Risk of progression to overt hypothyroidism in Indian patients with subclinical hypothyroidism: a prospective observational study

Background:Subclinical hypothyroidism (SCH) is a common endocrine disorder but spontaneous course of SCH in India is lacking. The aim of the study is to determine the spontaneous course of SCH and to identify the risk factors, which enhances the occurrence of overt hypothyroidism (OH).Method: This is a real world prospective observational study. 58 SCH were followed up six monthly for one year to determine the course of SCH.Results: After one year of follow up 11 (18.97%) patients progressed to OH. 37 (63.79%) remained in subclinical hypothyroid category. In 10 (17.29%) patients TSH (thyrotropin) normalized. Rate of progression (odds ratio: 4.58; 95% CI: 1.14, 18.28) was significantly more in anti-thyroid peroxidase (TPO) positive group as compared to anti-TPO negative group. Conclusions: This first data from India clearly shows that SCH has a variable course. Rate of progression to OH is high (18.97%) in Indian SCH patients. In a cohort of 58 patients followed for one year only the presence of anti-TPO antibody waspredictive of OH. The initial risk stratification can identify patients with SCH at greatest risk for progression to OH in which treatment is mandatory.

Blood pressure trend of lowlanders during first 6 days of acclimatisation to high altitude

Objectives: The present study was planned to delineate the blood pressure (BP) response of the lowlanders during initial 6 days of acclimatisation to high altitude. Materials and Methods: 398 normotensive sojourners at sea level ascended to HA (3,500 m). Blood pressure response of these subjects were analysed for 6 consecutive days at HA. Based on the BP response of these subjects on the 6th day at HA they were divided into two groups: HBP-high BP group and NBP- normal BP group. Results: It showed that on 6th day at HA, 51 out of 398 subjects presented with BP?140/90 mmHg (HBP) while others remained normotensive (NBP). Comparative systolic BP of HBP and NBP groups during successive days at HA were as follows: HA day 1 (146.8 ± 13.7 mmHg vs 146.3 ± 8.8 mmHg, p>0.05), HA day 4 (144.5 ± 8.7 mmHg vs 135.0 ± 7.0 mmHg, p<0.05) and HA day 6 (148.1 ± 7.9 mmHg vs 131.7 ± 5.3 mmHg, p<0.05). Whereas, diastolic BP of HBP and NBP groups were: HA day 1 (94.0 ± 8.1 mmHg vs 93.2 ± 6.6 mmHg, p>0.05), HA day 4 (88.9 ± 6.0 mmHg vs 85.3 ± 5.1 mmHg, p<0.05) and HA day 6 (93.8 ± 6.3 mmHg vs 83.7 ± 3.8 mmHg, p<0.05). Conclusion: It was found that NBP had initially raised BP which returned to normal levels after acclimatisation period of 6 days, but in HBP, it started rising after 4th day. It can be concluded that those individuals whose BP on 6th day at HA does not return to normal after acclimatisation period needs regular follow up as these individuals can have a delayed acclimatisation normalising BP later on or can become hypertensive subsequently

Study of the hormonal and reproductive factors associated with low back pain in reproductive female.

Background: Low back pain related disability and work absence accounts for high economical costs in modern society. A prevalence of 28-80% has been found with increase of prevalence with age and female preponderance. Methods: The present study was conducted on 250 non pregnant women complaining of low back pain attending department at Upper India Sugar Exchange Maternity Hospital, Department of Obstetrics and Gynaecology, GSVM Medical College, Kanpur during the period of one year. A brief questionnaire was used to screen, among the respondents, the occurrence of low back pain in the past year. Results: Low back pain was associated with high BMI, high waist circumference, more number of children, irregular and prolonged duration of menstruation, young maternal age at first birth and with history of abortion. Conclusions: Hormonal and reproductive factors are associated with low back pain.

Diversity of Globins in Myxobacteria.

Globins are heme proteins that are capable of reversible oxygen binding. All globins can be classified into three families: the M (myoglobin-like), S (sensor) and T (truncated) globins. M and S globins exhibit the canonical 3/3 α-helical fold, and T globins are characterized by a 2/2 α-helical fold. Globins in the genomes of myxobacteria have not been characterized till date. Myxobacteria have very large genomes relative to other bacteria and have a unique life cycle that involves the aggregation of cells into fruiting bodies under starvation conditions. The diversity of globin like sequences in 14 sequenced genomes of myxobacteria is presented in this review. In myxobacterial globins some unusual domain architectures are identified that have not been characterized in bacteria so far; these are: i) a unique chimeric group I 2/2 HbN in the genome of Corallococcus coralloides DSM 2259; ii) M globin chimera harboring a central and a C-terminal globin domain in Sorangium cellulosum ‘so ce 56’ and Plesiocystis pacifica SIR-1 respectively; iii) two tandem globin domains on the same M globin polypeptide in the genomes of Sorangium cellulosum.

Multiple drug resistant carbapenemases producing Acinetobacter baumannii isolates harbours multiple R-plasmids.

