Hipotiroidismo subclínico y pérdida de embarazo: una revisión de la literatura / Subclinical Hypothyroidism and Pregnancy Loss: A Literature Review

Existe una alta prevalencia de hipotiroidismo subclínico (SCH) en el embarazo. Está vinculado a una importante morbilidad y mortalidad materna y fetal. Los efectos de SCH sobre el embarazo incluyen mayores riesgos de hipertensión gestacional y ruptura prematura de membranas (PROM). Sus fetos y bebés tenían más probabilidades de sufrir de bajo peso al nacer (LBW) y retraso del crecimiento intrauterino (IUGR). El riesgo de aborto espontáneo se informa alto en varios estudios para SCH no tratado. SCH se asocia directamente con una mayor presencia de anti -cuerpos anti TPO en suero materno. La detección temprana y el tratamiento de SCH han sido testigos de mejores resultados en términos de resultado del embarazo. Esta revisión se centra para establecer la relación de una mayor prevalencia de SCH en los países en desarrollo, así como su asociación con el aumento de los cuerpos anti TPO en suero materna y sacar una conclusión que puede ayudar a reducir las razones y proporcionar una solución. Este estudio concluyó que SCH es más frecuente en los países en desarrollo, ya sea debido a la deficiencia de yodo, una disminución de la conciencia sobre este problema o menos acceso a las instalaciones médicas. Por lo tanto, se sugiere que las hembras con antecedentes de partos prematuros, IUGR anteriores o abortos involuntarios deben someterse a una detección de hipotiroidismo subclínico y niveles de anticuerpos anti TPO durante sus visitas prenatales

There is a high prevalence of subclinical hypothyroidism (SCH) in pregnancy. It is linked to significant maternal and fetal morbidity and mortality. SCH's effects on pregnancy include increased risks of gestational hypertension and premature rupture of membranes (PROM). Their fetuses and infants had been more likely to suffer from low birth weight (LBW) and intrauterine growth retardation (IUGR). The risk of miscarriage is reported high in various studies for untreated SCH. SCH is directly associated with increased presence of anti TPO anti bodies in maternal serum. Early detection and treatment of SCH have witnessed better results in terms of pregnancy outcome. This review focuses to establish the relationship of increased prevalence of SCH in the developing countries as well as its association with increased anti TPO anti bodies in maternal serum and draw a conclusion which can help narrow down the reasons and provide solution. This study concluded that SCH is more prevalent in developing countries, either due to iodine deficiency, decreased awareness about this problem or less access to medical facilities. Therefore, it is suggested that females with history of preterm deliveries, previous IUGRs, or miscarriages should undergo screening for subclinical hypothyroidism and Anti TPO antibody levels during their antenatal visits.

UNA ENCUESTA DE CONOCIMIENTOS, ACTITUDES Y MEDIDAS PREVENTIVAS TOMADAS POR ESTUDIANTES DE MEDICINA Y ODONTOLOGÍA DURANTE LA PANDEMIA DE COVID-19 EN RIAD, ARABIA SAUDÍ / A Survey of Knowledge, Attitude, and Preventive Measures Taken by Medical and Dental Students during the COVID-19 Pandemic in Riyadh, Saudi Arabia

