Study of implications of thyroid status over feto-maternal outcomes in pregnancy

Background: Thyroid disorders are reported at clinically significant prevalence during pregnancy, affecting ~5% of all pregnancies. Maternal thyroid status during pregnancy purportedly affects fetal as well as maternal outcomes. The objective of present study was to analyse the relationship of thyroid status in pregnancy and various maternal and fetal outcomes.Methods: In this hospital based observational study, a total of 913 pregnant women were enrolled as per fixed criteria and all the study participants were screened for thyroid disorders. Further, they were followed up throughout pregnancy and puerperium and evaluated for various maternal and fetal complications by predefined outcome measures. The results were compared by subgroup analysis.Results: Of the 913 patients screened, 105 were diagnosed with thyroid abnormality and followed up till delivery, with newborn thyroid profile on day 7. Total 49 patients were diagnosed with anaemia (46.66%), of which 46 (43.80%) had subclinical hypothyroidism (p <0.05); along with pregnancy induced hypertension in 42 (40%) cases of which 40 (38.09%) had subclinical hypothyroidism were observed to have statistically significant associations. Intrauterine growth restriction (IUGR) (37, 35.23%) and prematurity (19, 18.1%) were the most common fetal occurrences; the association of IUGR and subclinical hypothyroidism being statically significant.Conclusions: Thyroid disorders during pregnancy are commonly associated with maternal and fetal complications and thyroid profile is recommended as universal screening method in early pregnancy to diagnose and start required treatment early.

Comparative study of seasonal variability in peak expiratory flow rate amongst school children in rural and urban areas

Background: Peak Expiratory Flow (PEF) is a value test for lung function and can be conveniently measured by using relatively inexpensive and portable Peak Flow Meter, identifying and assessing the degree of airflow limitation of individuals. While PEFR is obviously related to factors like age, weight, height, race, gender, it may also be additionally affected by seasons and climate. The purpose of study being to observe seasonal variation in PEFR amongst school going children and to observe peak expiratory flow rate in school going children in urban and rural areas.Methods: This prospective and comparative study was carried out on total 600 children; with 300 each from rural and urban schools, of age group 10-14 years, both sexes. Peak expiratory flow meter was used for the measurements in the seasons of summer (April to June) and winter (December to February) of the year. The results thus obtained were compiled and analysed.Results: The mean PEFR value (Litres/min) during summers in the rural children was 243.50(S.D.=16.050) while during winters was 253.63(S.D.=16.934), highly significant (p<0.001); mean PEFR summers in the urban children was 241.50(S.D.=20.530)and during winters was 249.93(S.D.=21.685), again highly significant (p<0.001).In both rural and urban groups PEFR values increased with increase in height and weight of the children which was found to be highly significant (p<0.001). Girls representation proportion in rural vs urban schools being 49% vs 45%; whereas boys being 51% vs 55% respectively.Conclusions: Peak expiratory flow rate decreased during summer season of the year in both rural and urban school attending children. In both the groups PEFR values had a direct correlation with height and weight of the children. Rural schools showed more girl student representation than their urban counterparts indicating more awareness for girl child education amongst rural population.

Development of Protocol for Production of Primary Antibody against Ovalbumin Protein in Chicken for Detection of the Protein through Western Blotting

Ovalbumin, a major protein of egg white plays many roles including providing nutrition to the developing embryo, acting as coagulating agent, folliculogenesis and angiogenesis in chicken and other animals. This protein is expressed mainly in magnum and then deposited over the yolk of the oocyte/zygote. Hence, it is important in formation of egg and is an essential target to measure. We cloned chicken ovalbumin CDS in pAcGFP-C1 vector and has been initially expressed in chicken primary magnum cell culture. The ovalbumin protein tagged with 6x Histidine was purified from cell culture and used for production of primary antibody in rat. The ovalbumin protein along with freund’s adjuvant was injected to the rat, booster was given, and finally, hyper-immune sera was collected from rat. The antisera was purified for isolation of IgG. The IgG was used as primary antibody for Western blotting. Through Western blotting, ovalbumin protein isolated from chicken magnum was detected and the protocol was established to detect chicken ovalbumin protein.

