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   Table of Contents - Current issue
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October-December 2021
Volume 11 | Issue 4
Page Nos. 255-308

Online since Tuesday, October 26, 2021

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REVIEW ARTICLES  

Managing the Cytokine Storm in COVID-19: Can Melatonin Play a Part? Highly accessed article p. 255
Aruna Ganganna, Byalakere Rudraiah Chandrashekar, Madhugiri Prakash Venkatesh, Uzma Belgaumi, Sachin Shivnaikar, Purnima Bhandari
DOI:10.4103/ijnpnd.ijnpnd_53_21  
Some drugs with immunomodulatory and anti-inflammatory activity are identified as adjunctive therapy in the coronavirus disease 2019 (COVID-19) infections and researchers believe that such pathophysiologic pathway treatment approach is rational and important for future development of new therapeutic agents in managing this pandemic. This review will discuss various cytokines which go berserk and cause serious life-threatening complications in COVID-19 infections. Additionally, different therapeutic modalities in managing “cytokine storm,” with a special note on melatonin is discussed. The foundation laid by scientists on this wonder molecule may pave the path toward development of drug with satisfactory results either used alone or as an adjunct to other drugs. However, calming the angered cytokine profile seems pivotal during management of the devastating storm.
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Statistical Models for Estimating Linear Growth Velocity: A Systematic Review p. 262
Obvious N Chilyabanyama, Roma Chilengi, Innocent Ngaruye, Najeeha Talat Iqbal, Samuel Bosomprah
DOI:10.4103/ijnpnd.ijnpnd_6_21  
Poor linear growth among infants is still a global public health issue. Linear growth velocity has been variously suggested as a more robust measure for growth over the classical measure of attained height for age. In this study, we systematically reviewed available literature for models used in estimating linear growth velocity. We searched Medline, Embase, Cochrane methodology register, Joanna Briggs Institute EBP, through the Ovid interface, and PubMed database to identify relevant articles that used statistical models to estimate linear growth velocity among infants. Longitudinal studies published in English were included. Two reviewers independently screened the titles and abstracts to identify potentially eligible studies. Any disagreements were discussed and resolved. Full-text articles were downloaded for all the studies that met the eligibility criteria. We synthesized literature using the preferred reporting items for systematic review and meta-analyses guidelines for the most used statistical methods for modelling infant growth trajectories. A total of 301 articles were retrieved from the initial search. Fifty-six full-text articles were assessed for eligibility and 16 of which were included in the final review with a total of 303,940 infants, median sample size of 732 (interquartile range: 241–1683). Polynomial function models were the most used growth model. Three (18.8%) of the articles modelled the linear growth. Two (12.5%) articles used mixed-effects models and another two (12.5%) used the Jenss-Bayley growth models to model linear growth. Other models included residual growth model, two-stage multilevel linear spline model, joint multilevel linear spline model, and generalized least squares with random effects. We have identified linear mixed-effects models, polynomial growth models, and the Jenss-Bayley model as the used models for characterizing linear growth among infants. Linear mixed-effects model is appealing for its robustness even under violation of largely robust even to quite severe violations of model assumptions.
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ORIGINAL ARTICLES Top

Formulation and Standardization of Siddha Pediatric Tablet dosage: Bala Sanjeevi Mathirai p. 267
Shree Devi Munusamy Sampangi Ramulu, Parameswaran Sathiyarajeswaran, Kirubakaran Narayanan, Soman Vinayak, Kiruthiga Ganesan, Kadarkarai Kanakavalli
DOI:10.4103/ijnpnd.ijnpnd_25_21  
Herbal remedies have grown at an exponential rate since ancient times. Traditional medicines require newer standardization, manufacturing, quality control, and scientifically rigorous research to meet standardization. Bala Sanjeevi Mathirai (BSM) is a Siddha pediatric tablet formulation used for the treatment of cough, fever, vomiting, biliousness, and diarrhoea occurring in children due to dyspepsia. This work was purposed to formulate and standardize BSM as per the guidelines set forth by the regulatory authorities (PLIM). Three validation batches of the formulation were prepared. Tablets were standardized by different physiochemical parameters and evaluated by various studies such as precompression and post compression parameters. All parameters were passed with reference to the standard limits. The set parameters were sufficient to evaluate the tablet and further this could be used as reference standards for the quality control/quality assurance laboratory of the pharmaceutical house.
