Dyslipidemia in Diabetic Patients with Acute Myocardial Infarction

The present study was undertaken to check the lipid profile in patients of acute myocardial infarction withchronic diabetes and to evaluate the variations in various lipid levels in different age, gender and in patientswith different habits of diet, smoking and alcohol consumption. A total of 92 subjects aged between 40-70years were included. 5 ml of fasting blood sample was collected from antecubital vein under aseptic precautionsin a plain vacutainer and incubated at room temperature; serum was separated by centrifuge machine at 2000rpm for 5 minutes. The samples were analyzed for estimation of four biochemical parameters: total cholesterol,serum triglyceride, serum HDL and blood sugar using Abott Architect Autoanalyser. Mean levels of HDL werebelow the normal range in smokers and non-vegetarians whereas mean TG levels were elevated amongalcoholics, smokers and non-vegetarians. High TG levels and low HDL levels are the predominant lipidabnormalities in chronic diabetic patients with AMI. There is also a significant association between smokingand these parameters.

Probiotic and Lifestyle Modification in Obese Pediatrics with Non-Alcoholic Fatty Liver Disease

In the article, “Probiotic and Lifestyle Modification in Obese Pediatrics with Non-Alcoholic Fatty Liver Disease” [1] which appears in Volume 31, Issue 1 of Indian J Community Health, there is a correction in the disclosure of the name of the drug used in the article. At the time of the publication, we were not aware of any legal issues related to the product and the brand, otherwise we would have taken due care and would have mentioned about the “De Simone Formulation” in the article instead of the VSL#3 product. Also, the references we provided in the published article on the usage of VSL#3 in several indications should have been attributed to the De Simone Formulation.

Probiotic and Lifestyle Modification in Obese Pediatrics with Non-Alcoholic Fatty Liver Disease

Background: Non alcoholic fatty liver disease is an upcoming causes of chronic liver disease in pediatric population in Asia. Aims & Objective: To evaluate the potential of probiotic VSL#3 and Lifestyle modification in obese pediatrics with Non alcoholic fatty liver disease (NAFLD). Material & Methods: we conducted clinical trial in 106 obese children in age group of 5 to18 years and divided in to four groups;VSL#3 plus lifestyle intervention (n=26), VSL#3 (n=27), Lifestyle intervention (n=26) and Placebo (n=27) received interventions for four months. To identify NAFLD by ultrasonography, Body mass index (BMI), mid arm circumference (MAC), waist circumference (WC) and triceps skinfold thickness (TSF) were done. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), low-density lipoprotein cholesterol(LDL-c),high-density lipoprotein cholesterol (HDL-c), triglyceride (TG), cholesterol, fasting blood glucose(FBG), high sensitivity C-reactive protein (HSCRP), uric acid, obesity hormones were measured along with their dietary intake at baseline and post trial. Results: VSL#3 plus lifestyle intervention significantly the most pronounced therapy for reducing fatty liver grades, anthropometric with biochemical parameters and beneficial impact on obesity hormones (p<0.001) as compared to single therapy of VSL#3 and lifestyle intervention alone. Conclusion: Combined therapy of VSL#3 plus lifestyle intervention is promising treatment for management of NAFLD in Indian obese children.

Study of Clinical Spectrum and Factors Associated with Disabilities in Leprosy: A Ten Year Retrospective Analysis

Leprosy/Hansen's Disease (HD) is associated with impairments and disabilities leading to stigma attached to the disease. Our study looks at the clinical spectrum and factors associated with disabilities over a 10 year period. It was a cross sectional retrospective analysis and included 240 patients which were followed in Christian Medical College and Hospital, Ludhiana, a Tertiary Care Hospital in North India. Objective of the study was to assess the pattern, prevalence and risk factors of disabilities in leprosy patients. The findings shows that the overall prevalence of disabilities was 57.9% (n=139) and was more common in males (73.4%). Patients, residents of Punjab had the maximum prevalence of disabilities (37.4%) followed by Bihar (27.3%). The commonest visible disability was madarosis (19.6%) followed by claw hand (12.1%). The maximum prevalence of clawing was noted in patients with BT-HD (31%) followed by TT-HD (27.6%). WHO Grade 1 disability was 24.5% while 60.4% had WHO Grade 2 disability. On multivariate analysis, positive skin smears and presence of lepra reaction at the time of diagnosis were found to be the risk factors associated with disabilities in leprosy. While the magnitude of disabilities in a referral tertiary care settings will not reflect true extent of problem in the community, information is relevant for improving the preventive and management strategies. Even in the post elimination era of leprosy, significant number and types of disabilities still persist. Like the tip of an iceberg, these findings imply that a more vigorous approach towards early and adequate treatment of complications like reactions is the need of the hour. Community based intervention studies in partnership with tertiary care hospitals may be useful in taking appropriate public health measures.