Objetivo: Con la enfermedad del coronavirus-2019 (COVID-19) convirtiéndose en una aflicción global, es imperativo evaluar el conocimiento, la actitud y las prácticas de los incipientes profesionales de la salud ante la pandemia. Por lo tanto, este estudio tuvo como objetivo evaluar el conocimiento y la actitud de los estudiantes de medicina y odontología frente a la infección COVID-19. Además, se analizaron las medidas preventivas ejercidas por ellos durante el brote. Método: Este estudio fue un estudio prospectivo, transversal, basado en un cuestionario. Se llevó a cabo en un período de 5 meses desde el 15 de abril de 2021 hasta el 15 de septiembre de 2021. Se difundió un cuestionario autoadministrado bien diseñado y validado a través de la plataforma Google Forms a 726 estudiantes de medicina y odontología de Riyadh, Arabia Saudita, después de obtener el consentimiento informado electrónico. Resultado: De los 726 encuestados, 490 eran mujeres y 236 hombres. Según los resultados, >50% de la población del estudio siguió al Ministerio de Salud, KSA, como su fuente de información para obtener las últimas actualizaciones sobre la infección por COVID-19, el 17,8% confió en las actualizaciones de la Organización Mundial de la Salud y el 17,1% recurrió a la red social actualizaciones Se encontró que el 92,33% de los estudiantes de medicina y odontología tenían un conocimiento adecuado de la pandemia y que el 96,55% demostró una actitud positiva hacia esto. Además, el 81,84% de los participantes adoptaron buenas prácticas con respecto a la infección. Conclusión: El presente estudio estableció que los estudiantes de medicina y odontología de Riyadh, Arabia Saudita, tienen un conocimiento adecuado sobre la pandemia. Los estudiantes también mostraron una actitud positiva hacia la situación. Sin embargo, con la disminución de la tasa de infección, las medidas prácticas se han reducido.

Objective: With coronavirus disease-2019 (COVID-19) becoming a global affliction, it is imperative to assess the knowledge, attitude, and practices of budding healthcare professionals toward the pandemic. Hence, this study aimed to evaluate the knowledge and attitude of medical and dental students toward COVID-19 infection. In addition, the preventive measures exercised by them during the outbreak were analyzed. Method: This study was a prospective, cross-sectional, questionnaire-based study. It was conducted over a period of 5 months from April 15, 2021 to September 15, 2021. A well-designed and validated self-administered questionnaire was disseminated through the Google Forms platform to 726 medical and dental students of Riyadh, Saudi Arabia, after obtaining electronic informed consent. Result: Of the 726 respondents, 490 were women and 236 were men. As per the results, >50% of the study population followed the Ministry of Health, KSA, as their source of information to obtain latest updates on COVID-19 infection, 17.8% relied on the World Health Organization updates, and 17.1% resorted to social network updates. It was found that 92.33% of the medical and dental students had adequate knowledge of the pandemic and that 96.55% demonstrated a positive attitude toward it. Furthermore, 81.84% of the participants adopted good practices with regard to the infection. Conclusion: The present study established that the medical and dental students of Riyadh, Saudi Arabia, have an adequate knowledge about the pandemic. The students also displayed a positive attitude toward the situation. However, with the decline in the infection rate, the practice measures have been reduced.

Post cholecystectomy common bile duct dilatation: a study from upper hills of Himachal Pradesh, India

Background: Relationship between cholecystectomy followed by postoperative dilatation of the common bile duct is uncertain. Various studies have shown variable results regarding the dilatation of common bile duct after cholecystectomy.Methods: This study was a 1-year prospective study conducted at IGMC, Shimla with consent and ethical approval from the committee. Total 50 cases of symptomatic cholelithiasis belonging to either sex admitted in Surgical Wards of IGMC Shimla for elective surgery were selected for the present study. Cholecystectomy was done in all cases, after doing all the investigations.Results: The mean preoperative CBD diameter in the study group was 4.2mm, 48 hours postoperatively was 5.58mm and at 1-month interval following cholecystectomy was 6.02mm, so the mean postoperative diameter observed was (6.02+5.58=5.8mm).Conclusions: Significant dilatation does occur in CBD which is purely compensatory as there was no evidence of any pathological dilatation. This dilatation occur only in early post-operative period till the CBD adapts to contain bile equal to the Gall Bladder.