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Hypertension Severity and Inflammatory Burden as Evaluated by Neutrophil–Lymphocyte Ratio: Role of Telmisartan p. 274
Esraa H Fahad, Marwa S Al-Niemi, Nawar R Hussain, Hayder M Al-Kuraishy, Ali I Al-Gareeb
DOI:10.4103/ijnpnd.ijnpnd_54_21  
Background: Different studies implicated inflammation as associative or causative factor in the development of hypertension (HT). It has been reported that low-grade inflammation enhances development of HT, as high blood pressure is linked with high neutrophils, lymphocytes, C-reactive protein, and interleukin 6. Neutrophil–lymphocyte ratio (NLR) may reflect underlying chronic low-grade inflammation in different inflammatory disorders and cardiovascular diseases including HT. Telmisartan (TLS), which is an angiotensin II receptor type 1 blocker that used in the management of HT, may reduce the associated inflammatory disorders. Thus, the aim of the present study was to assess the level of NLR in relation to the HT severity in patients treated with TLS. Methods: Forty-four patients with severe HT compared with matched 20 patients with mild HT as controls were recruited. Anthropometric and biochemical variables as well as NLR were measured. Results: Blood pressure and lipid profile were higher in patients with severe HT on antihypertensive therapy other than TLS. TLS treatments had improved blood pressure; lipid profile and low NLR compared to patients with severe HT not were on TLS treatment. Conclusion: TLS reduces HT severity through reduction of NLR; therefore, it regarded the optimum angiotensin receptor blocker (ARB) drug in the management of HT. Thus, preclinical and prospective studies are warranted in this regards.
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Preparation and evaluation of sustained release dosage forms for posttransplant care p. 279
Mullaicharam Bhupathyraaj, Alka Ahuja, Nirmala Halligudi, Sushma Pole, Hiba Salim Al Balushi, Halima Ahmed Al Kaabi, Saleem M Desai
DOI:10.4103/ijnpnd.ijnpnd_46_21  
Aim: The purpose of the study was to prepare and characterize microbeads for oral sustained release of tacrolimus. Design, methodology, and approach: Tacrolimus-based microbeads were developed by ionic gelation method. Xanthan gum, chitosan, and sodium alginate were used as polymers for aqueous internal phase using calcium chloride as a cross-linking agent. The microbeads were evaluated for morphologic features by scanning electron microscopy, percentage yield, drug entrapment, and in vitro drug release. Findings and implications: Microbeads were examined for the effects of various variables in formulation process. The cross-linking reaction between sodium alginate and calcium chloride for being converted into calcium alginate in the formulation process was used in the microencapsulation of tacrolimus core material. The results showed the compatibility of the drug with the polymers in the formulation as observed in Fourier-transform infrared spectroscopy studies. The formulated microbeads showed high percentage yield and drug entrapment efficacy and the optimized formulation showed a delayed release effect following zero-order mechanism of release. Conclusion: Ionotropic gelation method was found to be a suitable method for preparing tacrolimus microbead-sustained-release drug delivery system. Chitosan and xanthan gum polymers showed potential in aiding the formulation of sustained release tacrolimus microbeads. Xanthan gum is soluble in water and confers high viscosity at low concentrations. The molecular weight of xanthan gum is more than the chitosan polymer which leads to better sustained release of microbeads prepared with xanthan gum compared to chitosan microbeads. Both chitosan and xanthan gum microbeads followed zero-order-release kinetic models.
