Gamma radiation induced changes in expression of heat shock proteins (Hsc70 and Hsp83) in the dengue vector Aedes aegypti (L.)

We aimed to assess the effect of gamma radiation on the expression of heat shock proteins Hsc70 and Hsp83 in Aedes aegypti. Adult males were irradiated with 50Gy of gamma radiation, and changes in the expression of proteins in SDS-PAGE gel bands corresponding to molecular weights ~60–75kDa and ~80–95kDa were analyzed at two different time points 6 and 12-hour post-irradiation, using a temporal mass spectrometry based semi-quantitative analysis. A 2-3-fold increase was observed in both proteins Hsc70 and Hsp83, at both time points. In addition, the experiment also revealed the overexpression of several other molecules such as Arginine Kinase - known to be upregulated in certain insects during stress, Esterase B1- implicated in insecticide resistance, and also down-regulation of the 26S proteasome non-ATPase regulatory subunit 1 and ubiquitin-activating enzyme E1 - both known to be involved in ubiquitin-mediated protein degradation. The results taken together with existing data on Hsp83 and Hsc70, indicate that these proteins may enhance the survival of Ae. aegypti following gamma radiation and could serve as molecular markers for the detection of radiation-induced stress.

Study to determine serum vitamin D levels in patients with congestive heart failure

Background: It was to evaluate the association of serum levels of vitamin D in patients with congestive heart failure.Methods: The present study was conducted in the department of Medicine at Chattrapati Shivaji Subharti Hospital among 100 patients, aged 18 years and above diagnosed as congestive heart failure on the basis of clinical and echocardiographic evidence. Clinical manifestations looked for CHF were: Dyspnea, orthopnea, acute pulmonary edema, cerebral symptoms, cheyne-stokes respiration, cyanosis, sinus tachycardia, raised jugular venous pressure, congestive hepatomegaly and pedal edema. In the present study deficiency/ insufficiency of vitamin D was considered when the presence of levels of 25-hydroxyvitamin D was <30 ng/ml. Laboratory tests performed to diagnose congestive heart failure and serum vitamin D levels were complete blood count, KFT (urea, serum creatinine), serum electrolytes, ECG, chest X ray and echocardiogram. Data were tabulated and examined using the statistical package for Social Sciences Version 22.0.Results: When data was assessed for comparison in relation to NHYA grades and vitamin D levels, it was found to be statistically significant. The Mean±SD scores of serum urea (mg/dL) was found to be 44.7±56.4, 47.3±63.8 and 36.4± 18.3 in whole study sample, vitamin D levels <30 and vitamin D levels >30 respectively with statistically significant difference. The Mean±SD scores of CPK MB (IU/L) was found to be 33.1±20.8 and 18.6±13.3 among the subjects having vitamin D levels <30 and vitamin D levels >30 respectively with statistically significant difference.Conclusions: The results of the present study suggest that low levels of vitamin D may adversely affect the cardiovascular system.

Prevalence and risk factors associated with prehypertension and hypertension among attendants of patients at a rural tertiary care institute of Haryana

Background: Hypertension (HTN) is the leading risk factor for death and disability globally and disproportionately impacts low-and middle-income countries. HTN is present in 25% of urban and 10% of rural subjects in India. Our objective was to estimate the prevalence of pre-HTN and HTN among the attendants of patients at a rural tertiary care institute of Haryana.Methods: This was a hospital-based cross-sectional study. A total of 309 attendants of patients were enrolled for this study. Diagnosis of pre-HTN and HTN was done on the basis of seventh joined national committee guidelines. Data were collected on a semi-structured proforma and were analysed by using R software.Results: The prevalence of pre-HTN and HTN was 18.4% and 21.4% respectively. Both the pre-HTN and HTN were significantly higher in males (p=0.002) and in the age group of 45 to 55 years (p<0.001). The multinomial logistic regression analysis revealed that sex, age >55 years and BMI >23 kg/m2 were significantly associated with pre-HTN and HTN.Conclusions: The prevalence of both prehypertension and hypertension is high in rural Haryana. This makes the people of this area vulnerable to several chronic diseases. The findings warrant urgent measures to lower the risk factors in rural communities. So, programs are needed to improve the surveillance systems and implementation of community based screening programs for early detection of hypertension.

