Efficacy and safety comparison of lacosamide and carbamazepine in the treatment of adult patients with newly diagnosed epilepsy / 中国药房

OBJECTIVE To compare the efficacy and safety of lacosamide （LCM） and carbamazepine （CAR） as monotherapy in the treatment of adult patients with newly diagnosed epilepsy. METHODS By methods of retrospective analysis， 84 adult patients with newly diagnosed epilepsy， were admitted to the Department of Neurology， Huaihe Hospital of Henan University during Sept. 2020-Jun. 2022， were divided into the control group （40 cases， receiving CAR treatment） and the observation group （44 cases， receiving LCM treatment） according to different medication regimens. Total response rate， epilepsy seizure frequency， blood lipid levels， and the occurrence of adverse events （AEs） of patients were compared between the 2 groups. RESULTS In the first month after treatment， there was no statistically significant difference in the total response rate between the observation group （63.64%） and the control group （55.00%， P＞0.05）； the frequency of epilepsy seizure in both groups was significantly reduced compared to before treatment （P＜0.05）， but there was no statistically significant difference between 2 groups （P＞0.05）. In the third month after treatment， the total response rate of the observation group （90.91%） was significantly higher than control group （67.50%， P＜0.05）； the frequencies of epilepsy seizure in both groups were significantly reduced compared to before treatment， and the observation group was significantly lower than the control group （P＜0.05）. In the third month after treatment， the levels of total cholesterol （TC）， triglyceride （TG） and low-density lipoprotein cholestrol （LDL-C） in the control group and the level of LDL-C in the observation group were significantly higher than before treatment， and the levels of TC， TG and LDL-C in the observation group were significantly lower than those in the control group （P＜0.05）. There was no statistically significant difference in the incidence of AEs between the observation group （15.91%） and the control group （17.50%， P＞0.05）. CONCLUSIONS Both LCM and CAR have certain effects in the treatment of newly diagnosed epilepsy in adults， which can reduce the frequency of epilepsy seizure in patients and have comparable safety. Meanwhile， LCM has better long-term efficacy than CAR in treating newly diagnosed epilepsy in adults， and its impact on the patient’s blood lipid is smaller than CAR.

Correlation between Peripheral Blood PLR with Treg, Th17 in Newly Diagnosed Multiple Myeloma and Its Influence on Prognosis / 中国实验血液学杂志

OBJECTIVE@#To investigate the correlation of peripheral blood platelet/lymphocyte ratio (PLR) with Treg and Th17 and its influence on prognosis in newly diagnosed multiple myeloma (MM).@*METHODS@#One hundred thirty-five newly diagnosed multiple myeloma patients admitted to the Department of Hematology of Zhengzhou People's Hospital from June 2015 to October 2022 were selected as MM group. Clinical data included sex, age, immune typing, ISS stage, blood calcium (Ca), albumin (ALB), hemoglobin (Hb), PLR, LDH, β2 microglobulin (β2-MG), Treg and Th17 levels. Sixty healthy volunteers who underwent physical examination in our hospital during the same period were selected as the control group. PLR, Treg and Th17 levels in MM group and control group were compared. Pearson was used to analyze the correlation between PLR and Treg, Th17. The relationship between MM patients with different PLR and clinical features and prognosis was analyzed.@*RESULTS@#The PLR and Th17 of MM patients were significantly higher than that of control group, and Treg was significantly lower than that of control group (P<0.05). In MM patients, PLR was negatively correlated with Treg (r=-0.616), and PLR was positively correlated with Th17 (r=0.555). Using mean PLR=132.72 as the boundary, 135 MM patients were divided into high PLR group (n=54) and low PLR group (n=81). In MM patients with high PLR, ISS stage, ALB and Treg were significantly higher than those in low PLR group, while Th17 was significantly lower than those in low PLR group (P<0.05). By univariate and COX regression analysis, PLR was an independent prognostic risk factor for newly diagnosed MM patients (P<0.05). MM patients with high PLR had better PFS and OS, and the difference was statistically significant compared with MM patients with low PLR (P<0.05). 65 patients admitted from June 2015 to December 2018 were used as the training set, and 70 patients admitted from January 2019 to October 2022 were used as the validation set. The OS of MM patients with different PLR were compared respectively. The results showed that the conclusions of the training set and the validation set were consistent. PLR with high expression had higher OS (P<0.01).@*CONCLUSION@#PLR is correlated with Treg and Th17 in newly diagnosed MM patients, and high PLR has better prognosis. PLR can be used to evaluate the prognosis of MM patients.