Low spontaneous apoptosis index at diagnosis predicts a high-risk phenotype in paediatric acute lymphoblastic leukaemia

Background & objectives: Significance of apoptosis as a prognostic marker is less well studied in paediatric acute lymphoblastic leukaemia (ALL) cases. Hence, a prospective study, involving 30 paediatric ALL cases, was done to assess the clinical relevance of in vivo apoptosis. Methods: Peripheral blood mononuclear cells from all patients were subjected to annexin V/propidium iodide staining to detect the degree of apoptosis [apoptotic index (AI)] at day 0 and day 35 post-induction chemotherapy. In addition, Bax and Bcl2 apoptotic protein expressions were studied at day 0 and their relative fluorescence mean intensity (RFMI) ratios were calculated. Results: Mean age of patients was 5.1 years. Of the 30 cases, 21 (70%) were at standard-risk, five (17%) at intermediate and four (13%) at high risk. Majority (83%) were B-ALL. Day 8 absolute blast count was >1000/?l in seven (23%) and <1000/?l in 23 of 30 (77%) cases. Day 35 marrow was M1 in 23 (92%) and M2 in two of 25 (8%) cases. AI at day 0 and day 35 ranged from 0.9 to16.6 per cent and 1.4 to 62.8 per cent with a mean of 5.90 and 19.64 per cent, respectively. The Bax/Bcl2 ratio ranged from 0.2 to 3.5 with a mean of 0.83. The ratio was predominantly anti-apoptotic, i.e. <1 (77%). A significant association was noted between low AI at day 0 and high total leucocyte count (P=0.02), T-cell phenotype (P=0.043) and high-risk as per NCI category (P=0.025). Significant increase (>30%) in day 35 AI was seen in only six cases. Interpretation & conclusions: Our study showed that low AI at day 0 was associated with a high-risk clinical phenotype in paediatric ALL. However, studies on larger group, especially with longer follow up or study of relapse cases, will help draw conclusions regarding apoptosis assessment in paediatric ALL.

Prevalence of Vitamin D Deficiency in Jammu Region.

Vitamin D deficiency is a worldwide health problem. This cross sectional one year study was carried among healthy subjects of both sexes without known, thyroid, renal or hepatic disease or malignancy. The 25(OH)D concentrations were measured by competitive radioimmunoassay. The subjects were classified as vitamin D-deficient, or -sufficient on the basis of 25(OH)D concentrations of <30 ng/mL, 30-100 ng/ mL respectively, according to recent consensus. Total 702 subjects participated in the study female predominated the study. Vitamin D deficiency was prevalent among 76.39% of the total population.Thus the current study sugest high prevalence of vitamin D deficiency exist in Jammu region among healthy population.

Characterization of mycobacteria isolated from bovines by PRA-targetting hsp 65 gene region.

Bovine tuberculosis caused by the bacterium Mycobacterium bovis is a major infectious disease of animals and has zoonotic importance for humans. Even though the incidence is believed to be very low in India, human tuberculosis caused by M. bovis has been increasingly recognized in many other countries of the world. As differentiation of mycobacterial species take long time, a method for the rapid identification of mycobacteria isolated from bovine samples to the species level was used, which is based on polymerase chain reaction (PCR) of the gene encoding for the 65-kD protein followed by restriction analysis. The method involves restriction enzyme analysis of PCR products obtained with primers common to all mycobacteria and generate M. tuberculosis complex specific pattern. PRA was performed on 33 bovine isolates of which 90.9% (30/33) isolates were identified clearly as M. tuberculosis complex, M. fortuitum, M. phlei and M. smegmatis using restriction enzyme Hae III.

Invasive aspergillosis in an immunocompetent host.

Invasive aspergillosis is an uncommon opportunistic infection usually seen in immunocompromised patients. Despite extensive therapeutic measures the outcome is usually unfavourable. We report a case of invasive aspergillosis in an immunocompetent individual.

Experimental Teaching and Interactive Computer Assisted Learning : The Student’s Viewpoint

A student view point regarding utility and present role of experimental teaching and interactive computer assisted learing was cited from three Medical Colleges of North India using a set of questionnaires. The majority of the student cited that animal experiments are important part of medical curriculum. However, computer assisted learning techniques will be useful aid in future but currently cannot replace animal experiments as the tool of choice for medical education and research.

Diversity of avifauna of Jamwa Ramgarh wetland of Rajasthan in India.

The present paper deals with the rich avifauna available at Jamwa Ramgarh Lake of Rajasthan in India. More than 100 species of birds belonging to 38 families were recorded at lake during the year 2002, maximum species were sighted during the winter season. Due to scanty rainfall in 2002, this lake was also affected and had only one-fourth of water of its total capacity, which affected the numbers of migratory waterfowl also. In the wetland most water birds were found to be migratory and few being resident. Some rare, endangered, uncommon, vulnerable, threatened and near threatened species of birds those already listed in Red Data Book were sighted.

Serodiagnosis of childhood tuberculosis by ELISA.

