022 up to September 2022. Nekemte lies at latitude of 90o 5' N and longitude of 36° 33' E with an elevation of 1,960 to 2,170 meters above sea level. Distance of the district is 331 km from Addis Ababa. The climatic condition alternates with long summer rainfall (June to September), short rain season (March to April) and winter dry season (December to February). The maximum and minimum annual rainfall and daily temperature range are between 2,200 to 1,500 mm and 15°C to 27° C respectively. This area is characterized by mixed farming system, which is engaged in agricultural and livestock production. The calves population of the town is 4812 cattle, 851 sheep, 359 goats, 81 horses, 21 mule, 851 donkeys and 4850 chickens . The majority of the people of the town belong to the O r o m o e t h n i c community and Afan Oromo (the Oromo language) is the widely spoken language in the area (EWAO, 2013). Study Population The study was conducted on calves younger than 24 months by dividing in to three groups: Birth up to 6 months, 6-12 months and 12-24 months which were determined by asking the owner of the animal orally (Mihreteab et al., 2012). This range of age was selected because the disease is more common in young animal. Epidemiological information with respect to their age, sex, breed, management system, and date of sample collection, hygienic states and kebele or name of the farm was collected. Simple random sampling was used to select the study animals from farms and from small holder. Hygienic status of calf pens and the calves themselves were assessed based on housing system (ventilation, stocking and sanitation) and body parts of the calves and was conveniently categorized as poor, medium and good (Mihreteab et al., 2012). Study Design A Cross-sectional study was conducted in and around nekemte town from November 2021 to March 2022 to determine the prevalence and associated risk factors of Coccidiosis in calves. Active data was generated from randomly selected calves with regard to age, breed, sex, Husbandry system, and hygienic states were considered as risk factors to test for occurrence of coccidiosis. Sample Size Determination Simple random sampling method was used to select the calves from target population. Since there was no similar work done in the area previously, expected prevalence was taken as 50% and the confidence interval chosen as 95% and precision 5%. By substituting these values in the formula, the sample size founded to be 384. Thus, the sample size is calculated according to (Thrusfield, 2007) as follows: Where, n=required sample size, d=absolute precision (usually 0.05) Pexp=expected prevalence Data Collection A total of 384 faecal samples were collected during the entire period of the study. About 10-20 g fresh faecal sample was collected per rectum from each calf using sterile disposable plastic gloves. Each sample was placed in a clean plastic container labeled and transported to Veterinary parasitology laboratory, School of Veterinary Medicine, Wollega University on the same day of collection, and preserved at refrigeration temperature until processing within 24 hours of arrival. At the time of sampling, the name of the farm, date of sampling, age, sex, breed, fecal consistency and hygienic status of farm was recorded for each calf on a recording format. A 3g portion of each of the 384 fecal samples collected was weighed out using a balance and put in a mortar. After grinding with pistil 40ml of sugar solution was added, mixed thoroughly and poured into a 100-ml glass beaker through a strainer. Then it was rinsed and the solution was poured into 15-ml centrifuge tubes but not filled. After centrifugation at 1200 rpm for 5 min, more sugar solution was added until a convex meniscus was formed on top of the tube. A glass cover slip was placed on top of each tube and was left for 30 min. Then, each glass cover slip was briskly lifted up and placed on a clean glass slide, not allowing formation of air bubbles. The entire area under each cover slip was examined under a binocular microscope at 40× magnification (Hendrix, 1998). 7661 Walkite Furgasa et al. /Int J Biol Med Res.14(4):7660-7664 Figure : Map of the study Area Source: Arc Map GIS 10.4 2 2 n = (1.96) pexp (1-pexp)/ d
Data Management and Analysis Data collected from study sites were coded and entered in to a Microsoft excel spread sheet program for analysis. Statistical analysis was done on Statistical Package for Social sciences (SPSS) software version 16. Descriptive statistics like percentage was used to express prevalence while chi-square (χ2) test was used to compare the association of coccidiosis with different risk factors. In all the cases, 95% confidence level and 0.05 absolute precision errors were considered. A p-value ≤ 0.05 was considered statistically significant. RESULT Out of 384 faecal samples examined, 176 were positive for Eimeria oocysts with the overall prevalence of 36.4%. Even if coccidian oocyst was detected on all age groups the highest prevalence was recorded in those calves found in the range from one to sixth month of age. There was a statistically significant difference (P<0.05) in the prevalence of coccidiosis among the various age group (Table 1). The prevalence of coccidiosis was a bit higher in cross breed calves than in local breed calves. However, the breed of the calves was significantly associated (P < 0.05) with prevalence of coccidiosis. There was no statistically significant association (P>0.05) between sex and coccidian infection. There was a statistically significant association (P<0.05) between prevalence of coccidiosis and the fecal consistency of the calf. Accordingly, calves with diarrheic condition showed higher prevalence than calves which have soft and normal fecal consistency (Table 2). Table : Prevalence of coccidiosis in calves in relation to consistency of feces Table : Prevalence of coccidiosis in calves in relation to host factors There was a statistically significant association (P<0.05) between prevalence of coccidiosis and the hygienic status of the calf. Accordingly, calves with poor hygienic condition showed significantly higher prevalence than calves which have relatively better hygienic condition (Table 3). Coccidian infections according to management system have significant difference with Intensive, semi-Intensive, and extensive husbandry systems with higher prevalence on intensive system than other systems and the lowest prevalence was observed on calves belongs to semi-intensive system. DISCUSSION The overall prevalence of coccidiosis in and around Nekemte based on coprological examination was 36.4% and this current study was in line with the prevalence study of calf coccidiosis in kombolcha which is 32% (Alemayew et.al., 2013). However, the prevalence was lower than the previous findings reported in Addis Ababa and bishoftu by (Abebe et al., 2008) (68.1%), in Pakistan by (Muhammad et al., 2010) (47.09%), in the coastal plain area of Georgia (USA) by (Ernst et al., 1987) (82.28%) and in sub-humid tropical climate by (Rodriguez-Vivas et al., 1996) (87.8%). This variation is most likely attributed to the differences in agro-ecology, management types and husbandry practices of the study animals in different areas (Radostits et al., 2006). The study has revealed that the prevalence of Eimeria has significant association with breed of calves. There was statistically significant association (P<0.05) between breed and coccidia infection. Higher prevalence of the disease condition was observed in exotic breed when compared to local and cross breed. This might be in relation to genetic factors as exotic breed are more susceptible to a disease. This finding agrees with the report of (Abebe et al., 2008) and (Alemayew et al., 2013). There was also no statistically significant association (P>0.05) between sex and coccidia infection. The prevalence in female calves was similar to that of males in this study. This finding agrees with the report of (Abebe et al., 2008) and (Alemayew et al., 2013). Age of the calves was significantly associated (P<0.05) with the risk of infection by coccidiosis and the highest prevalence was recorded in those calves with youngest age groups (1 to 6months). This is in contrast to (Abebe et al., 2008) who reported that risk of infection by Eimeria species appeared to increase with the age of the examined calves. However, this observation in the current study was in line with (Dennis et al., 2012), (Perfield, 2010) and (Mihreteab et al., 2012). who noted that young animal less than 6 months were Table : Prevalence of coccidiosis in calves in relation to husbandry system and hygienic status 7662 Walkite Furgasa et al. /Int J Biol Med Res.14(4):7660-7664
