Effect of pomegranate polyphenols on lipids metabolism in patients with myocardial infarction: a double-blind placebo controlled trial

Background: Myocardial Infarction (MI) is a leading disease globally. Major risk factors for MI are smoking, hypertension, diabetes mellitus, reactive oxygen species (ROS), obesity, coronary artery disease (CAD) and abnormally altered blood lipid levels. It is recommended that for healthy living the risk factors for CAD and ROS should be less. Consumption of natural food supplements rich in antioxidants and polyphenols reduce the risk of MI. One herb is Pomegranate. Pomegranate is polyphenols and antioxidants rich fruit. This prompted us to find out whether the presence of antioxidants in pomegranate offers any prognostic benefits in patients with MI?.Methods: Pomegranate Extract of Whole Fruit (PEWF) was prepared as tablet of 300mg to investigate its effects in patients with MI. Total 100 participants were included in the trial. Participants were assigned to two groups of 50 each. One group received “Add On” PEWF and other got matching placebo of same colour, shape and size as comparator agent in the dose of 300mg BD for 1 month.Results: Results were compared by Z test, Chi square test and coefficient of variations. Statistical analysis proves the prognostic effect after active medication (p<0.05). Study results indicate the rejection of Null Hypothesis (H0) and acceptance of Alternative Hypothesis (H1).Conclusions: Our findings suggest that consumption of antioxidant and polyphenols rich food supplements such as PEWFs for one month reduces the risk factors for CAD.

Effect of natural polyphenols on diabetes mellitus (type-2) with myocardial infarction: a double-blind placebo controlled trial

Background: Diabetes Mellitus Type-2(T2D); is a leading disease in world wide. T2D is a clinical syndrome characterized by hyperglycaemia. Hyperglycemias are caused by an absolute or relative deficiency of insulin and due to insulin resistance. Diabetic patients are highly prone to Reactive Oxygen Species (ROS) and leads to Cardio vascular complications. Several medicines have been recommended to cure T2D; and still discovery of newer drugs are in process. Now a day, the focus of researches in diabetes includes discovery of newer anti-diabetic agents as well as isolating the active compounds from herbal sources. One such herbal source is pomegranate. Pomegranate is polyphenols and antioxidants rich fruit; which has potency to cure T2D and ROS.Methods: A Pomegranate Extract of Whole Fruit (PEWF) was prepared as tablet of 300mg to investigate its effects in patients with T2D. Total 40 participants of either gender with nested cases of T2D with Myocardial Infarction (MI) were included in study. All participants were assigned in two groups (20 each). One group was under “Add On” therapy of PEWF and matching placebos of same colour, shape and size were used as comparator agent for second group (300mg BD for 1 month).Results: Levels of biochemical markers related to T2D were compared to analysed pre and post drug effects by Z test, chi square test and by coefficient of variations. Results highlighted that those participants who were under “add-on” therapy of PEWF showed highly prognostic significance. Thus, PEWF should be consumed in diet as food supplementation.Conclusions: In conclusion, polyphenols and antioxidants rich fruit supplements should be taken in diet for healthy living.

Antibiotic susceptibility pattern of extended spectrum ?-lactamase ESBL producing gram negative bacilli in a tertiary care teaching hospital, Bareilly, India

Background: The increasing prevalence of infections caused by antibiotic-resistant bacteria makes empirical treatment of these infections difficult. Resistance to a wide variety of common antimicrobials has made the proliferation of extended spectrum ?-lactamase (ESBL) producing strains a serious global health concern that has complicated treatment strategies and is very alarming. This study was undertaken to identify ESBL production in various gram negative bacilli isolated and to further study the antibiogram of ESBL producers and their contribution towards anti-microbial resistance.Methods: A total of 2008 samples were taken and studied for positive bacterial growth. Presence of ESBL positivity was detected using Kirby-Bauer sensitivity testing method and their antibiogram was studied. Data was analysed using IBM SPSS version 20. Chi-square test was applied wherever applicable to check the significant difference among the different groups. p value of ?0.05 was considered to be significant.Results: A total of 2008 samples were studied. Out of which 655 gave positive bacterial growth and amongst these 312 were ESBL producers. Resistance to multiple classes of antibiotics was observed among ESBL producers and mostly imipenem, colistin and polymyxin B were the antibiotics which were sensitive to most of the strains.Conclusions: The frequency of ESBL producing strains among clinical isolates has been steadily increasing. Advance drug resistance surveillance and development of newer antibiotics is necessary to guide the appropriate and judicious antibiotic use.

