This project mainly focuses on the identification of snake species with the help of a Point of care device as well as quantification of payload using mobile phone based application.

India is the second most populous country in the world with over 1.3 billion people .Every year around 8.3 million people die in India. According to WHO India has the highest Snake bite mortality in the world. Nearly 49000 death cases are reported in India each year. Many

Unreported cases are also there. Mainly four snakes species are primarily responsible for the reported cases of highest death rate. The big four species are Common Cobra (Najanaja), Krait (Bungaruscaeruleus), Russells Viper (Daboiarusseli ) and Saw Scaled Viper (Echiscarinatus).The major cause of death is due to the failure in identifying the snake species and in lacking suitable technology for payload quantification . Once the snake species and payload amount is known at the initial stage of snake bite, it’s easy for the clinicians to provide effective treatment .This project mainly focuses on the identification of snake species with the help of a Point of care device as well as quantification of payload using mobile phone based application.

Point of care (POC) testing has become the most well-known way of diagnosis in clinical analysis, food safety and environment. Lateral flow Assay (LFA) based POC devices are among very rapidly growing approach for qualitative as well as quantitative analysis. Compared to other techniques ( eg: Enzyme Linked Immunosorbent assay(ELISA)) , POC provide quick results in shorter times. Rapidity, one step analysis, low operational cost, simple instrumentation, user friendly format  ,high sensitivity and specificity ,long life span and portability of the device are the exceptional qualities of LFA strip. The present investigation is aimed to develop a lateral flow device to identify snake species and subsequent development of mobile phone based application for payload quantification

Fig: 1. Study by ELISA: Each of the four venoms was coated on a micro- ELISA plate then tested with polyvalent venom antisera.The result shows OD value of four antisera against four venom.(a) Indian Cobra (Najanaja), common krait (Bungaruscaeruleus), Russell’s viper (Dabiorusselii) and saw-scaled viper (Echiscarinatus).

Fig:2. Validated protocol of lateral flow assay

Transplantation is typically the standard of therapy for all patients with end-stage liver or kidney disease. Since the success of the transplant depends on a delicate balance between immunosuppression and rejection, reaching and maintaining an adequate therapeutic level by giving appropriate doses of immunosuppressive drugs is extremely important, especially in the first phases after the transplant.

Optimizing balance between therapeutic efficacy and occurrence of adverse drug reactions is critical in narrow therapeutic drugs like Tacrolimus (Tac), an immunosuppressive drug used to prevent solid organ rejection. Tac requires therapeutic monitoring of blood concentrations to prevent graft rejection owing to inadequate immunosuppression with low drug levels or toxicity due to high drug levels. It exhibits inter-individual pharmacokinetic variability, which affects the dose required to reach the target concentration in blood. Even with much progress in medicine, the fragile equilibrium between the risks and benefits of immunosuppression makes the management of immunosuppressive pharmacotherapy a challenge.

The main objective of the project is to develop a strong predictable marker with clinical applicability specific to our population, which can predict an individual’s response to Tac, so that patients at high risk of developing Tac-related complications can be identified even before their organ transplant. Though many studies largely concentrating on the role of CYP3A5 on Tac blood levels have been carried out, the pharmacogenetic factors identified so far are not of sufficient predictive value to be of much clinical use. Also, the lack of consensus about the role of CYP3A5 in the pharmacokinetics of Tac hinders the development of assays with clinical applicability.

Tac is metabolized by CYP3A in the gut and liver, and transported in the gut by P-glycoprotein (P-gp), an efflux pump, which is encoded by the multidrug-resistant protein (MDR1)/ABCB1 gene. Thus, CYP3A5, CYP3A4 and ABCB1 polymorphisms could have an important role in dose requirements.

We propose to investigate the role of polymorphisms in these three important genes and their interaction in influencing Tac response and dosing strategies in organ transplant recipients in South Indian population. Patients undergoing renal transplantation will be recruited from hospitals in Trivandrum, Kerala. DNA isolated from peripheral blood will be used to screen polymorphisms in CYP3A4, CYP3A5 and ABCB1 genes and correlated to the Tac blood levels in patients. Gene-gene interactions will be analysed to develop a better predictability marker involving a combination of functional variants.