**7.2 Indian scenario**

India is one among the many countries where child undernutrition is severe and also undernutrition is a major underlying cause of child mortality in India. Pattern of stunting prevalence among Indian districts is shown in **Figure 4**.

The prevalence of underweight children under age 5 was an indicator to measure progress towards MDG 1, which aims to halve the proportion of people who suffer from hunger between 1990 and 2015. For India, this would imply a reduction in the child underweight rate from 54.8% in 1990 to 27.4% in 2015. Sustainable development

#### **Figure 1.** *Global burden of malnourished under-5 children [8].*

In the 2018 Global Hunger Index, India ranks 103rd out of 119 qualifying countries [12]. With a score of 31.1, India suffers from a level of hunger that is serious. **Figure 6** depicts dimensions and indicators of Hunger index and its relationship

*Trends in various nutritional indicator values and U5 mortality rate from 2000 to 2018 (India).*

*Pattern of stunting prevalence among Indian districts (source: Menon et al. 2018).*

with child malnutrition.

**Figure 5.**

**15**

**Figure 4.**

*Childhood Malnutrition in India*

*DOI: http://dx.doi.org/10.5772/intechopen.89701*

#### **Figure 2.**

*Trends in global burden of malnourished under-5 children [8].*

#### **Figure 3.**

Goals (SDG) 2 focuses on end hunger, achieves food security and improves nutrition and promotes sustainable agriculture. By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women and older persons and indicators are primarily prevalence of stunting, wasting and overweight among children under 5 years of age. In a recently released Global Nutrition Report 2018, revealed the prevalence of stunting, wasting and overweight at national level as 37.9, 20.8 and 2.4% respectively [10].

In India as per National Family Health Survey IV (2014–2015, recent in the series) 38.4, 21 and 35.7% of children below 5 years suffer from stunting, wasting and underweight respectively (corresponding figure for NFHS III, 2005–2006 were 47.9, 19.8 and 42.5% respectively). Prevalence of severe acute malnutrition (SAM) in India is 7.5% [11]. Trends in various nutritional indicator values and U5 mortality rate from 2000 to 2018 (India) are shown in **Figure 5**.

*Comparison of burden of malnourished under-5 Asian and African children [8].*

**Figure 4.** *Pattern of stunting prevalence among Indian districts (source: Menon et al. 2018).*

#### **Figure 5.**

Goals (SDG) 2 focuses on end hunger, achieves food security and improves nutrition and promotes sustainable agriculture. By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women and older persons and indicators are primarily prevalence of stunting, wasting and overweight among children under 5 years of age. In a recently released Global Nutrition Report 2018, revealed the prevalence of stunting, wasting and overweight at national level as 37.9, 20.8 and 2.4%

*Comparison of burden of malnourished under-5 Asian and African children [8].*

*Trends in global burden of malnourished under-5 children [8].*

*Perspective of Recent Advances in Acute Diarrhea*

In India as per National Family Health Survey IV (2014–2015, recent in the series) 38.4, 21 and 35.7% of children below 5 years suffer from stunting, wasting and underweight respectively (corresponding figure for NFHS III, 2005–2006 were 47.9, 19.8 and 42.5% respectively). Prevalence of severe acute malnutrition (SAM) in India is 7.5% [11]. Trends in various nutritional indicator values and U5 mortality

rate from 2000 to 2018 (India) are shown in **Figure 5**.

respectively [10].

**14**

**Figure 3.**

**Figure 2.**

*Trends in various nutritional indicator values and U5 mortality rate from 2000 to 2018 (India).*

In the 2018 Global Hunger Index, India ranks 103rd out of 119 qualifying countries [12]. With a score of 31.1, India suffers from a level of hunger that is serious. **Figure 6** depicts dimensions and indicators of Hunger index and its relationship with child malnutrition.

other hand, approximately 22% of the Indian population live below the poverty line. Rural population, a major chunk (especially agriculturists) is mostly dependent on rains for their income. They always live in a state of uncertainty of income. Apart of income, illiteracy plays a crucial role. Most of the people are not aware about their health, nutrition, balanced diet and breastfeeding practices. Without these, effec-

India ranked 97 among a list of 118 countries on hunger as per Global Hunger Index (GHI). It concludes that Indian population does not have access to sufficient and nutritious food. National Food Security Act is a great step in the direction of ensuring greater access to adequate quantity of quality food at affordable cost via Targeted Public Distribution System (PDS). Desired outcomes were not achieved due to corruption in PDS [17]. Wastage of food grains (theft, rotting) in Food Corporation of India (FCI) warehouses has also dented the access of food to common man. Greater efforts are needed to strengthen the existing initiatives to make

State of maternal health illiteracy is an important determinant of child nutritional status. The type of care a mother provides to her child depends to a large extent on her knowledge and understanding of some aspects of basic nutrition and

Millions of beneficiaries have benefitted by ICDS Scheme however, problems are being observed in ensuring supply of quality food, and its uniform distribution. Anganwadi Workers (AWWs) and Anganwadi Helpers (AWHS) at Anganwadi centres are often dissatisfied by low wages. Thus they fail to play an effective role in

