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Background & objectives: During the COVID-19 pandemic, the death rate was reportedly 5-8 fold lower in India which is densely populated as compared to less populated western countries. The aim of this study was to investigate whether dietary habits were associated with the variations in COVID-19 severity and deaths between western and Indian population at the nutrigenomics level. Methods: In this study nutrigenomics approach was applied. Blood transcriptome of severe COVID-19 patients from three western countries (showing high fatality) and two datasets from Indian patients were used. Gene set enrichment analyses were performed for pathways, metabolites, nutrients, etc., and compared for western and Indian samples to identify the food- and nutrient-related factors, which may be associated with COVID-19 severity. Data on the daily consumption of twelve key food componentsacross four countries were collected and a correlation between nutrigenomics analyses and per capita daily dietary intake was investigated. Results: Distinct dietary habits of Indians were observed, which may be associated with low death rate from COVID-19. Increased consumption of red meat, dairy products and processed foods by western populations may increase the severity and death rate by activating cytokine storm-related pathways, intussusceptive angiogenesis, hypercapnia and enhancing blood glucose levels due to high contents of sphingolipids, palmitic acid and byproducts such as CO2 and lipopolysaccharide (LPS). Palmitic acid also induces ACE2 expression and increases the infection rate. Coffee and alcohol that are highly consumed in western countries may increase the severity and death rates from COVID-19 by deregulating blood iron, zinc and triglyceride levels. The components of Indian diets maintain high iron and zinc concentrations in blood and rich fibre in their foods may prevent CO2 and LPS-mediated COVID-19 severity. Regular consumption of tea by Indians maintains high high-density lipoprotein (HDL) and low triglyceride in blood as catechins in tea act as natural atorvastatin. Importantly, regular consumption of turmeric in daily food by Indians maintains strong immunity and curcumin in turmeric may prevent pathways and mechanisms associated with SARS-CoV-2 infection and COVID-19 severity and lowered the death rate. Interpretation & conclusions: Our results suggest that Indian food components suppress cytokine storm and various other severity related pathways of COVID-19 and may have a role in lowering severity and death rates from COVID-19 in India as compared to western populations. However, large multi-centered case?control studies are required to support our current findings.
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Moderate levels of endogenous reactive oxygen species (ROS) are important for various cellular activities, but high levels lead to toxicity and are associated with various diseases. Levels of ROS are maintained as a balance between oxidants and antioxidants. Accumulating data suggest that oxidative stress is a major factor in deterioration of renal function. In this review, we highlight the possible mechanism by which oxidative stress can lead to chronic kidney disease (CKD). This review also describes therapies that counter the effect of oxidative stress in CKD patients. Numerous factors such as upregulation of genes involved in oxidative phosphorylation and ROS generation, chronic inflammation, vitamin D deficiency, and a compromised antioxidant defense mechanism system cause progressive detrimental effects on renal function that eventually lead to loss of kidney function. Patients with renal dysfunction are highly susceptible to oxidative stress, as risk factors such as diabetes, renal hypertension, dietary restrictions, hemodialysis, and old age predispose them to increased levels of ROS. Biomolecular adducts (DNA, proteins, and lipids) formed due to reaction with ROS can be used to determine oxidative stress levels. Based on the strong correlation between oxidative stress and CKD, reversal of oxidative stress is being explored as a major therapeutic option. Xanthine oxidase inhibitors, dietary antioxidants, and other agents that scavenge free radicals are gaining interest as treatment modalities in CKD patients.
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Moderate levels of endogenous reactive oxygen species (ROS) are important for various cellular activities, but high levels lead to toxicity and are associated with various diseases. Levels of ROS are maintained as a balance between oxidants and antioxidants. Accumulating data suggest that oxidative stress is a major factor in deterioration of renal function. In this review, we highlight the possible mechanism by which oxidative stress can lead to chronic kidney disease (CKD). This review also describes therapies that counter the effect of oxidative stress in CKD patients. Numerous factors such as upregulation of genes involved in oxidative phosphorylation and ROS generation, chronic inflammation, vitamin D deficiency, and a compromised antioxidant defense mechanism system cause progressive detrimental effects on renal function that eventually lead to loss of kidney function. Patients with renal dysfunction are highly susceptible to oxidative stress, as risk factors such as diabetes, renal hypertension, dietary restrictions, hemodialysis, and old age predispose them to increased levels of ROS. Biomolecular adducts (DNA, proteins, and lipids) formed due to reaction with ROS can be used to determine oxidative stress levels. Based on the strong correlation between oxidative stress and CKD, reversal of oxidative stress is being explored as a major therapeutic option. Xanthine oxidase inhibitors, dietary antioxidants, and other agents that scavenge free radicals are gaining interest as treatment modalities in CKD patients.
