25-Hydroxycholecalciferol levels and its equation with lipid parameters and Insulin sensitivity in obese and non-obese young adults: A pilot study

Introduction: Vitamin D deficiency and Obesity are the two prevailing health issues of the globe, with India being no excep?on. The sub op?mal Vitamin D levels is associated with an elevated risk of a number of chronic disorders including malignancy, inflamma?on and autoimmune diseases. Obesity breeds metabolic disharmony. Recent data reports Vitamin D deficiency being more prevalent among the obese. Objec?ve: This study is undertaken to see the associa?on of Vitamin D levels with Body Mass Index (BMI), Lipid parameters and Insulin resistance in a sample popula?on represen?ng the urban Indian youth. Materials and Method: Fi?y five apparently healthy young adults of 18 to 22 years age were recruited in this study and their serum 25-hydroxycholecalciferol(25OHD), serum insulin, Total Cholesterol, High Density lipoproteincholesterol (HDL-c), Low Density lipoprotein- cholesterol (LDL-c) and Triglyceride (TGL) levels were es?mated. Insulin resistance(IR) was derived using the Homeostasis Model Assessment equa?on. Based on BMI, the par?cipants were divided into Obese group with BMI ? 25 (n=21) and nonobese group with BMI < 25 (n=34). Result: 25OHD levels were almost same in both Groups (Obese11.1 ± 4.6 ng/ml and non-obese 11.0 ± 5.2 ng/ml). Serum total cholesterol, VLDL and insulin levels were significantly increased in the Obese group(p= 0.005, p= 0.015 and p=0.054 respec?vely) when compared to the non-obese group. We found sta?s?cally significant associa?on between 25-hydroxycholecalciferol (25OHD) and TGL/HDL ra?o in the Obese group. Conclusion: In this pilot study we have unravelled the subtle onset of metabolic derangement in Obese individuals with Vitamin D deficiency.

Career Profile Of Community Medicine Alumni Of A Premier Teaching College Of Mumbai

Introduction: Diverse Factors influence medical student’s choice of eventual careers. Community Medicine is one of the specialities taken up at various hospitals by a number of doctors. This study was planned to review the career opportunities taken by doctors who passed MD Community Medicine or Diploma in Public Health from a premier teaching college located in Mumbai, Maharashtra. Results: 163 students were enrolled since 2009 off which 53 were currently pursuing either MD/DPH course. Data was collected for this study in the months of September 2017 to November 2017. The career profile were grouped as Academics in MCGM, Academics in State government colleges, Public health in MCGM, state, centre, etc. Most pursued current careers were Speciality Medical Officer (bond post) in MCGM colleges (16), Academic positions in State government colleges (16), public health positions in Maharashtra state government (13) and public health in MCGM (11). Very few candidates were currently working in international or national institutions. Conclusion: This study shows that Academics and Public Health still are the major career prospects for doctors who have done MD/DPH. It could be seen that very few opted for other career options like Preventive Oncology, Health Management or Research institutes. This study recommends better maintenance of records of alumni for future contacts and career counselling for post graduate students.

Influence of Obesity and Family History of Type 2 Diabetes Mellitus on Serum Ferritin and Insulin Levels in Young Adults.

Aim: Obesity and family history of Type 2 Diabetes mellitus are the major risk factors for the development of type 2 Diabetes mellitus in youth. The purpose of this study is to investigate the association between serum ferritin and insulin resistance in healthy young obese with and without family history of type 2 Diabetes mellitus. Place and Duration of Study: Department of Biochemistry, Rajarajeswari Medical College and Hospital, Kambipura, Bangalore, Karnataka, India, for eight months period in the year 2012. Material and Methods: A small group study was undertaken in 90 students who were in the age group of 17-22 years. The study population was divided into two groups based on body mass index, Group I /non-obese group (n=46) and Group II/ overweight & obese group (n=44). Fasting and postprandial blood glucose, Serum ferritin, serum insulin and lipid parameters were estimated and Homeostasis Model Assessment-Insulin resistance (HOMA-IR) was calculated for all the ninety students. Results: Statistically significant differences in Total cholesterol (p=0.05), Triglycerides (p=0.05), serum insulin (p<0.01) and HOMA (p<0.01) were observed between the two groups. Mean serum ferritin values were increased in group II (overweight/obese) but not statistically significant. Serum insulin and serum ferritin showed a significant correlation with BMI for the whole study group. Serum ferritin and insulin levels significantly correlated with waist to hip ratio in students with family history of Type 2 Diabetes mellitus as against individuals without family history. 59% of the obese students with family history of Diabetes mellitus had insulin resistance. Conclusion: Our study has shown that a significant proportion of obese students with family history of type 2 diabetes mellitus had insulin resistance and elevated levels of ferritin, highlighting the importance of early screening for obesity associated co morbidities like metabolic syndrome, Type 2 Diabetes mellitus and cardiovascular diseases in these individuals

Antibodies against 9-O-acetylated sialic acids in childhood acute lymphoblastic leukemia: a two-year study with 186 samples following protocol MCP 943.