Dibrugarh, Assam: two organizations have brought charges of rampant corruption in the Integrated Child Development Scheme (ICDS) amounting to more than Rs. 37 lakh in Panitola ICDS project of the district. While the officer-in-charge of the ICDS project in Panitola development block has drawn the money for 2007– 2008 through two cheques (Nos. 107,895 and 017896) from UCO Bank, Dibrugarh after collecting the cheque from the district social welfare department, All India Youth Federation and All Assam Mottock Yuba Chatra Sanmilan unearthed through Right to Information (RTI) Act that the money has not been utilized till date. Suspecting misuse of the allotted money, the two organizations have demanded that the district administration institute an enquiry into the anomaly immediately. They have also demanded exemplary punishment on the erring officials (source: The

Village Health, Sanitation and Nutrition committee (VHSNC), one of the key elements of the National Rural Health Mission are non-functional in many of the states due to lack of funds. Similarly, Village Child Development Centres (VCDCs) were set up by state government of Maharashtra to provide malnourished children with medical care and nutritious meals. These centres are mostly non-functional

In Nigoha, the hot food scheme has stopped functioning due to lack of funds. The condition of Rampura AWC is also the same. The centre does not open on regular basis. The AWH, Sarvesh Kumari, distributes toffees instead of proper nutritional food to the limited number of children who come to the centre. Villagers are not even aware of the facilities provided to them by the AWC. Community

tive nutrition communication campaign cannot succeed in their purpose.

them as corruption free and efficient institutions to get better results.

health care [18].

*Childhood Malnutrition in India*

*DOI: http://dx.doi.org/10.5772/intechopen.89701*

tackling the problem of malnutrition.

**8.1 Scam in ICDS project unearthed**

Assam Tribune, 12 May 2008).

due to lack of funds [19].

**17**

**8.2 Toffees in the name of nutritious food**

**Figure 6.** *Diagrammatic representation of child undernutrition with Hunger Index.*


*2.1. MAP1B Is the Most Significantly Upregulated Gene Associated with Microtubule Bundle Formation in UBUC Transcriptomes*

The UBUC transcriptome dataset includes 93 tissue samples, with 78 categorized as deeply invasive tissues (pT2–pT4) and 15 categorized as noninvasive or superficial (pTa and pT1) tissues. Metastasis was detected in 28 patients and absent in 49 patients. Through transcriptome profiling, we identified 11 probes spanning six transcripts associated with microtubule bundle formation (GO:0001578). Among these expressed genes, we found that tumors with increased *MAP1B* expression and decreased *MARK4* had a more advanced pT status and a higher incidence of metastatic events (Figure 1A). Our main goal was to find the most significant upregulated genes associated with advanced disease. Therefore, we choose *MAP1B* for further validation. Table 1 shows the *MAP1B* gene (Probe: 226084\_at, 214577\_at) upregulation with up to 1.2832-, 0.3773- and 0.9436-, 0.3943- fold log ratios in advanced and metastatic UC, respectively. Furthermore, we found through survival analysis that increased *MAP1B* expression

was significantly related to poor prognosis in patients with UBUC (Figure 1B). As shown in Figure 1c,d, the *MAP1B* transcripts level was significantly higher among tumors with high pT status (pT2–pT4) than in noninvasive tumors (pTa–pT1) in both the UTUC and UBUC groups (both *p* < 0.01). Our findings indicate that *MAP1B* is associated with tumor aggressiveness.

**Figure 1.** Analysis of gene expression in urinary bladder urothelial carcinoma (UBUC) using a published transcriptome dataset (GSE31684). (**A**) Cluster analysis of genes focusing on the GO microtubule bundle formation class (GO:0001578) revealed that *MAP1B* was one of the most significantly upregulated genes associated with more advanced pT status and metastatic disease. Tissue specimens from cancers with a distinct pT status are illustrated at the top of the heat map, and the expression levels of upregulated and downregulated genes are represented as a continuum of brightness of red or green, respectively. Specimens with no change in messenger RNA (mRNA) expression are shown in black. (**B**) Kaplan–Meier plots showing the prognostic significance of *MAP1B* expression for the survival of UBUC. Using a QuantiGene assay, *MAP1B* mRNA expression was significantly increased in both (**C**) upper tract urothelial carcinoma (UTUC) and (**D**) UBUC at advanced primary pT stages.

#, Meta., distal metastasis developed during follow-up; Non-Meta.: no metastatic event developed.

#### *Cancers* **2020**, *12*, 630

 to cancer

**Table 1.**

Summary of di

fferentially

 expressed genes associated with microtubule

 bundle formation (GO: 0001578) and showing positive associations


*Edited by Ravi Varala*

Scope of Selective Heterocycles from Organic and Pharmaceutical Perspective is a compilation of bioactive-chosen heterocyclic scaffolds intended for postgraduates, research scholars, pharmaceutical scientists, and others interested in an appreciation of the title subject. It is an edited book and is not comprehensive as well in the mentioned field. Few synthetic strategies along with bioactivity are presented, and some limitations were raised in order to arouse curiosity of the reader.

