A Study of Thyroid Profile and Lipid Profile in Patients with Chronic Kidney Disease with or without Hemodialysis in a Tertiary Care Hospital

Background: Chronic kidney disease (CKD), due to increasing frequency and prevalence, has become one of the leading public health issues. The Kidney Disease Outcome Quality Initiative (KDOQI) defines CKD as kidney injury or a reduction in the glomerular filtration rate (GFR) to <60 mL/minute/1.73 m2 for at least 3 months. This study aims to compare the effects of decreased renal function on thyroid profile and lipid profile in CKD patients. Materials and methods: This is a prospective cross-sectional observational study conducted among the patients attending Outpatient Department/Inpatient Department (OPD/IPD) at the School of Medical Sciences & Research, Sharda Hospital, Greater Noida, Uttar Pradesh, India, in known cases of CKD, irrespective of the treatment/stage of CKD. All patients of >18 years of age with CKD were included in the study. Result: A total of 200 patients who met the inclusion criteria were included after obtaining detailed informed consent, of which 100 were cases and 100 were controls. The mean age of patients in the study was 47.74 years, with the mean age in patients with CKD 52 years, and the control was 43 years. The mean level of triglycerides (TGs) was significantly higher among the cases, and the high-density lipoprotein (HDL) was significantly lower among cases compared to controls (p < 0.05). Pearson’s correlation between thyroid-stimulating hormone (TSH) with creatinine showed a weak albeit significant positive association (r = 0.200; p < 0.05). Conclusion: Our study shows a higher incidence of alteration in thyroid profile and dyslipidemia among the patients with CKD compared to controls. There is a necessary need to screen routinely for hypothyroidism and dyslipidemia among patients with CKD. Importantly, thyroid hormone levels and their effects on the progression of CKD have not been studied exhaustively.

Expert survey on management of prostate cancer in India: Real?world insights into practice patterns

To gain insights on the diverse practice patterns and treatment pathways for prostate cancer (PC) in India, the Urological Cancer Foundation convened the first Indian survey to discuss all aspects of PC, with the objective of guiding clinicians on optimizing management in PC. A modified Delphi method was used, wherein a multidisciplinary panel of oncologists treating PC across India developed a questionnaire related to screening, diagnosis and management of early, locally advanced and metastatic PC and participated in a web朾ased survey (WBS) (n = 62). An expert committee meeting (CM) (n = 48, subset from WBS) reviewed the ambiguous questions for better comprehension and reanalyzed the evidence to establish a revote for specific questions. The threshold for strong agreement and agreement was ?90% and ?75% agreement, respectively. Sixty?two questions were answered in the WBS; in the CM 31 questions were revoted and 4 questions were added. The panelists selected answers based on their best opinion and closest to their practice strategy, not considering financial constraints and access challenges. Of the 66 questions, strong agreement was reached for 17 questions and agreement was achieved for 22 questions. There were heterogeneous responses for 27 questions indicative of variegated management approaches. This is one of the first Indian survey, documenting the diverse clinical practice patterns in the management of PC in India. It aims to provide guidance in the face of technological advances, resource constraints and sparse high?level evidence.

Product Optimization, Storage Quality and Sensory Acceptance of Low Calorie Beverage Developed from Bitter Gourd and Kiwifruit

Abstract Bitter gourd (Momordica charantia L.) fruit is good source of many nutraceutical compounds and possess antioxidant, anti-diabetic and hypoglycaemic activities. However, its utilization in the preparation of beverages is limited due to its bitter after taste. Therefore, to realize the functional and therapeutic benefits of bitter gourd, an attempt was made to optimize nutritious and low caloriebitter gourd based beverage by blending with kiwifruit (Actinidia deliciosa), a store house of bioactive compounds and substituting sugar with stevioside (steviol glycoside). The standard (sugar sweetened) bitter gourd (BG)-kiwifruit (K) blended beverage was developed by utilizing 30% fruit part of BG:K blended juice (80: 20) with 40oB TSS and 1.3% acidity. Further, to develop the low calorie beverage, sucrose (table sugar) was replaced with 25, 50, 75 and 100% equi-sweetness level of stevioside (steviol glycoside). Results revealed that 75% substitution of sucrose with stevioside resulted in shelf stable beverage with identical taste, good antioxidant potential (68.80%) and strong antimicrobial activity (26 mm ZOI) with reduced calorie values (28.5 Kcal/100g) compared to the sugar sweetened control sample (150.60 Kcal/100g). Hence, the developed beverage can be commercialized as low calorie beverage with additional health benefits of natural compounds of bitter gourd and kiwifruit with highest bioactivity.

