Left ventricular global longitudinal strain imaging in identifying subclinical myocardial dysfunction among covid-19 survivors

Background: Covid-19 is multi-system viral infection caused by SARS-CoV-2 virus. Apart from having acute severe respiratory illness causing high mortality, the disease also has a variety of cardiovascular manifestations contributing to morbidity as well as mortality. Cardiac dysfunction and myocarditis are well established complications of Covid-19 as evident in multiple studies after the Covid-19 pandemic. However it is not sufficiently studied in Indian patients either by Echocardiography or by any other imaging modalities like cardiac magnetic resonance imaging (MRI). Methodology: In this study, we analysed the severity of Left ventricular(LV) dysfunction in Covid-19 survivors. A total of 100 consecutive patients of Covid-19 after one month of discharge who had no underlying cardiovascular diseases underwent echocardiography and global longitudinal strain (GLS) imaging. This study cohort included patients with mild 42 (42%),moderate 46(46%) and severe 12(12%) Covid-19 disease as defined by computerised tomography (CT) severity score. Result: We observed that total 36(36%) patients had reduced ejection fraction(EF) which included 11 patients having EF <40% and remaining 25(25%) having EF 40e50% (p<0.002). Also 22 (22%) patients had abnormal global longitudinal strain (GLS) values with normal ejection fraction which is suggestive of subclinical myocarditis. We observed LV dysfunction in 7(19.5%) patients who had severe Covid-19 while mild to moderate LV dysfunction observed in 29(80.5%) non critical patients. Conclusion: In conclusion our study demonstrates that myocardial dysfunction is common in covid-19 regardless of disease severity. 2D-echocardiography with GLS is likely to detect early LV dysfunction among these patients.

Moringa oleifera Derived Phytochemicals against 2-hydroxy-3-oxopropionate Reductase of Salmonella typhi Causing Typhoid

Phytochemicals from Moringa oleifera plant extract can cure Typhoid. It is caused by Salmonella typhi. Molecular docking method applied using “Biovia Discovery Studio”. “High positive values of -CDOCKER energy and -CDOCKER interaction energy” suggested that 4,8,12,16-tetramethylheptadecan-4-olide can effectively deactivate the 2-hydroxy-3-oxopropionate reductaseenzyme thereby interrupting the life cycle of the organism

Agronomic characters and genomic markers based assessment of genetic divergence and its relation to heterotic performance in maize

Aim: The present study was undertaken to examine the relation between genetic divergence of some tropical inbred lines of maize and extent of heterosis manifestation in their single cross hybrids. Methodology: Fifteen inbred lines and three inbred testers along with 45 single cross hybrids were evaluated by adopting randomized complete block design during two seasons. The observations recorded on eight metric traits of the entries in each of three replications were utilized during statistical analysis across the seasons. Relative importance of classification variables was determined by principal component analysis and the phenogram was generated using average taxonomic distance. Molecular profiling of inbred lines was carried out by employing 28 SSR primer pairs covering all the chromosomes. Principal coordinate analysis was performed and similarity indices based dendrogram was constructed. Relationship between parental genetic divergence and heterosis was statistically tested. Results: Significant differences due to parents, hybrids and parent vs. hybrids were observed for all metric characters. Principal component analysis based diagram and average taxonomic distance based phenogram separated the inbred lines into five clusters. Amplification profiles based principal coordinate analysis and hierarchical cluster analysis differentiated the inbred lines into four major clusters. Statistically non-significant correlation of genomic data based genetic similarity or phenotypic data based genetic dissimilarity of inbreds was revealed with grain yield and heterosis of hybrid combinations. Significantly positive correlation was found between heterosis over mid parent or better parent and grain yield of hybrids. Interpretation: Parental genetic divergence was not linearly or additively related to heterosis manifestation in hybrid. Moderate genetic divergence together with high per se performance of inbreds seemed to be a better criterion than consideration of merely extreme genetic diversity as the basis for the choice of parental inbreds during heterotic single cross hybrid development in maize

Association of Level of Physical Activity, Diet and Lipid Profile with Non-alcoholic Fatty Liver Disease – ACase Control Study