ISBN 978-953-51-2503-7

Scope of Selective Heterocycles from Organic and Pharmaceutical Perspective

Photo by JK1991 / iStock


**1. Introduction**

124 DNA Repair

Petalcorin MI, Galkin VE, Yu X, Egelman EH, Boulton SJ. 2007 Stabilization of RAD-51-DNA

Qiao GB, Wu YL, Yang XN, Zhong WZ, Xie D, Guan XY, Fischer D, Kolberg HC, Kruger S,

Rahan R et al., Links between DNA double strand break repair and breast cancer: accumulating evidence from both familiar and nonfamilial cases. *Cancer Lett.* 2007 248: 1-17 Rajendra E. and Venkitaraman A. R. Two modules in the BRC repeats of BRCA2 mediate

Rogakou E. Megabase chromatin domains involved in DNA double strand breaks *in vivo*. J.

Rowling PJ, Cook R, Itzhaki LS. 2010 Toward classification of BRCA1 missense variants using a biophysical approach. *J Biol Chem.* JBC 285(26): 20080–20087 San Filippo J, Sung P, Klein H. Mechanism of eukaryotic homologous recombination. *Annu*

Schild D, Wiese C. Overexpression of RAD51 suppresses recombination defects: a possible mechanism to reverse genomic instability. *Nucleic Acids Res.* 2010 38 1061-70 Seviour E & Lin S-Y 2010 Aging 2 900-907 The DNA damage response: Balancing the scale

Shivji MK, Mukund SR, Rajendra E, Chen S, Short JM, Savill J, Klenerman D, Venkitaraman

Slupianek A. Schmutte C., Tombline G., Nieborowska-Skorska M., Hoser G., Nowicki M.O.

Sonoda E, Sasaki MS, Buerstedde JM, Bezzubova O, Shinohara A, Ogawa H, Takata M,

Starita LM, Parvin JD. The multiple nuclear functions of BRCA1: transcription,

Tsuzuki T, Fujii Y, Sakumi K, Tominaga Y, Nakao K, Sekiguchi M, Matsushiro A,

Venkitaraman A.R. Linking the cellular functions of BRCA genes to cancer pathogenesis and

Vigneron A, Vousden KH. p53, ROS and senescence in the control of aging. *Aging (Albany*

West SC. Molecular views of recombination proteins and their control. *Nat Rev Mol Cell Biol.*

Williams RS, Chasman DI, Hau DD, Hui B, Lau AY, Glover JN. Detection of protein folding

defects caused by BRCA1-BRCT truncation and missense mutations. *J. Biol. Chem.*

homologs, resulting in drug resistance. *Mol. Cell* 2001 8: 795-806.

chromosomal breaks prior to cell death. 1998 EMBO J 17 598-608

embryonic mice. *Proc Natl Acad Sci U S A*. 1996 93: 6236-6240

ubiquitination and DNA repair. *Curr Opin Cell Biol* 2003, 15: 345-50 Stürzbecher HW, Donzelmann B, Henning W, Knippschild U, Buchhop S. p53 is linked

AR. The BRC repeats of human BRCA2 differentially regulate RAD51 binding on single- versus double-stranded DNA to stimulate strand exchange. *Proc Natl Acad*

Pierce A.J. Fishel R. and Skorski T. BCR/ABL regulates mammalian RecA

Yamaguchi-Iwai Y, Takeda S. Rad51-deficient vertebrate cells accumulate

directly to homologous recombination processes via RAD51/RecA protein

Yoshimura Y, MoritaT. Targeted disruption of the Rad51 gene leads to lethality in

*Acad Sci U S A*. 104: 8299–8304

*Res.* 2010, 38: 82–96

Cell Biol. 1999, 146 905-916

*Rev Biochem*. 2008 77 229

between cancer and ageing;

*Sci U S A.* 2009 106 13254–13259

interaction. *EMBO J.* 1996 **15:**1992-2002.

treatment. *Ann.Rev. Pathol.* 2009 4: 461-487

*NY)*, 2010 2:471-4.

2003, 278: 53007-16

2003 4:435-45.

filaments via an interaction domain in Caenorhabditis elegans BRCA2. *Proc Natl*

Stuerzbecher HW. High-level expression of Rad51 is an independent prognostic marker of survival in non-small-cell lung cancer patients. *Br J Cancer.* 2005, 93:137-43.

structural and functional interactions with the RAD51 recombinase. *Nucleic Acids*

Reactive oxygen species, ionizing radiation and alkylating agents can attack on DNA resulting in single or double strand breaks, generation of abasic sites, base and sugar lesions [1]. Double-strand breaks (ds breaks) are repaired by two different types of mechanism. One type takes advantage of proteins that promote homologous recombination (HR) to obtain instructions from the sister or homologous chromosome for proper repair of breaks. The other type permits joining of ends even if there is no sequence similarity between them. The latter process is called non-homologous end joining (NHEJ).The process by which complex single-strand breaks (those that cannot be directly religated) are repaired (SSBR) in some ways resembles NHEJ. Here we shall mainly discuss the mechanism of base excision repair (BER) of SSBR.