more susceptible than adults. Stress factors like weaning and change of diet can increase level of infection and incidence of the disease due to stress-induced immune suppression (Kaufman, 1996; Radostitis et.al., 2007). In addition to this, coccidiosis is a self- limiting disease in adult and spontaneous recovery without specific treatment is common when the multiplication stage of the coccidian has passed (Radostitis et.a., 2007). Based on this, previous exposure might have a contribution to the development of certain level of immunity of older calves as compared to younger that did not experience previous exposure (Faber et al.,. 2010). The influence of husbandry system from this study also shows that a significant association between prevalence of coccidian infection and different husbandry system which is agree with (Kennedy and Kralka 1987), but strongly disagrees with the work of Alemayew in Kombolcha on prevalence of bovine coccidiosis (Alemayew et al., 2013). Coccidiosis is mostly a disease of young animals kept under intensive management systems when there is stress, overcrowding, housing under conditions of poor hygiene, food changes, nutritional deficiencies, and adverse weather conditions which are favorable for the survival of oocysts and therefore higher infection rates when compared to extensive farming systems (Vorster and Mapham, 2012). The strong association of the infection with coccidiosis in relation to the hygienic status of calve has been demonstrated in this study. This observation agrees with (Mihreteab et.al, 2012). Calves with poor hygiene showed significantly higher prevalence than calves which have relatively better hygiene. This could imply that poor sanitation in calve housing areas as well as poor management of housing favours infection with coccidiosis. Obviously, poor ventilation, heavy stocking, cows present with calves, and soiled bedding were regarded as risk factors for coccidiosis (Daugschies and Najdrowski 2005; Radostitis et al., 2007; Vorster and Mapham, 2012). Positive correlation between fecal consistency and the occurrence of diarrhea was detected in the present study. During investigation, most of diarrheic calves show a positive result for Eimeria infection. These agree with (Pandit, 2009). The results of the present study confirmed the importance of coccidiosis among the causes of calf diarrhea in the study area. CONCLUSION AND RECOMMENDATION This study has revealed that the prevalence of calves coccidiosis in and around nekemte town was 36.4%, which can be taken as high rate of infection. The prevalence of coccidiosis has no significant association with sex and body condition of animals examined during the study period. However, the disease has a significant association (P<0.05) with breed, age, Husbandry system and hygienic status. Breed, age, husbandry system and hygienic status of calves were the major risk factors for the prevalence of coccidiosis in this area. In conclusion, the study revealed that calf coccidiosis was prevalent in and around nekemte town and consequently affects the productivity of the sector. In line with the above conclusion the following recommendation are forwarded: Calves should get colostrum in the first 24 hrs of their life to ensure their immune status,Sanitary prophylaxis should be maintained, Stressful conditions which triggers the disease occurrences should be avoided, Coccidiostats should be used in ration early for prevention and Awareness creation for Livestock producers for the improvement of hygienic status of calve Ethics Approval and Consent to Participate The current study was conducted after permitted ethical approval and a statement given by the Research Review Committee of Wallaga University on November 9, 2021 (Minutes No. 12/2021). Acknowledgments The authors acknowledged Wollega University, school of veterinary medicine for their contribution for this research. Author Contributions Authors made a significant contribution during this Msc thesis work from its beginning to end. 7663 References 1. Abebe, R., Wossene, A. and Kumsa, B. (2008): Epidemiology of Eimeria infections in calves in Addis-Ababa and Debre- Zeit dairy farms, Ethiopia. Inter J Appl Res Vet Med. (6), Pp 24-30. 2. Alemayehw, A, Mohammed, .N, and Timketa, B. (2013): Prevalence of bovine coccidian in Kombolcha district of south Wollow Ethiopia. J Vet Med and Animal Health Pp 41-45. 3. Almeida, A., Magalhaes, V., Muniz, E. and Munhoz, A. (2011): Frequency of species of the genus Eimeria in naturally infected cattle in Southern Bahia, Northeast Brazil. Brazilian J Vet Parasitol. 20, Pp 78-81. 4. Alula, A., Nuru, M. and Belina, T. (2013): Prevalence of bovine Coccidia in Kombolcha district of South Wollo, Ethiopia, J. Vet. Med. Anim. Hlth., 5(2), Pp 41-45. 5. Bangoura, B. and Bardsley, K. (2020): Ruminant coccidiosis. Vet Clin North Am Food Anim.Pract.36, Pp 187–203. 6. Bangoura, B., Mundt, C., Schmäschke, R., Westphal, B., Daugschies, A. (2012): Prevalence of Eimeria bovis and Eimeria zuernii in German cattle herds and factors influencing oocyst excretion. Parasitol Res 110(2), Pp 875-881. 7. Belli, S., Smith, N., Ferguson, D. (2006): The coccidian oocyst: a tough nut to crack! Trends Parasitol 22(9), Pp 416-23. 8. Bruhn, F., Lopes, A., Demeu, F., Perazza, A., Pedrosa., M. and Guimaraes., M. (2011): Frequency of species of Eimeria in females of the holstein friesian breed at the post-weaning stage during autumn and winter. Rev. Bras. Parasitol. 20(4), Pp 303-307. 9. Burton, J., Madsen, A., Chang. L., Weber, P., Buckham, K., Dorp, R. and Hickey, M. (2005): Gene expression signatures in neutrophils exposed to glucocorticoids: a new paradigm to help explain “neutrophil dysfunction” in parturient dairy cows. Veterinary Immunology and Immunopathology. 105, Pp 197-219. 10. Chapman, H. (1974a): The effects of natural and artificially acquired infections of coccidia in lambs. Res Vet Sci 16(1), Pp 1-6. 11. Chapman, H. (1974b): The immunity of lambs to coccidia acquired in the field and by artificial infection. Res Vet Sci 16(1), Pp 7-11. 12. Coetzer, J. and Justin, R. (2004): Infectious Diseases of Livestock. Second Edition 3, Oxford University press. Pp 319 – 331. 13. Coico, R., Sunshine, G. (2009): Immunology: a short course. Wiley-Blackwell, Hoboken, New Jersey. Pp 8-100. 14. Curt, A. (2005): Senior Extension Associate, Department of Agricultural and Biological Engineering, PRO-DA Biology and Management Conference, Program, Cornell University. Dairy Calves and Heifers. Biology and Management Conference, January Pp 25-27. 15. Daugschies, A. and Najdrowski, M. (2005): Eimeriosis in cattle: current understanding. J. Vet. Med. B Infect. Dis. Vet. Public Health, 52, Pp 417-427. 16. Davis, L., Rand, G., Bowman, D. and Schizonts, F. (1962): microgametocytes of Eimeria auburnensis Christensen and Porter, 1939, in calves. J. Protozool. 9, Pp 424- 427. 17. Dawid, F., Amede, Y., Bekele, M. (2012). Calf coccidiosis in selected dairy farms of Dire Dawa, Eastern Ethiopia. Global Veterinaria. 9, Pp 460-464. 18. Debela, E. (2002): Epidemiology of gastro-intestinal helminthiasis of Rift Valley goats under traditional husbandry system in Adami Tulu district, Ethiopia. Eth. J. Sci., 25, Pp 35-44. Walkite Furgasa et al. /Int J Biol Med Res.14(4):7660-7664
7664 19. Dennis, M., Georgekg. and Gerald, M. (2012): An investigation of factors associated with the prevalence of bovine coccidiosis and its spatial epidimology in Busia Bungoma and siaya countrys,Unversity of Nairobi Kenya pp 1-2. 20. Dubey, P., Wouda, W. and Muskens, J. (2008).Fatal intestinal coccidiosis in a three week old buffalo calf (bubalusbubalus).American Society of Parasitologists.94 (6), Pp1289–1294. 21. Ernst, J., Stewart, B. and Witlock, D. (1987): Quantitative determination of coccidian oocysts in beef calves from the coastal plain area of Georgia (USA). Vet. Parasitol, 23, Pp 1-10. 22. EWAO, (2013): Ethiopia Wollega Arctecture. Office Arc Map GIS 10.4. 23. Faber, J., Kollmann, D., Heise, A., Bauer, C., Failing, K., Burger, H., Zahner, H. (2002): Eimeria infection in cows and their calves: oocyst extraction and levels of specific serum and colustrum antibodies. Veterinary Parasitology. 104, Pp 1-17. 24. Fayer, R. (1980): Epidimology of protoan infection :The coccidian Veterinary Parasitology Parasitology. 6, 75 -103. 25. Ferguson, D., Hutchison, W., Dunachie, J. and Siim, J., Chr. (2005): Ultrastructural study of early stages of asexual multiplication and microgametogony of Toxoplasma gondii in the small intestine of the cat. Acta Path Microbiol Scand, Sect B 82, Pp 167-181. 26. Fox, J. (1997): Results of recent field trials using decoquinate coccidiostat. Agri-Pract .Pp 4-10. 27. Fox, J. (2017): Bovine coccidiosis: A review, including field safety studies with decoquinate for prevention. Modern Vet Prac Pp 599-603. 28. Gillhuber, J., Rügamer, D., Pfister, K. & Scheuerle, M. (2014). Giardiosis and other enteropathogenic infections: a study on diarrheic calves in Southern Germany. BMC Research Notes, 7: 112-120. 29. Hendrix, C. (1998): Diagnostic veterinary parasitology. 2nd ed. Alabama: Auburn University. Pp15-27. Hendrix, C. (1998): Diagnostic veterinary parasitology. 2nd ed. Alabama: Auburn University. Pp15-27. 30. Juyal, P. and Singal, L. (2011): Herbal immunomodulatory and therapeutic approaches to control parasitic infection in livestock.Department of veterinary parasitology college of veterinary science Punjab agricultural university Ludhiana-1441004-india. Pp. 1-8. 31. Kaufman, J. (1996): Parasitic infection of domestic animals, a diagnostic manual. Germany: birkhauservelag. Pp. 24-27. 32. Kennedy, .J. (2001): Coccidiosis in cattle. Government of Alberta agricultural and rural development. 16, Pp 1-2. 33. Kennedy, J. (2011): Coccidiosis in cattle.Government of Alberta agricultural and rural development.2, Pp 1-4. 34. Kennedy, J. and Kralka, A.(1987): A survey of Eimeria species in cattle in central Alberta. 35. Lassen, B. and Ostergaard, S. (2012): Estimation of the economical effects of Eimeria infections in Estonian dairy herds using a stochastic model. Prev Vet Med. 106, Pp 258–265. Available from. 36. Lucas, A., Sweeker, W., Seaglia, G., Lindsay, D and Zajac, M. (2006): Variation in Eimeria composition on weaning beef heifers. J Parasitol. (92), Pp 1115- 1117. 