Clinicoembryological Submission of Unusual Variation in Course and Branching Pattern of Lateral Cord of Brachial Plexus – A Case Report

Variations are commonly observed and being reported in the formation of lateral cord of brachial plexus and in the communicationof branches of lateral cord of brachial plexus, but formation of median nerve by lateral root of median nerve from lateral cord andmedial root of median nerve from medial cord at a substantially low level is quite unusual and the case reports regarding piercingof the coracobrachialis by lateral cord of brachial plexus are infrequent. The present case report describes an unusual unilateralcourse of lateral cord piercing the coracobrachialis and ensuing path followed by its various branches as well as unusuallylow-level formation of median nerve from lateral and medial roots coming from the lateral and medial cord of brachial plexus,respectively. This was witnessed in the infraclavicular part of the brachial plexus during the routine gross anatomy dissectionof the left upper extremity in a 35-year-old Indian male cadaver. Since axilla and upper half of the arm are challenging areasfor surgical procedures, so the unusual variations being reported in this case may help the surgeons of different specialties inexploration of neuronal tumor, shoulder reconstructive surgery shoulder arthroscopy, and using the coracobrachialis flap fordifferent surgical purposes.

Single-nucleotide polymorphisms in CLEC7A, CD209 and TLR4 gene and their association with susceptibility to paratuberculosis in Indian cattle

The aim of this study was to identify the single-nucleotide polymorphisms (SNPs) in bovine candidate genes CLEC7A, CD209 and TLR4, and explore the association between these SNPs with the occurrence of bovine paratuberculosis (PTB) disease. For this purpose, 549 animals were screened by a panel of four diagnostic tests, namely Johnin PPD test, ELISA test, faecal microscopy and IS900 blood PCR against Mycobacterium avium ssp. paratuberculosis (MAP) to develop case–control populations. SNPs were genotyped by polymerase chain reaction-restriction fragment length polymorphism method. Genotypic–phenotypic associations were assessed by the PROCLOGISTIC procedure of SAS 9.3. Of the seven SNPs; rs110353594 in CLEC7A gene and rs8193046 in TLR4 gene were found to be associated with PTB. For SNP rs110353594, odds of CC and CT genotypes vs TT genotype was 1.543 (0.420–5.667; 95% CI) and 0.284 (0.104–0.774; 95% CI), respectively which means that CT genotype was more resistant than TT and CC genotypes against bovine PTB. For SNP rs8193046, odds of AA and AG genotypes versus GG genotype was 0.947 (0.296–3.034; 95% CI) and 3.947 (1.555–10.022; 95% CI), respectively, i.e. probability for getting an infection in animals with AG genotype was 3.94 times more as compared to GG genotype. Hence, a selection programme favouring CT genotype for rs110353594 and against AG genotype for rs8193046 may be beneficial for conferring resistance against bovine PTB

Estimation of bone mineral density and its correlations with homocysteine, and various other biochemical bone markers in postmenopausal women

Introduction- Omocysteine (HCY) prevents collagen cross-linking and activates osteoclast function within the bones. Bone mineral density (BMD) may be affected by Hyperhomocysteinemia via Cathepsin K. Aim- To find the correlation of BMD with biochemical bone markers. Methods- BMD was investigated by the DXA scan with the help of the Hologic QDR1000 system. As per WHO guidelines, subjects were divided into three different subsets with; normal bone mass, osteopenia, and osteoporosis. Every subject underwent routine biochemical laboratory investigations, HCY, Vitamin B12, and folic acid levels. Results-Among 355 postmenopausal women, 69% (245) had osteoporosis while 11.27% (40) had normal BMD (mean age, 53 ± 8.35 years) and 19.72% (70) had osteopenia (mean age 52.86 ± 7.93 years). The mean age in the osteoporotic group was 56.49 ± 6.65 years. The mean levels of HCY in the three groups were 15.58± 7.92 μmol/L, 16.13± 7.34μmol/L and 17.05± 5.13μmol/L, respectively. Hip BMD showed a strong inverse correlation with age (r=-0.360, p=0.002), while no significant correlations were found between weight and BMI. PTH was consistently seen to be negatively correlated with BMD at Spine (r=-0.0339, p=0.004), Forearm (r=-0.267, p=0.027), and Hip (r=-0.224, p=0.064). Conclusion- Low BMD is an important problem in postmenopausal female patients. Age and duration of menopause are independent risk predictors for the development of osteoporosis. Vitamin D levels do not predict low BMD in postmenopausal females. Weight is protective for osteoporosis especially at spine and forearm BMD. Vitamin B12 and Hcy levels did not correlate with low BMD.