Characteristics of detection methods for 250 newly diagnosed leprosy cases in Hunan Province from 2013 to 2022 / 中国热带医学

@#Abstract：Objective To investigate the detection methods of newly discovered leprosy cases in Hunan Province in 2013-2022, and analyze the trend of changes, and provide scientific basis for the prevention and treatment of leprosy. Methods The detailed information of newly diagnosed leprosy cases in Hunan Province from 2013 to 2022 was collected through the Leprosy Management Information System (LEPMIS), and the descriptive epidemiological method was used to analyze the detection methods of newly discovered leprosy cases. Results From 2013 to 2022, a total of 250 newly diagnosed leprosy cases were detected in Hunan Province, including 143 cases (57.20%) were found in outpatient clinics, 33 cases (13.20%) were found in clue investigations, 27 cases (10.80%) were notifiable-reported, 23 cases (9.20%) were self-reported, 11 cases (4.40%) were found in other ways (e.g., group survey), 9 cases (3.60%) were found in contact examinations, 2 cases (0.80%) were found in census, and 2 cases (0.80%) were found in epidemic point inspection. From 2013 to 2022, the number of cases detected in outpatient clinics showed an upward trend (rs=0.515), while the cases detected in clue investigation (rs=-0.873), notifiable-reported (rs=-0.127), self-reported (rs=-0.301), contact examination (rs=-0.363), census (rs=-0.701) and epidemic point inspection (rs=-0.701) showed a downward trend. The majority of leprosy cases with different demography characteristics and clinical characteristics were found through outpatient clinics, except that the majority of leprosy cases in children were found by contact examination (66.76%). Of 165 male cases, 92 cases (55.76%) were found in outpatient clinics and 51 out of 85 female cases (60.00%) were found in outpatient clinics. Among age groups, 113 out of 187 cases aged 15 to 60 (60.43%) and 30 out of 60 cases aged over 60 (50.00%) were found in outpatient clinics. Among patients with differentoccupations, 112 out of 208 cases of farmers (53.85%) and 31 out of 42 cases of other occupations (73.81%) were found inoutpatient clinics. Among cases with different types of leprosy, 111 out of 185 cases of multibacillary leprosy (60.00%) and 32 out of 65 cases of paucibacillary leprosy (49.23%) were found in outpatient clinics. Among cases with different numbers of skin lesions, 4 out of 8 cases of skin lesion-free leprosy (50.00%), 3 out of 9 cases of single skin lesion leprosy (33.33%), and 136 out of 233 cases of multiple skin lesions leprosy (58.37%) were found in outpatient clinics. Of 72 cases without nerve damage, 48 cases (66.67%) were found in outpatient clinics. Of 27 cases with single nerve damage, 17 cases (62.96%) were found in outpatient clinics. Of 151 cases with multiple nerve damage, 78 cases (51.66%) were found in outpatient clinics. Among patients with different levels of malformation, 58 out of 102 cases with no malformation (56.86%), 28 out of 45 cases with Grade malformation (62.22%), 35 out of 68 cases with Grade Ⅱmalformation (51.47%), and 22 out of 35 cases with other types of malformation (62.86%) were found in outpatient clinics. Conclusions Outpatient clinics is the main way to detect newlydiagnosed leprosy cases under the low prevalence of leprosy in Hunan Province, and it is an important strategy to move the early detection of leprosy cases to comprehensive medical institutions in the future.

Recent trends in the patterns of dyslipidemiaand management strategy in newly diagnosed patients of type 2 diabetes mellitus-2