37. Maas, J. (2007): Coccidiosis in Cattle. University of California Department of Veterinary Views. California Cattlemen's Magazine. Pp 1-2. 38. Merck, C., (2005): Coccidiosis in Ruminants ; 9th edition,Merc and co.,Pp 163-166,16 39. Mihreteab, B., Ferid, D. and Yeshitila, A. (2012): Calf coccidiosis in selected dairy farms of Dire Dewa,Eastern Ethiopia Global Veterinaria 9(4):460-464. 40. Mosmann, T., Sad, S. (1996): The expanding universe of T-cell subsets: Th1, Th2 and more. Immunology Today. (12), Pp128-146. 41. Nagwa, I., Toaleb, M., FaragalLa, M., El-Moghazy. and Soad, Hassan, E.(2011): Diagnosis of Eimeriosis in Cattle by ELISA Using Partially Purified Antigen. World App. Sci. J. 12, Pp 33-38. 42. Nisar-Khan, M., Rehman, T., Sajid, M., Abbas, R., Zaman, M., Sikandar, A. and Riaz, M. (2013): Determinants influencing prevalence of coccidiosis in Pakistani buffaloes. Pakistan Vet J. (33), Pp 287-290. 43. Pandit, B. (2009): Prevalence of Coccidiosis in Cattle in Kashmir valley. ISSN 4(1), Pp 973-6980. 44. Pence, M. (2011): Coccidiosis in cattle. University of Georgia, collage of veterinary medicine.1-3. 45. Quigley, J. (2001): A Review of coccidiosis in calves. Calf notes. Com. (17), Pp 1-6. 46. Radiostitis, M., Constable, P. and Hinchliff, W. (2007): Disease associated with protozoa, veterinary medicine a text book of the disease of horse, sheep, pig, and goat. 10th ed. London: Harcourt publishers Ltd. Pp 1498-1506. 47. Radostits, O, Constable, P. (2006): Veterinary Medicine. A Text Book of the Disease of Cattle, Horse, Sheep Pigs and Goats. 10th Ed., Sanders, Edinburgh, Pp. 969-984. 48. Rodríguez-Vivas, I., Acosta, J., Alpizar, and L. (1996): Epidemiological factors associated to bovine coccidiosis in calves (Bosindicus) in a subhumidtropical. 49. Scott P. (2011). Coccidiosis in cattle. East of England Development Agency Pp1-2. 50. Step, L., Streeter, N., Kirkpatrick, G. (2002): Bovine coccidiosis-A review. The Bovine Practitioner. (36), Pp 126-135. 51. Taylor, M., Coop, L. and Wall, L. (2007): Veterinary parasitology. 3rd ed. Singapore: Black well published ltd. Pp 39-73. 52. Thrusfield, M. (2007): Veterinary epidemiology. 3rd ed. London: Blackwell Science. Pp. 222-234. 53. Vorster, J. and Mapham, P. (2012): Review on coccidiosis,Vetdiagnostix Veterinary Pathology services available at WWW onlinevets.co.za Pp 1- 11Veterinary Laboratory Agency, 2009.Coccidiosis in cattle.Available at Pp 1-2. 54. Yu SK, M., Huang, N., Jia, YQ., Lin, Q. (2011): Prevalence of coccidial infection in cattle in Shaanxi province, Northwestern China. J Anim Vet Adv. (10), Pp 2716-2719. All rights reserved. c Copyright 2023 BioMedSciDirect Publications IJBMR - ISSN: 0976:6685. Walkite Furgasa et al. /Int J Biol Med Res.14(4):7660-7664
BioMedSciDirect Publications Int J Biol Med Res.2023 ;14(4):7665-7668 Contents lists available at BioMedSciDirect Publications Journal homepage: www.biomedscidirect.com International Journal of Biological & Medical Research International Journal of BIOLOGICAL AND MEDICAL RESEARCH Int J Biol Med Res www.biomedscidirect.com Volume 14, Issue 4, Oct 2023 Copyright 2023 BioMedSciDirect Publications IJBMR - ISSN: 0976:6685. All rights reserved. c ARTICLE INFO ABSTRACT Keywords: Phosphide poisoning Inflammation Interstitial haemorrhage Vitamins C and D. 1. Introduction Nowadays, environmental pollution is a common health problem confronting humans. Many pollutants interfere with our daily lives whether directly or indirectly, but the residual build up of pesticides in the food we eat is one of the most toxic contaminants. According to World Health Organization (WHO), millions of pesticide poisoning occur yearly accounting for over 250,000 deaths (1). Aluminum phosphide (ALP) alone account for over 10.5% suicidal cases in 2019 (2). Unfortunately, there is no specific antidotes for phosphine poisoning consequently accounting for the high morbidity and mortality rates particularly among the youths (3). Some of the palliative care for ALP poisoning include oral administration of charcoal, coconut oil, and intravenous magnesium sulphate (4). Exposure to the toxic phosphine gas may reduce both humoral and cellular immune functions which causes oxidative stress, depletion of the antioxidant levels, and nephrotoxicity (5). In our previous study, we demonstrated and reported the mitigating effects of the co-administration of vitamins C and D in phosphineinduced liver damage (6). Moreover, Adikwu and Deo (7) reported that antioxidant supplementation especially vitamins C and vitamin D ameliorate the stress associated with metal poisoning. Similarly, in many experimental studies, vitamins C and D diminishes reactive oxygen species and heightens the antioxidant defence system (8,9,10). Besides, vitamin D is essential for a wide range of non-classical functions and its deficiency is associated to a number of chronic disorders including diabetes, cardiovascular and kidney diseases (11). Background: In Africa, Aluminium phosphide is commonly used for storage and transportation of food grains. Unfortunately, the chemical build up in the food we eat is poisonous without a specific antidote. We speculate that the antioxidant effects of vitamins C and D could mitigate the long list of side effects. Aim of the Work: To determine the possible protective effect of vitamins C and D against phosphine-induced kidney damage in Wistar rats Materials and Method: This is an experimental laboratory-based study. Twenty Wistar rats were assigned randomly into five groups (n=4). Group, I served as the normal control while Groups II-V were exposed to 2.5 mg/kg phosphine tablet. Group II was the positive control without treatment while Groups III-V were treated with vitamin C (100mg/kg/bw), vitamin D (10mg/kg/bw). Group V was co-administered with vitamins C and D. All treatments lasted for 30 days. Animals were euthanized and blood was collected via cardiac puncture for renal function parameter while excised kidney was processed histologically by the paraffin wax method. Result: There was a significant increase in the urea and creatinine levels in phosphine-induced animals, indicating the kidney was injured. Creatinine is a more reliable marker for assessing kidney function than urea. Moreover, a number of interstitial foci of haemorrhage and inflammatory cells observed on the kidney confirmed the renal toxicity of phosphine. However, the coadministration of vitamins C and D produced a dose-related improvements in the kidney parenchyma. Conclusion: Aluminium phosphide is toxic to the kidney parenchyma. However, co-administration of vitamins C and D ameliorates phosphine-induced kidney damage. Original article Exploring the Protective Effects of Vitamin C and D against Phosphine-Induced Kidney Damage a b c a d Akinpelu MORONKEJI, 2Frederick O AKINBO, Solomon Matthias GAMDE*, Temidayo Daniel ADENIYI, Abiodun Abioye OYELEKE, e IDOWU-Aiye Faith a Department of Medical Laboratory Science, Faculty of Allied Health Sciences, University of Medical Sciences, Ondo State, Nigeria. b Department of Medical Laboratory Science, Faculty of Basic Medical Sciences, University of Benin, Edo State, Nigeria c Department of Medical Laboratory Science, Faculty of Allied Health Sciences, Bingham University Karu, Nasarawa State, Nigeria d Department of Anatomy, Ladoke Akintola University of Technology, Ogbomoso, Oyo State. e Department of Medical Laboratory Science, Achievers University Owo, Ondo State, Nigeria. * Corresponding Author : Department of Medical Laboratory Science, Faculty of Basic Medical Sciences, University of Benin, Edo State, Nigeria email; [email protected]. c Copyright 2023 BioMedSciDirect Publications IJBMR - All rights reserved. Solomon Matthias Gamde
Some clinical studies on humans have associated positive health outcomes with vitamins C and D ingestion (4), however their significance are inexhaustible. From the perspective that the kidney is susceptible to more than a few damage due to high volume of blood and toxins flowing through it and its ability to filter, there is paucity of information on the histopathology of phosphine-induced kidney damage and their possible antidote. It is against this background we determined the proctective effect of vitamins C and D on phosphineinduced kidney damage. MATERIALS AND METHODS Ethical approval This study was carried out in accordance with the code of ethics for experiments involving the use of laboratory animals. The protocol was approved by The Ethics and Research Committee, Ondo State Ministry of Agriculture, Akure City, Ondo State, Nigeria as referenced (MNR/V384/9). Experimental animals This is an experimental laboratory-based study. Animals were obtained from the Animal Holding of the Department of Anatomical Science, Achievers University Owo, Ondo State, Nigeria. The animals were housed in ventilated cages at the Animal House and allowed access to a standard rodent diet and water ad libitum through out the experiment following the International Human-Animal Care Standard. Study Design This is an experimental study. Twenty Wistar rats were assigned randomly into five groups (n=4). Group, I served as the normal control while Groups II-V were exposed to 2.5 mg/kg phosphine tablet. Group II served as the positive control without treatment while Groups III-V were treated with vitamin C (100mg/kg/bw) and vitamin D (10mg/kg/bw). Group V was co-administered with vitamins C and D. All treatments lasted for 30 days and the animals were euthanized for sample collection. Sample collection Blood was collected via cardiac puncture into a lithium heparinized