OBJECTIVE: Diagnosis of childhood tuberculosis remains an enigma despite many recent technological developments. The present study has been taken up with the aim to assess the diagnostic potential of mycobacterium tuberculosis excretory-secretory ES-31 antigen and affinity purified anti ES-31 antibodies in the serodiagnosis of different spectrum of childhood tuberculosis. METHODS: Mycobacterium tuberculosis H37Ra excretory-secretory antigen (ES-31) and affinity purified goat anti ES-31 antibodies were used in stick penicillinase ELISA for IgG antibody detection and stick Sandwich penicillinase ELISA for detection of circulating free and immune complexed antigen in the sera of 230 children. RESULTS: Analysis of tubercular antibody, circulating free and immune complexed antigen (CIC-Ag) was done in both pulmonary and extrapulmonary form of childhood tuberculosis and overall sensitivity of 81.4% with a specificity of 93% was achieved for detection of antitubercular IgG antibodies. Of the five cases of pulmonary tuberculosis showing absence of IgG antibody, 3 showed the presence of CIC-Ag and one was found positive for both free and CIC-Ag. Similarly out of 8 cases of extrapulmonary childhood tuberculosis missed by IgG detection 5 were found to be positive for CIC-Ag and 1 showed the positive reaction for both free and immune complexed antigens. CONCLUSION: IgG antibody to excretory-secretory antigen ES-31 is found to be having good specificity with acceptable sensitivity in detecting different forms of childhood tuberculosis. Further detection of circulating free and/or immunecomplexed antigen can be used as an adjunct tool in the diagnosis of childhood tuberculosis.

In vitro microtuberization in potato (Solanum tuberosum L.) cultivars.

Mechanism of microtuberization in three elite cultivars kufri badhsha (KB), kufri chandramukhi (KCM) and kufri jawahar (KJ) of potato was studied. Sprouts of all the three cultivars were used to obtain in vitro shoot cultures. MS medium supplemented with chlorocholine chloride was found to be most suitable for all the cultivars. Maximum tuberization was obtained under incubation conditions of continuous darkness at 20 degrees +/- 1 degrees C. The highest number of micro-tubers per plant basis was produced under continuous darkness and KCM recorded the highest yield of micro-tubers and was found significantly superior to KJ and KB.

Pre-administration of beta-carotene protects tissue glutathione and lipid peroxidation status following exposure to gamma radiation.

The present study has been aimed to investigate the protective effect of beta-carotene against radiation-induced oxidative stress in mice tissues using lipid peroxidation and glutathione (GSH) as end points. Fourteen days oral priming administration of beta-carotene (35 mg/kg body weight) followed by an acute dose of gamma radiation (5 Gy) inhibited the augmented level of thiobarbituric acid reactive substance (TBARS) and a statistically significant protection against GSH depletion. Results evaluated from this study clearly indicate the antioxidative property of beta-carotene against gamma radiation, which is suggestive of free radical scavenging and singlet oxygen quenching.

Catheter ablation of left free wall accessory pathway in a patient with inferior vena cava interruption.

Access to the right side of the heart for diagnostic and interventional procedures is usually obtained via the femoral vein and inferior vena cava. Anatomic variations or obstruction of the inferior vena cava can make this access difficult. In such cases, alternative routes to the right side of the heart such as the azygos vein and the superior vena cava can be used.

Evaluation of semi-quantitative methods for protein and sugar estimation in urine.

OBJECTIVES: To compare the accuracy of semi quantitative methods for estimation of protein and sugar in urine as shown by their agreement with the quantitative estimation. Hundred randomly collected samples of urine were analysed for levels of protein and sugar. Protein estimation was dine by dipstick and sulphosalicylic acid method (SSA) and sugar by dipstick and Benedict's semi-quantitative methods. Kappa analysis was done on Epi Info 6.03 software to assess the agreement of these semi quantitative methods with the quantitative estimation. Neither of the two tests for urine protein, dipstick or SSA, showed good agreement with the quantitative estimation (Kappa coefficient: 0.26 and 0.07 respectively). However, the dipstick was significantly better than SSA (p < 0.05). For urine sugar, both dipstick and Benedict's tests showed good agreement with the quantitative estimation (Kappa coefficient: 0.78 and 0.84 respectively). The difference between them was insignificant. Results demonstrate that for urine protein, dipstick or SSA show poor agreement with quantitative values. For urine sugar estimation, Benedict's semi-quantitative test shows good agreement with the quantitative values and is as good as the dipstick method.

Atrial fibrillation: epidemiology, mechanisms and management.

The incidence of AF, the most common sustained arrhythmia in clinical practice, increases with age and coronary artery disease, hypertension and valvular heart disease are common underlying substrates; however, occasionally, AF may occur without any underlying heart disease. The most widely accepted theory of its mechanism is Moe's multiple wavelet hypothesis, although recent studies are helping to shed light on other mechanisms, including the focal origin of AF in some patients. Most patients experience palpitations, but fatigue, dyspnoea, and dizziness may also occur. Therapy includes prevention of thromboembolism, control of rate, and restoration and maintenance of sinus rhythm. The risks and benefits of each treatment modality need to be assessed according to each patient's circumstances. Unlike other arrhythmias, there is still no highly successful therapy for treating AF. However, significant advances are being made using non-pharmacological approaches to either prevent or cure this troublesome arrhythmia.