Audit For Endocrine Assay in a Rural Tertiary Care Centre: Clinical Chemistry Lab Perspective

Endocrine disorders account for a significant amount of the global burden of disease. Hospital-based data provide substantial insight into the patterns of disease at community level to bridge the gaps in literature about the epidemiology of specific endocrine disorders, to aid in early diagnosis and identify priority areas for resource allocation. Methods: It was a cross sectional study conducted in the Department of Biochemistry, MGIMS, Sevagram. Secondary data analysis of Electronic Medical Records spanning over the years 2016 and 2017 was done. Results: A total of 1739 patients, 702 in 2016 and 1037 in 2017 were included in which substantially more investigations were ordered for females in OPD whereas in IPD, more tests were ordered for male patients. Conclusion: This study helps us gain an insight into the trends followed by some endocrine abnormalities in patients of a tertiary care centre in Central India. They throw light upon the burden of disease on the community that our focus during screening for early diagnosis as well as while formulating policies should be these hormones.

Primary Pleomorphic Adenoma of the External Auditory Canal-A Case Report and Literature Review

Tumours primarily arising from the external auditory canal are very uncommon and 5% of these originate from the glands present in the skin. Primary Pleomorphic adenomas arising from the External Auditory Canal are extremely rare and are difficult to diagnose preoperatively. They have clinically unremarkable presentation, and are treated by wide local excision with adequate normal margins. These tumours are mostly diagnosed postoperatively by histopathological examination and requires a long term follow up. In this case report we describe one such unusual case of primary Pleomorphic adenoma of the external auditory canal along with the literature review.

Assessment Of Serum Paraoxonase-1 Enzyme Activity, Malondialdehyde And Vitamin-c In Oral Premalignancies

Background:Oral premalignancies are a group of disease or syndromes which if left untreatedcanleadtocancer.ItcarriesagreatsignificanceinIndianperspective. Theactual figure of oral cancers arising from oral premalignancies is not known and to predict accuratelythemalignanttransformationsofthemisstillnotpossible.Oxidativestressisa known player behind cancerogenesis. Recently decreased Paraoxonase-1 activity and increasedoxidativestressmarkerswarefoundtobeassociatedwithOralSquamousCell Carcinoma. So, thereis astrongpossibilityofasimilar findingin Oral Premalignanciestoo. Aim: This studyaims to investigatethecor-relation between serum PON-1 activityand oxidative stress markers (MDA& Vitamin C) in patients with Oral Premalignancies. MaterialandMethods:Atotalof62patientswithclinically diagnosedoralpremalignant lesions anddiseasedcontrolswerechosenforthe study. Venous bloodsampleswerecollectedandPON-1,MDA (inse-rum)&Vitaminc (inplasma) wereanalysed spectro-photometrically. Results:A significant decreased serum PON-1 activity (P<0.05) and concomitant significantlyincreased serum MDA(P<0.05)anddecreased Vitamin Clevels (P<0.05) were observedinpremalignanciescomparedtothecontrols.Thesefinding weremorepronounced inOral Leukoplakia (OL) thaninOral Submucous Fibrosis (OSMF)withasignificantdifference.Meanlevelsoftheanalysedparameters differedaccordinglyin theclinicalgrades of oral premalignancies. Conclusion:Itcanbeenvis-agedthatserumPON-1activity andincreasedoxidativestress mightbe acontributingfactorbehindpathogenesisandprogressionofOralPremalignant Diseases

Sertoli cell tumor arising in a cryptorchid testis presenting as a content of inguinal hernial sac.

Sertoli cell tumors (SCTs) are rare tumors accounting for <1% of all testicular tumors. Here, we report a rare case of SCT in a 60‑year‑old man presenting as a painless swelling in the right groin since childhood. Clinically, he presented with right‑sided inguinal hernia with absence of the right testis. He had normal left testis and had no gynecomastia or infertility. The specimen of hernial sac showed testis with a 1.6 cm × 1.5 cm nodular mass having gray tan‑cut surface. Histopathologically, the testis showed atrophy and the nodular portion showed tumor cells arranged in tubular and microcystic pattern, with no solid pattern or necrosis. The diagnosis of SCT was confirmed with immunohistochemical staining for inhibin which showed fine granular cytoplasmic positivity. Cryptorchid testis having SCT and presenting as a content of inguinal hernia is a rare occurrence.