anticoagulant bottles and was centrifuged at 3000 rpm for 15 mins to obtain the plasma. The plasma obtained was used for biochemical analysis while the excised kidney was fixed in 10% neutral buffered formalin for histological investigation. Biochemical analysis Plama urea (U) and creatinine (Cr) were analysed using diagnostic kits from Randox laboratory, United Kingdom while plasma electrolytes; potassium (K+), sodium (Na+), chloride (Cl-), and bicarbonate (HCO3) were estimated using “ARCHITECT c4000” Aboot automated chemistry analyser. Histopathological analysis Representative organs were processed histologically as described by Avwioro (12). Briefly, the grossed tissue was dehydrated in three changes of alcohol, xylene, and molten paraffin wax. Sections was cut at 4 microns on a rotary microtome (Leica RM2125 RTS, Leica Biosystems, Buffalo Grove, United States of America) and stained in hematoxylin-eosin (H & E). Statistical analysis Data were evaluated by one-way analysis of variance (ANOVA) using statistical package for social science (SPSS) Version 25 (SPSS, Cary, NC, USA) and expressed as the mean standard error of the mean, while the student t-test was used to assess if there is any difference in the data obtained, p values < 0.05 was considered statistically significant. RESULT Biochemical assessment In this study, there was a significant increase in plasma urea and creatinine levels in phosphine-induced animals compared to the control group, indicating that the kidney was injured (Table 1). Table 1: Effect of Vitamin C and D on kidney function markers: Results were expressed as mean value ± standard deviation (SD).*mean values were significantly different compared to the Normal control at P≤ 0.05.#mean values were significantly different compared with the positive control (Aluminum Phosphate). Group I: Control, Group II: Aluminum Phosphate, Group III: Aluminum Phosphate + Vitamin C, Group IV: Aluminum Phosphate + Vitamin D, Group V: Aluminum Phosphate + Vitamin C and D. Figure 1: The effect of Vitamin C and D on electrolytes and creatinine values. *mean values were significantly different compared to the phosphine group at P≤ 0.05. Figure 2: Effect of vitamin C and D on potassium and urea levels. *mean values were significantly different compared to the phosphine group at P≤ 0.05. 7666 Akinpelu MORONKEJI et al. /Int J Biol Med Res.14(4):7665-7668
Histopathology assessment There was inflammatory cells and foci of interstitial haemorrhage on the kidney parenchyma. However, coadministration of vitamins C and D produced a dose-related improvements in the kidney (Figures 3-5). Figure 3 Normal kidney section (I): shows renal corpuscle (white arrow), renal tubule (black arrow), and proximal tubule (blue arrow). Phosphine induced degenerated kidney (II) exhibited severe inflammation (red arrow). (H&E. Mag. X 400). Figure 4 Phosphine induced degenerated kidney (I) treated with Vitamin C exhibited severe inflammation (red arrow) while animals treated with Vitamin D (IV) exhibited extravasion of blood (red arrow). (H&E. Mag. X 400). Figure 5 Phosphine induced degenerated kidney (V) treated with Vitamin C and D shows mild interstitial haemorrhage (red arrow) with improved histological features compared to normal control (I). (H&E. Mag. X 400). DISCUSSION The protective effect of antioxidants against the many deleterious effects of ALP have been reported (13). We determined the protective effects of vitamins C and D against phosphine-induced kidney damage. In this experimental study, ALP caused significant changes in both the biochemical and anatomic structures of the kidney. There was a significant decrease in sodium (Na2+) levels in the phosphine-induced group whereas vitamin supplementation restored the Na2+ values with the most significant improvement detected in the group co-administered vitamins C and D. There was also significant restoration of potassium, chloride, and bicarbonate values to normalcy in the group. Previous studies has suggested that electrolytes abnormalities, such as high or low sodium and potassium levels may be present in phosphine poisoning (14,15,16). According to Mokhtari et al., (11), vitamin D improves the antioxidant defence system such as glutathione, glutathione peroxidase, and superoxide dismutase. Normal redox homeostasis would break down when their intracellular scavenging capacity is abridged. In some cases of metabolic stress, the levels of intracellular oxidants may rise with toxic effects indiscriminately damaging proteins, lipids, and DNA and activating specific signaling pathways that is linked to the onset of a number of diseases (4). In addition, some studies have also indicated the significance of vitamin C in reducing the oxidative effect of phosphine (17,18). Creatinine is a reliable marker than urea to assess kidney function (19), a significant increase in both creatinine and urea in the present study shows that the animals suffered nephrotoxic changes. The alleviating effect of vitamins when administered individually, as well as the co-administration of vitamins C and D was apparent in this study with a significant reduction in urea and creatinine values. Moreover, free radicals interacts with normal cellular components leading to tissue-breakdown (14,20). The histopathological changes in the present study is similar to previous reports (21,22) that documented interstitial haemorrhage in the kidney of experimental animals. A number of studies have reported the role of vitamin D supplementation in oxidative stress (23,24,25,26,27). The present study revealed for the first time that vitamins C and D supplementation improved the kidney function as well as histologic features in phosphine induced damaged in tandem with previous studies which established phosphine-induced kidney damage (28,29). CONCLUSION In this study, ALP significantly increased the plasma urea and creatinine levels, indicating that the kidney was injured. A number of inflammatory cells and interstitial haemorrhage proved the kidney was injured. However, co-administration of vitamins C and D produced a dose-related improvements in the kidney. Declarations: Ethics Approval: The protocol was approved by The Ethics and Research Committee, Ondo State Ministry of Agriculture, Akure City, Ondo State, Nigeria as referenced (MNR/V384/9). Consent for publication: Not applicable Availability of data and material: Data are available from the corresponding author upon request. 7667 Akinpelu MORONKEJI et al. /Int J Biol Med Res.14(4):7665-7668
Competing interests: Nothing to declare Funding: None Acknowledgments: The authors acknowledge the Animal Ethics Committee. 7668 References 1. Yang CC, Deng JF. Intermediate syndrome following organophosphate insecticide poisoning. Journal of the Chinese Medical Association, 2007; 70(11):467-72. https://doi.org/10.1016/S1726-4901(08)70043-1 2. Malik, B., Saleem, K., Afridi, H. K., Khan, R., & Zaman, M. U. Prevalence of aluminum phosphide intoxication amongst victims of poisoning – forensic medicine and toxicology registry data. Journal of Medical Sciences (Peshawar), 2021; 29(2): 75–78. https://doi.org/10.52764/jms.21.29.2.3. 3. Singh, Y., Joshi, S. C., Satyawali, V., & Gupta, A. Acute aluminium phosphide poisoning, what is new? The Egyptian Journal of Internal Medicine, 2014; 26(3):99–103. https://doi.org/10.4103/1110-7782.145298. 4. Tagliaferri, S., Porri, D., De Giuseppe, R., Manuelli, M., Alessio, F., & Cena, H. The controversial role of Vitamin D as an antioxidant: results from randomised controlled trials. Nutrition Research Reviews, 2019; 32(1): 99–105. https://doi.org/10.1017/S0954422418000197. 5. Atere, A. D., Moronkeji, A., Moronkeji, A. I., & Osadolor, H. B. Serum levels of inflammatory biomarkers, glycaemic control indices and leptin receptors expression in adult male Wistar rats exposed to Pyrethroids. Journal of Cellular Biotechnology, 2021; 7(1): 41–55. https://doi.org/10.3233/JCB210034. 6. Akinpelu, M., Gamde, S.M., Akinbo, F., Adeniyi, T.D., Elizebeth, A. F., & Obeagu, E.I. Histopathological and Biochemical Effect of Vitamin C and D on Phosphine - Induced Hepatotoxicity in Wistar Rats. Asian Journal of Dental and Health Sciences Open, 2023; 3(2): 18–22. 7. Adikwu E, Deo O. Hepatoprotective effect of vitamin C (ascorbic acid). P h a r m a c o l o g y & P h a r m a c y , 2 0 1 3 , 4 , 8 4 - 9 2 . http://dx.doi.org/10.4236/pp.2013.41012 8. Farzaneh, E., Ghobadi, H., Akbarifard, M., Nakhaee, S., Amirabadizadeh, A., Akhavanakbari, G., Keyler, D. E., & Mehrpour, O. Prognostic Factors in Acute Aluminium Phosphide Poisoning: A Risk-Prediction Nomogram Approach. Basic and Clinical Pharmacology and Toxicology, 2018; 123(3): 347–355. https://doi.org/10.1111/bcpt.13005. 9. Schroten NF, Ruifrok WP, Kleijn L, et al. Short-term vitamin D3 supplementation lowers plasma renin activity in patients with stable chronic heart failure: an open-label, blinded end point, randomized prospective trial (VitD-CHF trial). American Heart Journal, 2013; 166:357- 364. e352. DOI: 10.1016/j.ahj.2013.05.009. 10. Mastali VP, Hoseini R, Azizi M. The effect of short-term vitamin D on the antioxidant capacity following exhaustive aerobic exercise. Afri Health Sci. 2023;23(1):584-91. https://dx.doi.org/10.4314/ahs.v23i1.61. 11. Mokhtari, Z., Hekmatdoost, Z., & Nourian, M. Antioxidant efficacy of vitamin D. J o u rn a l o f Pa ra t hy ro i d Di s e a s e . 2 0 1 7 ; 5 ( 1 ): 1 1 – 1 6 . http://www.jparathyroid.com. 12. Avwioro O. Histochemistry and Tissue Pathology. Principles and Techniques, 2 th ed. 2014; 123-425. 