Assesment of Insulin Resistence in Different Stages of Chronic Kidney Disease

Introduction: Epidural anaesthesia and analgesia hasjustified use in the perioperative care of high-risk surgicalpatients, as they give better analgesia, and also improvedoutcome. Thoracic Epidural analgesia is an excellent methodof postoperative and post injury pain control in proceduresinvolving significant thoracic and abdominal injury weathertraumatically or surgically induced. Though Bupivacaine isconsidered to be the drug of choice, many other agents arebeing used for epidural anesthesia.Material and Methods: This study was carried out on 105ASA grade I and II nulliparous patients, between 20 to 70 yearsof age undergoing laparotomy, voluntary donor nephrectomyand renal surgeries. They were randomly divided in theBuprenorphine, Bupivacaine and Fentanyl Groups. Quality ofanalgesia and post-operative complications were monitored.Results: Analgesic failure was observed in all the threeGroups. But complete pain relief was better in theBuprenorphine Group. Also, complications (hypotension,bradycardia, sedation) were less in the Buprenorphine Groupthan in the Bupivacaine and Fentanyl Groups.Conclusion: Buprenorphine is safer and provides betterquality analgesia than Bupivacaine and Fentanyl.

Cherubism – A case report.

Cherubism is an autosomal dominant fibro-osseous lesion of jaws involving more than one quadrant that stabilizes after growth period, usually leaving some facial deformity and malocclusion.Here we present a case of 7 years old male patient who came with complaint of bilateral enlargement of lower face since 4 years. A thorough physical and radiographic examination was done and a diagnosis of cherubism was made.

Solid State Characterization and Effect of PEG 20000 and Lecithin on Particle Size Reduction and Stability of Complexed Glibenclamide Nanocrystals.

Aims: To formulate and characterize GLB-PEG-LEC NCs (lecithin complexed Glibenclamide nanocrystals) and to analyze the effect of PEG 20000 and lecithin on drug properties, particle size reduction and stability of GLB NCs. Study Design: Precipitated (GLB-PEG) and complexed nanocrystals (GLB-PEG-LEC) of glibenclamide were characterized for particle size, size distribution, zeta potential and stability assessment using photon correlation spectroscopy. The crystallinity was analyzed by X-ray powder diffraction spectroscopy and differential scanning calorimetry. The chemical stability was assessed by means of infrared spectroscopy and surface morphology by scanning electron microscopy. Place and Duration of Study: Asian Institute of Medicine Science and Technology, Malaysia, between May 2102 and June 2013. Methodology: GLB-PEG NCs were prepared by precipitation technique using PEG 20000 and complexed by soybean lecithin. The effect of lecithin in particle size reduction, change in crystallinity, stability and surface properties of NCs were analyzed and compared with pure glibenclamide (GLB) and precipitated NCs. The formulations were optimized and its stability was assessed during a 3 month period. Results: Pure GLB exhibited an average particle size of 1551 nm. The average particle size of precipitated NCs was between 236 - 7000 nm, while that of complexed NCs was between 155 - 842 nm. The particle size of NC was found to decrease, whereas its zeta potential was found to increase after complexation. DSC studies showed no change in crystalline structure. PXRD studies proved that crystallinity was maintained in NCs. SEM analysis showed presence of spherical shape particles with a lipid coat on the surface after complexation. Stability studies revealed no change in particle size during 3 month period. FTIR studies showed the compatability of excipients with the drug. Conclusion: These results show that lecithin complexed GLB NCs could be utilized as promising carriers in development of various formulations due to its high stability and decreased particle size.

Estimation of salivary glucose level and plasma glucose level in subjects with and without diabetes mellitus: a comparative study.

Objective: The objective of this study was to estimate and correlate salivary glucose levels and plasma glucose levels in non-diabetic subjects, controlled and uncontrolled diabetic subjects and to assess if salivary glucose can be a potentially useful non-invasive tool in diagnosing diabetes mellitus and in monitoring of glycemic control in diabetic patients. Materials and methods: A total of 90 subjects aged between 40-60 years participated in the study. Diabetic status was determined by estimation of random non-fasting plasma glucose levels and Glycosylated haemoglobin levels. Both unstimulated and stimulated saliva were collected and investigated for glucose levels. Salivary glucose levels were measured using the glucose oxidase method. Results: Salivary glucose levels were significantly higher in diabetics than non-diabetics. Mean un-stimulated salivary glucose level was 1.15 mg/dL in control group, 2.04 mg/dL in controlled diabetic group and 3.99 mg/dL in un-controlled diabetic group. There was a significant positive correlation between salivary and plasma glucose levels. Conclusion: These results show that salivary glucose concentration can be used as a potentially useful non-invasive tool for diagnosing diabetes mellitus and monitoring glycemic control in diabetic patients.