Initial studies have revealed an enhanced surface expression of 9-O-acetylated sialoglycoconjugates (9-OAcSGs) on lymphoblasts concomitant with high titers of antibodies (anti-9-OAcSGs) in childhood acute lymphoblastic leukemia (ALL). This study was undertaken in 186 coded samples from 69 ALL patients to evaluate if antibodies against these sialoglycans could monitor response to the treatment. An ELISA was developed using bovine submaxillary mucin (BSM) containing high % of 9-O-acetylated sialic acids (9-OAcSA) as the capture antigen, to investigate serum levels of anti 9-OAcSGs in a single-center series of pediatric, clinically-diagnosed and immunophenotypically confirmed ALL patients, as compared to 130 healthy controls. At presentation, a 3.8-fold increase in anti-9-OAcSGs levels was detected in 63/69 ALL patients (mean +/- SEM was 102.8 +/- 6.3 microg/ml) as compared to normal controls (27.17 +/- 0.76 microg/ml), assay sensitivity being 91.3%. On an individual basis (n = 25) in patients who were longitudinally monitored for two years, a significant decline in their mean +/- SEM of OD405 was observed from 0.85 +/- 0.06 to 0.28 +/- 0.03. Additionally, a dot-blot was developed to evaluate the proportion of immune-complexed 9-OAcSGs in these patients employing achatinin-H, a 9-OAcSA-binding lectin. Our data indicate that these economically viable ELISA-based approaches allow for reliable, sensitive and rapid diagnosis of ALL. We contend that these disease-specific antibodies could be considered as potential markers both for the initial diagnosis of ALL and possibly for longitudinal monitoring of the disease.

Desmoplastic small round cell tumor: extra abdominal and abdominal presentations and the results of treatment.

BACKGROUND: Desmoplastic small round cell tumor (DSRCT) is a rare malignant neoplasm of adolescent males. Current multimodality treatment prolongs life and rarely achieves cure. AIM: To review the presenting features, histopathology and outcome of 18 patients with DSRCT treated at a single institution. SETTING AND DESIGN: This is a retrospective observational study of patients with DSRCT who presented at the Tata Memorial Hospital between January 1994 to January 2005. MATERIALS AND METHODS: Eighteen patients of DSRCT seen during this period were evaluated for their clinical presentation, response to chemotherapy and other multimodality treatment and overall survival. The cohort of 18 patients included 11 males (61%) and 7 females (39%) with a mean age of 16 years (Range 1(1/2)--30 years). Majority (83%) presented with abdomino-pelvic disease. The others, involving chest wall and extremities. There were 6 patients (33%) with metastatic disease at presentation. RESULTS: The treatment primarily included a multimodality approach using a combination of multiagent chemotherapy with adjuvant surgery and radiotherapy as applicable. A response rate of 39% (CR-1, PR-6), with chemotherapy was observed. The overall response rate after multimodality treatment was 39% (CR-5, PR-2). The overall survival was poor except in patients who had complete excision of the tumor. Conclusion:0 Abdomino-pelvic site was the commonest presentation, the disease can occur at other non-serosal surfaces also. Despite aggressive treatment the outcome was poor. However, complete surgical excision seems to provide a better survival.

Isolated testicular relapse in acute lymphoblastic leukemia - effective treatment with the modified CCG-112 protocol.

BACKGROUND: The testes have been considered a sanctuary site for leukemic cells and testicular relapses used to account for a major proportion of the poor outcome of boys with acute lymphoblastic leukemia. With use of aggressive chemotherapy which includes intermediate or high dose methotrexate, the incidence of testicular relapses has declined. However once these patients have received cranial irradiation as a part of the front line protocol, high dose methotrexate needs to be avoided because of risk of developing leucoencephalopathy. AIM: To study the use of non cross resistant chemotherapeutic agents along with a regimen containing lower doses of methotrexate in patients of isolated testicular relapse (ITR). MATERIALS AND METHODS: This is a retrospective analysis of 12 consecutive patients with ITR treated with modified version of the CCG-112 protocol which consists of intensive systemic chemotherapy, cranial chemoprophylaxis along with testicular irradiation. RESULTS: One patient died of regimen related toxicity. Two patients relapsed in the bone marrow during maintenance. Of the nine patients who completed treatment, eight are alive and in remission. One patient had a bone marrow relapse two months after completing treatment. The Kaplan Meier estimates give us an Event Free Survival (EFS) of 66.7% at 10 yrs. CONCLUSIONS: Thus, though the incidence is very low, patients with ITR should be treated aggressively since they have an excellent chance of achieving a long term EFS.