A review on cardiovascular risk in rheumatoid arthritis

A systemic inflammatory disease known as rheumatoid arthritis (RA) is distinguished by excessive cardiovascular disease (CVD) morbidity and death. Traditional CV risk factors may partially contribute to CV disease in RA. Shared inflammatory mediators, post-translational modifications of peptides/proteins and subsequent immune responses, changes in the composition and function of lipoproteins, increased oxidative stress, and endothelial dysfunction are some of the mechanisms that link RA and CVD. The detailed pathogenetic pathway by which this association between RA and CVD might be explained is still not entirely known. It is crucial for controlling cardiovascular risk in people with RA. Optimizing care of traditional risk factors in addition to those inherent to RA is necessary to lessen the burden caused by CVD. The potential effect of planned Cardiac risk management in these individuals is highlighted by findings for under diagnosis and inadequate treatment of conventional CVD risk factors in RA. Present cardiovascular standards suggest RA patients to be examined for and treated for CVD risk factors without appropriate treatment goals. Utilizing potent anti-rheumatic medications that can reduce disease activity and treating the conventional CV risk factors should both be part of the therapy of CV risk in RA. There is currently insufficient scientific data to develop therapy targets for RA-related CVD risk factors. Thus, more study is required on the traditional CVD risk factor screening and management in RA patients.

Pharmacogenomics and Precision Medicine in Psychiatry: A Comprehensive Review

Three primary phenotypes in psychiatry have been the focus of pharmacogenetic studies: the development of side effects related to psychotropic drug treatment, the clinical effectiveness of antipsychotic drugs, and the efficacy of antidepressant medications. Pharmacokinetic or pharmacodynamic effects are the two categories into which pharmacogenetic studies of antidepressants can be divided. Genetic variations that impact antidepressant metabolism can alter pharmacokinetic parameters like plasma drug concentration and half-life. Pharmacodynamics may be changed by polymorphisms that impact the expression or operation of receptors and signal transduction molecules in the brain. Changes in pharmacokinetics and pharmacodynamics can impact antidepressant effectiveness and adverse effects. Using molecular genetic techniques offers a new way to analyze the variability in the response to psychotropic drugs. Traditionally known as "pharmacogenetics," this area of study offers several unique benefits for identifying informative correlates of psychotropic drug response. This shift from a one-size-fits-all approach to a targeted, patient-specific strategy holds the potential to revolutionize psychiatric care, providing more effective and efficient treatments. Additionally, precision medicine in psychiatry contributes to reducing trial-and-error prescribing, ultimately improving patient outcomes and the overall quality of mental health care. Student, CMR C.

Methyl-Prednisolone and Betamethasone Induced Iatrogenic Cushing Syndrome - A Rare Case Report

Effects of supraphysiologic Glucocorticoid levels originating from exogenous administration of Glucocorticoids known as iatrogenic Cushing syndrome and endogenous overproduction by the adrenal gland (ACTH dependent) or by abnormal adrenocortical tissues (ACTH independent) known as ectopic Cushing syndrome. We report a case of a 50-year-old male patient with symptoms of abdominal distension, swelling of the face, fat deposition around the neck, buffalo hump, and loss of muscles in the upper limbs. The patient had a history of administration of Betamethasone 0.5mg for about 6 months and Methylprednisolone 16mg OD for 15 days. The patient was diagnosed with iatrogenic Cushing syndrome. The steroid dose was tapered gradually to bring back the adrenal function to a normal position. The co-morbid condition leads to the overall worsening of health condition. Therefore, strict control of the co-morbid condition must be a priority. Similar management strategies were adopted by slowly tapering the dose of steroids weekly along with the addition of Furosemide and Metformin to the treatment regimen to control the underlying co-morbid conditions. The case was well managed with appropriate guidelines followed by medication. Identification and diagnosis of this kind of clinical condition are not always clear and consistent. Hence, awareness of diverse forms of presentation of this disorder should be encouraged. Clinical pharmacists have to be aware of these rare syndromes and support the clinicians in whatever ability is required. Far outreach to all healthcare professionals in the form of such case studies can also be an additional tool to create awareness.

Identification of risk factors for specific subsites within the oral and oropharyngeal region--a study of 647 cancer patients.

Studies on site specific risks for oral cancers are few. Present investigation explores the possible role of human sociodemographic factors in causing oral cancer. Majority of patients had poor oral hygiene (85.5%) and belonged to 51-60 years age group (35.7%). Most of the subjects were agriculture workers (30.3%). Tongue and floor of mouth included majority of the affected sites (77.2%). Male to female ratio was highest for tonsil (32.3%) but differed marginally for other subsites. Majority of females used tobacco (81%) while males users of tobacco, alcohol and smoking reported in nearly equal proportions. Tobacco and smoking were found as primary risk factors for several intraoral subsites. However, for tongue, palate and lip no risk factor could be identified from given patients' characteristics. In general, tobacco posed high risk for buccal mucosa and alveolus in comparison to other subsites. Smoking affected tonsil and floor of mouth more than other sites. Alcohol posed more risk for buccal mucosa and floor of mouth than tongue.

Isolation and characterization of allergens from the seeds of Vigna sinensis.

Allergenic components of cowpea vegetable green seeds (Vigna sinensis) were isolated based on solubility, isoelectric precipitation and molecular mass. The allergenicity of the cowpea fractions was monitored by enzyme-linked immunosorbent assay (ELISA) and skin-prick test. The allergenic albumin fraction was characterized by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and IgE-specific immunoblotting. The 41 and 55 kDa protein components were found to be major allergens and the allergenicity was resistant to heat and proteolytic enzyme digestion. This study confirms the presence of potent allergens in cowpea seeds.

A comparative study on the periodontal health status of adult populations of Kenya and India.

The purpose of this study was to compare the oral hygiene and periodontal health status of 497 randomly selected Kenyan and Indian adult populations aged between 20 and 35 years. Oral hygiene and periodontal health status were assessed using Silness and Loe plaque Index and Russel's Periodontal Index respectively. Results revealed that the overall mean plaque and periodontal index scores of Kenyan participants were significantly lower than those of Indians. Increase of mean Periodontal index with age was found to be significant among Kenyan participants and insignificant among Indian participants Kenyan female participants were found to have significant lower mean plaque and periodontal index scores than males. However, the mean periodontal index score of Indian male participants was found to be lower than that of female participants. It is concluded that Kenyan participants had better periodontal and oral hygiene status than Indian participants and that Indian females unlike Kenyan females had poorer periodontal health status than male.