13. George B, Kaur C, Khurdiya DS, Kapoor HC. Antioxidants in tomato (Lycopersium esculentum) as a function of genotype. Food Chemistry, 2004; 84(1):45-51. 14. Hashemi-Domeneh, B., Zamani, N., Hassanian-Moghaddam, H., Rahimi, M., Shadnia, S., Erfantalab, P., & Ostadi, A. A review of aluminium phosphide poisoning and a flowchart to treat it. Arhiv Za Higijenu Rada i Toksikologiju, 2016; 67(3), 183–193. https://doi.org/10.1515/aiht-2016-67-2784. 15. Chugh S, Kishore K, Aggarwal N, Attri S. Aluminium phosphide (ALP) is a widely used fumigant posticide. J Assoc Physicians India, 2000; 48:855-6. PMID: 11273495. 16. Farzaneh, E., Ghobadi, H., Akbarifard, M., Nakhaee, S., Amirabadizadeh, A., Akhavanakbari, G., Keyler, D. E., & Mehrpour, O. Prognostic Factors in Acute Aluminium Phosphide Poisoning: A Risk-Prediction Nomogram Approach. Basic and Clinical Pharmacology and Toxicology, 2018; 123(3): 347–355. https://doi.org/10.1111/bcpt.13005. 17. Mehrpour, O. Comment on “An update on toxicology of aluminum phosphide.” DARU, Journal of Pharmaceutical Sciences, 2012; 20(1): 1–8. https://doi.org/10.1186/2008-2231-20-50. 18. Tamegnon Victorien Dougnon, Edna Hounsa, Eric Agbodjento, et al. Toxicological Characterization of Ten Medicinal Plants of the Beninese Flora Used in the Traditional Treatment of Diarrheal Diseases. Hindawi EvidenceBased Complementary and Alternative Medicine. 2021, 13 pages doi.org/10.1155/2021/6676904. 19. Solomon Matthias Gamde, Chinenye J. Ugwah-Oguejiofor, Aminu Garba, Godwin O Avwioro, Akinpelu Moronkeji, Abdullahi Abiodun Jimoh. Histologic and Biochemical Effect of Balanite aegyptiaca Fruit Extract on Alloxan-Induced Diabetes in Wistar Rats. Ethiop J Health Sci. 2023;33(3):13. doi:http://dx.doi.org/ 10.4314/ejhs.v33i3.3. 20. Toussi, A. G. Successful treatment of aluminum phosphide; is it possible? Asia Pacific Journal of Medical Toxicology, 2017; 6(3): 90–96. 21. Solomon Matthias Gamde, Abubakar Sadiq, Ajayi Ayooye Samuel, Samuel Eugene Bwede, James O. Adisa. Histological Effects of Ethanolic Stem Bark Extract of Anacardium Occidentale on the Kidney of Rabbits. International Journal of Innovative Research & Development, 2019; 8(8):286-291. DOI No.: 10.24940/ijird/2019/v8/i8/AUG19088. 22. Eric, E. U., Boloya, V. E., & Osuamkpe, A. E. Aggravation of Aluminum Phosphide Induced Liver Damage and Hematotoxicity in Adult Wistar Rat: The Role of Allium Sativum. European Journal of Biology and Biotechnology, 2021; 2(2): 51–59. https://doi.org/10.24018/ejbio.2021.2.2.176. 23. Bresm, M. H. A., & Habeeb, M. H. H. Effect of Vitamin D3 on some antioxidant parameters in chilled semen in Awassi Ram. Archives of Razi Institute. 2022; 78(2), 721–727. https://doi.org/10.22092/ARI.2022.359482.2433. 24. Sepidarkish, M., Farsi, F., Akbari-Fakhrabadi, M., Namazi, N., AlmasiHashiani, A., Maleki Hagiagha, A., & Heshmati, J. The effect of vitamin D supplementation on oxidative stress parameters: A systematic review and m e t a - a n a l y s i s o f c l i n i c a l t r i a l s . P h a r m a c o l o g i c a l R e s e a r c h , 2 0 1 9 ; 1 3 9 , 1 4 1 – 1 5 2 . https://doi.org/10.1016/j.phrs.2018.11.011 25. Lin AM, Chen KB, Chao PL. Antioxidative effect of vitamin D3 on zinc-induced oxidative stress in CNS. Annals of the New York Academy of Sciences, 2005;1053(1):319-29. 26. Adikwu, E., & Deo, O. Hepatoprotective Effect of Vitamin C (Ascorbic Acid). P h a r m a c o l o g y &a m p ; P h a r m a c y, 2 0 1 3 ; 0 4 ( 0 1 ), 8 4 – 9 2 . https://doi.org/10.4236/pp.2013.41012. 27. Olubukola Sinbad, O., Folorunsho, A. A., Olabisi, O. L., Abimbola Ayoola, O., & Johnson Temitope, E. Vitamins as Antioxidants. Journal of Food Science and N u t r i t i o n R e s e a r c h , 2 0 1 9 ; 0 2 ( 0 3 ) , 2 1 4 – 2 3 5 . https://doi.org/10.26502/jfsnr.2642-11000021. 28. Karimani, A., Mohammadpour, A. H., Zirak, M. R., Rezaee, R., Megarbane, B., Tsatsakis, A., & Karimi, G. Antidotes for aluminum phosphide poisoning – An u p d a t e . To x i c o l o g y Re p o r t s , 2 0 1 8 ; 5 ( 7 ): 1 0 5 3 – 1 0 5 9 . https://doi.org/10.1016/j.toxrep.2018.10.009. 29. Haghi Aminjan, H., Abtahi, S. R., Hazrati, E., Chamanara, M., Jalili, M., & Paknejad, B. Targeting of oxidative stress and inflammation through ROS/NF-kappa B pathway in phosphine-induced hepatotoxicity mitigation. L i f e S c i e n c e s . 2 0 1 9 ; 2 3 2 ( 6 ) : 1 1 6 6 0 7 . https://doi.org/10.1016/j.lfs.2019.116607. 30. Moghadamnia AA, Abdollahi M: An epidemiological study of poisoning in northern Islamic Republic of Iran. East Mediterr Health J. 2002; 8:88–94. Akinpelu MORONKEJI et al. /Int J Biol Med Res.14(4):7665-7668 All rights reserved. c Copyright 2023 BioMedSciDirect Publications IJBMR - ISSN: 0976:6685.
BioMedSciDirect Publications Int J Biol Med Res.2023 ;14(4):7669-7672 Contents lists available at BioMedSciDirect Publications Journal homepage: www.biomedscidirect.com International Journal of Biological & Medical Research International Journal of BIOLOGICAL AND MEDICAL RESEARCH Int J Biol Med Res www.biomedscidirect.com Volume 14, Issue 4, Oct 2023 Copyright 2023 BioMedSciDirect Publications IJBMR - ISSN: 0976:6685. All rights reserved. c ARTICLE INFO ABSTRACT Keywords: Ligature Asphyxia Autopsy Hanging Ligature Strangulation 1. Introduction Asphyxia is derived from Greek word and it literally means pulselessness [1].It can be categorised into two broad groups; mechanical and non-mechanical. Mechanical asphyxia means that the flow of air into the body is interfered through some physical impediments and is considered the most common type in medicolegal practice [2].Constriction around the neck plays a major role in producing mechanical asphyxia. Hanging and ligature strangulation, both are examples of asphyxial fatalities [3]. In cases of hanging or ligature strangulation, there will be evidence of ligature mark around the neck [4].Ligature mark is an important finding when ligature material is not available. The most important findings in a ligature mark are level, discontinuities and obliquity, which may differentiate hanging from ligature strangulation [5].The aim of present study was to find the morphological differences in ligature mark in cases of death due to hanging and ligature strangulation. Materials and Methods: The prospective observational study was carried out during the medico-legal autopsies on the cases of death due to hanging and ligature strangulation conducted in the Department of Forensic Medicine and Toxicology, Post Graduate Institute of Medical Sciences (PGIMS), Rohtak (Haryana) from the year 2018 to 2021. A total of 64 post-mortem cases with alleged history of hanging and ligature strangulation brought for autopsy were considered. Bodies with putrefactive changes and all the cases of strangulation death other than ligature strangulation were excluded from the study. Informed consent was taken from the next of kin of the deceased. A thorough external examination was conducted in the mortuary with emphasis over ligature mark and ligature material. Routine instruments and material of dissection were used for internal examination of body. Aim & objectives: To study the difference between morphology, pattern and variations in ligature mark in cases of the hanging and ligature strangulation.Material & methods: The ligature mark was studied in detail in cases of asphyxial deaths due to hanging and ligature strangulation brought for the autopsy in the mortuary of a tertiary care centre of Haryana on 64 autopsy subjects. Results: Atotal number of 64 cases were included in the study out which 60 cases were of hanging and 4 cases were of ligature strangulation. The direction of ligature mark was oblique in all 60 (100%) cases of hanging and transverse in all 04 (100%) cases of strangulation. The ligature mark was interrupted in 43 (72%) cases of hanging, continuous in 17 (28%) cases of hanging whereas interrupted in 02 (50%) cases while continuous in 02 (50%) cases of ligature strangulation. The ligature mark was situated above thyroid cartilage in 44 (73%) cases and at the level of the thyroid cartilage in 16 (27%) cases of hanging while it was below the level of thyroid cartilage in all 04 (100%) cases of ligature strangulation.Conclusion: Theobliquity of ligature mark is one of the best measure to differentiate hanging and ligature strangulation. However, discontinuation, interruption and position of ligature mark either above or at the level of thyroid cartilage also strongly suggests hanging. Original article A Study of Gross Morphological Differences in Appearance of Ligature Mark in Post-Mortem Cases of Asphyxial Deaths in a Tertiary Care Centre of Haryana a b c d e Kunal Khanna , *Jitender Kumar Jakhar Sandeep Kumar Giri Naveen Sharma Gajender Yadav a Associate Professor, Department of Forensic Medicine & Toxicology, Kalpana Chawla Govt. Medical college Karnal, Haryana (132001) b Professor,Department of Forensic Medicine & Toxicology, Pt. B. D. Sharma PGIMS, Rohtak, Haryana (124001) c Assistant Professor, Department of Forensic Medicine & Toxicology, Kalpana Chawla Govt. Medical college Karnal, Haryana (132001) d Assistant Professor, Department of Forensic Medicine & Toxicology, MMCMSR Sadopur, Ambala Haryana (134007) eMedical Officer, Department of Forensic Medicine, District Hospital, Rewari, Haryana (123401) * Corresponding Author : Professor,Department of Forensic Medicine & Toxicology, Pt. B. D. Sharma PGIMS, Rohtak, Haryana (124001) [email protected] Jitender Kumar Jakhar c Copyright 2023 BioMedSciDirect Publications IJBMR - All rights reserved.