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Influence of Abdominal Obesity (Waist–Hip ratio) on Memory Consolidation in Adolescent Medical Undergraduates − A Cross-sectional Study p. 287
R. Rakesh, Prathibha K Muthu, Prem Kumar Sundararajan, Naresh K Gutta
DOI:10.4103/ijnpnd.ijnpnd_51_21  
Background: Waist Hip Ratio (WHR), a measure of abdominal obesity is being co-related with memory consolidation based on its relation with stress and sleep. The objective of the present cross-sectional study was to evaluate the association between WHR and memory consolidation in adolescent medical undergraduates. Methodology: An analytical cross-sectional study was conducted in a South Indian medical college. After obtaining ethics clearance, the study was conducted on 42 males and 63 females of 17–19 years of age. WHR was measured according to WHO guidelines using Gulick 2 plus inch tape. Sleep-dependent memory consolidation test was conducted in evening 3:00 pm followed by next morning 9:00 am. WHR between genders was compared using Student t test. The study population was divided into obese and non obese individuals, based on the calculated WHR. Then, the mean memory consolidation test scores were compared using Mann Whitney U test. The correlation between WHR and memory consolidation test scores was evaluated using Pearson’s correlation test. Results & Discussion: The average WHR of males (0.845 ± 0.058) was significantly higher than females (0.778 ± 0.051) (P<0.001). The morning session memory consolidation test scores were higher in the normal group when compared to the substantially increased risk for obesity groups, although not statistically significant. WHR showed significant negative correlation with sleep dependent memory experiment scores. Conclusion: The relationship between WHR and memory consolidation in the present study highlights the need for an awareness to adopt life style modifications which might not only benefit the general health status but also might have an impact on their memory consolidation and academic performance.
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CONFERENCE PAPERS Top

Food Consumption Pattern and Body Mass Index of Adolescents − A Descriptive Study p. 293
E. Lakshmi
DOI:10.4103/ijnpnd.ijnpnd_39_21  
Context: Adolescence is a period of growth spurt. During this crucial period, food intake patterns are set in place and these patterns can have vital impact on lifetime nutritional status and health of the individuals. Aim: The present study aimed to assess food consumption pattern of adolescent girls and to associate the same with the body mass index (BMI). Materials and methods: A quantitative research approach and a descriptive design were adopted for the study. Nonprobability purposive sampling technique was used to select 217 adolescents (girls) in the age group of 13 to 18 years after obtaining informed consent. Researcher-designed questionnaire was developed to collect the data on demographic profile. A food frequency questionnaire was used to elicit information regarding food consumption pattern (general and fast food) for over four months during the period of study from December 2018 to February 2019. The height and weight were measured using inch tape and weighing scale. The BMI was calculated and compared with BMI classification of World Health Organization. Statistical analysis: Descriptive statistical measures such as percentage distribution, mean, and standard deviations were used for variables. Chi-squared test of significance was used to predict the association between BMI and food intake. Results: The percent adequacy of food intake presented a deficit in the intake of green leafy vegetables (−31.05%), fruits (‒46.34%), milk and milk products (−21.44%). BMI revealed that a higher percentage (45.16%) of adolescent girls were under weight. Conclusion: There was no significant association (χ2 = 0.46, P = 0.99) between BMI and food intake.
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Thermophysical Properties of Brackish Water Shrimp (Litopenaeus vannamei) for Process Design and Optimization p. 298
N. Manimehalai, P. Karthickumar, K. Rathnakumar
DOI:10.4103/ijnpnd.ijnpnd_28_21  
The proximate compositions, moisture (74.2%), protein (28.07%), ash (2.62%), lipid (3.39%), and carbohydrate (4.39%) of brackish water shrimp (Litopenaeus vannamei) were determined. The density, specific heat, thermal conductivity, thermal diffusivity, and latent heat obtained as functions of the proximate composition of the shrimp and found to be 1110 kg/m3, 394 kJ/kgK, 0.5113 W/mK, 1.1773 × 10−6 m2/s, and 256.39 kJ/kg, respectively. The thermophysical values obtained were correlated with the proximate composition value. Correlation analysis reveals that specific heat (0.83), thermal conductivity (perpendicular model) (0.99), and latent heat (0.12) have positive correlation with protein content of shrimp. On the contrary, thermal diffusivity (−0.92) and thermal conductivity (parallel model) (−0.99) have negative correlation with protein content of shrimp. Further, latent heat of shrimp has a weak positive correlation (0.12) with protein content of shrimp and strong positive correlation with carbohydrate (0.82), fat (0.94), and water (1.0). Thermal conductivity (perpendicular model) has weak positive correlation with fat (0.18) and water (0.19), and has strong positive correlation with protein (0.99) and ash (0.81). Shrimp density has strong correlation with protein (0.98) followed by ash (0.86). Heat may be transferred better across the