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Here we report a 25 years old male patient came to our emergency department with chief complaints of headache from 3 months, blurring of vision 7 days, abdominal pain 7 days, and vomiting from 2 days. Young male, with no known comorbidities, presented to our casualty with headache since, 3 months, episodic in nature, increased over the last 1 week, holocranial, gradually progressive in severity. last recorded Blood pressure outside was 220/120 mmHg and papilledema were noted on fundoscopy. USG abdomen and pelvis, CECT abdomen done and diagnosed to have bilateral adrenal pheochromocytoma. Patient underwent bilateral adrenalectomy was performed with good intra op BP control. Right adrenals were enlarged and shows multiple nodular lesions, left adrenal noted shows nodular lesions. Surgery remains the first line of management in malignant pheochromocytoma. Norepinephrine, epinephrine, and dopamine all act on their target receptors, which causes a physiological change in the body. Increase in catecholamines cause severe hypertension and multiple systemic complications like (cardiovascular, cerebrovascular events) and can lead to death if untreated.
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Breast cancer is the second leading cause of cancer related deaths. Breast cancer survival is strongly determined based on the stage of the cancer after diagnosis. This demonstrates the benefits of early detection of breast cancer in keeping survival rates of patients higher. Triple Test that comprises clinical examination, radiological assessment (USG/Mammography) and FNAC is considered as the gold standard in diagnosing carcinoma breast. This study aimed at diagnosing carcinoma breast in patients with the help of triple assessment and studying its relevance and validity.METHODSWomen who presented with a lump in breast to surgery OPD in the department of general surgery, NMCH, Patna were included in the study. This is a prospective study undertaken from December 2017 to November 2019. After taking informed consent from the study participants, they were thoroughly examined, and detailed history was taken. Subsequently, they were subjected to other components of triple test, so that a definitive diagnosis could be formed. Cases of breast abscess and those with fungating or ulcerative mass were excluded from the study.RESULTSClinical examination had a sensitivity of 90% and specificity of 86.66%. FNAC had a sensitivity of 95% and specificity of 96.66%. Radiological assessment when used alone, yielded a sensitivity of 90% and specificity of 96.66%. The sensitivity and specificity of all the modalities used in triple assessment when combined together was 100% and 96.66% respectively. The positive predictive value was 95.23% and negative predictive value was 100%. The p value was highly significant (<0.0001).CONCLUSIONSTriple assessment is an important diagnostic tool in the assessment of carcinoma breast and is better than either of the modalities used alone.
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Objectives@#Regions with limited sanitation facilities have higher rates of infections with various enteric pathogens. It is therefore important to identify different hosts and their relative contribution to pathogen shedding into the environment, and to assess the subsequent health risks to humans. @*Methods@#In this study, human faecal (n=310), animal faecal (n=150), and environmental (soil) samples (n=40) were collected from the same locality and screened for selected enteric pathogens by immunochromatography and/or polymerase chain reaction. @*Results@#At least 1 microbial agent was detected in 49.0%, 44.7%, and 40.0% of the samples from human, animals, and soil, respectively. Among humans, rotavirus was predominantly detected (17.4%) followed by enteropathogenic Escherichia coli (EPEC) (15.4%), Shigella (13.8), and Shiga toxin-producing E. coli (STEC) (9.7%). Among animals, STEC was detected most frequently (28.0%), and EPEC was the major enteric pathogen detected in soil (30.0%). The detection rate of rotavirus was higher among younger children (≤2 years) than among older children. Single infections were more commonly detected than multiple infections in humans (p<0.01), unlike the observations in animal and soil samples. For diarrhoeagenic E. coli and Shigella, most of the human and animal isolates showed close relatedness, suggesting possible cross-infection between humans and domesticated animals in the area studied. @*Conclusions@#The present study provides an improved understanding of the distribution of major enteric pathogens coexisting in humans and animals in the region, thereby suggesting a high potential for possible transmission among livestock and communities residing in the studied locality.