Treatment Seeking in Reproductive Age Women with RTIs/STIs : A Community based Cross-sectional Study.

The socio-cultural and economic contexts in developing countries influence the epidemiology or STls and helps in making them an important public health priority. This study was carried out to explore the health care seeking pathway of the women suffering from RTls/STls. influence or major socio-demographic variables on treatment seeking pattern. This cross sectional study was carried out comprising or eight hundred reproductive age (15-49 years) women selected following a multistage sampling procedure. The information pertaining to health seeking behaviour were collected from them using a pre-designed pretested interview schedule. Quantum of RTls/STls in the study group was estimated and symptomatics were asked specially about time lag between appearance of symptoms and seeking acre; reason for not seeking care; outcome of treatment they have taken if any. Out of total 359 subjects with symptoms of RTls/STls only about one-third (37.3%) had sought treatment. Only a few (4.5%) had sought treatment within 1 month of appearance of symptoms. Considering it to be physiological about half of the subjects (45.3%) did not seek treatment. The treatment seeking pattern was highly associated with the level of education (p=0.000). Reluctance in seeking treatment, delay in its initiation, prelerencc for unqualified practitioners in first consultation and significant association between education and treatment seeking pattern emphasize BCC and service provision for control and prevention of RTls/STls.

Portal system thrombosis: a complication of long-term residence at extreme altitude.

BACKGROUND: With induction of the Indian Army to heights over 5,000 meters above sea level, complications of long-term stay at extreme altitude have come to light. We describe our experience with patients developing portal system thrombosis. METHODS: Clinical data were collected over 2 years on patients hospitalized for thrombotic complications from high-altitude (HAA) and non-high altitude (non-HAA) areas. Site of thrombosis was confirmed by imaging or at surgery. Patients were investigated for conditions that predispose to venous thrombosis. RESULTS: Ten cases of portal system thrombosis were seen during the period; of these, 9 (mean age 28 [SD 3.9] years; all men) were from HAA. Mean duration of residence in HAA was 12.4 (4.9) months; two were smokers and six drank 7-22 g alcohol/day at least 5 times a week. The first symptom was abdominal pain; this was later complicated by gastrointestinal bleeding (n=5), fever (7), vomiting (7), and weight loss (5). Average time between onset of first symptom and reaching a tertiary-care hospital was 9.5 (4.7) days. Clinical examination showed ascites (8 cases), splenomegaly (7), and hepatomegaly (6). Mean hemoglobin level at admission was 15.8 (3.4) g/dL. Ascites was hemorrhagic; five cases also had large splenic hematoma. The site of thrombosis was splenic vein (7 cases), portal vein (6), and superior (4) and inferior (1) mesenteric vein. None of 5 patients investigated had any prothrombotic condition. Endoscopic/ sonographic evidence of development of collaterals appeared as early as 12-20 days after onset of symptoms. CONCLUSION: Residence in HAA for extended periods is a risk factor for development of portal system thrombosis. Persistent pain in abdomen in such individuals should raise the possibility of portal system thrombosis.

Thrombosis as a complication of extended stay at high altitude.

BACKGROUND: There is limited knowledge about the medical problems of long term stay at high (> 3000 m) and extreme (> 5000 m) altitudes, as these areas are generally considered uninhabitable. METHODS: Prospectively collected clinical records of all patients hospitalized at Command Hospital, Western Command between November 1998 and February 2000 were reviewed to identify thrombotic complications among patients from high and extreme altitude areas as well as those from non-high altitude areas who were < 45 years of age. RESULTS: Of 20,257 hospital admissions during the study period, 1692 were from high and extreme altitude areas. Forty-six patients from these areas had thrombosis-related diseases compared to 17 from non-high altitude areas (odds ratio: 30.49; 95% CI: 17.06-51.67; p < 0.001). The mean (SD) age of all patients with thrombotic complications was 32 (8) years and all were men. The mean duration of stay at high and extreme altitudes of such patients was 10.2 (5.6) months. Only 25 were smokers (mean 5.2 pack-years) and 39 consumed alcohol (mean 54 ml/day). Apart from frostbite in 5, no other medical condition was noted in these patients. The vascular events were deep vein thrombosis (20), pulmonary thromboembolism (6), stroke (15), thrombosis of the abdominal veins (8), and retinal artery and peripheral arterial thrombosis (1 each). The presenting complaint in all patients with thrombosis of the abdominal veins was poorly localized pain in the upper abdomen followed by ascites (6/8). Five of these patients also had a large spontaneous splenic haematoma. None of the patients investigated was found to have a procoagulant disorder. CONCLUSION: Long term stay at high and extreme altitudes is associated with a 30 times higher risk of spontaneous vascular thrombosis. Veins are common sites of such thrombotic events. We also encountered thrombosis of the portal, splenic and superior mesenteric veins in our patients who had stayed at high and extreme altitudes.

