Association of cognitive function, depression, and quality of sleep with statins among oldest-old individuals

Background: Oldest?old population is rapidly increasing in all countries, with many prescribed statin therapy. Statins are associated with multiple cardiovascular benefits at various ages. The benefits of statins above the age of 75 are being questioned. The objective of this study was to measure statins use among the oldest?old population, aged 80 years and above, and to study the effect of statins on cognitive function, depression, and quality of sleep. Materials and Methods: This cross-sectional study randomly enrolled 200 community-dwelling individuals aged >80 years. Data were collected upon home visits on sociodemographic, cognitive functions, depression, sleep, chronic diseases, functional limitations, and disabilities. Cognitive function (Mini Mental State Examination), depression (Geriatric Depression Scale), and quality of sleep (Pittsburgh Sleep Quality Index) among individuals using statins versus not using statins were compared. Chi?square test and t-test were done; odds ratios (ORs) with 95% confidence interval (95% CI) were reported. Logistic regression was done to calculate adjusted ORwith age, antidepressants, sedatives, antihistaminics, and sleep medicines. P < 0.05 was considered statistically significant. Results: Overall prevalence of statin use in our study population was 12%; 11.3% in women and 13.2% in men. Cognitive functions, depression, and quality of sleep improved among those using statins (P < 0.05): cognitive impairment – OR: 0.38; 95% CI: 0.16–0.91; depression – OR: 0.41; 95% CI: 0.17–1.02, and poor sleep quality – OR: 0.39; 95% CI: 0.16–0.96. On stratification by gender, men showed a significant association of improved cognitive function and quality of sleep with the use of statins, whereas women did not show any significant associations with cognitive function and quality of sleep but showed almost significant association with improvement in depression. Conclusions: The prevalence of the use of statins was low in our population. Statins had positive effects on cognitive functions, quality of sleep, and depression over 80 years of age in our population, although gender difference exists

Cervical cancer: a hospital based KAP study among women aged 18 years and above in Northern India

Background: Cervical cancer is known for its late detection due to a variety of reasons chiefly lack of knowledge, undesirable attitudes and poor practices. Early screening and adequate knowledge about the disease remains the important safe guards against this disease. The study aimed to assess the knowledge, attitudes and practices of the women aged 18 years and above regarding cervical cancer visiting a tertiary care teaching hospital.Methods: The present cross sectional hospital based study was conducted in Jammu city, Jammu and Kashmir, India. All the women aged 18 years and above visiting OPD of gynaecology-obstetrics department of Government Medical College Jammu and willing to participate were administered a pretested questionnaire to collect the relevant data.Results: It was found that 91.56% of the respondents had heard of cervical cancer with 83% reporting that it was both preventable as well as curable. Multiple sex partners were the most important risk factor identified. Among the attitudes, 62% agreed that screening was harmless to the client. Only one third knew about the availability of preventive vaccine. About 83.6% of them had never been screened by Pap smear. However willingness to get HPV vaccination was found to be high.Conclusions: Though knowledge among the respondents was found to be adequate but it lacked transformation into attitudes and practices. In this connection, authors recommend health promotion campaigns to educate women and the community about cervical cancer and its preventability through screening.

IL-10 down-regulates the expression of survival associated gene hspX of Mycobacterium tuberculosis in murine macrophage

Abstract Mycobacterium tuberculosis (MTB) adopts a special survival strategy to overcome the killing mechanism(s) of host immune system. Amongst the many known factors, small heat shock protein 16.3 (sHSP16.3) of MTB encoded by gene hspX has been reported to be critical for the survival of MTB. In the present study, the effect of recombinant murine interferon-gamma (rmIFN-γ) and recombinant murine interleukin-10 (rmIL-10) on the expression of gene hspX of MTB in murine macrophage RAW264.7 has been investigated. By real-time RT-PCR, it was observed that three increasing concentrations (5, 25 and 50 ng/ml) of rmIFN-γ significantly up-regulated the expression of hspX whereas similar concentrations of rmIL-10 (5, 25 and 50 ng/ml) significantly down-regulated the hspX expression. This effect was not only dependent on the concentration of the stimulus but this was time-dependent as well. A contrasting pattern of hspX expression was observed against combinations of two different concentrations of rmIFN-γ and rmIL-10. The study results suggest that rIL-10 mediated down-regulation of hspX expression, in the presence of low concentration of rIFN-γ, could be used as an important strategy to decrease the dormancy of MTB in its host and thus making MTB susceptible to the standard anti-mycobacterial therapy used for treating tuberculosis. However, as these are only preliminary results in the murine cell line model, this hypothesis needs to be first validated in human cell lines and subsequently in animal models mimicking the latent infection using clinical isolates of MTB before considering the development of modified regimens for humans.

