Tulika Das

Randomised controlled trial to assess acceptability of phenobarbital for childhood epilepsy in rural India

BACKGROUND The use of phenobarbital for childhood epilepsy is controversial because of reported behavioural side-effects; however, whether this research can validly be extrapolated to developing countries is not clear. We undertook a randomised comparison of phenobarbital and phenytoin to assess the acceptability and efficacy of phenobarbital as monotherapy for childhood epilepsy in rural India. METHODS Between August, 1995, and February, 1996, 109 unselected children aged 2-18 years with partial and generalised tonic-clonic epilepsy were identified by population screening. 15 families declined to take part. 94 children were randomly allocated treatment with phenobarbital (1.5 mg/kg daily for 2 weeks; maintenance dose 3.0 mg/kg daily; n = 47) or phenytoin (2.5 mg/kg daily then 5.0 mg/kg daily; n = 47). Children were followed up for 12 months. The primary outcome measure was the frequency of behavioural side-effects; behaviour was assessed by the Conners parent rating scale for children aged 6 years and older, and by the preschool behaviour screening questionnaire (BSQ) for those aged 2-5 years, at 12 months or at withdrawal from treatment. Analysis was by intention to treat. FINDINGS The mean log-transformed scores on the behaviour rating scales did not differ significantly between the phenobarbital and phenytoin groups (Conners 2.64 [SD 0.71] vs 2.65 [0.89], p = 0.97; n = 32 in each group: BSQ 2.12 [1.31] vs 2.18 [1.02], p = 0.94; n = 4 vs 3). The odds ratio for behavioural problems (phenobarbital vs phenytoin) was 0.51 (95% CI 0.16-1.59). There was no excess in parental reports of side-effects for phenobarbital. We found no difference in efficacy between the study drugs (adjusted hazard ratio for time to first seizure from randomisation 0.97 [0.28-3.30]). INTERPRETATION This evidence supports the acceptability of phenobarbital as a first-line drug for childhood epilepsy in rural settings in developing countries.

Bioleaching of low-grade uranium ore using Acidithiobacillus ferrooxidans

Bioleaching of uranium was carried out with Turamdih ore sample procured from Uranium Corporation of India Limited, Jaduguda. The bacterial strain that was used in the leaching experiments was isolated from the Jaduguda mine water sample. Efficiency of bioleaching was studied by varying parameters like pulp density and initial ferrous concentration as source of energy. It is observed that the efficiency of bioleaching was 49% at 10% pulp density (w/v) and initial pH 2.0. Addition of external has no effect on efficiency of bioleaching showing domination of direct leaching mechanism over indirect.

Case-control and qualitative study of attrition in a community epilepsy programme in rural India

Dropout from epilepsy programmes is a serious problem in developing countries and has not been systematically studied before. We set up a community-based programme for children with epilepsy in rural India. The aim of this study was to assess reasons for dropout. We assessed medical and sociodemographic variables for their effect on dropout at 12 months using an unmatched case-control design on 32 cases and 62 controls. We also interviewed the parents of 32 children who dropped out of treatment, using a topic schedule. Two-thirds of the dropouts occurred within the first 6 months of treatment. Severely impaired children were more likely to drop out (odds ratio 4.60, 95% CI: 1.0-21.0) and families who had tried AEDs before were less likely to do so (odds ratio 0.12, 95% CI: 0.015-0.88). Denial of diagnosis, access problems and symptom resolution were the other main reasons underlying attrition. Active ascertainment methods should be reconsidered in community programmes. Very poor families without a male head or with long journey times are at high risk of dropout. People with severe impairments need appropriate integrated rehabilitation.

A comparative study of biosorption of Cu using Aspergillus niger and Aspergillus flavus

In the present work a comparative study has been made to adsorb Cu ion from solution using pre-treated biomass of two fungal strains, Aspergillus niger and Aspergillus flavus . Several parameters such as pH, adsorbate and adsorbent concentration and fraction size of the fungal biomass were studied to observe their effect on the percentage of metal uptake by the treated biomass. Although both the fungal strains proved to be potential biosorbents, but novel observation was, under similar experimental conditions Aspergillus flavus showed better biosorption properties than Aspergillus niger . Overall experimental data fitted well to both Freundlich and Langmuir adsorption isotherm models.