Results: Out of studied 64 death cases, 60 were of hanging while 4 were of ligature strangulation. 51 (85%) deaths by hanging and 02 (50%) deaths by ligature strangulation were reported to be in 11-40 years of age (Table-I). The ligature material around the neck was absent in 39 (65%) cases of hanging and was present in 21 (35%) cases. It was absent in all 04 (100%) cases of strangulation (Table-II, Figure-1). The colour of ligature mark was observed to distinguish between hanging and ligature strangulation. Reddish brown ligature mark was present in 44 (73%) cases, yellowish brown in 08 (15%) cases and pale yellow in 04 (07%) cases of hanging. It was hypopigmented/scabbed in 04 (07%) cases of delayed deaths due to hanging. However, it was reddish brown in all 04 (100%) cases of strangulation (Figure-2). The width of ligature mark was between 1 to 3 cm in 44 (73%) cases, more than 3 cm in 09 (15%) cases and less than 01 cm in only 07 (12%) cases of hanging. The width was between 1 to 3 cm in 02 (50%) cases while it was less than 1 cm and more than 3 cm in 1 (50%) case each of strangulation (Figure-3). Various characters of ligature mark were recorded at the time of autopsy in cases of hanging and ligature strangulation (Table-III). Direction of ligature mark was oblique in 60 (100%) cases of hanging and transverse in all 04 (100%) cases of strangulation. Continuity of ligature mark was interrupted in 43 (72%) cases of hanging, continuous in 17 (28%) cases of hanging whereas it was interrupted in 02 (50%) cases while continuous in 02 (50%) cases of strangulation. Parchmentization of ligature mark was present in 54 (90%) cases of hanging while it was absent in 6 (10%) cases of hanging whereas present in 02 (50%) cases while absent in 02 (50%) of strangulation. The position of ligature mark in respect of thyroid cartilage was situated above in 44 (73%) cases and over thyroid cartilage in 16 (27%) cases of hanging while it was below thyroid cartilage in all 04 (100%) cases of strangulation. Knot placement was observed on back of neck in 29 (48%) cases, on right side in 16 (27%), on left side in 13 (22%), below chin in 02 (03%) cases while it was on back of neck in all 04 (100%) cases of strangulation (Figure-4). TABLE-I: AGE AND SEX WISE DISTRIBUTION OF CASES. TABLE-II. DISTRIBUTION OF CASES AS PER PRESENCE OR ABSENCE OF LIGATURE MATERIAL IN SITU TABLE-III: DISTRIBUTION OF CASES AS PER CHARACTERS OF L I G AT U R E M A R K I N H A N G I N G A N D L I G AT U R E STRANGULATION. 7670 Kunal Khanna et al./Int J Biol Med Res.14(4):7669-7672
Discussion: The ligature mark in hanging and ligature strangulation needs detailed and extensive examination. Inspection, palpation and internal examination have to be carried out in an orderly manner. The nature and texture of ligature material also plays a vital role in correlating the findings in respective cases.6 In the present study, it is observed that maximum 24 (40%) cases of hanging were from the age group of 21 to 30 years followed by 17 (28%) cases of the age group 31 to 40 years. The above findings can easily be explained by the fact that 21 to 30 years of age group is most susceptible to frustration in life as a result of multiple factors such as failure of love affairs, stressful marital life, dowry, financial crunch and pressure of making a good career after completion of studies etc. It is also observed that maximum number 02 (50%) cases of strangulation were from age group 41 to 50 years, the age group having more financial disputes. It is observed that majority of deaths due to hanging were of males 47 (78%) as compared to females 13 (22%). In deaths due to strangulation also males were dominant i.e. 03 (75%) and female was 01 (25%). Males outnumbered the females in the present study. Male preponderance can be explained by the fact that in Indian society the male members are more expected to bear all the responsibilities. So, they have the dual pressure of career and family responsibilities. These findings are similar in studies done by Rawat V et al (2015) [7] and Rangaiah YKC et al (2015) [8]. Reddish brown ligature mark was present in 44 (73%) cases of hanging and all 04 (100%) cases of strangulation followed by yellowish brown in 08 (15%) cases of hanging. It was pale yellow in 04 (7%) cases of hanging. The colour of ligature mark depends largely upon the duration of suspension of the body and nature of the ligature material used. Reddish brown colour of ligature mark is the most common and reflects the ante-mortem nature of ligature mark though other type of coloured ligature mark are also present in antemortem hanging. Similar findings were observed by Pal SK et al (2018) [9]. The study depicts that width of ligature mark was between 1 to 3 cm in 44 (73%) cases, more than 3 cm in 09 (15%) cases and less than 01 cm in only 07 (12%) cases of hanging. Width was between 1 to 3 cm in 02 (50%) cases of strangulation while it was less than 1 cm (25%) and more than 3 cm in 1 (25%) case each. In this study the width of the ligature material can be categorised into three groups; narrow when the width is <1 cm, medium when the width is between 1-3 cm and broad when the width is >3 cm. The most common width in this study was the medium between 1-3 cm in both hanging and strangulation cases. This shows the most common width of ligature materials used in cases of hanging and strangulation. It is observed that the direction of ligature mark was oblique in all 60 (100%) cases of hanging and transverse in 04 (100%) cases of strangulation. The direction of ligature mark is considered from the position of the knot towards most prominent area of ligature mark [4]. Obliquity is the most consistent feature and plays an important role in describing cause of death and differentiates between hanging and strangulation. In the continuity of ligature mark, it is found that it was interrupted in 43 (72%) cases, continuous in 17 (28%) cases of hanging and interrupted in 02 (50%) cases while continuous in 02 (50%) cases of strangulation. In cases of hanging, similar findings were observed by Patel et al (2013) [10], Prasad et al (2016) [6], Rao D (2016) [11] and Sharma et al (2018) [3]. The higher incidence of incomplete ligature mark in cases of hanging was observed in most of the studies with same observation of this study. Continuous 7671 Kunal Khanna et al./Int J Biol Med Res.14(4):7669-7672
cartilage in most cases of hanging and below the thyroid cartilage in all cases of strangulation. Reddish brown ligature mark is more suggestive of ante-mortem phenomenon rather than differentiation of hanging and strangulation as comes out in this study. Suggestions: In cases where the ligature material is not present at the time of post-mortem examination, using a cellophane tape over the ligature mark and analysing under comparative microscope to corroborate with the li ligature mark in cases of hanging could be due to slip knot allowing to completely encircling of neck by the ligature material. Discontinuity of ligature mark is strongly suggestive of hanging but it neither confirms nor rule out strangulation. In the present study in 02 (50%) cases of strangulation, it was continuous. This is because in one case it was interrupted by the hairs of female and in another case, the strangulation was entangling of clothes in machinery. Patel et al (2013) [10] in 66.6% cases and Singh et al(2018) [12] in 10 % cases of strangulation observed the continuity of ligature mark. Parchmentization of ligature mark was present in 54 (90%) cases of hanging while it was absent in 6 (10%) cases. It was present in 02 (50%) cases of strangulation while absent in 02 (50%) cases of strangulation. Parchmentization is the thinning and hardening of tissues beneath the ligature mark in which it is converted to parchment paper like. It depends upon multiple factors such as ligature material left in-situ, post-mortem interval and temperature of environment etc. Higher temperature favours parchmentization. Rawat V et al (2015) [7] and Sharma et al (2018) [3] observed the colour and parchmentization as a single parameter though these are different entity. The position of ligature mark in respect to thyroid cartilage is also observed in this study. It was situated above the level of thyroid cartilage in 44 (73%) cases and over the thyroid cartilage in 16 (27%) cases of hanging. It is a well-known fact that the ligature mark of hanging and strangulation are not found at same level. Ligature mark in cases of hanging is situated higher in the neck usually above the thyroid cartilage. Where suspension is low; the resulting mark may be set at a lower level typically immediately above or below the thyroid cartilage. In cases of hanging, the presence of ligature mark above the thyroid cartilage is because of the fact that the ligature material slides upward and constriction force around the neck is applied in upward direction due to weight of the body. Several studies have reported similar findings with ligature mark below the level of thyroid cartilage in 02 to 07 % cases of hanging as observed in the present study [6,11]. This can be found where the victim makes a larger loop of ligature material keeping the ligature mark below thyroid cartilage. In present study, the ligature mark was present below the level of thyroid cartilage in all 04 (100%) cases of strangulation which is contrary to the study done by Patel et al (2013) [10] and Kumar V et al (2017) [13]in which ligature mark in strangulation was found at the level of thyroid cartilage in 100 % and 87.5% cases respectively. It is observed that in cases of hanging, placement of knot was on the back of neck in 29 (48%) cases, on right side in 16 (27%), on left side in 13 (22%), below chin in 02 (03%) cases while it was on back of neck in all 04 (100%) cases of strangulation. Pal SK et al (2018) [9] observed that knot was observed on left side of neck in 61 (50%) cases, on right side of neck in 29 (23.77%) cases, on front of neck in 7 (5.73%) cases and nape/backside in 5 (4.09%) cases of hanging. Reddy TTK et al (2019) [14] found position of the knot in most cases of hanging over right and left side of neck 45% and 25% respectively. Conclusion: In this study, obliquity of mark is the best measure for differentiation of hanging and ligature strangulation as it is present in all cases of hanging and absent in all cases of strangulation. Horizontal ligature mark is a better measure for diagnosis of strangulation as it was present in all cases of this study. Discontinuity of mark also strongly suggests hanging as it is present in most cases of hanging of this study though it may present in strangulation. In this study, ligature mark was situated above the level of thyroid gature material is also recommended with this study. 7672 1. Bardale R. Principles of Forensic Medicine and Toxicology. New Delhi: Jaypee Brothers Medical Publishers(P) Ltd 2011: p-326. 2. Vij K. Textbook of Forensic Medicine and Toxicology. 5thed. New Delhi: Elsevier 2011. 3. Sharma N, Shrivastava A, Vyas PC. A study of morphology and histopathology of ligature marks in asphyxial deaths by compression of neck in Jodhpur region, Rajasthan. J Medical Sci and Cli Res 2018; 6(6): 923-929. 