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Objectives@#Regions with limited sanitation facilities have higher rates of infections with various enteric pathogens. It is therefore important to identify different hosts and their relative contribution to pathogen shedding into the environment, and to assess the subsequent health risks to humans. @*Methods@#In this study, human faecal (n=310), animal faecal (n=150), and environmental (soil) samples (n=40) were collected from the same locality and screened for selected enteric pathogens by immunochromatography and/or polymerase chain reaction. @*Results@#At least 1 microbial agent was detected in 49.0%, 44.7%, and 40.0% of the samples from human, animals, and soil, respectively. Among humans, rotavirus was predominantly detected (17.4%) followed by enteropathogenic Escherichia coli (EPEC) (15.4%), Shigella (13.8), and Shiga toxin-producing E. coli (STEC) (9.7%). Among animals, STEC was detected most frequently (28.0%), and EPEC was the major enteric pathogen detected in soil (30.0%). The detection rate of rotavirus was higher among younger children (≤2 years) than among older children. Single infections were more commonly detected than multiple infections in humans (p<0.01), unlike the observations in animal and soil samples. For diarrhoeagenic E. coli and Shigella, most of the human and animal isolates showed close relatedness, suggesting possible cross-infection between humans and domesticated animals in the area studied. @*Conclusions@#The present study provides an improved understanding of the distribution of major enteric pathogens coexisting in humans and animals in the region, thereby suggesting a high potential for possible transmission among livestock and communities residing in the studied locality.
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@#Introduction: The first five years of life constitute the foundations of the child's physical, mental growth and development. Mortality and morbidity are high during this age group. Early detection of danger signs is very crucial to prevent this. The objectives were to assess the knowledge of mothers regarding under-five danger signs and explore the association between the effects of knowledge with selected factors. Method: A descriptivestudy was conducted in a rural community of West Bengal from Jan’2018 to Sept’2018. Total study sample was 110 mothers having under five children. Door to door data collection was done through interview and data was analyzed both manually and by computer feeding. Results: Out of total study sample, majority (60%) belongs to age group 18-25 years followed by 31% among 26-33 age group, then 16% were more than 33 years. Out of total mothers, majority (40%) belongs to higher educated group, (37%) secondary group, followed by 10% with primary education and 13%were illiterate. Knowledge score was more than 50% among higher educated group (64%). Out of total respondents 61 (55.5%) mothers were not able to identify any danger signs whereas, 35.5 % mothers identified 1-2 danger signs and 9% mothers were able to identify 3-4 danger signs. Knowledge score about danger signs was more who visited antenatal clinic more than 4 times (61%). Conclusion: Awareness regarding under five danger signs are more among higher educated mothers. Number of antenatal visits also influences knowledge score.
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In recent years, nanotechnology has revolutionized global healthcare and has been predicted to exert a remarkable effect on clinical medicine. In this context, the clinical use of nanomaterials for cancer diagnosis, fertility preservation, and the management of infertility and other pathologies linked to pubertal development, menopause, sexually transmitted infections, and HIV (human immunodeficiency virus) has substantial promise to fill the existing lacunae in reproductive healthcare. Of late, a number of clinical trials involving the use of nanoparticles for the early detection of reproductive tract infections and cancers, targeted drug delivery, and cellular therapeutics have been conducted. However, most of these trials of nanoengineering are still at a nascent stage, and better synergy between pharmaceutics, chemistry, and cutting-edge molecular sciences is needed for effective translation of these interventions from bench to bedside. To bridge the gap between translational outcome and product development, strategic partnerships with the insight and ability to anticipate challenges, as well as an in-depth understanding of the molecular pathways involved, are highly essential. Such amalgamations would overcome the regulatory gauntlet and technical hurdles, thereby facilitating the effective clinical translation of these nano-based tools and technologies. The present review comprehensively focuses on emerging applications of nanotechnology, which holds enormous promise for improved therapeutics and early diagnosis of various human reproductive tract diseases and conditions.