Production and characterization of monoclonal antibodies to Newcastle Disease Virus.

Newcastle Disease (ND) is one of the major causes of economic loss in the poultry industry. Newcastle Disease Virus (NDV) is a single-stranded, negative-sense enveloped RNA virus (Fam. Paramyxoviridae; Order Mononegavirales). In the present study three monoclonal antibodies (MAbs) were produced by polyethyleneglycol (PEG)-mediated fusion of lymphocytes sensitized to NDV Bareilly strain and myeloma cells. NDV possesses ability to agglutinate erythrocytes of avian species. All the three MAbs designated as 2H7, 3E9 and 3G6 caused hemagglutination inhibition of NDV by specifically binding to NDV. The reactivity for all the 3 MAbs on indirect ELISA was found to be significantly higher than the antibody and antigen controls. On flowcytometry of HeLa cells infected with NDV using the MAbs as primary antibodies, there was a significant difference in the percentage of cells showing positive fluorescence compared to the mock control. One of the MAbs (3E9) was found to react with hemagglutinin-neuraminidase (HN) protein on western blot.

Study of conformational properties of solid phase synthesized ovine kisspeptin-14 using Circular Dichroism spectroscopy.

Kisspeptins are peptide products of Kiss-1 gene and have been substantially associated with the initiation of puberty by virtue of their ability to cause pulsatile release of GnRH. Kisspeptin consists of 54 amino acids domain called metastin and its biological activity may be localized to the C-terminal (C-10, C-13, and C-14) segments. Kisspeptin binds to its cognate receptor GPR54 in the hypothalamic neurons and it is a G-coupled membrane receptor. This study is an attempt to understand the tentative conformation of the peptides in its native membrane mimicking environment. A 14 amino-acid derivative of kisspeptin (Asp-58-Val59-Ser60-Ala61-Tyr62-Asn63-Trp64-Asn65-Ser66-Phe67-Gly68-Leu69-Arg70-Tyr71NH2) was synthesized by f-moc (9-fluorenyl methoxy carbonyl) solid phase synthesis strategy. The synthetic peptide was cleaved and purified by Reverse phase-HPLC. CD spectroscopic analysis of secondary structure of the peptide revealed random coil disordered conformation in the aqueous environment. However, the peptide adopted more ordered β-sheet conformation in the solvents such as TFE and HFIP.

Xanthogranulomatous cholecystitis: A rare radiological diagnosis.

Xanthogranulomatous cholecystitis [XGC] is an unusual focal or diffuse destructive inflammatory process of the gallbladder that may mimic a malignant neoplasm with associated complications. We present a rare case of Xanthogranulomatous cholecystitis with associated complications of liver abscess and enterobiliary fistula that was diagnosed radiologically and confirmed on histopathology.

Serum aminotransferase levels in healthy population from western India.

Background & objectives: Serum alanine aminotransferase (ALT) level is most commonly used as a marker for the assessment of various liver diseases. Currently upper limits of normal for aspartate aminotransferase (AST) or ALT levels used are based on the western literature. This study was conducted to determine the ALT and AST levels in healthy blood donors from western India and to determine the relation with body mass index (BMI) and waist-to-hip ratio (WHR). Methods: A total of 5077 voluntary blood donors were selected with strict routine inclusion and exclusion criteria. Weight, height, BMI and WHR were determined along with AST and ALT levels. BMI and WHR were correlated with liver enzymes. Results: Of the 5077 donors, 160 were excluded due to positive serological results. In the remaining 4917 individuals, 4643 (94.4%) were males and 274 (5.6%) were females. Majority 3024 (61.5%) showed BMI more than 23 kg/m2. WHR > 0.85 and 0.80 was found in 4046 (87.0%) males and 250 (91.2%) females. Mean AST and ALT levels in males were 23.4 ± 9.9 IU/l and 27.0 ± 17.3 IU/l and in females 19.1 ± 9.8 IU/l and 17.7 ± 11.2 IU/l, respectively. With increase in BMI, there was a significant increase in AST and ALT levels. Similar increase was also seen with WHR. Interpretation & conclusions: Majority of voluntary blood donors showed high BMI and WHR which was directly related to AST and ALT levels. This study highlights the magnitude of obesity in general healthy population of western India and a need to revise the current normal limits of serum ALT.

Evaluation of the physico-chemical characteristics of river Varuna at Varanasi, India.

