A Comparative Study of Chromium: Therapeutic Uses and Toxicological Effects on Human Health

Chromium is an essential trace element whose deficiency can cause impairment of glucose tolerance, growth and various biological functions. There are two isotopes of chromium-trivalent chromium and hexavalent chromium. Both the isotopes of chromium have quite different effects on the human body. The objective of this narrative review is to compile the different effects of the two isotopes of chromium and give a comprehensive analysis of the effects of hexavalent and trivalent chromium. Data from various studies across different forums were compared to provide a concrete analysis of the therapeutic and harmful effects of two isotopes of chromium on human health. Chromium plays a vital role in the biological functions of the body. It might be helpful in balancing the glycaemic levels, triglyceride levels and cholesterol levels in the body. Excessive intake of chromium is harmful for health. Overexposure to chromium can lead to carcinogenic effects. Consumption of an insufficient amount of chromium might not be adequate as well. Trivalent chromium can be quite beneficial if taken in proper quantities. Hexavalent chromium can cause cancer. Trivalent chromium is beneficial, while hexavalent chromium is harmful to human health.

Estimation of serum creatinine, serum urea, glomerular filtration rate and proteinuria among apparently healthy adults to assess the renal impairment and its association with body mass index: An observational hospital-based study

Background: Serum urea, creatinine, and estimated glomerular filtration rate (eGFR) are the most widely accepted parameters for the assessment of renal impairment. Renal dysfunction in Indian obese adults has not been sufficiently investigated. Aims: To evaluate the renal function by using serum urea, serum creatinine, eGFR, and proteinuria in normal, overweight, and obese adults to identify renal impairment. Materials and Methods: This observational and cross-sectional study was done on a total of 100 normoglycemic, normotensive healthy adults, and these were divided into three groups as per the criteria of body mass index (BMI) as; normal, overweight and obese groups. Estimation of urea and creatinine was done by fully automated chemistry analyzer methods. eGFR was calculated by Modified Diet Renal Disease (MDRD) formula. The excretion of protein in urine was checked by the urine dipsticks method. p<0.05 was considered as significant level. Results: The present study was conducted in 100 normal study subjects which included 48 males and 52 females. A maximum number of subjects were found in the obese subgroup (34%). Among subjects low eGFR prevalence was found 3% and prevalence of chronic kidney disease (CKD) was also found 3%. The obese subjects showed higher urea and creatinine levels compared to normal subjects. A significant negative relationship was noted in eGFR (MDRD) and BMI. The prevalence of proteinuria among subjects was 3%. Conclusions: A total of 3% prevalence of renal dysfunction was noted among adults and out of this 2% was found in obese adults. Therefore, it can be concluded that increasing BMI has a significant contributing factor for renal impairment in obese adults.

Metformin-induced Photocontact Dermatitis in a 67-year-old male: A case report

Introduction@#Photocontact dermatitis is a type IV delayed hypersensitivity response to an allergen that is activated by radiation energy. Its incidence is uncertain and only a small number of drugs causing such reaction have been studied. This is a case of a 67-year-old filipino male, diabetic, who presented with scaly, erythematous, and hyperpigmented plaques with areas of desquamation and erosions on sunexposed areas of the skin after taking metformin.@*Case@#Four months prior to consult, the patient was diagnosed with type 2 diabetes mellitus and was started on metformin therapy. Days later, he started noticing scaly, erythematous and hyperpigmented plaques with areas of desquamation and erosions on sun-exposed areas, namely the upper and lower extremities, posterior neck, and forehead. There was notable sparing of areas that are usually covered with clothing such as the torso, inguina and both thighs. There were also no lesions on the scalp, palmar aspect of the hands and plantar surface of the feet. Skin biopsy was considered but was not done per patient’s preference. After discontinuation of metformin and avoidance from sun exposure, the skin lesions gradually improved.@*Conclusion@#Metformin is rarely associated with adverse skin reactions. The diagnosis of photocontact dermatitis as a side effect of metformin needs to be considered as a differential diagnosis in patients who present with skin rashes, especially in sun-exposed areas. It is recommended that there should be a high-index of suspicion for adverse drug reactions in such patients. This would reduce medical errors and medical cost and would result to prompt initiation of appropriate treatment.