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In recent years, nanotechnology has revolutionized global healthcare and has been predicted to exert a remarkable effect on clinical medicine. In this context, the clinical use of nanomaterials for cancer diagnosis, fertility preservation, and the management of infertility and other pathologies linked to pubertal development, menopause, sexually transmitted infections, and HIV (human immunodeficiency virus) has substantial promise to fill the existing lacunae in reproductive healthcare. Of late, a number of clinical trials involving the use of nanoparticles for the early detection of reproductive tract infections and cancers, targeted drug delivery, and cellular therapeutics have been conducted. However, most of these trials of nanoengineering are still at a nascent stage, and better synergy between pharmaceutics, chemistry, and cutting-edge molecular sciences is needed for effective translation of these interventions from bench to bedside. To bridge the gap between translational outcome and product development, strategic partnerships with the insight and ability to anticipate challenges, as well as an in-depth understanding of the molecular pathways involved, are highly essential. Such amalgamations would overcome the regulatory gauntlet and technical hurdles, thereby facilitating the effective clinical translation of these nano-based tools and technologies. The present review comprehensively focuses on emerging applications of nanotechnology, which holds enormous promise for improved therapeutics and early diagnosis of various human reproductive tract diseases and conditions.
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Aim: This study intended to compare the dosimetric parameters using different definitions of prescription point A in high dose rate (HDR) brachytherapy of cervical cancer patients. Background: Manchester point A has been widely used for prescribing dose in brachytherapy. However, due to certain limitations of this point, a new definition of point A has been recommended by the American Brachytherapy Society (ABS). Materials and Methods: We retrospectively investigated 55 computed tomography-based plans of 20 cervical cancer patients treated with Ir-192-based intracavitary HDR brachytherapy. The dose of 7 Gy in 3 fractions each was prescribed to point A using revised Manchester definition of point A (AMAN) and ABS guideline definition (AABS). The effect of both definitions on various parameters including dose to point A and 90% of tumor volume (D90), dose received by 2cc volume of bladder, rectum and small bowel and treatment volume receiving 100% of prescription dose (V100) was analyzed. Results: Mean percentage difference of point AMAN dose and AABS dose with respect to prescription dose was 1.25% ± 1.43% and 1.21% ± 1.01%, respectively. Mean V100 was 80.4 ± 20.45cc and 88.47 ± 16.78cc for AMAN and AABS plans, respectively, while mean percentage difference between prescribed dose and D90 was found to be –37.90% ± 25.06% and –30.47% ± 25.50% respectively for both the definitions. Conclusion: Doses to both Manchester point A and ABS point A may be recorded during the transition period. However, ABS point A can be preferred over the Manchester point A as it conforms better with the desired dosimetric outcome and is found to be more static.
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Background: Serum uric acid is increased in ischemic conditions and is significantly higher in patients with acute myocardial infarction. The aim of study was to correlate serum uric acid level with KILLIP class in respect of mortality and morbidity profile of patients with acute coronary syndromes..Methods: 100 patients fulfilling the standard diagnostic criteria for acute coronary syndromes on the basis of classical history, clinical signs, ECG changes and biomarkers were included in the study. Age and sex matched 50 normal healthy subjects were also included as control group after obtaining informed consent. Serum uric acid level was measured on day 0, 3 and 7 of various ACS.Results: There was statistically significant higher level of serum uric acid concentration in patients of AMI on day of admission as compared to controls and unstable angina patients. On all three days of serum uric acid estimation, the serum uric acid levels were higher in AMI patients who were in higher KILLIP class as compared to lower KILLIP class group. Smokers had significantly higher baseline serum uric acid but age, sex, dyslipidemia, hypertension and diabetes mellitus did not significantly affect serum uric acid level at any stage in various ACS patients. Five patients who died during hospital stay, had serum uric acid level more than 7.0 mg/dL and all of them were in KILLIP class III and IV.Conclusions: serum uric acid level is a strong and independent risk factor in predicting mortality and morbidity profile of patients of acute myocardial infarction. Also, serum uric acid level correlates well with KILLIP class.
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No abstract available.
