Recently the great interests to developing novel plant purified p

Recently the great interests to developing novel plant purified product have been triggering the apoptotic program. The common impacts of tumors have defects in the p53 pathway and many overexpresses of different proteins such as Bcl-2, Box and BH3 or their close relative enzymes. According to the UMI-77 cluster mechanisms of apoptotic

machinery remains fail to function in cell death clock. Especially, the plant derived drug that could have bind to the pro-survival protein by in which controls the cancer cells and inactivate further protein synthesis mechanisms. Nowadays cancer prospects are upbeat for the findings the mechanisms of tumor and novel drug analog for cancer and treatments. Cancer treatment and preventing methodologies are still challenge for traditional conceptions of disease. Likewise the demanding to the development GSK J4 clinical trial modern plant derived anticancer compound is more important for cancer control. The broad containment strategy for cancer might target all stages of disease progression. Effort to exploit on the emerging

prospects of plant derived drug to treat cancer will profit significant benefits for patients as well as to those engaged in the field of drug development. All authors have none to declare. The authors gratefully acknowledge Universiti Malaysia Pahang, Malaysia for the financial assistance through the Internal Research Grant RDU 120302, RDU 110397 and GRS 130336. Also we would like to thank Science Officers of Faculty of Industrial Sciences and Technology for their technical support throughout the work. “
“The genus Premna (Verbenaceae) comprises a group of more than 200 different trees, distributed in tropical and subtropical areas of the world. Premna tomentosa (Verbenaceae) is a well known GPX6 medicinal plant used extensively for the treatment of various ailments. In Indian system of medicine, all parts of P. tomentosa have been employed for

the treatment of various disorders. 1 Its bark extract is claimed to have a lasting cure for hepatic disorders 2 Extracts from P. tomentosa leaves are known to have diuretic, hepatoprotective, antioxidant, lipid-lowering, immunomodulatory activities, and protective against acetaminophen-induced mitochondrial dysfunction properties. 3, 4, 5, 6, 7 and 8 In spite of the various pharmacological uses of P. tomentosa extracts, little is known about the chemical constituents. Previous studies on this species have resulted in the isolation of various compounds, including flavonoids, triterpenoids, and steroids, 9 as part of our continuing efforts directed towards the discovery of the structurally interesting and biologically active compounds from the Indian medicinal plants. 10 and 11 The α-glucosidase inhibitors present broad-spectrum therapeutic applications.

All participants underwent clinical examination prior to arthrosc

All participants underwent clinical examination prior to arthroscopy. A subgroup of participants also underwent MRI investigation prior to arthroscopy. The decision to undertake an MRI investigation was made at the surgeons’ discretion. The order of the provocative tests and MRI was dictated by convenience, but both the provocative tests and MRI were completed before the arthroscopy. All provocative tests were performed as close as possible to arthroscopy. The longest delay was 21 days. Provocative tests were conducted blind to the results of MRI, and MRIs were interpreted blind to the results of the provocative tests. The surgeons performing the arthroscopies were blinded to the results

of the provocative tests but not to the results of the MRIs. Clinical examinations were performed primarily (87%) by one hand therapist (RP) with 27 years of experience. The other clinical examinations were performed by two therapists with 20 and 10 years of selleckchem experience. Initially, a subjective assessment was undertaken and included questions to determine the time of injury, location of pain, and the functional demand on the wrist. The functional demand placed on the wrist by work and activities of daily living was

classified by participants on a 3-point scale designed for this study. On this scale ‘light’ reflected sedentary or office work, ‘moderate’ reflected Microbiology inhibitor intermittent use with heavier activities such as gardening, and ‘heavy’ reflected manual work or participation in manual sports such as martial arts and racquet sports on a regular basis. Participants were also asked to self-rate perceived wrist stability on a 4-point scale designed for this study. The levels of the scale were ‘does not give way’, ‘gives way with heavy activity’, ‘gives way with moderate activity’, and ‘gives way with light activity’. Pain and function were assessed with the Patient-Rated Wrist and Oxalosuccinic acid Hand Evaluation questionnaire (MacDermid and Tottenham, 2004). The physical examination consisted of an assessment of the integrity of various wrist ligaments, the TFCC, and the lunate

cartilage. The tests used were the SS test, LT test, MC test, TFCC test, TFCC comp test, DRUJ test, and the GRIT (LaStayo and Weiss, 2001). Both asymptomatic and symptomatic wrists were tested to establish if there was hypermobility in the symptomatic wrist with respect to the asymptomatic wrist and to determine if there was pain. The outcomes of tests were reported as positive, negative or uncertain except for the GRIT which was only reported as positive or negative. A test was only reported as positive if it reproduced the participant’s pain (with or without hypermobility compared to the contralateral side). A test was reported as uncertain if there was hypermobility (compared to the contralateral side) or if the pain produced was not the primary pain that the participant presented with.