Background: Objective of the study was toevaluate the patternsof dyslipidaemia in newly diagnosed type 2 diabetes mellitus-2 (T2DM) patients and to understand the initial management options utilised by the treating physician.Methods: The real world, retrospective, observational REcent trends in the patterns of dyslipidemia and Management strategy in newly diAgnosed Patients of type 2 diabetes mellitus-2 (REMAP-2) study was conducted at various centers including hospitals, clinics, and health care institutes across India between Apr-2021 and Mar-2022. Clinicians at the respective center captured the data in REMAP-2 study data capture form. Dyslipidemia was considered as: total cholesterol >200 mg/dl, low density lipoprotein cholesterol (LDL-C) >100 mg/dl, high density lipoprotein cholesterol (HDL-C) <40 mg/dl, or triglyceride >150 mg/dl.Results:Of 9605 newly diagnosed T2DM patients with dyslipidemia, 68.94% (n=6622) had mixed dyslipidemia. The mean age was 53.8 years. Majority of the patients were males (63.3%), had family history of diabetes (52.5%), physical activity category of 憂ot very active� or 憀ightly active� (79.33%), and were overweight or obese (58.9%). About 25.9% of the patients were smokers. Hypertension (72.33%) was the most common comorbidity followed by coronary artery disease (23.44%). The mean glycated hemoglobin (HbA1c) was 8.3%. The most commonly prescribed antidiabetic medication was metformin (87.71%), while lipid lowering therapy was atorvastatin (77.79%).Conclusions:This study on newly diagnosed T2DM patients with dyslipidemia found that majority of the patients had hypertriglyceridemia, family history of diabetes and were physically inactive. More than half of T2DM patients were either overweight or obese. More than2/3rdof the patients had mixed dyslipidemia. Statins were prescribed to the majority of these patients and atorvastatin was the most commonly prescribed statin in Indian T2DM patients with dyslipidemia.

Seropositivity For Viral Markers in Patients Undergoing Cataract Surgery Diagnosed Unexpectedly

Background: To find the prevalence of unexpected seropositive viral markers in the patients undergoing cataract surgery.Material & Methods:It was a longitudinal observational study. Total1180 cataract patients were studied. Patients were discovered unexpectedly positive for hepatitis B antigen, hepatitis C, human immunodeficiency virus during preoperative screening for cataract surgery. HBV and HCV patients were referred for medicine opinion and operated after treatment and clearance. HIV patients were referred to ART center for further management.Results:During the study period 1180 patients, 504 males and 676 females were studied. 34 patients work positive for HIV, twelve patients were positive for hepatitis B and 50 patients were found positive for HCV. The patients accidentally found positive were 18/34 for HIV, 6/12 for hepatitis B and 32/50 for hepatitis C.Conclusions:We concluded that preoperative screening should be done for viral markers before every cataract surgery to prevent spread of such infections. Mass immunization against hepatitis B should be done among health care workers.

COVID 19 INFECTION IN A PATIENT NEWLY DIAGNOSED WITH HIV/TB COINFECTION – A CASE REPORT

HIV/TB coinfection, COVID 19 with HIV/TB, immune reconstitution inflammatory syndrome (IRIS), TB lymphadenopathy

To Evaluate The Incidence Of Diabetic Retinopathy In Newly Diagnosed Diabetic Patients Presented At Tertiary Care Hospital

Background:Diabetes mellitus is defined as metabolic disorder of multiple etiologies characterized by chronic hyperglycemia with disturbances of carbohydrate, protein and fat metabolism resulting from defects in insulin secretion, insulin action, or both. It occurs in two forms: Insulin dependent diabetes mellitus and Non –insulin dependent diabetes mellitus1. This disease results in generalized macrovascular and microvascular complication directly affects kidneys, eyes, peripheral nerves and heart. The incidence of diabetes retinopathy in Indian population was 21.7%. Material And Methods:In this cross sectional study all the patients attending eye OPD and indoor patients at tertiary eye care were screen for eligibility. Total of 150 patients were included in the study for duration of 28 months. Detail history including hypertension and other systemic illness was asked. Best corrected visual acuity was taken after refraction. Anterior segment examination was done with slit lamp, specially looking for rubeosis iridis, pupillary reaction and type of lens opacity. Statistical analysis was done using Z test, unpaired T test and chi-square test with the help of software and methods. Result: Patients with type 2, diabetes have more incidence of developing diabetic retinopathy thanpatients with type 1. Hypertension was more commonly associated disease than other systemic illness. Diabetic retinopathy is more prevalent in patients with higher FBS and HB1Ac.Conclusion:The frequency of retinopathy is more common in patients with high blood sugar profile. Hypertension is more commonly associated with diabetes than other systemic illness.

