Geriatric Mental Health Challenges in India- A Review.

Geriatric mental health issues have yet to receive their due recognition in India. Geriatric mental health is plagued by many challenges that prevent the development and progress of its services. The present article is a narrative review that looks at the various challenges faced by geriatric mental health in India. The article describes different specific and general unique challenges faced by geriatric mental health and discusses in detail the nature of each challenge and what must be done to overcome it. The challenges range from demography of Indian aging to sexual issues in the elderly, geriatric depression, dementia care, and the aging lesbian, gay, bisexual, cross-dressers and transgender community. Old age people face special physical and mental health challenges in routine life which are necessary to be recognized and rehabilitate. Mental health problems are often under identified or overlooked by themselves, health‑care professionals and even by family members of older people, and the stigma related to mental illness makes people reluctant to seek help. The prevalence of co-morbid condition of illnesses is a powerful demonstration of the link between physical and mental illnesses. Various issues related to policy and research that challenge geriatric mental health are also discussed in this article. The need to incorporate geriatric mental health into primary health care along with the need to train primary care workers and preventive work aimed at suicide prevention in the elderly is stressed. The article addresses these challenges with the aim of positing before the clinician the various challenges faced by geriatric mental health in India in the current era.

Role of Angiotensin Converting Enzyme (ACE) Gene Polymorphism in Breast Cancer among North Indian Population

Background: The most common cause of cancer related death among women in the world is Breast cancer (BCa). Almost Every year, approximately 1,300,000 cases and 450,000 deaths are related with Carcinoma of Breast are reported worldwide. The incidence of invasive Carcinoma of Breast and mortality in American women in 2017 was 252,710 and 40,610 respectively as quoted by a study. According to latest survey conducted by the Indian Council of Medical Research (ICMR) in India, there were an estimated 150,000 new cases of Carcinoma of Breast in the year 2016. The rise in both Carcinoma of Breast incidence and mortality, therefore, necessitates an examination of risk factors associated with this disease. Molecular subtypes-based classification system characterized by the presence or absence of immunohistochemical expressions like Progesterone receptor (PR), Estrogen receptor (ER), and Human epidermal growth factor receptor 2 (HER2) may show certain limitations. The gene encoding ACE (Angiotensin Converting Enzyme,) in humans is located in the chromosome 17 (17q23), consisting of 26 exons and 25 introns and spanning 21 kb. ACE is a zinc dependent dipeptidyl carboxypeptidase which catalyzes conversion of inactive decapeptide Angiotensin I (Ang I) to active octapeptide Ang II . Ang II mediates physiological effects by binding to two subtypes of the receptors, AGTR1 and Angiotensin II receptor type II (AGTR2), which belongs to superfamily of G-protein-coupled receptors (GPCRs).So, keeping all these physiological effects in mind, this study was conducted to see the role of ACE gene in carcinoma of breast. Methods: From confirm and control cases 3.0 ml of venous blood from each study subject was collected in an EDTA vial. Genomic DNA was extracted by phenol-chloroform method. The genotyping was performed by using PCR (Polymerase Chain reaction), using gene-specific primers. The resulting PCR products were separated on 2% agarose gels using ethidium bromide stain and visualized under UV light. The clinicopathologic parameters of breast cancer patients were obtained from medical records. Results: Of the 10 patients, 3 (30%) had Deletion/deletion genotype DD, 6 (60%) had ID, and 1 (10%) had II genotypes. In control subjects, 2 (20%) had DD, 6 (60%) had ID, and 2 (20%) had II genotypes. Conclusion: The results showed no significant association of ACE gene polymorphism with breast cancer (p>0.05). There is a necessity to conduct large-scale studies with adequate methodological quality and larger sample size in order to come to a definitive conclusion.

Urine Analysis Revisited: A Review

Analysis of urine represents a basic test in the diagnostic battery for most of the systemic disorders and renal diseases in particular. Significant informations can be obtained by urinalysis as many disease processes invariably display urinary abnormalities. It offers a simple, often quick way of following response to treatment in these diseases, without putting the patient under much distress. For urinalysis to be maximally useful as a diagnostic tool, attention to details is necessary in the methodology of urine collection, timely sample processing and most importantly, a thorough knowledge on the various abnormalities that can be detected during the analysis. This article is a comprehensive review on urinalysis, including the intricacies of sample collection, various normal and abnormal physical and chemical parameters with an emphasis on the importance of a meticulous microscopic examination of urine sample to arrive at a diagnosis.