Comparative proteomic analysis of sequential isolates of Mycobacterium tuberculosis from a patient with pulmonary tuberculosis turning from drug sensitive to multidrug resistant.

Background & objectives: Tuberculosis is a major health problem in India, and the emergence of multidrug resistant (MDR) and extensively drug resistant (XDR) strains of Mycobacterium tuberculosis (Mtb) has further complicated the situation. Though several studies characterizing drug sensitive and drug resistant strains are available in literature, almost all studies are done on unrelated strains. Therefore, the objective of this study was to compare the proteomic data of four sequential isolates of Mtb from a single patient who developed MDR-TB during the course of anti-tuberculosis therapy (ATT). Methods: In this study, using two-dimensional (2D) gel electrophoresis and MALDI-TOF mass spectrometry, we compared and analyzed the cell lysate proteins of Mtb sequential clinical isolates from a patient undergoing anti-TB treatment. The mRNA expression levels of selected identified proteins were determined by quantitative real-time polymerase chain reaction (qRT-PCR). Results: The genotypes of all four isolates remained homologous, indicating no re-infection. The initial isolate (before treatment) was sensitive to all first-line drugs, but the consecutive isolates were found to be resistant to isoniazid (INH) and rifampicin (RIF) and developed mutations in the katG, inhA and rpoB. the intensities of 27 protein spots were found to be consistently overexpressed in INH and RIF resistant isolates. The most prominent and overexpressed proteins found during the development of drug resistance were GarA (Rv1827), wag31 (Rv2145c), Rv1437 and Rv2970c. Interpretation & conclusions: This preliminary proteomic study provides an insight about the proteins that are upregulated during drug resistance development. These upregulated proteins, identified here, could prove useful as immunodiagnostic and possibly drug resistant markers in future. However, more studies are required to confirm these findings.

Estimating the Economic Burden of Malaria and Assessing Its Relationship with Socio-Economic Condition in Rohtak and Mewat Districts of Haryana, India.

Aim: Malaria continues to remain a serious public health problem and causes significant economic burden especially among the poor tribal and marginalised communities in the tropical and subtropical countries of the World. In view of the lack of information in respect of malaria and economic losses in Haryana, an attempt was made to assess the relationship between the occurrence of malaria and socio-economic conditions as well as to estimate the direct and indirect costs incurred due to malaria in Rohtak and Mewat districts of Haryana. Methodology: A community based cross-sectional survey was carried out in a highly malaria endemic cluster of six selected villages of Rohtak and Mewat region of Haryana, to estimate the economic burden in terms of direct and indirect costs of malaria. Results: The study revealed that on an average a household incurred a total cost of Rs.1835 (29.77 US$) in Rohtak district and Rs 2027 (32.91 US$) in Mewat district as direct and indirect cost per patient. It was estimated that direct costs due to malaria consumed 36-40% of annual income of poor households and 3-4% of high income households suggesting that the burden of malaria is significantly higher among poor households. Conclusion: The study revealed that malaria posses a significant economic burden on poor households both through out-of-pocket expenditure and man-days lost. To reduce the economic burden of malaria implementation of suitable intervention measures with focus on poor and marginalised along with better allocation of resources and health care facilities at the Government hospitals must be taken into consideration. It is also needed the intensification of IEC (Information, Education and Communication) campaigns regarding malaria to enhance awareness and solicit community participation.

Emerging Molecular Targets for the Treatment of Asthma.

Current therapeutic approaches for the treatment of asthma have limitations in their ability to target all the features of the disease. Indeed, existing pharmacological asthma therapies are based on decades old strategies that were developed prior to the rapid growth in knowledge stemming from cell and molecular biology in the past decade. Thus, there is an unmet need for developing new drugs to target these features along with improved efficacy and safety. In the present review, the limitations of prevalent pharmacological asthma therapy are discussed briefly, and some explanations are suggested as to why new therapeutic targets are required to treat asthma, and finally directions for novel asthma therapies are proposed.