Symptoms of COVID-19 in children

The aim of this study was to review the symptomatic manifestations of COVID-19 in children in the scientific literature. An integrative review of studies published between December 2019 and September 5, 2021, from the Medical Literature Analysis and Retrieval System Online, Web of Science, Scopus, Literatura Latino-Americana em Ciência de Saúde, and Base de Dados de Enfermagem databases, was carried out to answer the following research question: What symptomatic manifestations does COVID-19 cause in children?". Twenty articles were included. The main symptoms described were fever, cough, diarrhea, vomiting, sore throat, dyspnea, headache, abdominal pain, malaise, and weakness or tiredness. The findings of this review can contribute to the diagnosis and clinical decision-making of the health team by providing information that facilitates the identification of COVID-19 in the target population, favoring early identification, better care, and consequently a better prognosis.

A single-center retrospective analysis of 100 consecutive cases treated with lenalidomide/bortezomib/dexamethasone in newly diagnosed multiple myeloma / 中华内科杂志

Objective:To investigate the efficacy and safety of lenalidomide combined with bortezomib and dexamethasone (RVD) in patients with newly diagnosed multiple myeloma (NDMM).Methods:A total of 100 consecutive NDMM patients treated with RVD from August 2016 to September 2020 at Peking University People′s Hospital were retrospectively analyzed, including response, drug toxicity, follow-up and survival, and subgroup analysis.Results:The median follow-up time was 19.5 (2.0-57.0) months. For patients undergoing autologous stem cell transplantation (ASCT) after RVD regimen, the objective response rate (ORR)/complete response+stringent complete response (CR+sCR)/≥very good partial response (VGPR) rates were 100%, 73.3% (33/45), 95.6% (43/45) respectively. For 54 patients not receiving transplantation, the ORR/CR+sCR/≥VGPR rates were 79.6% (43/54), 18.5% (10/54), 51.9% (28/54) respectively. As to the survival analysis, 2-year progression free survival (PFS) rates were 84.5% and 70.9% in transplant and non-transplant patients respectively ( P=0.102). Two-year overall survival (OS) rates were 100% and 80.8% in transplant and non-transplant patients respectively ( P=0.003). The common hematologic adverse events (AEs) were thrombocytopenia (33%) and neutropenia (25%). Abnormal liver function (43%) and peripheral neuropathy (24%) were recognized more as non-hematologic AEs. Conclusion:RVD as front-line regimen has high efficient response rate and acceptable safety in Chinese NDMM patients.

Influencing factors of late diagnosis of newly identified HIVAIDS cases in Sanya Hainan, 2010-2021 / 中国热带医学

@#Abstract: Objective　To analyze the epidemiological characteristics of late diagnosed HIV/AIDS cases (LD) in Sanya from 2010 to 2021, and to provide evidence for reducing the LD rate. Methods　The database was downloaded from the AIDS Prevention and Control Information System of China's Disease Prevention and Control Information System and newly reported HIV/AIDS cases between 2010 and 2021 in Sanya were included, identified LD according to the LD criteria proposed by Chinese Center for Disease Control and Prevention in 2014 and analyzed the relevant factors of LD. Results　From 2010 to 2021, a total of 710 research objects were included in this study. The proportion of LD was 33.4% (237/710), and decreased from 95.5% to 22.4% between 2010 and 2021 (χ2trend=34.777, P<0.001). Ethnic groups, educational level, sample sources and confirmed date were the relevant factors of LD of HIV/AIDS in Sanya City. The proportion of LD was 56.8% in Li ethnic group, which was higher than that in Han ethnic (OR=2.253, 95%CI=1.361-3.670). The proportion of LD of patients who were middle school and less was 55.5%, which were more likely to be LD than high school or above (OR=1.722, 95%CI=1.072-2.765). The proportion of LD was 56.8% in patients whose samples were from medical institutions or testing consultation were more likely to be LD than MSM (OR=5.564, 95%CI=3.278-9.444; OR=2.204, 95%CI=1.239-3.923). Compared with patients who were confirmed between 2018-2021, the patients derived from 2010 to 2013 had higher LD (OR=2.246, 95%CI=1.311-4.488). Conclusion　The LD of HIV/AIDS in Sanya cannot be ignored, especially the HIV/AIDS from counseling and testing and medical institutions. We should strengthen HIV testing, strengthen health education.