Comparative Study of Hemoglobin estimation by different methods

Background: Hemoglobin (Hb) estimation is one of the most frequently ordered investigations. Estimation of exact levels is important to stratify the grade of anemia and subsequently direct the necessary treatment. Conventionally, Hb has been estimated using colorimetric method, which is time tested and recommended by the WHO. Now-a-days, the automated method is also becoming a popular method in many hospitals. However, there are not many studies assessing the accuracy of the automated method over the gold standard. Materials and methods: We retrospectively analyzed hemoglobin values in 180 adult patient-samples (18 per batch in 10 batches). Hemolyzed samples were excluded from the study. Blood samples were drawn in vials having K3 EDTA anticoagulants. After a proper mixing, hemoglobin was estimated by automated Sysmex XS-800i. Parallel estimation for Hb content was done manually by spectrophotometer 4010. Results: Patients ranged from ages 20 to 40 years (M:F=102:78). The lowest value recorded by Sysmex XS-800i was 5.8 while the highest value recorded was 18.6 gm%. The mean hemoglobin concentration on Sysmex XS-800i was 12.89. The lowest, highest and mean values recorded by the cyanmethemoglobin method on photometer were 5, 18 and 13.49 gm% respectively. This showed a mean difference of 0.597 and with significant p-value of <0.001. Conclusion: The lowest values of Hb were similar in both the methods but the mean as well as the highest values differed significantly. Our study found an accuracy of 95.57% with the 5 part analyzer when compared to the gold standard colorimetric method.

Nanotechnology And Nanomedicine-heigh–ho:the Age Of Dwarfs

It's a small wonder. Yes, nanotechnology is already touching our lives for better. The recent progress in the field of medicine has been phenomenal. None could have ever imagined that the Nanotechnology would have such a promising and extensive application in medical sciences. Right from developing newer therapeutics and imaging techniques to targeted drug delivery you can name it all. Nanotechnology science is still in its nascent stage with a long way to go. A nanometer is a billionth of a meter. Manipulation of matter on a very small scale is Nanotechnology and its utilization in medicine is Nanomedicine. In fact in recent times no other branch has seen the amalgation of such varied disciplines including physicists, chemists, engineers and biologists. Nanotechnology is still a very nascent science. It needs to grow and as its grows its true virtues and vices would come to fore. At the most now we can say that it has a very promising future. The genesis of nanotechnology can be traced to the promise of revolutionary advances across medicine, communications, genomics and robotics.

Effects Of Natural Products On Body Weight And Biochemical Parameters In Healthy Rats

The present study was undertaken to evaluate effect of natural products i.e. Anthocephalus indicus; KADAM, roots, Hibiscus rosa sinensis roots, Tinospora cordifolia stem and Cassia tora seeds in normal healthy rats. In this study ethanol extract of above mentioned medicinal plants had macerated with aqueous gum acacia (2%, w/v) suspension and fed orally (500 mg/kg bw p.o.) to male adult healthy normal rats of Charles Foster strain for 30 days. Results of this study showing that alcoholic extracts caused no any signicant reduction in blood glucose, total cholesterol, triglyceride, phospholipids, free fatty acid, lipid peroxide and no signicant increased in post heparin lipolytic activity, but on the other hand as per pre-existing data and my published studies in diabetic patients and diabetic experimental animals showed that extracts exerting all above effects signicantly. That's why it is very clear here if healthy person will take natural products, it never cause hypoglycemia, hypolipidemia and under weight. Natural products also not cause any signicant change on hepato-specic parameters. Thus from this study we conclude that, natural products are safe, non toxic and free from side effects, in comparison to synthetic drugs.