In present investigation an attempt was made to assess variation in physico-chemical characteristics of river Varuna at Varanasi. The water samples were collected monthly from five sites during January to December 2009 and analyzed for physico-chemical properties. The investigation showed variation in temperature (18.5-32.5oC), transparency (13.5-77.0cm), pH (8.0-8.8), alkalinity (96-486 mgl-1), free CO2 (1.6-64 mg l-1), DO (0.12-8.4 mg l-1), BOD (3.6-116.5 mg l-1), COD (5.9-225.4 mg l-1), chloride (11-80mg l-1), nitrate (0.036-0.996 mgl-1) and phosphate (0.06-1.36 mg l-1). From the investigation it is clear that there was marked variation in different parameters at different sites during the different months of the year. The site-5 was found to be highly polluted (BOD 116.5 mg l-1) whereas the site-1 (BOD 3.6 mg l-1) was the least polluted.

Anti ulcer activity of ethanol extract of the stem bark of Careya arborea Roxb.

The aim of the study was to determine anti ulcer activity of stem bark of Careya arbore Roxb. on the Wister strain albino rats. Dried stem bark of Careya arbore Roxb. was powdered and this coarse powder was extracted with 70% ethanol by soxhlet extraction method to yield a Ethanol extract of stem bark of Careya aborea Roxb. (EECA). The extract was subjected for preliminary phytochemical analysis and was evaluated for anti ulcer activity against various models such as Ethanol induced, cold restraint stress induced and Pylorus ligation induced models. In acute toxicity study, EECA was found to be safe till 3000mg/kg. So the doses of EECA at various concentration of 300 and 600mg/kg body weight was administered orally, twice daily for 5 days for prevention of ulcer from Pylorus ligation, Ethanol and cold restraint stress - induced ulcers. Analytical parameters like Percentage of Ulcer protection was calculated based on Ulcer index and Gastric juice volume, pH and acidity of gastric juice. Preliminary phytochemical analysis of EECA showed the presence of carbohydrates, glycosides, phytosterols, phenolic compounds, tannins and saponins. The EECA has shown significant activity at both 300mg/kg and 600mg/kg dose level in a dose dependent manner. Phytoconstituents like tannins and saponins may be responsible for anti ulcer activity of EECA.

Anti ulcer activity of ethanol extract of the stem bark of Careya arborea Roxb.

The aim of the study was to determine anti ulcer activity of stem bark of Careya arbore Roxb. on the Wister strain albino rats. Dried stem bark of Careya arbore Roxb. was powdered and this coarse powder was extracted with 70% ethanol by soxhlet extraction method to yield a Ethanol extract of stem bark of Careya aborea Roxb. (EECA). The extract was subjected for preliminary phytochemical analysis and was evaluated for anti ulcer activity against various models such as Ethanol induced, cold restraint stress induced and Pylorus ligation induced models. In acute toxicity study, EECA was found to be safe till 3000mg/kg. So the doses of EECA at various concentration of 300 and 600mg/kg body weight was administered orally, twice daily for 5 days for prevention of ulcer from Pylorus ligation, Ethanol and cold restraint stress - induced ulcers. Analytical parameters like Percentage of Ulcer protection was calculated based on Ulcer index and Gastric juice volume, pH and acidity of gastric juice. Preliminary phytochemical analysis of EECA showed the presence of carbohydrates, glycosides, phytosterols, phenolic compounds, tannins and saponins. The EECA has shown significant activity at both 300mg/kg and 600mg/kg dose level in a dose dependent manner. Phytoconstituents like tannins and saponins may be responsible for anti ulcer activity of EECA.

Mammary gland stem cells: More puzzles than explanations.

Mammary gland stem cells (MaSC) have not been identified in spite of extensive research spanning over several decades. This has been primarily due to the complexity of mammary gland structure and its development, cell heterogeneity in the mammary gland and the insufficient knowledge about MaSC markers. At present, Lin–CD29hiCD49fhiCD24+/modSca-1– cells of the mammary gland have been reported to be enriched with MaSCs. We suggest that the inclusion of stem cell markers like Oct4, Sox2, Nanog and the mammary gland differentiation marker BRCA-1 may further narrow down the search for MaSCs. In addition, we have discussed some of the other unresolved puzzles on the mammary gland stem cells, such as their similarities and/or differences with mammary cancer stem cells, use of milk as source of mammary stem cells and the possibility of in vitro differentiation of embryonic stem (ES) cells into functional mammary gland structures in this review. Nevertheless, it is the lack of identity for a MaSC that is curtailing the advances in some of the above and other related areas.