Clinical Efficacy of Modified Huanglian Wendantang in Treatment of Newly Diagnosed Type 2 Diabetes Mellitus with Phlegm (Dampness)-Heat Syndrome / 中国实验方剂学杂志

Objective:To observe the efficacy of modified Huanglian Wendantang in treating newly diagnosed type 2 diabetes mellitus （T2DM） with phlegm （dampness）-heat syndrome， in order to study the effect on islet β cell function and adipocytokines. Method:A total of 130 patients were randomly divided into two groups by random number table （65 cases in each group）. The 60 patients in control group completed the treatment （4 patients fell off or lost visit， 2 were eliminated because of breach of plan）， and the 61 patients in observation group completed the treatment （3 patients fell off， 1 were eliminated）. And 20 healthy volunteers were taken as normal control group. Both groups′ patients got lifestyle interventions and metformin hydrochloride tablets （1 tablet/time， 1 time/day during the meal）. In addition， patients in control group got Huazhuo Qingshen Keli in the morning and at night， 5 g/time， 2 times/day， and patients in observation group got modified Huanglian Wendantang， 1 dose/day. And the treatment was lasted for 3 months. Before and after treatment， levels of fasting blood glucose （FBG）， postprandial 2 blood glucose （PBG）， HbA1c and fasting insulin （FINS）， insulin resistance index （HOMA-IR）， insulin sensitivity index （InISI）， islet β cell function index （HOMA-β）， early insulin secretion index （I30/△G30） and late insulin secretion index （AUCI30~I120/G30~G120）， total cholesterol （TC） and triglycerides （TG）， high-density lipoprotein （HDL-C）， low-density lipoprotein （LDL-C）， adiponectin， TNF -α （TNF-α）， resistin and leptin were detected. And syndrome of phlegm （dampness） combined with heat were scored， and the safety was discussed. Result:The total effective rate in observation group was 91.80% （56/61）， which was higher than 78.33% （47/60） in control group （χ2=4.333， P<0.05）. And the score of phlegm （dampness）-heat syndrome was lower than that in control group （P<0.01）， levels of FBG， PBG， HbA1c， HOMA-IR， AUCI30~I120/G30~G120， TC， TG， LDL-C， TNF-α， leptin and resistin were lower than those in control group （P<0.01）， while levels of I30/△G30， HOMA-β， InISI， HDL-C and adiponectin were higher than those in control group （P<0.01）. There was no adverse reaction related to modified Huanglian Wendantang. Conclusion:In addition to treatment with metformin， modified Huanglian Wendantang can effectively control blood glucose and lipid， regulate adipocyte factor， improve early and late phase insulin secretion， improve the function of β cell and insulin sensitivity of islet， improve IR， with a better comprehensive efficacy and a safety in clinical use.

Prevalence of self-medication practices in urban area of Kanchipuram district, Tamil Nadu

Background: Self-medication is the selection and use of medicines by individuals to treat self-recognized illnesses or symptoms. Self-medication is one element of self-care. The World Self-medication Industry defines self-medication as the treatment of common health problems with medicines especially designed, labelled and approved for use without medical supervision. It is also defined as the use of drugs to treat self-diagnosed disorders or symptoms, or the intermittent or continued use of a prescribed drug for chronic or recurrent disease or symptoms. This study was carried out to investigate the problem and factors responsible for self medication.Methods: A community based cross sectional descriptive study was conducted in Anakaputhur, an urban field practice area of Sree Balaji Medical College. A pre-tested structured questionnaire was used as a study tool to interview the study participants, conducted by face to face interview.Results: There is an association present between age groups and self-medication were the p value was 0.035. There is an association present between occupation and subjects on self-medication p=0.001. An association present between education and self-medication, per capita income and self-medication and marital status and self-medication with a p=0.000. No statistically significant association was found between other factors like tobacco use and alcohol use with self-medication.Conclusions: Self-medication is an important health issues in India. Health education of the public and regulation of pharmacies may help in limiting the self-medication practices.

A prospective evaluation of microvascular complications in diabetes mellitus patients at time of diagnosis

Background: The microvascular complication is also showing increasing trend. This is because of lack of awareness and lack of regular screening programme. Early diagnosis and Intensive glycemic control has been the most effective approach to prevent the progress of microvascular complication.Methods: Based on exclusion and inclusion criteria 100 patients were enrolled for this study. For diagnosis of diabetes mellitus, we used American Diabetes Association (ADA) guidelines was followed. Detail history of patient was taken related to microvascular complication and they underwent extensive medical examination for the assessment of microvascular complications.Results: Mean age of patient with microangiopathy was 59.942±7.18 years and without microangiopathy was 54.31±13.15years. Microangiopathy was common in patient whose HbA1c was more than 10.7. Out of 26 patient 20 patient having microangiopathy. Neuropathy was present in 31 patients and absent in 69 patients.Conclusions: It was observed that a continuous linear association between HbA1c and microvascular complications. This is more common in patient in patient with higher HbA1c. Neuropathy is most common which is followed by nephropathy and retinopathy least among all.