Background: Spectrum of liver pathology that develops in the absence of alcohol abuse or any otherpredisposing medical condition is being recognised as a major health issue, ranging from simple steatosisto florid cirrhosis and hepatocellular carcinoma. Objectives: To study the association between level ofphysical activity, dietary pattern and lipid profile in subjects diagnosed with NAFLD compared with controls.Methods: The study was conducted with 33 persons diagnosed with NAFLD and 31 controls in the departmentof physiology with the support of the Department of Radio diagnosis of Pushpagiri Institute of MedicalSciences and Research Centre. Results: The level of physical activity as measured by MET score in theNAFLD group was 948.80±628.4 (Mean±SD) and 4475.77±3202.3 (Mean ±SD) in the control group with a pvalue of < 0.001. 26 out of 31 participants in the control group (83.9%) were having high level of physicalactivity and only 4 out of 33(12.1%) had high level of physical activity in the NAFLD group. Low level ofphysical activity was reported by 15 out of 33 participants in the NAFLD group as compared to none in thecontrol group. Moderate physical activity levels were reported by 14 out of 33 participants (42.4%) in theNAFLD group and 5 out of 31 participants 5(16.1%) in the control group and the difference is statisticallysignificant (p<0.001). The calorie consumption in the NAFLD group was 2576.48±364.41 (Mean ± SD) and2305.19±323.35 in the control group with a p value of 0.003. Both BMI and the waist hip ratio were foundto be significantly greater in the NAFLD group compared to controls. But the p value was more for BMI(p=0.001 OR=6.8 CI=2.07–22.2) as compared to WHR (p=0.04 OR=2.77 CI =1.0007–7.6). SGPT levels wasmore in the NAFLD group (70.94±73.2) as compared to controls (37.71±32.5) with a p value of 0.001(OR=5.75CI=1.948–16.968). Conclusion: Physical activity has a strong inverse relationship with Non-Alcoholic FattyLiver Disease but excess calorie intake and obesity has vice versa relationship. The only biochemicalabnormality found was an elevation in SGPT levels in the NAFLD group.

Intrauterine unilateral single inferior accessory renal artery: a case report

In comparison with other organs, variants of blood supply to the kidneys were always at special attention due to end arteries. Anatomic variations in the renal vasculature are common and occurrence is varying in between 25% to 40%. The most common variation is presence of accessory renal arteries. Accessory renal artery generally diagnosed on abdomen angiography studies or cadaveric dissection. Only few studies or case report of intrauterine detection of accessory renal artery are available in printed and online literature. During a dedicated anomaly scan of 23 week foetus, detection of an accessory renal artery on left side entering kidney in inferior pole courses parallel to main renal arteries and arising from abdominal aorta. Knowledge of the possible anatomic variations and anomalies of the renal arteries like accessory renal arteries are necessary for proper surgical management during renal transplantation, abdominal aorta aneurysm repair, different urological procedures and angiographic procedures. As the various type of vascular and non - vascular interventions increase, knowledge of the different type of variations of the renal arteries is necessary for proper surgical management in the different specialties.

Clinical presentation and outcome of ectopic pregnancies in a tertiary care rural hospital

Background: Ectopic pregnancy is the commonest cause of the maternal morbidity and mortality in the first trimester of the pregnancy. The aim of this study was to see the clinical presentation, associated risk factors, mode of treatment and outcome.Methods: Retrospective study conducted in a tertiary care rural hospital. Women with diagnosis of ectopic pregnancy admitted between August 2016 to September 2018 were studied. Medical record files were scrutinized to get the details. Data was analyzed using Microsoft Office Excel (version 2007). Numerical data were subjected to descriptive analysis, with mean±standard deviation (SD) and categorical data as frequency and percentage.Results: Forty cases of ectopic pregnancy were included who were unbooked, non-smokers, married and belonged to rural areas. Eighty percent were in the age group of 20 to 30 years.  Maximum were gravida 3 or 4 with commonest presentation was pain, site was tubal. Laparotomy was done in 95% of women salpingectomy was the commonest surgical procedure done in 32 (80%) women. Salpingoophrectomy was done in one woman and lifesaving hysterectomy in 2 (5%) women for cervical and ruptured interstitial ectopic pregnancy one each. Blood transfusion was required in 28 (70%) women. No mortality was seen.Conclusions: Women of reproductive age group with pain abdomen and menstrual complaints, even without amenorrhoea, ectopic pregnancy should be ruled out. Treating reproductive tract infections / PID and offering contraceptives will decrease the incidence of ectopic pregnancy. Medical and paramedical staff should do the timely referral to higher centres.