A four year experience in narcolepsy from a sleep clinic at a tertiary care centre with a short review of contemporary Indian literature

Narcolepsy is a common sleep disorder in Western countries but rarely reported from India. Here, we report a small case series of four narcolepsy patients seen over a four year period in the sleep clinic of a tertiary care hospital in north India. The diagnosis was established by clinical history and two or more sleep-onset rapid eye movements (SOREMs) on multiple sleep latency tests (MSLTs) following overnight polysomnography (PSG). The mean age of patients was 26.2±6.4 yr; one patient had associated cataplexy and another one had all four cardinal symptoms of narcolepsy. All these patients had a history of excessive daytime sleepiness (EDS). The mean body mass index was 24.2±4.7 kg/m[2]. The mean sleep latency during MSLT was 2.7±1.3 min, and the mean REM latency was 5.7±2.9 min. Narcolepsy, although rarely reported from India, should be suspected in young non-obese patients complaining of EDS and confirmed by performing MSLT following overnight PSG.

Dietary factors and cancer chemoprevention: an overview of obesity-related malignancies.

Obesity is a growing health problem in developed nations and in countries that are in the process of westernization like India. Obesity is linked with several health disorders such as hypertension and cardiovascular diseases, Type 2 diabetes, dyslipidemia and certain cancers. Currently, obesity-related malignancies, e.g., cancers of the breast, prostate and colon are the leading cancers in the industrialized societies. An increased amount of fat or adipose tissue in an overweight or obese person probably influences the development of cancer by releasing several hormone-like factors or adipokines. The majority of adipokines are pro-inflammatory, which promote pathological conditions like insulin resistance and cancer. On the other hand, many recent studies have shown that adiponectin, an anti-inflammatory adipokine, has anti-cancer and insulin-sensitizing effects. Adiponectin exerts its physiological functions chiefly by activation of AMP kinase via adiponectin receptors. Interestingly, several fruits and vegetables may contain adiponectin-like molecules or may increase the biosynthesis of adiponectin in our body. Studies on adiponectin analogues or adiponectin receptor agonists are a promising area of cancer chemoprevention research. In general, fruits and vegetables contain various dietary substances such as vitamins, minerals (like calcium and selenium), fiber and phytochemicals or phenolic compounds (like flavonoids and vanilloids), which may act as anti-cancer agents. Similarly, several dietary constituents including phytochemicals may have anti-obesity effects. Consumption of such dietary compounds along with caloric restriction and physical activity may be helpful in preventing obesity-related cancers. For this review article, we searched PubMed primarily to get the relevant literature.

Health point prevalence of human immunodeficiency virus and pulmonary tuberculosis among patients in various parts of Delta State, Nigeria

To assess the prevalence of human immunodeficiency virus [HIV] and pulmonary tuberculosis [PTB] in the study population in Delta State of Nigeria. Two hundred and five patients suspected of HIV and TB were prospectively studied in Kwale, Agbor and Eku in Delta State of Nigeria from February 2006 to February 2008. Human immunodeficiency virus status was determined using World Health Organization systems II, and Zeihl Nelson staining technique was used for TB screening. A health point prevalence rate of 53.2%, was obtained for HIV, 49.3% for TB, and 16.6% for HIV/TB. The population of HIV positive [p=0.890, p=0.011, p=0.006] and TB positive [p=0.135, p=0.0003, p=0.0001] subjects were statistically significant among the suspected subjects while the HIV/TB positive cases were not statistically significant [p=0.987, p=0.685, p=0.731]. Our study showed that HIV and PTB infections remains high in parts of Delta State in Nigeria

Polaron hopping in some biomolecular solids and their charge transfer complexes.

The solid state spectroscopy of charge transfer complexes of biomolecules such as fatty acids, tripalmitin, lysozyme. folic acid, beta-carotene, cytochrome c, valinomycin and gramicidin has been carried out. The absorption coefficient is related with electronic conductivity. A half-power beta density is found common among these macromolecular solids, indicating photon-induced polaron hopping or hopping of a charge carrier between two branches of a polariton. Band gap vs full width at half-maximum of the mid-IR peak also reveals a linear relation.

Effect of body temperature on mortality of acute stroke.