This study provides strong evidence to support physiotherapysuper

This study provides strong evidence to support physiotherapysupervised PFMT as an effective intervention which may delay, or ultimately prevent, the need for surgery, when delivered at an effective dosage. “
“Summary of: Spittle AJ et al (2010) Preventive care at home for very preterm infants improves infant and caregiver outcomes at 2 years. Pediatrics 126: e171–e178. [Prepared by Nora Shields, CAP Editor.] Question: Does a home-based preventive care program improve cognitive, language, and motor development in very preterm infants, and mental health in their primary caregivers? Design: Randomised, controlled

trial with concealed allocation and blinded outcome assessment. Setting: In the homes 26s Proteasome structure of participants in Australia. Participants: Infants born at less than 30 weeks gestational age, with no major congenital brain anomalies were included. Infants were excluded if the family did not live within 100 km of the recruiting centre or if their family did not speak English. Randomisation of 120 participants allocated 61 to an education and support program group and 59 to a control group. Interventions: Both groups received standard follow-up care, including access to a maternal and child

health nurse and referral to early intervention services if deemed appropriate. In addition, the intervention group received nine, 90–120 minute visits over one year by a psychologist and a physiotherapist. The visits

consisted of education on infant self-regulation, techniques to improve postural stability, co-ordination, and BGB324 supplier strength, and parental support. Outcome measures: The primary outcomes were the cognitive, language, and motor Idoxuridine development domains of the Bayley Scales of Infant and Toddler Development III at 2 years corrected age and the Hospital Anxiety and Depression Scale for the primary caregivers. Secondary outcome measures were child behaviour and emotional regulation assessed using the four domains of the Infant- Toddler Social and Emotional Assessment (externalising, internalising, dysregulation, and competence). Results: 115 participants completed the study. At 2 years corrected age, the cognitive, language, and motor domains of the Bayley scales did not differ significantly between the groups. Three of the four domains of the Infant-Toddler Social and Emotional Assessment improved significantly more in the intervention group than in the control group at 2 years corrected age: externalising by –4.1 units (95% CI –8.2 to –0.02), dysregulation by –8.7 units (95% CI –13.2 to –4.2), and competence by 6.3 units (95% CI 0.7 to 11.8). The groups did not differ significantly on the internalising domain. The primary caregivers in the intervention group reported lower levels of anxiety and depression on the Hospital Anxiety and Depression Scale, compared with those in the control group by –2.

Both groups were progressed after 4 weeks of training to 70% of t

Both groups were progressed after 4 weeks of training to 70% of their predicted 1RM or

age-predicted heart rate depending on grouping. The metabolic equivalents (METs) for both the aerobic exercise and progressive resistance exercise training were estimated to be approximately 3.5 in accordance with the compendium of METs provided by the American College of Sports Medicine (ACSM 2000), a value defined as moderate intensity (Pate et al 1995). The aerobic exercise intervention is presented in Table 1. All participants wore a heart rate monitor during the warmup and exercise program and were supervised in their exercises in a group. Each participant was scheduled to complete 18 exercise sessions over 8 weeks at a frequency of 2 to 3 times a week. The primary outcome measure was HbA1c. Secondary outcomes included blood glucose, lipid profile, and anthropometric and cardiovascular measures. Alpelisib molecular weight Adverse events were also recorded. All outcome assessors were blinded to group allocation. HbA1c was measured using 10 ml of blood drawn from participants who fasted at least 10 h from the night before and analysed at the Biochemistry Laboratory of the Pathology Department in Singapore General Hospital by laboratory Panobinostat in vivo assistants who were also blinded to the project. HbA1c was measured using high performance liquid

chromatography with a coefficient of variation (CV) of 2.4% at 5.1% (HbA1c) and a CV of 1.9% at 9.6% (HbA1c). Glucose was measured using the glucose oxidase method with a CV of 1.6% at 3.3 mmol/L and a CV of 1.1% at 18.8 mmol/L. The lipid profile comprised total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). Total cholesterol and triglycerides were measured using enzymatic colorimetric methods with cholesterol oxidase-peroxidase amino phenazone almost phenol and glycerol-3-phosphate oxidase-peroxidase amino phenazone phenol. The CV for cholesterol is 1.9% at 3.22 mmol/L and 1.3% at