Clinical Profile of Ocular Diseases with the Assessment of Knowledge, Awareness and Eye-care Practices in Newly Diagnosed Diabetics in Working Age Group

Introduction: Ocular complications in diabetes have asignificant impact on the working population. Apart fromdiabetic retinopathy, diabetes can lead to several non-retinalcomplications like cataract, ophthalmoplegia, dry eye, cornealkerato-epitheliopathy and refractive error. With the additionof substantial number of newly diagnosed diabetics per yearthere is a significant ever-growing burden on health services.Materials and methods: It was a hospital-based studyconducted at Hi-tech Medical College and hospital wherepatient diagnosed as diabetics within one year and in theworking age-group 30-65 years were included. After theroutine ocular evaluation these subjects were administereda concise questionnaire containing questions testing theirawareness about diabetes, its ocular complications and eyecare practices.Results: A total of 727 newly diagnosed diabetics wereassessed with mean age 49.64 +/-7.28. The incidence ofcataract was 18.7% and DR 9.35% respectively. Althoughnearly half the study population had some knowledge ofdiabetes, knowledge about ocular complications was limited.The main source of the information was the prescribing doctor.Conclusion: Determining the clinical profile of ocularcomplications with an assessment of knowledge and awarenessof eye-care practices in the newly diagnosed diabetics canhelp to formulate the interventional measures to control theocular morbidity.

Clinical and demographic profile associated with prevalent complications among newly diagnosed Diabetes Mellitus type 2 patients seen at the Family Medicine Outpatient Department of East Avenue Medical Center from May 2018-April 2019

Background@#Diabetes ranks 8th among the Top 10 causes of mortality in the Philippines. Development of complications add to the burden of the disease. The passage of the Universal Health Care Law ensures all Filipinos access to comprehensive set of quality and preventive services without causing financial hardships@*Objective@#To determine the clinical and demographic profile associated with prevalent complications among newly diagnosed T2DM seen at the outpatient setting of a tertiary DOH hospital@*Methods@#A retrospective/cross – sectional study of newly diagnosed Diabetes Mellitus Type 2 from May 2018 – April 2019 using their charts through random sampling was used. Data were analyzed using descriptive statistics, iIndependent Sample T-test and Fisher’s Exact/Chi-square test for the difference of mean and frequency, respectively, and odds ratio from binary logistic regression for significant predictors of complications@*Results@#Of the 116 newly diagnosed T2DM patients. 88 had complications and 28 patients had no complications. Majority of patients were 60-69 years old (40.52%), with SBP range of 140-150 mmHg (44.83%), FBS of >7.5mmHg (43.97%). Values for BUN and Creatinine between the two groups were significantly different. Most frequent complication was hypertension (54.87%). For every 10-year increase in age, the odds of having complications among newly diagnosed increased by 48%. For every 10 mmHg increase in SBP, the odds of having complications among newly diagnosed also increases by 75%.For every 0.5 mg/dl in FBS, the odds of having complications among newly diagnosed also increased by 91%.For every μmol/L in creatinine, the odds of having complications among newly diagnosed also increased 7.51 times@*Conclusion@#The most frequent complications among newly diagnosed T2DM were hypertension, microvascular, then macrovascular complications. The association between the profile and complication seen among newly diagnosed T2DM using odds ratio revealed predictors such as age, systolic blood pressure, FBS and creatinine.

Traditional Chinese medicine insights of newly-diagnosed and young hypertension and clinical practice of Tianma Gouteng Decoction for hypertension treatment / 中国中药杂志