Experimental Validation Of Anti-Diabetic And Antioxidant Potential Of T. Cordifolia Stems (M.): An Indigenous Medicinal Plant

This case control study had been carried out to evaluate antidiabetic and antioxidant activities of Tinospora cordifolia (T. cordifolia; family: Menispermaceae) against streptozotocin induced diabetes in experimental rats to scientifically validate its use against diabetes. Ethanolic extract of T. cordifolia stem extract and standard drug (glibenclamide) macerated with aqueous gum acacia (2%, w/v) suspension and fed orally to streptozotocin induced male adult diabetic rats of Charles Foster strain for 30 days. Biochemical parameters in normal, diabetic control, standard (600µg/kg bw p.o.) and treated (500 mg/kg bw p.o.) animals group were determined and compared. Treatment of streptozotocin induced diabetic rats with ethanolic extract caused significant (p<0.001) reduction in blood glucose, total cholesterol, triglyceride, phospholipids, free fatty acid, lipid peroxide and significant increased (p<0.001) post heparin lipolytic activity. Furthermore, the stem extract (100-400 µg) when tested for its antioxidant activity in vitro, shown significant (p<0.001) inhibit the generation of super oxide anions in enzymic system a, in enzymic system b, non enzymic system and hydroxyl radicals in enzymic system and non-enzymic system. The results of the present study demonstrated antidiabetic antidyslipidemic and anti oxidant activities of T. cordifolia stem extract which could help in prevention of diabetic- dyslipidemia and related complications.

Philadelphia Chromosome Positive Chronic Myelogenous Leukemia In Childhood: A Rare Case Report

CML is a clonal hematopoietic stem cell disorder. As per WHO classification, CML is included in Myeloproliferative disorder. Adult type - CML is rare in childhood constituting about 3% of childhood leukaemia. We have reported such a case in a 7yr old male child. Peripheral blood smear and bone marrow revealed features of chronic myeloproliferative disorder and cytogenetic analysis has proved Ph chromosome positivity. We report one such case of Philadelphia positive CML in a 7 year old male patient with chief complaints of fever on & off since 4-5 months and sense of abdominal fullness since 1 month, on examination pallor was found with mild hepatomegaly and moderate splenomegaly. The clinical differential diagnosis was malaria, storage disorder or tropical splenomegaly. Though biological behaviour and prognosis are identical to that of adult type, we are reporting this case because of its extremely uncommon incidence.

Comparative Review on Carbohydrate Metabolism in Gestational Diabetes Mellitus and Normal Gestational Female.

Gestational diabetes mellitus (GDM) incidence is rising in developing countries. It is associated with varied fetal and maternal morbidities. Normal pregnancy is also associated with insulin resistance in later half of pregnancy, which along with other pathogenic mechanism like decreased β cell response is associated with GDM. Glucose tolerance test is used to diagnose GDM but there is controversy in cut-off values in different group. As HAPO (Hyperglycemia associated Pregnancy outcome) trial results are showing fetal and maternal morbidities associated with maternal hyperglycemia, there is a need of early diagnosis of GDM and proper management using appropriate diagnostic cut-off.

Hypolipidemic Activity Of Cassia Tora Seeds In Hyperlipidemic Rats

The hypolipidemic activity of Cassia tora (Chakvat, Chakunda) (Family: Caesalpiniaceae) seeds extract has been studied in two hyperlipidemic models of rat. These are triton injected and cholesterol rich HFD fed model of hyperlipidemia. In triton WR-1339 induced hyperlipidemia, feeding with root extract (500 mg/ kg body wt/ day p.o. ) exerted lipid lowering effect as assessed by reversal of plasma levels of total cholesterol (TC), phospholipids (PL), triglyceride (TG) and reactivation of Post Heparin Lipolytic Activity (PHLA) of plasma. The other model was fed with cholesterol rich HFD and seeds extract of Cassia tora (500 mg/ kg body wt/ day p.o.) simultaneously for 30 days. This also caused lowering of lipid levels in plasma and liver homogenate and reactivation of plasma post heparin lipolytic activity, hepatic total lipoprotein lipase activity. The hypolipidemic activity of Cassia tora seeds was compared with a standard drug guggulipid (200 mg/ kg body wt/ day p.o.), a known lipid lowering drug in both models.