Role of educational intervention with practical demonstration in improving inhaler technique

Background: Chronic respiratory diseases are among the leading causes of morbidity and mortality worldwide with chronic obstructive pulmonary disease (COPD) and asthma being the most common. There is under-utilization of the basic tools of inhalation therapy technique(s) in their management. Implementation of a personalized educational and demonstrational intervention by the attending physician during regular follow-up visits of these patients will substantially improve the treatment outcome.Methods: This prospective interventional study was conducted on 239 diagnosed cases of asthma and COPD. Inhaler technique was assessed in accordance to standard checklist and errors were corrected by a practical demonstration. A follow-up assessment was conducted for the same after 2 weeks. Data thus collected was evaluated.Results: Out of 239 patients, 47.6% (n=114) reported for follow-up assessment. Average reporting time for follow-up assessment was 27.4 days. Amongst them, an improvement of at least one step was found in 86.8% (n= 99) and about 28% (n=32) patients performed all steps correctly. Average number of steps improved was 2.1.Conclusions: Majority of the patients showed an improvement in the inhaler technique during follow-up assessment after an educational intervention and practical demonstration. Near perfection was achieved by about more than quarter of the patients. Regular practical demonstration of the inhalation technique during subsequent follow-up sessions unequivocally improves results.

Induced defence responses of contrasting bread wheat genotypes under differential salt stress imposition.

Plants, being sessile in nature, have developed mechanisms to cope with high salt concentrations in the soil. In this study, the effects of NaCl (50-200 mM) on expression of high-affinity potassium transporters (HKTs), antioxidant enzymes and their isozyme profiles were investigated in two contrasting bread wheat (Triticum aestivum L.) genotypes viz., HD2329 (salt-sensitive) and Kharchia65 (salt-tolerant). Kharchia65 can successfully grow in salt affected soils, while HD2329 cannot tolerate salt stress. Differential expression studies of two HKT genes (TaHKT2;1.1 and TaHKT2;3.1) revealed their up-regulated expression (~1.5-fold) in the salt-sensitive HD2329 and down-regulated (~5-fold) inducible expression in the salt-tolerant genotype (Kharchia65). Specific activity of antioxidant enzymes, viz. superoxide dismutase (SOD), peroxidase (POX), ascorbate peroxidase (APX), catalase (CAT) and glutathione reductase (GR) was found to be higher in the salt-tolerant genotype. Isozyme profile of two (POX and GR) antioxidant enzymes showed polymorphism between salt-tolerant and salt-sensitive genotypes. A new gene TaHKT2;3.1 was also identified and its expression profile and role in salt stress tolerance in wheat was also studied. Partial sequences of the TaHKT2;1.1 and TaHKT2;3.1 genes from bread wheat were submitted to the EMBL GenBank database. Our findings indicated that defence responses to salt stress were induced differentially in contrasting bread wheat genotypes which provide evidences for functional correlation between salt stress tolerance and differential biochemical and molecular expression patterns in bread wheat.

Tuberculosis in HIV co-infected patients- a study at tertiary care hospital, Amritsar (India).

Background: The dual epidemic of tuberculosis and HIV is a significant problem in the developed and developing countries. Tuberculosis is the most common human immunodeficiency virus related opportunistic infection in India and caring for patients with both diseases is a major public health challenge. Aim: The aim of the present study was to record the different clinical patterns of tuberculosis in HIV co-infected patients as a function of CD4+T cell count. Material and Methods: The study was a retrospective analysis of the HIV-TB co-infected patients admitted in the Chest and TB Hospital, Government Medical College, Amritsar (Punjab) during the calender year 2011. Results: Out of total 47 HIV sero-positive patients (n=47), 36 were males (76.59%) and 11 females (23.41%) of age group 14 to 51 years. Cough was the most common presenting symptom (72.34%).A large number of patients were diagnosed as having pulmonary tuberculosis (48.94%). The other diagnoses were tubercular meningitis (n=4), pleural effusion (n=4), tubercular lymphadenopathy (n=2), pneumothorax (n=2), hydropneumothorax (n=2) and abdominal tuberculosis (n=2). A total of 34 (72.34%) patients were having a CD4+T cell count of < 200. Conclusion: The manifestations of tuberculosis in HIV infected patients are quite varied and generally show a different pattern as a function of CD4+ T cell count. Co-infection with HIV infection leads to difficulties in both diagnosis and treatment of tuberculosis. High degree of suspicion of tuberculosis, with astute clinical and laboratory evaluation is the key for early diagnosis and management.

Impact on Morbidity & Mortality by Rodenticidal Poisoning.