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Introduction: The mediastinum is the central portion of the thoracic cavity, limited by pleural cavities laterally, thoracic inlet superiorly, and the diaphragm inferiorly. Housing numerous organs, it is a veritable Pandora’s box, within which various lesions may develop. This study was conducted to assess the epidemiologic profile, clinicoradiological features, cytological, and histopathological findings in patients presenting with mediastinal masses in a tertiary care hospital over a period of 3 years. Materials and Methods: This is a retrospective study of cases presenting with mediastinal masses attending the Cardiothoracic Surgery Department of Medical College, Kolkata between May 2011 and April 2014. Detailed history, physical, and radiological findings were noted. Fine needle aspiration cytology (FNAC) was performed when feasible. Following surgery, histopathological, and immunohistochemical (IHC) examinations of the specimens were undertaken. Results: Of the 22 cases included in our study, ten were anterior, seven middle, and five posterior mediastinal masses. Fifteen cases were male and seven were female. Thymic pathology was detected in seven cases, lymphoma in five, extragonadal germ cell tumor (GCT) in three, schwannoma and pericardial cyst in two cases each and neurofibroma, ganglioneuroma, and retrosternal thyroid in one case each. The age group of the patients for each diagnostic category was found to be of significance. FNAC was done in 15 cases. IHC was required for classification of lymphoma cases (CD45, CD15, CD30, CD20, CD3, Tdt, CD34, and Ki‑67). Conclusion: This study reflects the incidence of different mediastinal masses in West Bengal with their clinicopathologic correlation.
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It is well established that there is a heritable element of susceptibility to chronic human ailments, yet there is compelling evidence that some components of such heritability are transmitted through non-genetic factors. Due to the complexity of reproductive processes, identifying the inheritance patterns of these factors is not easy. But little doubt exists that besides the genomic backbone, a range of epigenetic cues affect our genetic programme. The inter-generational transmission of epigenetic marks is believed to operate via four principal means that dramatically differ in their information content: DNA methylation, histone modifications, microRNAs and nucleosome positioning. These epigenetic signatures influence the cellular machinery through positive and negative feedback mechanisms either alone or interactively. Understanding how these mechanisms work to activate or deactivate parts of our genetic programme not only on a day-to-day basis but also over generations is an important area of reproductive health research.
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Humains , Signaux , Méthylation de l'ADN , Épigénomique , Caractéristiques familiales , Code histone , Modes de transmission héréditaire , microARN , Nucléosomes , Santé reproductiveRÉSUMÉ
China bears a large burden of global maternal mortality, and the largest burden of maternal deaths in China is in poor western provinces. This study aimed to investigate the trends in maternal mortality and its associated factors in Guizhou province of western China between 1996 and 2009, and examine differences between minority and non-minority counties. A population-based, longitudinal, retrospective study was performed in a poor western province of China with a considerably large ethnic minority population. All 86 counties/districts of Guizhou were included with population at county, township and village level. Maternal mortality data were collected from routine reporting database of Guizhou Provincial Health Bureau. Trend and comparative analyses and multivariate linear regression analyses were performed using SPSS 17.0. Maternal mortality ratio (MMR) and its change over time, differences between ethnic groups were analyzed. A declining trend in maternal mortality and rising trend in hospital delivery in Guizhou was observed; ethnic differences between two ethnic groups persisted. The reduction in maternal mortality between 1996 and 2009 was related with increased gross domestic product, decreased male illiteracy rate, and increased hospital delivery rate. We found the declining trends in maternal mortality in Guizhou with persisting ethnic differences. The declining trends are related with economic development, hospital delivery and male illiteracy. Effective health education on maternal health is urgently needed for the minority groups, and basic education for the new generation should be enhanced to eradicate the illiteracy.