7.72 mmol/L. The CV for triglyceride is 1.8% at 1.02 mmol/L and 1.4% at 2.27 mmol/L. HDL-C was measured using homogenous enzymatic colorimetric assay with a CV of 4.8% at 0.93 mmol/L and 3.7% at 2.06 mmol/L. LDL-C was calculated using the Friedewald formula. Anthropometric measurements included weight, body mass index, body fat measured by skin fold and by bioimpedance, waist circumference and waist:hip ratio. Body mass index was calculated as weight in kg divided by the square of height in m. Skin-fold thickness was measured at four sites: biceps, triceps, sub-scapular, and suprailiac, on the right side of the body (Heyward 2002), and percentage body fat was estimated using a formula applicable to Singaporeans (Deurenberg-Yap et al 2003). Percentage body fat was also measured using two-point bioimpedance analysisa and a regression equation based on measured resistance and reactance.

Films started to shrink was viewed through the microscope and was

Films started to shrink was viewed through the microscope and was noted as Micro Shrinkage Temperature. click here Cellulose paper was dipped in a boiling tube containing oleic acid in hexane (0.1 M) solution. After

adding the initiator AIBN into the above boiling tube, the oxidation of oleic acid was monitored for the absorbance at λ234 for 30 min and the tube was plugged tightly to prevent the evaporation of hexane. Different concentrations of CAEICDF’s, CAEICCDF’s, TAEICDF’s, and TAEICCDF’s were placed over the cellulose paper separately containing oleic acid, the experiment was repeated and the absorbance was measured at λ234. Adult male Wistar rats weighing 180–200 g were procured from the animal house of Bapatla Pharmacy College (1032/ac/07/CPCSEA), Bapatla, were maintained at a temperature of 26 ± 2 °C constantly and humidity of 30–40% with 12 h light & dark cycle throughout the experiment. The animals were housed in clean polypropylene cages in an air conditioned animal house and the rats were fed with commercial rat feed and sterile water. The experiment protocol was approved by the Institutional Animal Ethical Committee (IAEC/II/12,14,15 & 16/BCOP/2009) of Bapatla College of Pharmacy. For this,

the area was cleared off from hair by using Selleckchem Trichostatin A a depletory and anaesthetized using chloroform. A metal template of size 1 × 1 cm (0.785 cm2 area) was placed on the stretched skin and an outline of the template was traced on the skin using a whatever fine tipped pen. The wound was made by excision wound technique. The plain collagen film, collagen cross-linked film, marketed (Neuskin™), various natural extracts (C. asiatica and T. arjuna) of collagen incorporated concentrations were then applied separately

on the excised wound to the healthy male animals of groups. The wound healing data obtained for natural extract impregnated collagen and cross-linked collagen film were subjected to unpaired statistical student ‘t’ test. By subjecting to one-way Analysis of Variance (ANOVA), the differences between the wound healing values obtained for the highest wound healing group and other groups were compared. By using a Rotatory Microtome (WSWAX®) serial sections of paraffin embedded tissue (1 mm2 area) of 3–5 μm thickness were cut off and stained under light microscope (OLYMPUS I 20®) whose stage micrometer of 100 μ was calibrated with 96 μ of eyepiece meter. The tissue was focused and fibroblasts were counted at 40X × 10 magnification and presented in number per 100 μm. To evaluate re-epithelization, the epithelial gap was measured at 10X × 10 magnifications (Table 4). A peak at 3401 cm−1, proved the existence of hydroxyl group, characteristic feature arjunolic acid of triterpenoids. A peak at 1519 cm−1, confirmed the existence of acid carbonyl group, characteristic feature arjunolic acid of triterpenoids. A peak at 1448 cm−1, confirmed the presence of gem dimethyl, characteristic feature of triterpenoids.