4. Dikshit PC. Textbook of Forensic Medicine and Toxicology. New Delhi: Peepee Publishers and Distributors (P) Ltd 2010. 5. Gordon I, Shapiro HA, Berson SD. Forensic medicine A Guide to Principles. 3rd ed. Edinburgh: Churchill Livingstone 1988. 6. Prasad KJ, Khalid MA, Faheem K, Narayana BL, Arumalla VK. Ligature mark in hanging – gross and histopathological examination with evaluation and review. JAddiction and Dependence 2016; 2(2): 1-7. 7. Rawat V and Rodrigues EJ. Medicolegal Study of Hanging Cases In North Goa. InternatJ Forensic Sci & Pathol 2015; 3(5): 110-118. 8. Rangaiah YKC, Shankar R, Obulesu LC. An analytical study of ligature mark in cases of hanging & ligature strangulation. J Evolution of Medical and Dental Sci 2015; 4(81): 14156-14162. 9. Pal SK, Rana A, Sharma A, Kaushik N, Sehgal. A Forensic Analysis of Ligature Material in Suicidal Hangings. InternatJ Forensic Sci 2018; 3(2): 138. 10. Patel JB, Bambhaniya AB, Chaudhari KR, Upadhyay MC. Study of death due to compression of neck by ligature. Internat J Health Sciand Res 2015; 5(8): 76- 81. 11. Rao D.An autopsy study of death due to Suicidal Hanging - 264 cases. Egyptian J Forensic Sci 2016; 6: 248-54. 12. Singh NK, Shubhendu K, Mahto T, Chaudhary AK, Gawasker SP. A comparative study of ligature marks in cases of Hanging and strangulation autopsied at RIMS, Ranchi. IOSR J Dental and Medical Sci 2018; 17(8): 01-05. 13. Kumar V, Roy P, Kumar G and Saha S. Study of cases of hanging and strangulation by ligature with special reference to morphological changes in lungs, thyroid and adrenal glands. Indian J Forensic Medi & Toxicol 2012; 11(1): 33-8. 14. Reddy TTK, Krishnamurthy V, Rao NPC, Prakash KR and Kumar KS. A study of various patterns of ligature mark produced in cases of hanging brought to the mortuary, GGH, Guntur. Internat J Clinical and Diagnostic Pathol 2019; 2(2): 33-7. REFERENCES All rights reserved. c Copyright 2023 BioMedSciDirect Publications IJBMR - ISSN: 0976:6685. Kunal Khanna et al./Int J Biol Med Res.14(4):7669-7672
BioMedSciDirect Publications Int J Biol Med Res.2023 ;14(4):7673-7674 Contents lists available at BioMedSciDirect Publications Journal homepage: www.biomedscidirect.com International Journal of Biological & Medical Research International Journal of BIOLOGICAL AND MEDICAL RESEARCH Int J Biol Med Res www.biomedscidirect.com Volume 14, Issue 4, Oct 2023 Copyright 2023 BioMedSciDirect Publications IJBMR - ISSN: 0976:6685. All rights reserved. c ARTICLE INFO ABSTRACT Keywords: partograph morbidity mortality complication 1. Introduction Childbirth is the process when women give birth to a child, the most beautiful time in a woman's life is during childbirth, because women and their families experience the greatest expectations during childbirth. (1) The expected period of uncertainty, anxiety and fear ends with the beautiful birth of a baby. An Indian hospital study shows that the maternal mortality rate is 4.21/1000 live births. 50-98% of maternal deaths are due to non-deviant obstetric causes. 50% of maternal deaths caused by sepsis or related to illegitimate induced abortion.(2) An international survey shows that more than 50 million women suffer as a result of serious diseases or dysfunctions related to pregnancy.(3) At least 1.2 million newborns die as a result of inadequate and untrained care they receive at the time of birth, and it is estimated that that more than 585,000 women die worldwide each year from complications related to pregnancy and childbirth(4) METHODOLOGY: Partograph study among midwifery nurses at Ashwin Hospital using pre-experimental one-group pre-test post-test was adopted. Non-probability convenience sampling was used to select 40 samples. This study was conducted at Ashwin Hospital from April 2023 to June 2023. Self-administered questionnaires were used to assess knowledge of the use of the partograph, review-based direct observations were conducted on all participating midwives to determine the actual practical use of the partograph. was analyzed using descriptive and inferential statistical methods and interpretations were made based on the objectives of the study DATA COLLECTION All midwives who were involved in the study were directly observed by data collectors to check whether they were using and filling in the partograph parameters correctly or not. Observation was carried out until the end of delivery. An observation checklist was created as a partographic aid for direct observation of study participants during labor. Data were then collected using a structured questionnaire on partograph use by midwives and a realistic survey. inform about consent and completed questionnaires to maintain confidentiality. Partograph users were considered midwives who completely and correctly recorded at least the fetal heart rate, cervical dilation, uterine contraction, vital Background: Partograh is a pictorial representation used during the birthing process for the Shepherding Mother. It is mainly used to prevent prolonged and obstructed labour. Globally, maternal morbidity and mortality affected 13.6 million mothers. Most of these deaths occurred in countries with limited resources. Because midwives can improve outcomes and predict the course of labor using a partograph during labor. this can help the mother and baby to heal and reduce the baby's risk factor. Method: A study conducted on a partograph among nurses at Ashwin Hospital using a pre-experimental one-group pre-test post-test design was adopted. Non-probability convenience sampling was used to select 40 samples. Self-administered questionnaires were used to assess knowledge on the partograph. Direct observations based on control were made to all midwife participants to determine the actual practical use of the partograph. Data were analyzed using descriptive and inferential statistical methods and interpretations were made based on the objectives of the study. Result: In this study, 22 (55%) of the 40 study participants used the partograph. After gaining knowledge and training, there were positive predictors of partograph use. The average knowledge score in the pretest was 6.2 and in the posttest was 12.1, and the obtained use of the partograph in the pretest was 6 and in the posttest was 12.5. Conclusion: Educational measures show that during childbirth it is important to significantly improve knowledge about the use of the paratograph and a realistic review of the rendering parotograph among nurses, which will prevent complications for both mother and child. Short report Effectiveness of knowledge and Utilization of Partograph among midwifery in labour ward at Ashwin hospital ,Coimbatore Hatlin Sugi .M, Ph.D Scholar PSG* College of Nursing, Tamil Nadu Dr. M.G.R. Medical University, Chennai, India Guide: Dr.Jayasudha. A, Principal, PSG College of Nursing, * Corresponding Author : PSG* College of Nursing, Tamil Nadu Dr. M.G.R. Medical University, Chennai, India [email protected] c Copyright 2023 BioMedSciDirect Publications IJBMR - All rights reserved. Hatlin Sugi .M
signs, amniotic fluid, and descent of the fetal head in all laboring mothers. Nine questions on partographer knowledge were prepared to estimate overall partographer knowledge, and midwives who answered five or more were considered to have a good level of knowledge unless they were reported to have a low level of knowledge. Data were analyzed using descriptive and inferential methods. RESULTS : Assessment of pre and post test level of knowledge of partograph among midwifery Nurses n-40 Significant 0.05% Comparison of post test value between the knowledge and utilization of partograph among midwifery nurses. (n-40) DISCUSSION In this study, there were six independent variables, namely Type of labor facility, supportive supervision, mentoring, partograph training, number of midwives working per shift, Partograph knowledge was significantly associated with partograph use(7). This means that supportive supervision and mentoring are key determinants, as professionals would support, teach, discuss and review the system and practice of midwives in their own health facilities. Health-care staff should be updated by providing training and asking them about the difficulties faced at their health center. Then only the real potential of this wonderful tool will be maximally utilized. (8)This study is the path breaking, which targeted the midwifes who working in the delivery room .The current intervention reported was improved the plotting of partograph in delivry room .Most of the time ,statistically significant differeances are the only things that draw attention to published this type study to improve the quality of maternal health .It can be identified the progress of labour and also prevent the morbidity and mortality .(9) CONCLUSIONS: Most important is the use of a partograph during labor to reduce morbidity and mortality. About a third of the midwives did not use the partograph and had incomplete records. (10) Midwives' knowledge of the partograph showed a positive association with use. it forms a reinforced training system; regular supportive supervision; professional mentoring; sustainable supply of partographic sheets; recruitment of midwives in acceptable numbers; a spirit of commitment by administrative authorities to improve maternal health and further studies on predictors for use of the partograph are recommended.(11) 7674 Hatlin Sugi .M /Int J Biol Med Res.14(4):7673-7674 References [1] Abdullah nurus salam khan (2018 sep 6) study of partograph utilization as a deceision making tool for referral of abnormal labour [2]Dutta DC (2015) ,” Text Book Of Obstetrics”, 6th Edition , new central book agency (p) ltd, kolkotha,Pp524-549 [3]WHO. Trends in maternal mortality: 2020: estimates by WHO, UNICEF,UNFPA, World Bank Group and the United Nations population division. Geneva, Switzerland: World Health Organization. 2015 [4]Sidrah nausheen sadia jattl tauquir(2019)assessment of improving knowledge and skills amongst the trainees. [5]Haymanot MAS, Balewgizie S. Health professional's knowledge and use of the partograph in public health institutions in eastern Ethiopia. BMC Pregnancy Childbirth. 2017;17(1):291. [6]WHO (15 February 2018) evidence on the diagnostic test accuracy (DTA) of using the 1-cm/ hour threshold to diagnose risk of adverse birth outcomes. [7]Raj bir kaur (2018,june 7)published on april 2019 study to assess the knowledge regarding partograph among staff nurses. [8]Asibong U OI, .Agan Tu,Oku A. The use of the partograph in labor monitoring: a cross-sectional study among obstetric caregivers in general hospital, Calabar, cross river state. Int J Womens Health 2014;6 873–880. [9]Habtamu R. TT, Hasen A. Partograph utilization and its determinant factors among obstetric caregivers in hospitals of Western Oromia, Ethiopia. Panacea J Med Sci January-April 2018;8 (1):21–24. [10]Zelellw DA TT. Level of partograph utilization and its associated factors among obstetric care givers at public health facilities in East Gojam zone, North west Ethiopia. 2018;13(7). [11]Negash Wakgari AA, Berta M, Tessema GA. Partograph utilization and associated factors among obstetric care providers in North Shoa Zone, Central Ethiopia. Afr Health Sci J. 2015;15(2):55 All rights reserved. c Copyright 2023 BioMedSciDirect Publications IJBMR - ISSN: 0976:6685.