Ethanol production by Kluyveromyces marxianus HM36338: Optimization of fermentation conditions using response surface methodology

Bioethanol interests researchers as the greener alternative to fossil fuels. Fungal strains play a major role in this process. On the other hand, whey disposal in dairy industry is an issue of environmental concern. The cheese whey is a source of ethanol production. Kluyveromyces marxianus HM363381 is one such fungal strain used in ethanol production from crude whey. Here, we studied the process of ethanol production by the above strain and attempted to optimize the fermentation conditions adopting response surface methodology (RSM). A total of 20 fermentation trials were carried out which were produced from RSM with the central composite design using the three parameters, lactose concentration (5-20%), yeast extract (10-60%) and the inoculum size (5-14%). The experimental results were analyzed using analysis of variance (ANOVA) and lack of fit tests. The best operating conditions were found to be 14.14% (w/v) lactose concentration, 9.44 % inoculum size and 59.67 g/L yeast extract by keeping the other variables at their zero level, under which the strain Kluyveromyces marxianus HM363381 produced 59 g/L of ethanol. The results demonstrated a correlation of the experimental data to the dynamic models with high significant values of R2 and, thus, could be useful for scaling up the ethanol production by fermentation of crude whey.

Effect of Seaweed Liquid Fertilizer on Antioxidant and Enzyme Activity of Different Vegetables Seeds

The aim of the study was to find the antioxidant activity and enzyme activity of catalase and peroxidase of vegetable plants. The results indicated that the use of seaweed liquid fertilizer can enhance the antioxidant activity of Solanum melongena L., Lycopersicon esculentum Mill., Capsicum annuum L., Brassica oleracea var. Capitata L. and Allium cepa L. The 1,1-diphenyl-2-picrylhydrazyl (DPPH) assays were used to determine the antioxidant properties of seaweeds by measuring the decrease in absorbance at 517 nm. The DPPH activity was highest in brown seaweed liquid fertilizer. This study implied that impacts on vegetable plantlets by seaweed liquid fertilizer extracted with enzymes is better in brown seaweed liquid fertilizer as compared to control.

Herbal remedies, vaccines and drugs for dengue fever: Emerging prevention and treatment strategies

Dengue fever is a disease that is caused by five dengue virus (DENV) serotypes. It is endemic in more than 128 countries. Millions of people are affected by this disease. But still, there is no specific treatment available till now to combat it. Some of the preventive measures using plant extracts showed certain promising ovicidal activity against Aedes aegypti. There are some vaccines as preventive measure and antiviral agents to cure the dengue fever, which are under clinical trials but their results have not been reported or approved yet. Dengvaxia is the only licensed vaccine to prevent dengue fever in some South American countries, but it is not approved by other regulatory authorities worldwide. Scientific research has been going on to find a permanent cure for dengue fever, but till now, no successful invention has been done. There are some general treatments for dengue patient by employing analgesics and fluid replacement; however, specific treatment is needed to overcome the lethal effect of dengue fever. Since this disease has affected millions of people and not much invention has been made in this field; therefore, advancement in dengue therapy is required for the safety and well-being of dengue patients. Herein we collectively describe the different chemotherapeutics agents, alternative methods like vaccines and antiviral agents to prevent and cure this lethal disease. Furthermore, the future perspective for the treatment of dengue is discussed in this review.

Herbal remedies, vaccines and drugs for dengue fever: Emerging prevention and treatment strategies

Dengue fever is a disease that is caused by five dengue virus (DENV) serotypes. It is endemic in more than 128 countries. Millions of people are affected by this disease. But still, there is no specific treatment available till now to combat it. Some of the preventive measures using plant extracts showed certain promising ovicidal activity against Aedes aegypti. There are some vaccines as preventive measure and antiviral agents to cure the dengue fever, which are under clinical trials but their results have not been reported or approved yet. Dengvaxia is the only licensed vaccine to prevent dengue fever in some South American countries, but it is not approved by other regulatory authorities worldwide. Scientific research has been going on to find a permanent cure for dengue fever, but till now, no successful invention has been done. There are some general treatments for dengue patient by employing analgesics and fluid replacement; however, specific treatment is needed to overcome the lethal effect of dengue fever. Since this disease has affected millions of people and not much invention has been made in this field; therefore, advancement in dengue therapy is required for the safety and well-being of dengue patients. Herein we collectively describe the different chemotherapeutics agents, alternative methods like vaccines and antiviral agents to prevent and cure this lethal disease. Furthermore, the future perspective for the treatment of dengue is discussed in this review.