Hypertension is a global major public health problem. Early intervention and timely blocking are necessary for newly-diagnosed hypertensive and young hypertensive patients. Tianma Gouteng Decoction recorded in Zabing Zhengzhi Xinyi written by HU Guangci has the major functions in treating excess syndrome and wind-Yang disturbance syndrome with effects in calming liver-wind, clearing heat and activating blood, and nourishing liver and kidney. As we known, Tianma Gouteng Decoction is a classical formula for treating hypertension. However, due to the limitation of historical conditions, some problems impede Tianma Gouteng Decoction from being handed down successfully, such as uncertain diagnosis, uncertain antihypertensive efficacy and treatment-course. In this case, we ask whether Tianma Gouteng Decoction can be used as antihypertensive therapy and the exactly decrease of systolic and diastolic blood pressure, and wonder the half-life of Tianma Gouteng Decoction and the relationship with Western medicine. Therefore, defined prescription and syndrome, efficacy, treatment-course are important in clinical practice. According to the findings, ① previously, we thought that hypertension was a liver-Yang hyperactivity and liver-wind stirring syndrome, and the liver-based therapy theory was effective. However, based on our study, long-term treatment with Western medicine could block disease progression, control the increased blood pressure and change the pathogenesis and syndrome of traditional Chinese medicine. Therefore, the frequency of liver-Yang hyperactivity syndrome "fire syndrome" decreased sharply, and the main syndrome was fluid-retention syndrome and deficiency syndrome. The etiology and pathogenesis of hypertension was prone to deficiency syndrome accompanied with excess syndrome. Therefore, it was necessary to intervene hypertension in "liver-wind" and "liver-Yang" excess syndrome stage, and the early intervention and treatment are important. ② The newly-diagnosed hypertensive and young hypertensive patients usually had no Western medicine intervention. Thus, the etiology and pathogenesis of hypertension were free from Western medicine, which maintained the initial stage of hypertension in line with the liver-Yang hyperactivity syndrome. ③ The pathological mechanisms of newly-diagnosed and young hypertension were mainly increase in sympathetic activity, active renin-angiotensin-aldosterone system, change in morphology of vascular smooth muscle cells and endothelial cell dysfunction. ④ According to the syndrome of Tianma Gouteng Decoction, in modern medicine, Tianma Gouteng Decoction was widely used to treat the early-stage hypertension and the early-intervention of hypertension without Western medicine, particularly newly-diagnosed, young hypertension, Ⅲ hypertension, hypertensive crisis and hypertensive emergency. Tianma Gouteng Decoction can treat such symptoms as headache, dizziness, fullness of head, slurring of speech; facial flushing, conjunctival congestion and blurred vision; dysphoria, anxiety, palpitation, insomnia, mental disorder and hot flushes; dry-mouth with bitter taste and sweeting; myasthenia of limbs and lassitude in loin and legs; brown urine with burning sensation during urination; a solid or liquid stool consistency; red tongue, slippery and rapid pulse, wiry and rapid pulse over to Cunkou. ⑤ After treatment with Tianma Gouteng Decoction for three to six months, the blood pressure was decreased, and the symptoms were improved with reduction or even discontinuance of Western medicine. ⑥ According to recent studies, Caul is Polygoni Multiflori of Tianma Gouteng Decoction induced certain hepatotoxicity and increased the risk of long-term treatment. However, with the regular monitoring of biomedical index, long-term treatment with Caulis Polygoni Multiflori(3-10 g·d~(-1) for 3 to 6 months) didn't show hepatic dysfunction. ⑦ The pharmacological activity of Tianma Gouteng Decoction coincided with the pathology and disease mechanism of newly-diagnosed and young hypertension. Therefore, Tianma Gouteng Decoction was the specific recipe for newly-diagnosed and young hypertension. Therefore, further studies of efficacy, safety and molecular mechanism of Tianma Gouteng Decoction may make a medical breakthrough for hypertension treatment.

Alteration in Serum Lipid Profile in Oral Squamous Cell Carcinoma

Background: Alteration in the pattern of serum lipid profile has been associated with a variety of cancers and precancerousconditions. Low levels of serum lipid serve as a prognostic marker in the early detection of oral precancerous and cancerousconditions because lipid plays an important role in new membrane biogenesis and maintains cell integrity.Aim: The aim of our study is to evaluate the alteration in serum lipid profile in oral squamous cell carcinoma (OSCC) andcompared it with control group.Materials and Methods: A total of 80 subjects were selected from the Department of Oral Pathology and Microbiology,RUHS College of Dental Sciences, Jaipur (GDC-Jaipur). Among 80 subjects, 40 individuals were diagnosed with squamouscell carcinoma and other 40 individuals were taken in healthy control group selected randomly from other departments. Thetotal parameters assessed include total cholesterol (TC), high-density lipoprotein cholesterol (HDLC), low-density lipoproteincholesterol (LDLC), very LDLC, and triglycerides (TGLs). Statistical analysis was carried out by Chi-square and one-wayANOVA test to evaluate parameters.Results: There was a significant decrease in TC, HDLC, and TGL in the oral cancer group as compared with the control group.Conclusions: There was an inverse relationship between serum lipid profile and OSCC. The lower serum lipid status may beconsidered a useful prognostic biochemical indicator for initial changes occurring in the neoplastic proliferating cell.