Interictal brain 99m Tc-HMPAO SPECT study in cases of epilepsy with single ring enhancing CT lesion.

BACKGROUND: Contrast enhancing single ring or disc lesion (CESRL), a frequent finding in the CT scan of Indian patients with seizures, has a diverse etiology. Underlying cause in many of these cases remains conjectural. Some of these ring lesions show spontaneous resolution without any specific treatment and in others their temporal profile remains unpredictable. MATERIAL AND METHODS: In a prospective study we studied 17 cases of epilepsy, with the CT scan finding of single contrast enhancing ring lesion. Detailed clinical evaluation and interictal EEG was performed. CT scan and SPECT study was done initially and were then repeated. RESULTS: On the second CT, one lesion disappeared and 2 reduced in size, three showed no change in size. Third CT showed complete disappearance in one case and no change in the second case. Initial SPECT study was abnormal in all 17 cases, showing areas of hypoperfusion corresponding to the anatomical location of ring lesion. On follow up, patients with decreased ring size on CT showed decrease in area of perfusion deficit on the SPECT, but cases in which the lesion disappeared on the CT, the SPECT perfusion abnormality continued to persist, though to a lesser extent. CONCLUSION: Persistence of perfusion defects suggest the presence of altered underlying physiology. Hence, early withdrawal of antiepileptic drugs after disappearance of ring lesion on CT may lead to seizure recurrence. SPECT studies repeated after 3 months may help to prognosticate cases with CESRL and also help in deciding the optimum duration of antiepileptic therapy in individual cases.

Wilson's disease: clinical and radiological features.

BACKGROUND: Wilson's disease is a treatable movement disorder with autosomal recessive inheritance which is associated with severe morbidity and mortality if not treated early. MATERIAL AND METHODS: The clinical and radiological features of 22 cases of Wilson's disease seen during January 1984 to December 1993 were analysed for clinical presentation and common radiological features. RESULTS: Among all the patients extrapyramidal features were the commonest (19/22 patients), followed closely by impaired higher mental functions (17/22 patients) and cerebellar signs (11/22 patients). In patients with onset of symptoms before 20 years, the common presentations were impaired higher mental functions, speech disturbance, dystonia and choreo-athetosis; whereas in patients with onset after 20 years cerebellar signs were commonest. The commonest CT head abnormality was basal ganglion hypodensity (10 patients) followed by brain stem hypodensity (6 patients). CONCLUSIONS: The clinical and CT scan features are evaluated and compared with reported series. Hypodensities of brain stem earlier reported a rarity, was seen in 6 out of 22 cases.

Interictal brain 99m Tc-HMPAO SPECT study in chronic epilepsy.

We performed interictal brain 99m Tc-HMPAO study in eight cases of chronic epilepsy. SPECT (single photon emission computed tomography) study showed abnormality in seven cases. As compared to computed tomography (CT) scan and electroencephalogram (EEG) which were positive in 25% and 62% cases respectively it showed abnormality in 87%. In two cases where CT scan and EEG both were normal, SPECT showed areas of hypoperfusion. In one case where EEG indicated a bilateral focus, SPECT study showed a clearly defined unilateral focal hypoperfusion defect. Areas of hyperperfusion were not seen in any of our cases. Our results indicate that HMPAO SPECT is more sensitive than CT scan and EEG, in localising an epileptogenic focus in cases of chronic epilepsy.

Paroxysmal nocturnal haemoglobinuria.

Paroxysmal nocturnal haemoglobinuria is an uncommon condition characterised by undue susceptibility of the red cells to get lysed by the complement components. Three cases of this disorder encountered over a period of two years are presented here.