A Qualitative Study To Evaluate Effect Of Sleep Quality On Handgrip Strength And Cognition.

Background: It is often seen that college students struggle to get enough sleep whether it is due to studies or their lifestyle. This affects their sleep habits, making it overwhelmingly negative. This inconsistent sleep patterns, lack of efficient sleep, late bed times and other sleep related problems negatively affect quality of life. Objective:In this we tried to report the effect of sleep quality on student's cognitive performance and handgrip strength. Methods: 73 healthy female students were assessed using the Pittsburgh Sleep Quality Index (PSQI). On basis of PSQI out of 73 students, there were 29 good sleepers and 44 poor sleepers. Their hand grip strength and visual reaction time was measured. Statistical analysis was performed using R software (v. 3.2.5). Pvalue was considered to be significant at (p<0.05). Results: On the basis of data analysis, it was found that good sleepers have significantly higher cognitive functions than poor sleepers. Their hand grip strength was not found significant in comparison with good and poor sleepers. Conclusion:We may conclude that, quality of sleep does have positive correlation with cognitive changes.

To Determine Prevalence of Low Haemoglobin in Healthy Females and its Correlation with Diet, Weight and Body Mass Index.

Background: More than a quarter of the total world population is anemic and half of them have iron deficiency anemia. Many studies done have shown that iron fortified legume staples are important source of proteins and non- heme iron in children; all infants treated with oral iron and visited weekly to record iron intake, feeding, and health showed improvement in cognitive, motor, and social-emotional development hand washing with soap and hand finger nail clipping reduced prevalence of anemia.  So we designed this study to find out the cause of low hemoglobin in healthy females and its correlation with diet, weight and body mass index. Material and Methods: This open-label, prospective, observational study was conducted in 90 healthy volunteers belonging to nearby areas. The following parameters were observed and recorded: height, weight, body mass index (BMI) and hemoglobin estimation and questionnaire was given to the participants to record dietary intake. Results: All the volunteers completed the study were of an average age of 20.28±0.10 years and had average hemoglobin of 11.91 ± 0.11gm/dl and the average body mass index (BMI) was 21.73 ± 0.33 (kg/m2) respectively. It has been observed that haemoglobin has non-significant (p>0.05) correlation with age, weight, height and BMI. Majority of volunteers took more than three meals per day; eating food outside on one-two occasions per week and reported that their food was fried.  Most of the participants reported consuming small proportions of food with fruits and milk being essential component. Conclusion: To conclude our study found that the participants although were not anaemic they had haemoglobin on the lower side of normal values and there was no correlation between with age and BMI.

Transcatheter aortic valve replacement: a review article

Transcatheter aortic valve replacement [TAVR] is a novel therapeutic intervention for the replacement of severely stenotic aortic valves in high-risk patients for standard surgical procedures. Since the initial PARTNER trial results, use of TAVR has been on the rise each year. New delivery methods and different valves have been developed and modified in order to promote the minimally invasive procedure and reduce common complications, such as stroke. This review article focuses on the current data on the indications, risks, benefits, and future directions of TAVR. Recently, TAVR has been considered as a standard-of-care procedure. While this technique is used frequently in high-risk surgical candidates, studies have been focusing on the application of this method for younger patients with lower surgical risk. Moreover, several studies have proposed promising results regarding the use of valve-in-valve technique or the procedure in which the valve is placed within a previously implemented bioprosthetic valve. However, ischemic strokes and paravalvular leak remain a matter of debate in these surgeries. New methods and devices have been developed to reduce the incidence of post-procedural stroke. While the third generation of TAVR valves [i.e., Edwards Sapien 3 and Medtronic Evolut R] addresses the issue of paravalvular leak structurally, results on their efficacy in reducing the risk of paravalvular leak are yet to be obtained. Furthermore, TAVR enters the field of hybrid methods in the treatment of cardiac issues via both surgical and catheter-based approaches. Finally, while TAVR is primarily performed on cases with aortic stenosis, new valves and methods have been proposed regarding the application of this technique in aortic regurgitation, as well as other aortic pathologies. TAVR is a suitable therapeutic approach for the treatment of aortic stenosis in high-risk patients. Considering the promising results in the current patient population, recent studies have been conducted to evaluate the efficacy of this approach as a standard-of-care procedure

Anti-diabetic activity and safety assessment of Ayurvedic medicine, Jasada bhasma (zinc ash) in rats.