OBJECTIVES: The exact relation between body temperature and mortality of acute stroke victims is poorly understood. However, body temperature can affect the outcome of stroke cases in relation to mortality. In the initial (4-12 hrs) hours of stroke, the temperature rise is often neurogenic in origin and mortality is also higher with raised body temperature. Though the anatomical lesion or nature of lesion along with other established risk factors influence the mortality of stroke cases, change in temperature does affect the outcome of stroke cases. We sought to find out the significance of stroke victim's body temperature (within 4-12 hrs) with respect to short-term mortality rate in our study. METHODS: We selected 100 ischemic and 100 hemorrhagic stroke patients proved by CT scan of brain and 2-hrly oral temperature was strictly recorded for the initial 4-12 hrs of admission. RESULTS: It was evident from the study that hyperthermia (>37.5 degrees C) was associated with highest mortality rate in both hemorrhagic (51.78%) and ischemic (56.66%) cases. In normothermic group, mortality was 13.5% and 8.8% in hemorrhagic and ischemic group respectively, whereas hypothermia (<36.5 degrees C) was associated with 0 % mortality. CONCLUSION: Hyperthermia in acute stroke victim carries a bad prognostic parameter in short term basis.

Separation of thoraco-omphalopagus Siamese twin.

A pair of female thoraco-omphalopagus twins, with two pairs of lungs, common diaphragm and separate pleural cavities was separated at the age of 5(1/2) months after a parasitic relationship had developed between them. Before separation both the babies developed recurrent respiratory tract infection and frequent diarrhea. They were treated with medical therapy and made fit for anesthesia. The combined weight of the twins was 4(1/2) kg at birth and the combined weight at the time of separation was 9(1/2) kg. One baby was smaller in growth compared to the other baby. The closure of anterior abdominal wall was difficult in both babies. However, we could close it without use of any biodegradable patches or tissue expander. Both the babies survived and are doing well after 3 months of separation.

Post PSRRP anorectol manometry--experience of 115 cases of imperforate anus.

The conventional treatment of high and intemiediate anomalies of anorectal malformations is proximal pelvic colostomy in neonate (day 1) followed by PSARP (postsagittal anorectoplasty) by the age of 4-6 months and closure of colostomy when adequate dilatation of neo-anus has been performed using Nol 2 or 13 Hegar's dilator or No4 St Mark's anal dilator, It is usually done 3 months after the PSARP operation (anorectal pull through), ie, around 9 months. So the child born without anus in the perineum should be able to pass stool via his or her neo-anus by the age of 9 months and they should ideally be penneally continent. The present study, between August 1993 and December 1999, on the anorectal continence evaluation by doing anorectal manometry was carried out in 115 babies who underwent PSARP operation and subsequent closure of the colostomy. The study showed intermediate anomalies dominated the picture in both males and females (103 babies belonging to intermediate anomalies and 12 babies having high anomalies). In all these children the results of continence have been studied both clinically (Kiesewetter criteria) and by anorectal manometry.

Distribution of prognostically unfavourable product of c-erbB-2 oncogene and EGF-R in carcinomas of the breast and uterine cervix.

A comparative study was undertaken between cancer of the uterine cervix (n = 50) and female breast cancer (n = 50) with reference to the expression of c-erbB-2 oncoprotein (HER-2/neu) and that of epidermal growth factor receptor (EGF-R), both being highly homologous structurally. Expressions of EGF-R and c-erbB-2 oncoprotein were viewed in breast and cervical cancer tissues by immunochemical staining. Cervical cancer cases showed much higher expression of EGF-R which also revealed significant association with the expression of c-erbB-2 oncoprotein and tumour grading. Among breast cancer cases, over-expression of EGF-R correlated significantly with metastasis of lymph node; and expression of c-erbB-2 oncoprotein showed a significant relationship with histological grading of the tumour. Moreover, an association was noticed between the tumour grade and the concomitant immuno positive expression of EGF-R and c-erbB-2. Our study revealed an existence of a conflicting pattern in the expression of EGF-R and c-erbB-2 oncoprotein between carcinomas of the breast and uterine cervix.

Infra-red spectroscopic analyses of banana waste degraded by oyster mushroom.

Carbon, hydrogen and nitrogen analyses of banana leaf and pseudostem biomass revealed their potentiality as substrates for microorganisms. Infra-red (IR) spectra of both biomass show presence of cellulose, xylan and lignin. IR spectra of leaf and pseudostem biomass degraded in solid state fermentation (SSF) by two Pleurotus species (P. sajor-caju and P. ostreatus) for 40 days showed the utilization of cellulose, xylan and lignin by these microbes. Dynamics of various lignocellulolytic enzymes of Pleurotus species and analyses of carbon, hydrogen and nitrogen contents of degraded biomass supported the same. Both the Pleurotus species exhibited lignin consumption ability on both the substrates.

A case of primary mucus secreting adenocarcinoma of the appendix.