To Evaluate Efficacy of Sonographic Cervical Length to Predict Preterm Labour.

Background: Preterm birth is a major challenges faced by obstetricians worldwide during their practice. Preterm birth is one of a leading direct cause of neonatal death (27%) and more than one million preterm newborns die annually due to various complications. This study done to look for diagnostic efficacy of sonographic cervical length to predict preterm labour. Methods: A prospective study comprised of a total of 132 pregnant women with a singleton foetus with symptoms of preterm labour. Sonographic trans-cervical length measurement taken in all patients. Results: Out of which 17 patients were lost during follow up, 3 patients develop premature rupture of membrane. Hence, a study was conducted over 112 patients. Among these 62 patients went in preterm labour and 50 patients delivered at term. For predicting preterm delivery, sensitivity, specificity, positive and negative predictive value of cervical length was 82.2%, 74%, 79.6% and 77%. Conclusion: Sonographic cervical length is a good predictor. Patients with reduced cervical length are more likely to deliver preterm.

Assessment of attitude and practice toward post-exposure prophylaxis for HIV among healthcare workers at a tertiary care hospital.

Background: Prevention and control of AIDS are now a major problem as there is no vaccine or effective-curative treatment for this disease. Health care workers (HCWs) are at increased risk for HIV infection. There were inadequate studies about post-exposure prophylaxis (PEP) of HIV among HCWs in southern India. Hence, we are conducting this study to assess the attitude and practice of PEP toward HIV among HCWs. Methods: The cross-sectional study was done among HCWs (doctors, surgeons, nurses, and dentists). Pre-tested questionnaire was given and requested to fill it after explaining the purpose of the study. About 65% and above correct answers was considered as adequate response. Values expressed as mean, proportions and analyzed by SPSS version 17. Results: Overall 6 (66%) of the total 9 questions in attitude were answered satisfactorily, and thus can be said to have good attitude regarding PEP in HIV. Only 16 people (10%) of the participants had taken PEP regimen. Among those who took PEP, the responses for the questions about the time of initiation of regimen, completion of prescribed duration of therapy and checking of HIV status after completion of regimen were unsatisfactory. Among the professions, surgeons were exposed more compared to other professions. Conclusion: Overall attitude toward PEP was positive among all the HCWs. The practice of PEP was not satisfactory even after exposure to risks. Informing HCWs about completing treatment course and post-treatment testing is important to prevent HIV transmission. Awareness of PEP should be improved among health professionals, by regular training meetings and introducing the guidelines of the safe practices in the academic syllabus of all the professions.

Comparison of Amount of Phenolic Compounds and Antioxidant Activity Between Green Tea Beverage and Tea Freshly Prepared from Green Tea Leaf

Free radical damage may lead to cancer. Green tea contains antioxidant phenolic compounds that interact and stabilize free radicals. Green tea is widely consumed around the world. Conventionally, tea has been prepared by brewing dried tea leaves with hot water. Due to their worldwide acceptance, ready-to-drink green-tea beverages with different concentrations of tea have been manufactured for consumer convenience. This study aimed to compare amount of phenolic compounds and antioxidant activity between green tea beverages and tea freshly prepared from dried green-tea leaf. Green-tea beverages without artificial flavoring (n=16) and dried green-tea leaf (n=5), available in Bangkok, were collected. Phenolic compounds and antioxidant activity were determined by Folin-Ciocalteu and Ferric Reducing Antioxidant Power methods. The differences in the amounts of phenolic compounds and antioxidant activity, between green tea beverages and tea freshly prepared from dried green-tea leaf, were analyzed by Mann-Whitney U Test using a 95% confidence limit. The correlation between the amount of phenolic compounds and antioxidant activity of green-tea beverages, and tea freshly prepared from dried green tea leaf, were determined by Spearman Rank Correlation Coefficient. It was found that the amount of phenolic compounds and antioxidant activity of tea freshly prepared from dried green tea leaf were significantly higher than the green tea beverages (p\<0.05). A positive correlation between the amount of phenolic compounds and antioxidant activity were found in both green tea beverages (r=0.845) and tea freshly prepared from dried green-tea leaf (r=0.975). (Thai Cancer J 2010;30:127-134)

Recommended Core Cultural Competency for Thai Dental Students

Abstract in Thai

Antimutagenic effects of piperine on cyclophosphamide-induced chromosome aberrations in rat bone marrow cells.