, 2014) Many studies have also investigated the role of the meso

, 2014). Many studies have also investigated the role of the mesolimbic dopamine system and opioid regulation of rewarding social behaviors such as pair-bonds between mates www.selleckchem.com/products/azd9291.html (Aragona, 2009 and Resendez et al., 2012); we describe these and additional research avenues throughout. In addition to considering how social behavior is assessed, we must consider the significance of the behavior to the species

in which it is assessed. Social behavior encompasses skills from social recognition to social memory, as well as many distinct types of interaction, including with peers, potential reproductive partners, competitors, and offspring. Some of these interactions are better studied in some species than others; for example biparental care is only present in a

few rodent species that have been studied in laboratories, namely prairie voles (Microtus ochrogaster), California mice (Peromyscus californicus), and Djungarian hamsters (Phodopus campbelli). Monogamous pairing with mates is similarly rare among rodents, and is most studied in prairie voles and California mice. Mechanisms supporting group living have been in explored in colonial rodents including naked mole-rats (Heterocephalus glaber), tuco-tucos (Ctenomys sociabilis), seasonally social meadow voles (Microtus pennsylvanicus), and others ( Anacker and Beery, 2013). The idea that some problems are best studied in particular species is far from new; this principle was promoted in 1929 GSI-IX nmr by the late physiologist and Nobel laureate August Krogh ( Krebs, 1975). In contrast to Krogh’s assertion that species should be selected for their suitability for studying particular problems, modern biological research is strongly biased towards rats and mice; Oxygenase in 2009 rats and mice made up approximately 90% of mammalian research

subjects in physiology, up from 18% at the time Krogh’s principle was articulated ( Beery and Zucker, 2011 supplementary material). Lab strains of mice and rats are highly inbred and in many ways quite different from their wild peers. Use of multiple species allows researchers to compare and contrast mechanisms across the phylogenetic tree. While the depth of mechanistic information available for non-model organisms is much less than for rats and mice, the comparative perspective is essential for understanding to what extent mechanisms underlying social behavior are unique to particular species, common across broader groups, or are variations on a theme (Phelps et al., 2010 and Katz and Lillvis, 2014; Hofmann et al., 2014). In this review we focus on rats and mice for which data on stress and social behavior are most abundant, but incorporate findings from other rodent species whenever possible. And although laboratory research in rodents is heavily male-biased (Beery and Zucker, 2011), we review a substantial body of findings on the interrelationship of stress and social behavior in females. All mammals interact with other individuals.

The lesions observed were smaller in size in comparison to those

The lesions observed were smaller in size in comparison to those seen in the non-vaccinated infected animals. No tongue lesions were observed in these two unprotected vaccinated animals. Foot lesions in two of the non-vaccinated

buffalo were observed at 7 dpc, whereas foot lesions in the other four non-vaccinated buffalo were observed at 11 dpc. Only one non-vaccinated buffalo developed a tongue www.selleckchem.com/products/Everolimus(RAD001).html lesion, which was observed at 7 dpc. Five non-vaccinated cattle showed foot lesions at 10 dpc and one showed a foot lesion at 11 dpc. Four of these six unprotected cattle showed tongue or dental pad lesions at 10 dpc, one showed at 7 dpc and the 6th one did not show any tongue or dental pad lesion. Pyrexia (≥39.0 °C to 40.2 °C) was recorded at the same time as the appearance of vesicles, but was less evident in the vaccinated check details unprotected animals in comparison to the unprotected non-vaccinated animals. A neutralizing antibody titre to FMDV O/IND/R2/75 was detected as early

as 14 dpv and peak antibody titres were obtained at 28 dpv in vaccinated buffalo and cattle. The mean antibody titre in vaccinated buffalo and cattle were 101.2 (95% confidence interval (CI): 100.8–101.7) and 101.5 (95% CI: 101.2–101.8), respectively, at the time of exposure. Two vaccinated buffalo that showed clinical signs had low serum neutralizing antibody titres (100.9; 101.1) whereas a third vaccinated buffalo with low neutralizing antibodies (101.1) at the time of exposure was protected. Following the challenge exposure, the serum neutralising antibody titres were observed in the range of 101.2 to 101.8 up to 32–39 days post challenge in vaccinated buffalo and cattle (Fig. 2). In non-vaccinated control buffalo and cattle a rapid however seroconversion was evident following exposure