BioMedSciDirect Publications Int J Biol Med Res.2023 ;14(4):7675-7677 Contents lists available at BioMedSciDirect Publications Journal homepage: www.biomedscidirect.com International Journal of Biological & Medical Research International Journal of BIOLOGICAL AND MEDICAL RESEARCH Int J Biol Med Res www.biomedscidirect.com Volume 14, Issue 4, Oct 2023 Copyright 2023 BioMedSciDirect Publications IJBMR - ISSN: 0976:6685. All rights reserved. c ARTICLE INFO ABSTRACT Keywords: Conjoined twins Dicephalic Paraphagus Siamese twins Tribrachius. Introduction Due to abrupt embryogenesis, conjoined twins are born as an unexpected occurrence. One in 200,000 live births actually result in conjoined twins.1 There are two widely accepted theories for how conjoined twins develop: the fission theory, which describes the incomplete fission of a single embryonic disc on 13 to 15 days after ovulation, and the fusion theory, which describes the secondary fusion of two distinct monovular embryonic discs. Conjoined twinning is no longer thought to be based on fusion theory.1-4 Conjoined twins, commonly referred to as Siamese twins after Chang and Eng Bunker of Siam (Thailand), are a rare congenital condition that affects 1/50,000 to 1/100,000 pregnancies.5,6 Due to significant morbidity and mortality that are associated with such conjoined twins as well as the associated ethical, moral, and legal challenges, caring for and treating twins can be extremely difficult for both parents and medical professionals.7 Parapagus (anterolaterally fused) or dicephalus (two-headed) type conjoined twins typically have a poor prognosis because of their shared thoraco-abdominal and spinous anatomy and extremely rare occurrence.8-10These dicephalic twins share a set of reproductive organs as well as a body that extends from the neck or upper thorax below. We outline the findings of the tribrachial dicephalic parapagus twins' autopsy. Case Report In Southern India, an adolescent primigravida, age 19 years, with no congenital defects or twins in the family, and no significant past medical history, delivered at 36 weeks of gestation, a male conjoined twin. There was no history of teratogenic agent exposure during pregnancy, and before to admission, she had not undergone any antenatal checkup or had an ultrasonography evaluation. Her husband aged 59 years and the age gap between the couple being 40 years has to be noted. Live conjoined twins with two heads, two necks, three arms (two normal arms and one arm at the top of the torso fused with ten fingers), and two legs coming from one trunk were the result of an emergency caesarean section. Ten minutes after delivery, the twins expired. Autopsy Findings External Examination: Radiographs taken prior to autopsy revealed dicephalic parapagus twins fused anterolaterally, with two heads, fused upper limbs up to the wrist but separated hands, and fused upper limbs revealing two separate humerus, ulna, and radius. The radiographs also showed two separate spines which are not fused. Conjoined twins are a rare occurrence that poses serious difficulties for parents and medical professionals, and many theories have been put out to explain this occurrence. The name "Parapagus" is relatively new, and it refers to a very unusual condition in which identical twins fuse ventro-laterally and lie side by side. This condition accounts for only 0.5% of all known occurrences. Approximately 11% of conjoined twins are dicephalic. A rare type of lateral partial twinning known as dicephalic parapagus has two heads on one trunk. In this case study, we provide the autopsy findings of a set of male parapagus twins with tribrachius delivered via caesarean section at SNR district hospital Kolar. The various anomalies of the thoracic, abdominal cavity and central nervous system are illustrated. Case report Dicephalus parapagus tribrachius - A rare variety of conjoined twins : A Case Report a b c d e Akshath K S , Balasunder B C , Srihari Alapati , Beeregowda Y C , Thageeru Mahesh kumar * Corresponding Author : Senior consultant in Pediatrics ,Sri Narasimharaja district hospital, Kolar, Karnataka , Gmail: [email protected] c Copyright 2023 BioMedSciDirect Publications IJBMR - All rights reserved. Dr.Balasunder B C , a Junior resident, Sri Narasimharaja district hospital, Kolar, Karnataka b Senior consultant, Department of pediatrics, Sri Narasimharaja district hospital, Kolar, Karnataka, cHead of the department, Department of pediatrics, Sri Narasimharaja district hospital, Kolar, Karnataka d Senior consultant, Department of pediatrics, Sri Narasimharaja district hospital, Kolar, Karnataka e Junior resident, Sri Narasimharaja district hospital, Kolar, Karnataka
The conjoined twin was centrally and peripherally cyanosed. Conjoined twin had 3 upper limbs, one on either side, one fused upper limb with two palms, ten fingers and 2 lower limbs with normal fingers and toes. They share a single external male genitalia and a single anus which was patent. En mass evisceration of organs was done by a “ y ” incision, exposing the unfused vertebral bodies. Additionally, ribs were seen extending between the thoracic vertebrae. Internal Examination Respiratory System: Conjoined twin has a grossly normal larynx, trachea and bronchi without rings or fistulas. Triple lunged twin. While twin one had 3 lobes on both the left and right lung, twin two only had 2 lobes on the left lung. Cardiovascular system: There were two hearts with four chambers each. Two atria and two ventricles each. Gastrointestinal System: It was possible to see two esophagus that connected to two distinct stomachs. The two small bowels persisted as independent structures from their respective stomachs until they converged into a single lumen in the jejunum. The gastrointestinal tract then proceeded as a single unit, ending in a single patent anus. Hepatobiliary System: There were two unfused gallbladders and two livers which were fused in midline. Lymphoreticular System: One normally appearing spleen was observed. There were grossly normal lymph nodes in the hilar, retroperitoneal, and intra-abdominal regions. Genitourinary System: There were two kidneys, each of which had a single ureter that empties into a single urinary bladder. Right testis was undescended and was found in the right superficial inguinal ring, left testis was descended till scrotum. Discussion One set of conjoined twins are born alive every 200,000 live birth. This is a random occurrence that has nothing to do with maternal age, parity, or genetics. Although modern research implies the fusion of two monovular embryonic discs based on examination of numerous conjoined twins, the classic theory for conjoined twinning is incomplete separation of a single embryonic disc at day 13–15 post fertilization phase. Conjoined twins are categorized according to site they attach, either ventrally or rostrally. The most common types discovered were thoraco omphalopagus (28%), thoracopagus (18.5%), omphalopagus (10%), craniopagus (6%) and cephalopagus (5%), while cephalo thoracopagus and cephalo thoraco omphalopagus are incredibly rare.11 The unfused structures provide the basis of the second classification. Examples include dipygus, which has a single head and torso with a divided pelvis and four legs, and dicephalus, which has two heads on one body.2 Based on fusion (Spencer et al.), we further categorise them into three groups: twins with dorsal fusion, twins with lateral fusion, and twins with ventral fusion. The ventral union group is composed of the cephalopagus (fused with the head), thoracopagus (linked with the chest), omphalopagus (joined with the umbilicus), and ischiopagus (fused with the hips).12 Twins with a dorsal union fall into one of three categories: Union of cranium (Craniopagus), sacrum (Pyopagus), or spine (Rachipagus). The only twin type with lateral fusion indicated in the Rachipagus type is Parapagus (fused by the side).13 According to the literature, 35% of conjoined twins die during the first 24 hours of life, and 40% of them are stillborn. Furthermore, only 60% of conjoined twins who undergo surgery survive. 7676 Akshath K S et al. / Int J Biol Med Res.14(4):7675-7677