Piperine is a major pungent substance and active component of black pepper (Piper nigrum Linn.) and long pepper (Piper longum Linn.). Both plants are used worldwide as household spices and condiments. They are also used as important ingredients in folklore medicine in many Asian countries. Therefore, it is of interest to study antimutagenic effects of piperine. In this study, its influence on chromosomes was investigated in rat bone marrow cells. Male Wistar rats were orally administered piperine at the doses of 100, 400 and 800 mg/kg body weight for 24 hours then challenged with cyclophosphamide at a dose of 50 mg/kg body weight by intraperitoneal injection. Twenty-four hours thereafter, all animals were sacrificed and bone marrow samples were collected for chromosomal analysis. The results demonstrated that piperine at a dose of 100 mg/kg body weight gave a statistically significant reduction in cyclophosphamide-induced chromosomal aberrations. In conclusion, piperine may have antimutagenic potential. The underlying molecular mechanisms now require attention.

Mortality risks of appendicitis patients Who had different levels of health insurance coverage status.

The objective of this retrospective cohort study was to determine the association between mortality risks of appendicitis inpatients with different levels of health insurance coverage status. The subjects were the appendicitis inpatients admitted to the Ministry of Public Health (MOPH) hospitals in the year 2000. The patients’ information (65,233 patients) recorded in the Diagnosis-Related Group (DRG) database of the Thai MOPH was used for this data analyses. After controlling for length of stay, age, sex, hospital type, and marital status, The results showed that patients who were in the low income scheme plan (LIS) had higher mortality risk than those who were insured (OR = 3.38, p = 0.025). However, the mortality risk of patients in the LIS plan and those of patients in other levels of health insurance coverage status (full pay, under MOPH policy, partially pay) were not different.

Initial and long-term results of coronary angioplasty: a report from King Chulalongkorn Memorial Hospital.

PTCA is one of the treatments for coronary heart disease. But in Thailand, there is no available data on the long-term outcomes of patients who have undergone this procedure. To determine initial and long-term outcomes of patients who underwent percutaneous transluminal coronary angioplasty (PTCA), patients who underwent PTCA from January 1996 to December 1997 were enrolled. The initial results were received from the PTCA registry. The follow-up data were collected from medical records, phone calls and mail. Three hundred and forty patients (male 68.8%) were enrolled. Mean age was 61.8 +/- 10.1 years. Dyslipidemia was the most common risk factor (50.3%), followed by hypertension (44.4%), smoking (40%), and diabetes (33.8%). Indications for PTCA were chronic stable angina (47.9%), unstable angina (22.1%), acute myocardial infarction (4.3%) and post myocardial infarction angina (25.8%). Diseased vessels were left anterior descending (44.8%), right coronary artery (28.0%), left circumflex artery (25.5%), left main artery (0.9%) and saphenous vein grafts (0.8%). Initial case success rate was 93.5 per cent. Stent was implanted in 41.8 per cent of cases. In-hospital mortality rate was 1.2 per cent. Two patients (0.6%) developed Q-wave myocardial infarction (MI). Four patients (1.2%) required emergency bypass surgery (CABG). Major adverse cardiac events occurred in 6 patients (1.8%). Two hundred ninety one patients (85%) had complete follow-up data, mean follow-up time was 990 +/- 326 days. Twenty-one patients died (6.4%) but only 12 (3.5%) were cardiac in origin. Other cardiovascular events were non-fatal MI (1.2%), unstable angina (10.7%), congestive heart failure (4.6%), and chronic stable angina (41.1%). Target lesion revascularization by PTCA was done in 55 patients (16.9%) and CABG was performed in 22 patients (6.7%) Conclusion: PTCA can be performed with a high success rate and low in-hospital complications. Long-term outcomes are acceptable and comparable with Western data.