Optimization and evaluation of tear protein elution from Schirmer’s strips in dry eye disease

Purpose: Extraction of tear protein from Schirmer’s strip is a prerequisite for the proper identification and screening of biomarkers in dry eye disease. The study compares different methods of extraction of tear proteins from the Schirmer’s strip. Methods: Reflex tear was collected from healthy controls (HC; n = 12), Stevens–Johnson syndrome (SJS; n = 3) and dry eye disease (DED; n = 3) patients using capillary tube. This tear was used to measure the volume absorbed by Schirmer’s strip per microliter. Different buffers (6) were used to compare the protein yield from the Schirmer’s strip in four different conditions. The tear proteins extracted using the highest protein yield buffer were analyzed by mass spectrometry. Results: A linear relationship between the tear volume and wetting length was observed (r = 0.0.997, n = 6). The highest yield was observed after incubation of the Schirmer’s strip in 100 mM ammonium bicarbonate (ABC) with 0.25% Nonidet P?40(NP?40) at 4°C for an hour (P < 0.00005). The in?solution digestion of tear eluted in the above condition 100 Mm ABC + 0.25% NP?40 with one?hour incubation yielded a total of 2119 proteins in HC, SJS, and DED. The unique protein observed in SJS and DED was 0.6% and 17.9%, respectively. The significantly expressed proteins are associated with innate immune response, proteolysis, wound healing, and defense response. Conclusion: A method for extraction of protein from Schirmer’s strip was optimized for increase in protein yield from the tear sample. SJS and DED tear samples have unique protein signature. The study will aid in better design of tear protein?based experimental study.

Effect of Supplementation of Vitamin C and Thiamine on the Outcome in Sepsis: South East Asian Region

Introduction: The global burden of sepsis is overwhelming and novel therapeutic agents is the need of the hour. The present study was designed to understand the role of Malondialdehyde as a marker of the oxidative stress in sepsis, as well as the effect of supplementation of Vitamin C and Thiamine in patients of sepsis. Methods: 80 patients of sepsis were randomly divided into 4 groups of 20 each. Twenty age-sex matched healthy volunteers were chosen as controls. The first group received Vitamin C, the second group received Thiamine, the third group received both and the fourth group received neither. Vitamin C (2g 8 hourly) and Thiamine (200 mg 12 hourly) were given intravenously for five days. The outcome was recorded in terms of mortality in the various groups as well as by the improvement in SOFA scores (?SOFA). The serum levels of Vitamin C, Thiamine and Malondialdehyde were estimated. Results: Among the 80 patients, 17 (21%) were in septic shock. The mortality rate was 10% overall, and 47% among patients of septic shock. No additional mortality benefit was observed in the groups supplemented with Vitamin C and Thiamine. However, the ?SOFA score in patients who received both Vitamin C and Thiamine was significantly higher as compared to the other groups. The mean malondialdehyde level was higher in patients of sepsis (1.81±1.18 ?mol/l) as compared with healthy controls (0.78 ± 0.36 ?mol/l). The Vitamin C level and Thiamine level (estimated indirectly by TPP effect), at presentation were 5.14±4.19 ng/ml and 52.99±28.45 % in patients of sepsis, which was significantly lower than that in healthy controls, in whom the levels were 14.64±5.51 ng/ml and 27.55±13.67% respectively. Conclusion: Vitamin C and Thiamine supplementation is a cost-effective approach with a good safety profile. Additional studies including a larger population is required to study the mortality benefits and reaffirm our findings.

Shanmugasundaram Balasubramanian, Singh Vijay Kumar, Shrestha Shrijana, Sarkar Sajib Kumar, Jeevaratnam Kadirvelu, Koner Bidhan Chandra

Coconut oil and sesame oil are commonly used in South India for frying foods. On heating, edible oils form hazardous chemicals. This study explores the effect of consumption of unheated and thermally-altered sesame and coconut oils on coronary artery disease (CAD) risk factors in Wistar rats. Thirty Wistar albino rats were randomly divided into five groups (n=6/group). Group I (Control) was fed only chow, Group II: chow + unheated sesame oil, Group III: chow + heated sesame oil, Group IV: Chow + unheated coconut oil, Group V: chow + heated coconut oil. After eight weeks of treatment, serum lipid profile, hs-CRP, leptin, glucose, insulin, HOMA-IR, TNF-α, IL-6 and plasma homocysteine and fibrinogen levels were estimated. Rats in Group II showed a significant decrease in serum cholesterol, LDL-c, TNF-α, hs-CRP, insulin, and HOMA-IR but a significant increase in HDL-c, Group III showed opposite effects on these parameters, except that it decreased serum triglycerides level. Group IV and V did not show any significant effect on stated parameters. We conclude that consumption of unheated sesame oil gives protective effects against the CAD. Thermally altered sesame oil increases the CAD risk. Unheated and thermally altered coconut oil did not show any significant effect. Hence, we recommend that sesame oil better be used for dressing the food and coconut oil for frying.