Jasada bhasma (zinc ash) is an extensively used Ayurvedic medicine for treating diabetes mellitus. The present communication presents yet unavailable comprehensive scientific data on its physico-chemical nature vis-à-vis anti-diabetic activity and toxicity profile.Zinc ash prepared by traditional method was found to consist of 200-500 nm sized particles, predominantly zinc oxide with hexagonal wurtzite crystal structure.The effective dose range of zinc ash in oral glucose tolerance tests performed using normoglycemic Wistar rats was found to be 3-30 mg/kg. Subsequently anti-diabetic activity was assessed in streptozotocin induced type 1 and type 2 diabetic rats. Four weeks treatment with zinc ash (1, 3, 10 mg/kg) resulted in improved glucose tolerance (16-19%), lowered blood glucose levels (20-33%) and reduced serum insulin levels (27-32%). Systemic absorption was assessed by single dose pharmacokinetic study where serum zinc levels were found to be elevated (3.5 folds) after oral administration of zinc ash. Acute and sub-acute toxicity tests demonstrated safety of zinc ash up to 300 mg/kg doseie. 100 times the efficacy dose in rats.These findings, the first of their kind, provide concrete scientific evidence that justifies usage of zinc ash in diabetes treatment.

Birth defects in India: Hidden truth, need for urgent attention.

Birth defects (structural, functional and metabolic disorder present from birth, may be diagnosed later) rising up as an important cause of infant mortality even in developing countries where infant mortality has been reduced to much extent. Seventy percent of birth defects are preventable through the application of various cost effective community genetic services. Indian people are living in the midst of risk factors for birth defects, e.g., universality of marriage, high fertility, large number of unplanned pregnancies, poor coverage of antenatal care, poor maternal nutritional status, high consanguineous marriages rate, and high carrier rate for hemoglobinopathies. India being the second most populous country with a large number infant born annually with birth defects should focus its attention on strategies for control of birth defects. Many population based strategies such as iodization, double fortification of salt, flour fortification with multivitamins, folic acid supplementation, periconceptional care, carrier screening and prenatal screening are some of proven strategies for control of birth defects. Strategies such as iodization of salt in spite of being initiated for a long time in the past do have a very little impact on its consumption (only 50% were using iodized salt). Community genetic services for control of birth defects can be easily flourished and integrated with primary health care in India because of its well established infrastructure and personnel in the field of maternal and child health care. As there is wide variation for infant mortality rate (IMR) in different states in India, so there is a need of deferential approach to implement community genetic services in states those had already achieved national goal of IMR. On the other hand, states those have not achieved the national goal on IMR priority should be given to management of other causes of infant mortality.

Depression Among the Elderly Population in a Rural Community : A Study of its Prevalence and Correlates.

Background: The next few decades are expected to see an unprecedented increase in the number of older people needing mental health interventions in India. The elders living in rural areas represent a special risk group. Objective: To assess the magnitude of depression and its significant sociodemographic correlates among elderly. Setting: Rural community of Delhi, India. Participants: Elderly aged above fifty years, selected by cluster sampling. Tool: Geriatric Depression Scale (GDS). Statistical Analysis: Proportions, Chi square test. Results: Mean age of the sample population was 61.7 ± 8.2 years and included 58% females. It was found that 45 (35.7%) of the subjects had a score suggestive of depression. Poor sleep at night and tension at home, poor perception of own health, not receiving any financial support in the form of pension for self or spouse and poor nutritional indicators were found to be associated with depression. Depression was less common among those who had a positive approach, including doing some exercise daily (p=0.03) and doing yoga daily (p=0.026). Conclusion: The present study found a significant proportion of the rural elderly population to having depressive symptoms and several important risk factors were found to be associated with depression. Identification of these risk factors among the elderly population at higher risk for depression can help to plan for better care of the elderly.