Study of oxidative stress and C-Reactive protein in type-2 diabetes mellitus

Background: Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion and insulin action or both. T2DM is associated with chronic low grade inflammation, possibly through a pathway involving a cytokine-mediated acute-phase response to infection and other inflammatory processes. authors aim to study C-reactive protein (CRP) which is an acute-phase reactant produced primarily in the liver hepatocytes. Oxidative stress levels in newly diagnosed T2M patients were analysed with respect to malondialdehyde (MDA) and nitric oxide (NO).Methods: Case-control study comprising of aged-sex matched subjects: newly diagnosed T2DM cases (n=30) and controls (n=30). The serum samples of subjects were analysed for levels of MDA by Buege and Aust method, while NO levels by Cortas and Wakid’s kinetic cadmium reduction method using spectrophotometer. CRP levels were analysed by using turbidimetry. Statistical analysis was done using Mini-tab 17 software with 95% confidence interval.Results: Serum levels of MDA, NO and CRP in newly diagnosed T2DM patients were significantly increased as compared to healthy controls.Conclusions:  Authors concluded that the oxidative stress and inflammation plays a pivotal role in the aetiology of hyperglycemia in T2DM. Oxidative stress and inflammatory markers might help prognosis of T2DM in hyperglycemic individuals with the help of which precautionary measure can be taken to reduce the rate of disease progression. Treatment involving anti-oxidant and anti-inflammatory medications might help to rescue vital organs from damage.

A Prospective Study on Prevalence and Percentage of Undiagnosed Type 2 Diabetics Patients Undergoing Elective Surgery

xIntroduction: The major form of diabetes mellitus is Type 2diabetes. It accounts for 90 percent of the diabetic population.Patients with diabetes mellitus (DM) are prone to adverseoutcomes. It is observed that one fifth of the patientsundergoing surgery are diabetic.Methodology: This study was conducted in the Department ofSurgery in the Department of General Surgery, Ananta Instituteof Medical Sciences and Research Centre, Rajsamand. 289total numbers of cases were included in this study. Each casehas Type 2 DM.Results: In our study, 289 total numbers of cases wereincluded. Among the 289 cases 53.9% were male & 46.1%were female. Incidence of Diabetic Mellitus in undiagnosed &diagnosed cases was found 41.5% & 58.5% respectively.Conclusion: This study concludes that there is a strong needof awareness about diabetes and early diagnosis of diabetes toreduce its various complications.

Cd4 count at the time of presentation in newly diagnosed HIV patients in a tertiary care hospital in south India: implications for the programme

Background: Lower CD4 count at initiation of antiretroviral therapy (ART) can have a significant negative impact on subsequent disease progression and mortality among HIV patients. Hence, author assessed the status of the CD4 count at the time of diagnosis and factors associated with lower CD4 count among newly diagnosed HIV cases.Methods: A prospective observational study was conducted in a single integrated counseling and testing center, affiliated with a Medical College and Hospital, Andhra Pradesh. All newly diagnosed HIV cases in the setting between January to December 2017 were included. The CD4 count was assessed as per national guidelines for enumeration of CD4 2015.Results: The final analysis included 125 participants. The mean CD4 count at diagnosis was 276.51±228.37. Only 19 (15.20%) people had CD4 count >500, 47 (37.60%) had between 200-500 and 59 (47.20%) had CD4 count <200. Only 20% had appropriate knowledge of treatment. Among the study population, 43 (34.70%) had symptomatic conditions attributed to HIV infection, 44 (35.50%) participants had an AIDS-defining illness at the time of diagnosis. Only 3 (2.40%) had voluntary counseling and testing. Even though male gender, poor educational status, having more sexual partners, poor knowledge related to HIV diagnosis and treatment was associated with higher odds of low CD4 count (<200), none of the associations were statistically significant.Conclusions: The mean CD4 count was low and almost half of newly diagnosed cases had low CD4 count (<200) at the time of diagnosis. There is a strong need to intensify the efforts to fill the gaps in the screening for the early diagnosis to maximize the benefits of HAART and to stop the spread of the infection.