Effect of Sertraline on biomarker alterations in patients of multidrug resistant tuberculosis with depression: a prospective clinical trial

Background: Lipid profile parameters may be used as biomarker for depression. Sertraline belongs to selective serotonin reuptake inhibitors (SSRIs), the most commonly used group to treat the depression in multidrug resistant tuberculosis patients.Methods: A prospective clinical trial was carried out in department of Psychiatry and department of Tuberculosis and Respiratory disease G.S.V.M. Medical College, Kanpur. Diagnosed MDR TB patients were screened for depression applying Hamilton Depression Rating Scale (HDRS) and these patients were referred to Psychiatrist for diagnosis of depression. Total 25 diagnosed patients of MDR TB with mild to moderate depression were selected. HDRS Score and morning blood sample of 5ml were collected to analyze biomarker for depression before intervention. Same test was repeated in 18 patients who completed the study at day 30 and 120 after administering Sertraline (50mg). Data were compiled and analyzed using SPSS 20.0 and paired t - test.Results: The mean decrease in HDRS score from base line at day 30 and 120 of administering Sertraline were 6.22 (±1.26) and 2.72 (±0.67) which were significant (p?0.001). The mean increase in serum cholesterol at day 30 was 153.94 (±19.31) and at day 120 was 157.83 (±19.36) which were significant (p?0.001). Rest of Tg, HDLc, LDLc and VLDL cholesterole levels were not increased significantly.Conclusions: As the depression symptoms improved by sertraline. The biomarkers of depression were also increased (within the normal range) from baseline but significant increase was observed in serum cholesterol only.

Perception of sex workers of Lucknow City, Uttar Pradesh, India towards sexually transmitted infections.

The prevention, control, and management of sexually transmitted infections/reproductive tract infection (STI/RTI) are well-recognized cost-effective strategies for controlling the spread of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). A cross-sectional descriptive study was done over a period of 1 year to assess the prevalence of STI, knowledge level about STI, and the STI-HIV link among the female sex workers (FSWs) of Lucknow city, Uttar Pradesh, India along with their biosocial characteristics. Most of the FSWs were illiterate, married, Hindus, and belonged to general category. The prevalence rates of STI among street-based and home-based FSWs were 50.6% and 29.8%, respectively. Knowledge about the role of condom in prevention of STI and the STI-HIV link was significantly less among home-based FSWs than those who are street-based. There is a great lack in the awareness among FSWs regarding STI and their prevention. Behavior change communication (BCC) and advocacy strategy were developed, especially for the home-based group, to strengthen their knowledge regarding the STI-HIV link.

Factors Associated with the Preference for Delivery at the Government Hospitals in Rural Areas of Lucknow District in Uttar Pradesh.

For assuring safe maternal and newborn health, institutional delivery was given paramount importance. In India, in spite of several efforts, lesser than 40% deliveries are conducted at health facilities, mostly at private sector. The present cross-sectional study aimed to fi nd out the determinants of preference for delivery at government hospitals in rural areas of Lucknow, a district in Uttar Pradesh. Multistage random sampling was used for selecting villages. From them, 352 recently delivered women were selected, following systematic random sampling. Overall, 84.9% of deliveries were conducted at health institutions. Out of them, 79.3% were at government hospitals. Applying multivariate logistic regression, Hindu women (odd’s ratio [OR] = 3.205), women belonging to lower socio-economic class (OR = 4.630) and late registered women (OR = 2.320) were found to be more likely to deliver at government hospitals. Attention should be given to religion, social status and timing of registration for ensuring higher fraction of deliveries at government set-up.

Endometrial thickness as a test for endometrial cancer in women with abnormal postmenopausal and perimenopausal vaginal bleeding & its histopathological correlation.