Doing meta-analysis in research: A systematic approach.

Meta-analysis is an objective, systematic review that employs statistical methods to combine and summarize the results of several studies. It is a quantitative synthesis of all the unbiased evidence, meant for summarizing large volume of data, establishing and determining the magnitude of an effect, and to increase power and precision of studies. The steps to performing a meta-analysis include making a hypothesis and defining the domain of research, defining inclusion/exclusion criteria, literature search, selecting the final set of studies, extracting data on variables of interest, coding procedures, calculating effect sizes and interpretations, selecting potential moderators and examine their relationships, report writing, and critical evaluation. Meta-analysis has several strengths as well as weaknesses.

Amylase production by aspergillus niger under submerged fermentation using ipomoea batatas.

Submerged fermentation holds tremendous fungal potentiality in high biomass yield of alpha-amylase. The effect of varying pH, temperature and nitrogen sources of the medium for the productivity of α- amylase from Aspergillus niger utilizing Ipomoea batatas was investigated. The maximum activity of α-amylase was recorded as 450 U/mg after 7 days of submerged fermentation at pH 7.0 and room temperature 28 C. Among the organic and inorganic nitrogen ⁰ sources, inorganic sources showed maximum yield in which ammonium nitrate showed highest amylase activity of 475U/mg at the same pH and temperature. The enzyme produced by Aspergillus niger can be used in industrial process after characterization.

Synthesis and antimicrobial activity of novel 3-Chloro- [1- (3,6-(Diphenyl) [1,2,4] Triazolo [3,4b] [1,3,4] Thiadiazole)] -4-(3,4-Diethoxy Phenyl- Azetidin-2-One and their derivatives.

A series of eight novel 2-Azetidinones (8a-h) have been synthesized by cyclocondensation of various Schiff bases based of ATT with chloroacetyl chloride in presences of triethylamine. Various Schiff bases were synthesized by condensation of ATT with various aryl aldehydes (7a-h). The synthesized compounds 8a-h were screened for their antibacterial activity against four microorganisms: Staphylococcus aureus (Gram positive), Bacillus subtilis (Gram positive), Psuedomonas aeruginosa (Gram negative) and Escherichia coli (Gram negative). They were found to exhibit good to moderate antibacterial activity. The structures were confirmed by elemental analysis, IR, 1H-and 13C-NMR spectral data.

Formulation and evaluation of Salbutamol sulphate microspheres by solvent evaporation method.

Salbutamol sulphate (SS) loaded microspheres were prepared by solvent evaporation method with combination of hydroxy propyl methyl cellulose and Carbopol polymers in various proportions. A total of eleven formulations were prepared i.e. E1, E2, E3, E4, E5, E6, E7, E8, E9, E10 and E11.The particle size of all the formulations were ranged between 110±0.02 and 183±0.02μm. The entrapment efficiency was ranged between 68.3±0.01 and 94.9±0.02%. Based on above parameters four formulations were selected i.e. E5, E8, E9 and E10 for further studies like micromeretic properties, swelling index and in-vitro release profile. It was confirmed with the results of micromeretic property that all the selected formulations showed good flow property. Release data were analyzed based on Highuchi kinetics and Korsmeyer-Peppas equation and all the selected formulations showed good fit to Highuchi model. Stability studies showed almost negligible changes in particle size, entrapment efficiency and drug release throughout the study period.

Herbs and herbal constituents active against snake bite.

Snake bite, a major socio-medical problem of south east asian countries is still depending on the usage of antisera as the one and only source of treatment, which has its own limitations.  In India, mostly in rural areas, health centres are inadequate and the snake bite victims mostly depend on traditional healers and herbal antidotes, as an alternative treatment. The present review has been focussed on the varied folk and traditional herbs and their antisnake venom compounds, which might be a stepping stone in establishing the future therapy against snake bite treatment and management.