to challenge and the antibody titres (101.0 to 101.4) were detected up to 32–39 dpc (Fig. 2). Both vaccinated buffalo and cattle had significantly higher neutralising antibody titres than non-vaccinated control buffalo and cattle at all time points post exposure, but there was no significant difference in serum neutralising antibody titres between vaccinated buffalo and cattle at any time point post exposure. NSP antibodies appeared at 9 dpc in three non-vaccinated buffalo and four non-vaccinated cattle, at 14 dpc in two non-vaccinated buffalo and two non-vaccinated cattle and at 19 dpc in one non-vaccinated buffalo. NSP antibodies were detected at 14 dpc in three vaccinated buffalo and two vaccinated cattle while two vaccinated buffalo and one vaccinated cattle showed NSP antibodies at 32 dpc. One vaccinated buffalo and two vaccinated cattle were not positive for NSP antibodies. Virus replication occurred earlier in non-vaccinated control animals than in the vaccinated animals as was evident from antibody responses against NSP (Fig. 3).

, 1995) Outbreaks of Mycoplasma pneumoniae among HCWs have been

, 1995). Outbreaks of Mycoplasma pneumoniae among HCWs have been observed in Finland, where 44% (n = 97) of HCWs tested positive for the pathogen without detectable M. pneumoniae-specific antibody, suggesting acute infection ( Kleemola and Jokinen, 1992). Legionella has also

been described as an occupational risk factor for HCWs ( Borella et al., 2008 and Rudbeck et al., 2009). In contrast to these outbreaks, there are few prospective studies of bacterial respiratory infections or colonization and the clinical implications for HCWs. There has been Metformin recent interest in the role of medical masks and respirators in preventing respiratory infections in HCWs and the general community (MacIntyre et al., 2009, MacIntyre et al., 2011 and Macintyre

et al., 2013). Medical masks (MMs) are unfitted devices worn by an infected person, HCW, or member of the public to reduce transfer of potentially infectious body fluids between individuals. They were originally designed for surgeons in order to attenuate wound contamination, but have not been Erlotinib cell line demonstrated to have their intended efficacy (Mitchell and Hunt, 1991, Orr, 1981 and Tunevall, 1991). Of note, MMs have not been shown to clearly provide respiratory protection in the community or HCW setting (Aiello et al., 2012, Cowling et al., 2009, MacIntyre et al., 2009 and MacIntyre et al., 2011). This may be attributed to lower filtration efficiency and poorer fit than respirators which, in contrast, are specifically designed to provide respiratory protection (Balazy et al., 2006, Lawrence et al., 2006 and Weber et al., 1993). We have previously shown that a N95 respirator provides significantly better protection against clinical respiratory infection than medical masks in HCWs (MacIntyre et al., 2011 and Macintyre et al., 2013). Although our previous work tested clinical efficacy in preventing infection, the relative importance of different routes of transmission (airborne, aerosol, and direct hand-to-mouth contact) in the clinical

Parvulin efficacy of respiratory protection is unknown. That is, a mask may provide protection against more than one mode of transmission. The only bacterial infection for which respirators are considered and recommended for HCWs is tuberculosis (Chen et al., 1994 and Nicas, 1995). In this study, our aim was to determine the efficacy of respiratory protection in preventing bacterial colonization and co-infections or co-colonization in HCWs. A prospective, cluster randomized trial of N95 respirators (fit tested and non-fit tested) and medical masks compared to each other and to controls who did not routinely wear masks was conducted in frontline HCWs during the winter of 2008–2009 (December to January) in Beijing, China. The methodology and consort diagram used in the study and the primary clinical and viral infection outcomes have been previously described (MacIntyre et al., 2011).

We have recently shown that a semi-purified RBD produces failure

We have recently shown that a semi-purified RBD produces failure to thrive, small intestinal mucosal atrophy and gut barrier dysfunction in mice [31]. We hypothesized that undernutrition caused by the regional basic diet would impair the efficacy of oral rotavirus immunization and that undernutrition exacerbates rotavirus infection in weanling mice. Here we report that: (1) Despite altered antibody responses following murine rotavirus EDIM challenge, oral rotavirus vaccination appears to adequately protect undernourished mice against shedding of rotavirus, (2) In undernourished mice, anti-rotavirus IgA levels are altered in both immunized and

signaling pathway unimmunized mice following EDIM challenge, and (3) Unimmunized, undernourished mice produce lower levels of anti-rotavirus IgG in response to EDIM infection. The rhesus rotavirus (RRV) strain used in this study was obtained from Dr. Harry Greenberg (Stanford University, Palo Alto, CA). The murine rotavirus strain EDIM was originally obtained from M. Collins (Microbiological Associates, Bethesda, MD). Both viruses were passaged in the African green monkey kidney MA-104 cell line. Viruses were titered in this same cell line using a fluorescent focus assay as previously described [34]. Timed pregnant BALB/c mice were purchased from Harlan http://www.selleckchem.com/products/Erlotinib-Hydrochloride.html Laboratories (Indianapolis,