Introduction: The menopausal & perimenopausal age are characterized by a deficiency of progesterone and relative hyperestrogenism leading to increased risk of carcinoma endometrium. Transvaginal ultrasonography is used to evaluate the thickness of endometrium in perimenopausal & postmenopausal women presenting with abnormal bleeding per vaginum & its histopathological classification was done. Material & Methods: This retrospective study was carried out in R D Gardi Medical College and Hospital, Ujjain. Seventy five cases were selected from May 2010 - May 2012 and studied in respect to age,parity,socio-economic status, and endometrial thickness in women with abnormal bleeding per vaginum & its relation to histopathology findings of endometrium obtained through D & C. Results:Out of seventy five cases, 49(65.5%) were in perimenopausal age group, and 26(34.5%) in postmenopausal age group. Endometrial thickness greater than 12mm was in 73.4% of perimenopausal and 25.3% of postmenopausal women. In perimenopausal women with abnormal bleeding,histopathology showed‘Benign Hyperplasia’in 51%, ‘Proliferative endometrium’in 26.5%, ‘Secretary endometrium’ in 4.08%, ‘Atrophic endometrium’ in 2.04%, ‘Atypical Hyperplasia’ in 10.2%, andcarcinoma in 6.12%.Whereas in postmenopausal women, Atypical Hyperplasia in 11.4%, carcinoma in 46.12%,benign hyperplasia in 7.6%, proliferative endometrium in 15.33%, secretary endometrium in 7.69%, and atrophic in 11.4%. Conclusion: In majority endometrial thickness by TVS may be helpful in planning investigation protocol and further management.

Tobacco Smoking, Cigarette Butt Smoking: Markers for Early Intervention in Adolescents at School Level.

Introduction: Tobacco use in children and adolescents is reaching pandemic levels. The World Bank has reported that nearly 82,000-99,000 children and adolescents all over the world begin smoking every day. WHO Fact Sheet May 2010 reported the annual death toll of five million could rise to eight million by 2030 unless an urgent action is taken to control this “epidemic”. Preventive strategies are needed to be initiated on urgent basis focused towards adolescents. There is difficulty to enforce the laws and implementing preventive programs in the developing countries like India. Due to some constraints the Tobacco Free Initiative (TFI) is facing defeat in the third world. This study was conducted in high school students of Hapur, Ghaziabad (Dist.) of U.P. to identify the various correlates which induce these impressionable young adolescent minds to indulge in the use of tobacco. Material & Methods: Eight hundred seven high school children aged 12-18 years were surveyed by using an anonymous pre-tested self-report questionnaire. Personal indulgence in tobacco use over the period of one year was measured. A three point scale (yes / no / don’t know) was used. Consent / assent were duly taken from the student / teachers / principal. Results were tabulated and analysed. Results: The overall prevalence of smoking was found to be 31.97%. The use rate of tobacco was 53.53%. Among the tobacco users 59.72% were smokers. The prevalence of current smoking among tobacco users is 59.72%. The prevalence of smoking was 76.74% among male students and 23.25% amongst girls. Age of smoking initiation in both genders was mostly in 14+- 16 years. Parental (father) influence of smoking was noted to the extent of 36.04% in boys and 13.95% in girls, influence of teacher’s smoking was 39.90% in males but much less in females (23.25%). Poor academic performance and prolonged TV watching was noted as factor in both the genders. Even 13.95% females without pocket money indulged in the habit by using discarded cigarette butts (75%) which are freely available. Butt smoking was also found in boys (40%). They were aware that this habit was bad, yet indulged in it, indicating that curiosity (55% F) and peer pressure (56.56% M) and addictive nature of substance. Advertisements and promotional campaigns, mimicking their role model, were an important source of initiation of habit in both genders. Feeling of freedom from inhibitions and in females possible weight reduction to improve the looks also accounted for the habit was also noted. Our study highlights behavioural pattern of smoking as also the various factors identifying the first use and its perpetration up to habituation/ addiction. Monetary considerations and low availability of pocket money were found to be circumvented by the habit of using the discarded cigarette butts which are available for free, avoids detection, contains ash, partially burnt tobacco and paper, carbon particles, filter tissue, cellulose acetate etc. with harmful effects on lungs and other yet unidentified adverse health effects. The butt use was found in males (41.93%) and females (62.5%) and save them from deleterious effects of tobacco smoking. Conclusion: The markers thus identified in this study provide basis for early appropriate intervention of vulnerable school population and help in identification of modifiable risk factors and psychosocial clusters to provide the basis for intervention.

Effect of yogic package on rheumatoid arthritis.

This study aimed at studying the effect of yogic package (YP) with some selected pranayama, cleansing practices and meditation on pain intensity, inflammation, stiffness, pulse rate (PR), blood pressure (BP), lymphocyte count (LC), C-reactive protein (CRP) and serum uric acid (UA) level among subjects of rheumatoid arthritis (RA). Randomized control group design was employed to generate pre and post data on participants and controls. Repealed Measure ANOVAs with Bonferroni adjustment were applied to check significant overall difference among pre and post means of participants and controls by using PASW (SPSS Inc. 18th Version). Observed result favored statistically significant positive effect of YP on selected RA parameters and symptoms under study at P<0.05, 0.01 and 0.001 respectively that showed remarkable improvement in RA severity after 40-day practice of YP. It concluded that YP is a significant means to reduce intensity of RA.