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Femelle , Humains , Grossesse , Chine , Épidémiologie , Ethnies , Mortalité maternelleRÉSUMÉ
China bears a large burden of global maternal mortality, and the largest burden of maternal deaths in China is in poor western provinces. This study aimed to investigate the trends in maternal mortality and its associated factors in Guizhou province of western China between 1996 and 2009, and examine differences between minority and non-minority counties. A population-based, longitudinal, retrospective study was performed in a poor western province of China with a considerably large ethnic minority population. All 86 counties/districts of Guizhou were included with population at county, township and village level. Maternal mortality data were collected from routine reporting database of Guizhou Provincial Health Bureau. Trend and comparative analyses and multivariate linear regression analyses were performed using SPSS 17.0. Maternal mortality ratio (MMR) and its change over time, differences between ethnic groups were analyzed. A declining trend in maternal mortality and rising trend in hospital delivery in Guizhou was observed; ethnic differences between two ethnic groups persisted. The reduction in maternal mortality between 1996 and 2009 was related with increased gross domestic product, decreased male illiteracy rate, and increased hospital delivery rate. We found the declining trends in maternal mortality in Guizhou with persisting ethnic differences. The declining trends are related with economic development, hospital delivery and male illiteracy. Effective health education on maternal health is urgently needed for the minority groups, and basic education for the new generation should be enhanced to eradicate the illiteracy.
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Plants are used as medicine since ancient time, in organized (Ayurveda, Unani & Siddha) and unorganized (folk, native & tribal) form. In these systems, drugs are described either in Sanskrit or vernacular languages. Avartani (Helicteres isora Linn.) is a medicinal plant which is used in several diseases. It is commonly known as Marodphali, Marorphali, Enthani etc. due to screw like appearance of its fruit. Avartani is used as a folk medicine to treat snake bite, diarrhoea and constipation of new born baby. In the research, antioxidant, hypolipidaemic, antibacterial and antiplasmid activities, cardiac antioxidant, antiperoxidative potency, brain-antioxidation potency, anticancer activity, antinociceptive activity, hepatoprotective activity, anti-diarrheal activity and wormicidal activity in this plant were reviewed.
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Background & Objective: Transthyretin (TTR) has been associated with spinocerebellar ataxia (SCA) by several independent case reports. Coexistence of TTR and SCA mutations, overlapping clinical symptoms as well as altered levels of TTR in SCA patients suggest a correlation between TTR and SCA. To our knowledge, no large cohort based study has been attempted to examine the association of SCA with polymorphism in TTR gene. Here, we chose to investigate TTR variations in SCA patients (n=266) and controls (n=192) of North Indian ethnicity. Methods: We sequenced the exons including exon-intron boundaries of TTR gene in 55 patients and 55 controls. We observed four variations which were further genotyped by single base extension method (SNaPshot) in a larger cohort (SCA patients n=211 and controls n=137). Results: A novel synonymous variation c.372 C>G in exon 4 was detected in heterozygous condition in one control sample. We found nominal association for rs1800458 (Gly6Ser), with SCA (p-value < 0.05) which did not remain after Bonferroni correction for multiple tests. Pairwise linkage disequilibrium (LD) analysis revealed no LD between studied SNPs. Further, we employed two-marker sliding window analysis and observed a weak association of haplotype AT of rs1800458 and rs1667251 with SCA patients (p-value <0.05) which was not retained after Bonferroni correction. Conclusion: Our data suggests no association of genetic variations of TTR in SCA pathology.
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Schizophrenia causes considerable functional disability. The present study was designed to assess disability in person with schizophrenia and to see its relationship with psychopathology (PANNS score), UKU side effect, duration of illness, duration of treatment, perceived social support and other socio-demographic factors . The study was done at the Institute of Post Graduate Medical Education & Research (IPGMER), Kolkata, India. For this study 100 patients with a clinical diagnosis of schizophrenia as per ICD-10 were taken. Thereafter, all patients were assessed on Positive and Negative Syndrome Scale for Schizophrenia (PANSS) for psychopathology, on Indian Disability Evaluation Assessment Schedule (IDEA) for disability, on UKU Side Effect Rating Scale for side effects of drugs and on Social Support Questionnaire (SSQ) for perceived social support. It was found that majority of the patients were having severe level of disability in global, interpersonal activity and communication & understanding area and moderate level in work and self care domains. PANSS total score had a significant (<0.035) positive correlation and SSQ total score had a significant (p<0.000) negative correlation with global disability. Age of onset, duration of illness have an effect on disability. The total score of PANSS and SSQ SERS total score emerged as the sole significant predictor of global disability. Treatment in schizophrenia should be focused on psychopathology and social support system to improve competencies in retaining an occupation, better interpersonal relationship with co-workers, and significant others.