Background : Rodenticidal poisoning is a very common clinical entity regularly encountered in outdoor & emergency department in various parts of India. This is the commonest type of poisoning. We present the prospective study of clinical profile, course, complication & outcome of various rodenticidal poisoning in 170 patients. Objectives : To determine the clinical symptoms, morbidity and mortality in various rodenticidal poisoning. To study the clinical profile & laboratory investigations. To study the course, complications & outcome. Methods : Study period was from 01 May 2011 to 30 April 2012. Historically and documented evidence of 170 patients of various rodenticidal poisoning admitted in the emergency, medical wards & I.C.U. under department of medicine, undergone for various laboratory investigations and imaging study. Statistical analysis was done in mean, range, standard deviation and percentage. Results : A total of 170 cases of various rodenticidal poisoning admitted in MBS hospital, Govt. Medical College, Kota were studied. The age of patients ranged from 10 to 65 years. Age groups were divided in four group, 10-18, 19-30, 31-45 & 45-65. Most common age group was ranged from 18-30 year. Most common gender was female (females 92 males 78). Mode of poisoning were suicidal, accidental & homicidal. Commonest mode of poisoning was suicidal uptake of poison. Route of poisoning was ingestion. Common presenting signs & symptoms were nausea & vomiting seen in 157(92.35%), Tachycardia in 156(91.7%), Tachypnoea in 137(80.62%), & Abdominal pain 129(75.8%). Few patients presented with Headache, Palpitation & Sweating. Deranged laboratory findings on day third of admission include Anemia in 21.76%, Leucocytosis in 20.59%, prolonged Prothrombin time (PT) in 16.47% & increased serum Bilirubin in 11.18%. Morbidity developed in 8 cases(4.71%), Of which four have Hemorrhagic complication ( e.g. Bleeding gums, Purpura Melena & Hematuria) by Dicoumarol , Bromadiolone and Brodifacoum. Three patients of Zinc phosphide poisoning produced cardiac insult and one patient of Barium carbonate poisoning developed cardiac arrhythmia. Transient arrhythmias and respiratory failure developed in other rodenticidal poisoning. All patients treated symptomatically and according to complications. Six cases of our study remained asymptomatic for two to three days then they developed delayed hemorrhagic complication ( Bleeding gums, Purpura, Melena & Hematuria). These patients had deranged liver function test (LFT) & prolonged Prothrombin time (PT). Mortality was seen in 1.76%( 3 cases). By Zinc phosphide in 2 patient and Barium carbonate in 1 patient. Conclusion : We concluded that bleeding, bruising & other hemorrhagic complications should be treated and monitored according to Prothrombin time (PT) & INR. Awareness should be increased especially for Zinc phosphide and arrhythmia produced by Barium carbonate.

Polymorphism of exon 2-3 of bovine major histocompatibility complex class I BoLa-A gene

The exon 2-3 region of bovine major histocompatibility complex (MHC) class I BoLa-A gene was investigated for polymorphisms in three breeds of cattle originated in the Indian subcontinent namely Sahiwal, Tharparkar, Hariana, as well as crossbred (Bos taurus x Bos indicus) cattle and Jersey, the exotic breed (Bos taurus). The PCR amplified fragment of 714 bp showed distinct DdeI-, TaqI- and HinfI- RFLP patterns, thus confirming a higher degree of polymorphism in this region. To our knowledge this is the first report of HinfI restriction patterns for BoLa-A exon 2-3. The sequencing results revealed a number of nucleotide substitutions in this region, which resulted in amino acid changes. The present investigation confirmed that MHC class I BoLa-A exon 2-3 is highly polymorphic in cattle.

DNA polymorphism of leptin gene in Bos indicus and Bos taurus cattle

Leptin plays an important role in the regulation of feed intake, energy metabolism, growth and reproduction of cattle. We used the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique to screen for DNA polymorphisms of the leptin gene in 403 cattle belonging to various breeds of Bos indicus (Hariana, Sahiwal, Gir and Nimari cattle), Bos taurus (Holstein Friesian (HF) and Jersey cattle) as well as Bos taurus x Bos indicus crossbreds (½ HF x ½ Hariana). In all the cattle we amplified two regions of the leptin gene, a 522 bp fragment comprising the partial intron 2 and exon 3 and another 94 bp fragment consisting of part of exon 2. Digestion of 522 bp PCR products with the BsaAI restriction enzyme revealed three genotypes in all the breeds of cattle studied. This is the first report of the presence of leptin gene polymorphism in purebred Bos indicus cattle of Indian origin (indicine cattle). Almost similar gene and genotype frequencies were observed in all the breed groups, while the frequency of mutant homozygotes (AA) was very low (0.03 to 0.07). On digestion of the 94 bp fragment with the Kpn2I restriction enzyme, three genotypes were observed in HF, Jersey and crossbred cattle. The CC genotype had the highest frequency (0.68) in crossbreds whereas the frequency of CT heterozygotes was highest (0.69) in HF cattle. This mutation was absent in all the breeds of indicine cattle. The results suggest that the BsaAI-RFLP mutation has occurred far back in evolution before the divergence of taurine and indicine cattle while the Kpn2I mutation has occurred recently as indicated by the fact that this mutation was only detected in taurine cattle.