IN). All mice were housed in microisolation cages and shown to be rotavirus-negative by serology prior to

use. Adoptions were set up to allocate 6 to 7 pups per cage. Fourteen dams of 3-day-old pups were randomized to an ad lib purified control diet (Control: 15% fat, 20% protein, 65% CHO) or an isocaloric regional basic diet (RBD: 5% fat, 7% protein, 88% CHO) to induce weanling undernutrition, as previously described [29]. Both diets were irradiated prior to administration. Beginning on day of life (DOL) 3, mice were weighed every three days. On DOL 21 pups were weaned to their dams’ diet (3,4 mice per cage) and body weights were recorded weekly. All animal procedures were conducted in accordance with the Cincinnati Children’s Hospital Research Foundation Institutional Animal Care and Use Committee. On DOL 21, Idoxuridine 86 weanlings received a single dose (1.0 × 107 ffu/ml) of RRV by oral gavage (vaccine) or PBS sham. To determine shedding of RRV, two fecal pellets were collected by massage from each mouse individually at days 2, 3, and 4 after immunization and kept in 1 ml of Earle’s balanced salt solution (EBSS). Samples were stored frozen until analyzed, at which time they were homogenized and centrifuged to remove debris. Three weeks later, animals were bled from the orbital sinus and stool was collected for antibody analysis. Serum samples were centrifuged 10 min at 400 × g and the sera was stored at −20 °C.

Nonetheless, in pre-licensure trials, it is critical to remain vi

Nonetheless, in pre-licensure trials, it is critical to remain vigilant to the risk of intussusception in trial participants and to determine

if there are safety signals of larger magnitude than currently expected that might preclude licensure. We describe the surveillance for intussusception among children enrolled in a phase III clinical trial for safety and efficacy and present some of the lessons learnt that might be relevant as countries plan post marketing surveillance for intussusception prior to or following introduction of vaccines in their NIP. Participants were enrolled, after written informed consent was obtained, in a phase III, double-blind placebo-controlled, randomized clinical trial to evaluate the efficacy of three doses of Rotavac against severe selleck inhibitor rotavirus gastroenteritis Selleckchem PFI-2 which was conducted at three

sites (Delhi, Pune and Vellore) in India between 2010 and 2013. The ethics review committees of participating sites approved the protocol. Subjects recruited between 6 and 7 weeks of age were randomized in a 2:1 ratio to receive 3 doses of vaccine or a placebo. Routine childhood vaccines were co-administered and breastfeeding was not restricted. The first one third of the participants enrolled in the study at all three sites were included in a detailed safety follow which involved study staff making daily contact for fourteen days after each dose of vaccine to solicit information on occurrence of solicited adverse events. All children recruited in the trial were also followed up weekly until the age of 2 years for safety and efficacy endpoints. Primary caregivers were provided a mobile phone and access to the study team round the clock and Sclareol were advised to contact the study team whenever the child had an episode of gastroenteritis, signs and symptoms of intussusception or any illness that required hospital referral. The study used broad screening criteria for suspected intussusception to ensure all intussusceptions were identified early and treated appropriately. All

children who had three or more episodes of vomiting in an hour or blood in stool or complaints of abdominal distension with an increase in abdominal girth of 2 cm or more in a 4 h period or an abdominal mass palpable per abdomen were considered to have a suspected intussusception event. Every subject with suspected intussusception was examined by the study team and taken for pediatric consultation and hospitalized, if required. Ultrasonography was performed within eight hours and a pediatric surgeon consulted if advised by the pediatrician. Pediatric surgeons assessed children with evidence of intussusception on ultrasonography and instituted appropriate management as per treating facility protocol. All children who presented with blood in stool along with one other finding suggestive of intussusception had stool samples tested for rotavirus shedding at a central laboratory.