Non-Albicans Candiduria: An Emerging Threat.

Objective: The incidence of Candida has been on rise worldwide. Clinicians face dilemma in differentiating colonization from true candiduria. The species identification of Candida is important, as non albicans Candida species are increasing in number and more resistant to antifungal drugs. Material and methods: The present study was conducted at a tertiary care teaching hospital of North India with an aim of investigating prevalence of NAC spp. among Candida isolates from urinary tract specimens. Results: A total of 7627 urine samples were analysed in a tertiary care hospital. The Candida isolates (180) were further speciated by Gram stain, culture on sabouraud’s dextrose agar, germ tube test, sugar fermentation test. A total of 180 (2.36%) Candida species were isolated from 7627 urine samples. Among them non albicans Candida species were predominant (66.7%), compared to Candida albicans(33.3%).The rate of isolates of Candida species were more in females, 101 (56.1%) than in males 79 (43.9%). The highest isolation rates of Candida among uropathogens were found in age group above 60 years.The emergence of non-albicans Candida similar to the trends in the western countries should be a cause of concern in our country. Conclusions: NAC spp. have emerged as an important cause of urinary tract infections. Its isolation from clinical specimens can no longer be ignored as nonpathogenic isolate nor can it be dismissed as a contaminant. Proper surveillance of these fungal pathogens is important to improve quality of care in tertiary care setting.

Hb Q in India: An uncommon hemoglobin variant diagnosed in two patients â Case series.

Hemoglobin Q-India (α 64 Asp→His) is an important member of the hemoglobin Q family, molecularly characterized by the replacement of aspartic acid by histidine. The first case of Hb Q India was reported by Sukumaran in 1972 in a Sindhi family with associated β-halassemia. India is known as a country with a high prevalence of α - and β-thalassemia and different types of hemoglobinopathy. Many of these variants are yet to be identified. Here, we are reporting two cases of Hb Q- India diagnosed during premarital thalassemia screening.

Rare Haemoglobin Variant Hb J Meerut in 27 Years Old Female - A Case Report.

Hemoglobin has plenty of variants and fast moving hemoglobins (FMH’s) are the rare hemoglobin variants. They are having tendency to migrate anodally to hemoglobin A on alkaline gel electrophoresis. Because of the mutation in the globin genes, these hemoglobin variants have the fast moving nature. The basic pathophysiology behind it is the substitution of a negatively charged amino acid residue in either α, β or γ globin chains. Hb J Meerut is an infrequently found α-globin variant. It has previously been reported in various populations around the world. Here, we are reporting a case of Hb J meerut who came to laboratory for thalassemia screening.

In Search of an Ideal Test for Diagnosis and Prognosis of Kala-azar.

The latex agglutination test (KAtex), direct agglutination test (DAT), and the rK39 immuno-chromatographic strip test (dipstick test) were evaluated for their role in the diagnosis and prognosis of visceral leishmaniasis (kala-azar) in India. Sera and urine samples from 455 subjects—150 confirmed visceral leishmaniasis cases, 160 endemic controls, 100 non-endemic controls, and 45 other febrile diseases—were included in the study. The sensitivity of the KAtex, DAT, and rK39 strip test was 87% [95% confidence interval (CI) 80-96], 93.3% (95% CI 88-100), and 98% (95% CI 93-100) respectively. The specificity of these tests was 98% (95% CI 93-100), 93% (95% CI 87-100), and 89% (95% CI 82-97) for the KAtex, DAT, and rK39 strip test respectively. Fifty cases were followed up and subjected to the KAtex, DAT, and rK39 strip test after 30 days of successful treatment. The DAT and rK39 strip test showed positive results in all the 50 cases whereas the KAtex showed no positive reaction in any case. Based on the results, it is concluded that the sensitivity and specificity of the DAT and rK39 strip test are comparable but the greater convenience of use of the strip test makes it a better tool for the diagnosis of visceral leishmaniasis in the peripheral areas of endemic regions whereas the sensitivity of the KAtex needs to be improved to promote its use as a first-line diagnostic test in the field-setting. It may be used for the prognosis of the disease as antigen becomes undetectable in urine after 30 days of the completion of the treatment. Alternatively, it can be used as an adjunct with rK39 for sero-epidemiological surveys.