Primary mucus secreting adenocarcinoma of the appendix is a rare finding, one in 2500 cases of intestinal malignancies. This is a report of a young man with vague abdominal symptoms for about two years followed by appendicitis. Interval appendectomy revealed a neoplasm of the appendix. Histopathology confirmed the diagnosis of mucus secreting adenocarcinoma and right hemicolectomy was done.

Effect of estradiol-17beta on cell area, lumen area and trehalase activity of posterior silk gland of Bombyx mori L.

Estradiol-17beta (E2) at the dose of 1 microg/g caused an increase in cell area, lumen area and the total (cell + lumen) area of posterior silk gland (PSG) in Bombyx mori indicating that exogenously applied estradiol-17beta has a regulatory influence on silk gland activity. A dose-dependent variation in trehalase activity of PSG was found on the 5th day after topical administration of estradiol on 1st and 2nd day of the fifth larval instar. Of all the doses of E2 used, 1 microg/g dose had maximum stimulatory effect on trehalase activity. Co-administration of each of a specific receptor antagonist for estradiol, the ICI-182780 and a protein biosynthetic blocker, cycloheximide with E2 suppressed the E2-induced increase in silk gland activity. The results suggest some specific metabolic action of E2 on silk gland and offer a promising way for future investigations regarding the physiological significance of vertebrate steroids in insects.

Problems of laparoscopic sterilisation camps in rural West Bengal.

Laparoscopic sterilisation camps were performed in all the remote places of the Himalayan and sub-Himalayan areas in the district of Darjeeling and rural areas of North 24 Parganas, West Bengal where 22,500 patients were studied. Follow-up done up-to-date. No mortality or major complications reported so far. Surgical difficulties found were markedly obese patients (0.42%), scar in the lower abdomen (0.99%), early pregnancy (2.2%), early puerperal cases (1.83%) and cases with pelvic inflammatory disease (4.5%). Difficulties also found in cases of postburn contracture of the lower abdomen (0.02%). There were 420 cases where some sorts of complications were encountered. Complications included minor perforation of the uterus (1.8%), transaction of tubes (0.27%), bleeding from cervical tear (0.15%), and omental prolapse (0.04%). Problems faced regarding organisation of some of the camps in the remote areas, which could be preventable are discussed.

Effect of cancer treatment modalities on serum lipids and lipoproteins among women with carcinoma of the breast.

Serum lipids and lipoproteins were studied in 61 breast cancer patients before initiation of therapy and subsequently during and after completion of cancer therapy. Different serum lipid fractions were estimated by enzymatic method. It was observed that mean levels of serum triglycerides, total cholesterol and low density lipoprotein (LDL)-cholesterol among untreated breast cancer patients decreased significantly after treatment. On the contrary, an increasing trend in the levels of high density lipoprotein (HDL)-cholesterol was noticed in patients during the course of treatment. This study reflects the effects of cancer therapy in the alteration of levels of different serum lipid fractions in the patients with breast cancer.

Oncoprotein c-erbB-2 in squamous cell carcinoma of the uterine cervix and evaluation of its significance in response of disease to treatment.

Tissues from 50 cases of squamous cell carcinoma of the uterine cervix were analysed for immunohistochemical expression of c-erbB-2 oncoprotein and the patients were followed-up for 2 years. Immunopositivity of c-erbB-2 was studied with reference to clinical stage, histopathological differentiation and response to the cancer therapy. Expression of c-erbB-2 protein was found to be higher (37.5%) in cases with stage II disease, whereas more expressions were noticed in poorly differentiated squamous cell carcinoma (33.3%). Among cases who showed complete response to the treatment, 20.8% were positive for c-erbB-2 oncoprotein. On the contrary, 36.8% of prognostically unfavourable cases revealed positivity for c-erbB-2 immunostaining. However, the difference between c-erbB-2 expressions of these two said groups of patients, which were divided in accordance with the response to treatment, did not attain to statistical significance. Study on c-erbB-2 among larger number of patients with cervical carcinoma may prove to be an important factor in response to cancer therapy.

Role of garlic (Allium sativum L.) in human and plant diseases.

A resurgence of interest in garlic due to recent revelations of its beneficial effects in the treatment of various human and plant diseases and also due to validation of claims made in traditional systems of medicine has resulted a plethora of publications on different aspects of garlic in recent years. Chemical constituents of garlic and their variations on the methods of isolation have been discussed in the present review. Effect of garlic and its constituents against various human and plant pathogenic and saprophytic microorganisms has also been reviewed.