Background & objectives: The nosocomial human pathogen Acinetobacter baumannii has high propensity to develop resistance to antimicrobials and to become multidrug resistant (MDR), consequently complicating the treatment. This study was carried out to investigate the presence of resistant plasmids (R-plasmids) among the clinical isolates of A. baumannii. In addition, the study was performed to check the presence of common β-lactamases encoding genes on these plasmids. Methods: A total of 55 clinical isolates of A. baumannii were included in the study and all were subjected to plasmid DNA isolation, followed by PCR to check the presence of resistance gene determinants such as blaOXA-23, blaOXA-51, blaOXA-58 and blaIMP-1 on these plasmids that encode for oxacillinase (OXA) and metallo-β-lactamase (MBL) type of carbapenemases. Plasmid curing experiments were carried out on selected isolates using ethidium bromide and acridine orange as curing agents and the antibiotic resistance profiles were evaluated before and after curing. Results: All the isolates were identified as A. baumannii by 16SrDNA amplification and sequencing. Plasmid DNA isolated from these isolates showed the occurrence of multiple plasmids with size ranging from 500bp to ≥ 25 kb. The percentage of blaOXA-51 and blaOXA-23 on plasmids were found to be 78 and 42 per cent, respectively and 20 isolates (36%) carried blaIMP-1 gene on plasmids. Significant difference was observed in the antibiograms of plasmid cured isolates when compared to their parental ones. The clinical isolates became susceptible to more than two antibiotic classes after curing of plasmids indicating plasmid borne resistance. Interpretation & conclusions: Our study determined the plasmid mediated resistance mechanisms and occurrence of different resistance genes on various plasmids isolated from MDR A. baumannii. The present findings showed the evidence for antibiotic resistance mediated through multiple plasmids in A. baumannii clinical isolates. This indicates towards a need for preventive measures to avert the dissemination of plasmid resistance determinants in clinical environments.

Comparative toxicity of Butachlor, Imidacloprid and Sodium fluoride on protein profile of the walking cat fish Clarias batrachus.

Freshwater cat fish Clarias batrachus was exposed to Butachlor, Imidacloprid and Sodium fluoride with lethal and sub-lethal concentration for 72 hrs and 21 days durations. Protein changes in liver and muscles were analyzed after exposure period. Imidacloprid and sodium fluoride caused remarkable protein loss lethal concentration but at sub-lethal level their toxicity was moderate. But Butachlor caused remarkable protein loss at lethal as well as sublethal conentartion.

Contaminants in milk and impact of heating: An assessment study.

Background: The major contaminants usually encountered in milk and milk products include pesticide residues, heavy metals, and aflatoxin M1 (AFM1). Primarily, milk get contaminated before milching, from the cattle feed, from sources/materials used during the processing of milk as well as improper handling of the milk during the pre- and postprocessing period. Objective: The purpose of this study was to evaluate the effect of household practices on milk contaminants. Materials and Methods: Samples of pasteurized as well as unpasteurized milk (Vendor's milk) were analyzed for AFM1, pesticide residues, and heavy metals. Simulating the household practices, the impact of boiling on these contaminants was assessed. Results: The contaminant Aflatoxin M1 (AFM1) was detected at a concentration ranging from 0.071-0.075 ppb in unpasteurized as well as pasteurized milk samples analyzed during the course of study. Moreover, boiling had no impact on the quantity of AFM1 present in the milk. Pesticides and heavy metal contents were found to be within acceptable limits in all the milk samples tested. Conclusion: Mycotoxins especially aflatoxins in cattle feed and their consequential presence in milk and milk products is a serious concern world over as they are reported carcinogens. These fungal toxins are resistant to high temperatures and may lead to various health hazards. Preventive steps must be taken at each stage to ensure good quality of milk and milk products free from these contaminants. Awareness programs and education for the dairy farmers and milk processors may be helpful in this regard.

Concomitant hypo-hyperdontia with dens invaginatus.

Although developmental anomalies of tooth number are quite common in permanent dentition, concomitant occurrence of hypohyperdontia is a very rare mixed numeric anomalous condition of teeth. Very few cases of this condition have been reported in the English literature. Here we report such a rare case noted in a 26 year-old male dental graduate with no other associated systemic condition or syndrome.

Characterization of plant growth promoting bacteria from soil of central and upper Himalayan region.

Natural ecosystems are directly dependent on beneficial microorganisms present in the rhizosphere for soil health and plant productivity. Soil bacteria were isolated from soil of central and upper Himalayan region with a view to screen/evaluate their Plant growth promoting potential. Plant growth-promoting rhizobacteria (PGPRs) are employed as inoculants for biofertilization, phytostimulation and biocontrol. Dominant morphotypes were picked up from King`s B, CAS, YEMA and Pikovaskaya Agar by employing dilution plating. A total of 55 isolates were evaluated for growth promotion using Paper Towel Assay on lentil and 9 isolates were selected for detailed characterization. In dual plate assay all 9 isolates inhibited Fusarium solani; few isolates were inhibitory towards Ganoderma lividense and Colletotrichum dematium.

Unusual presentation of an iatrogenic esophageal perforation in a newborn.

Spontaneous rupture of esophagus (Boerhaave's Syndrome) in neonates is a rare occurrence. However iatrogenic perforation of the esophagus is not that uncommon, especially in a premature. The presentation of esophageal perforation is rather stereotyped. In the present case however patient presented with unusual features.