fibers of the shrimp than along the fiber. Context: Shrimp is one of the most valuable sources of high-grade protein among the seafood category. Shrimp has healthy fat a unique source of essential nutrients, including long-chain omega-3 fatty acids, iodine, vitamin D, and calcium. The global shrimp production has increased at a compound annual growth rate (CAGR) of 3.2% during the period 2011 to 2017. High market demand and consumer preference for shrimp food are attributed due to the attractive and sleek appearance, substantial flesh, ease of preparation for processing (mainly due to absence of scales), etc. With the potential and promise of further increases in production, it is essential to provide a firm base for development of technologies suitable for the value-added products from shrimp to further enhance its market expansion. Understanding on thermal properties of foods plays an important role in the design and prediction of heat transfer operations during the handling, processing, canning, storing, and distribution of foods. In addition, they are fundamentally important in mathematical modeling studies for the design and optimization of food-processing operation involving heat and mass transfer. Aims: The aim of the present study is to determine some thermophysical properties of shrimp as a function of its proximate composition to provide data for the development of appropriate equipment and processing technology for brackish water shrimp (L. vannamei). Settings and design: Proximate composition of the brackish water shrimp (L. vannamei) was measured. Prediction equations were developed to predict the thermophysical properties of shrimp. Correlation matrix was prepared to understand the dependence of proximate composition and thermophysical properties of shrimp. Materials and methods: Shrimp (L. vannamei) were obtained from an aquaculture farm in Nagapattinam. Shrimp were handled in accordance with the Codex General Principles of Food Hygiene (CAC/RCP 1-1969) and Code of Practice for Fish and Fishery Products (CAC/RCP 52-2003). The Kjeldahl method was performed according to method 981.10 of the AOAC International. Total lipids in tissue sample were extracted and analyzed by the method. Water content was determined by oven drying at 105°C, and ashing by incineration in a muffle furnace at 525°C. Carbohydrate content was determined by difference method as given in the following equation: % Carbohydrate = 100–% (Crude protein + Total fat + Ash) × 100. Comprehensive models were used predict volume and thermal properties. Statistical analysis used: Correlation matrix of proximate composition and the thermophysical properties of shrimp were prepared to understand the dependence of thermophysical properties with the proximate composition of shrimp. Results: The predicted values of the thermophysical properties of farmed shrimp were in accordance with the already published values. The density of the shrimp is slightly higher side when compared with water alone, indicating the influence of proximate composition. Correlation matrix thus prepared, better explains dependence of thermophysical properties (specific heat, thermal conductivity, thermal diffusivity, latent heat, and density) with the proximate compositions (moisture, protein, ash, lipid, and carbohydrate) of brackish water shrimp (L. vannamei).Shrimp is “nature’s superfood,” an important source of proteins and healthy fat, and a unique source of essential nutrients, including long-chain omega-3 fatty acids, iodine, vitamin D, and calcium. The knowledge of its engineering properties is essential to its processing and preservation to increase its value as food. The thermophysical data obtained in this study could be used as input in heat transfer calculations and to establish critical control points during the drying, freezing, and thermal processing of shrimp meat.
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Nutritional Composition and Sensory Evaluation of Phytoestrogen-Rich Supplement for Women with PCOS p. 303
K. Gayathri, V. Supriya, N. Palaniappan
DOI:10.4103/ijnpnd.ijnpnd_29_21  
Background: Polycystic ovary syndrome (PCOS) is a common endocrinopathy in reproductive-aged women affecting up to 15% of the population and exhibiting ovulatory dysfunction, hyperandrogenism, obesity, and insulin resistance. Phytochemical like phytoestrogen helps alleviate the symptoms of PCOS without any adverse effects such as improvement in ovulation and regulation of blood glucose. Therefore, this study has developed a supplement enriched with phytoestrogen. Aim: The study was aimed at developing a phytoestrogen-rich supplement. Methods: The supplement was prepared under proper hygienic conditions. Organoleptic evaluation was done by a group of panel members. Microbial activity and nutrient composition were analyzed by standard methods such as mass spectrometry and high-performance liquid chromatography. Statistical analysis was done by Statistical Package for the Social Sciences (SPSS) software version 21. Result: The formulated supplement was statistically significant (P < 0.05). The microbial analysis showed that it was microbe free at the end of 30 days. The nutrient analysis concluded that phytoestrogens such as polyphenols and flavonoids, omega-3 fatty acid, irons, and fiber were present in adequate amounts. Conclusion: The present study revealed that the developed supplement is found to be rich in phytoestrogens and it can be effective for the treatment of PCOS.
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