Analysis of the relation between elevated neutrophil lymphocyte ratio, and erythrocyte sedimentation ratein Helicobacter pyloripositive chronic gastritis patients

Background:Aim of the study was to analyse the relation between elevated neutrophil lymphocyte ratio (NLR), and erythrocyte sedimentation rate (ESR) in Helicobacter pylori(H. pylori)positive chronic gastritis patients, as compared to the control group containing H. pylorinegative chronic gastritis patients.Methods:Chronic gastritis patients were segregated in equal numbers based on H. pyloristatus. NLR was calculated, and ESR noted from the observations, comparison was done between the control and the study groups.Results:A total of 100 patients were included in the study. The 50 each from the control and study group. An observation of elevation in NLR and ESR in H. pyloripositive chronic gastritis patients, as compared to the control group was seen. With an average NLR of 2.43 and 1.43, in the control and study group, respectively.Conclusions:Raise in NLR in H. pyloripositive chronic gastritis patients with an associated raise in ESR suggests, the severity of the infection and the need for eradication and prevent complications

HLA-G 3’UTR polymorphisms & response to a yoga-based lifestyle intervention in rheumatoid arthritis: A randomized controlled trial

Background & objectives: Human leucocyte antigen (HLA)-G plays a vital role in immunomodulation in rheumatoid arthritis (RA). The mounting evidence suggests a link between HLA-G gene polymorphisms, disease susceptibility and methotrexate treatment response. Various environmental factors influence the onset and progression of RA and its treatment outcomes. The aim is to identify the treatment response of HLA-G 3’ untranslated region polymorphisms to yoga-based lifestyle intervention (YBLI). Methods: In this eight-week single-blinded randomized controlled trial (CTRI/2017/05/008589), patients with RA (n=140) were randomized into two groups namely, yoga group or non-yoga group. Baseline genomic DNA was isolated using salting-out method. PCR-based methods were used for genotyping. The levels of soluble (s) HLA-G and disease activity were assessed by ELISA and disease activity score-28–erythrocyte sedimentation rate (DAS28-ESR), respectively, at baseline (day 0) and after eight weeks of intervention. Results: Low-producing sHLA-G genotypes, i.e. +3142GG and 14 bp ins/ins, showed a significant increase in sHLA-G levels after YBLI. The association analysis between HLA-G polymorphisms and treatment for RA showed no considerable differential treatment remission in either of the groups (P>0.05). The percentages of improvement were higher in the yoga group as compared to the non-yoga group in both the HLA-G +3142G>C and 14 bp ins/del polymorphisms irrespective of their respective genotypes. No significant association was found between sHLA-G levels and disease activity with respect to genotypes. Interpretation & conclusions: Yoga intervention results in improvement and reduced severity of RA in patients irrespective of the HLA-G 14 bp ins/del or +3142G>C polymorphisms. YBLI may be used as an adjunct therapy in RA independent of the genotypes

Analysis of Q-markers of Arisaema Cum Bile Acting on Stroke Based on UPLC-QTOF-MS/MS and TCMIP v2.0 / 中国实验方剂学杂志

ObjectiveTo predict the possible quality markers （Q-markers） of Arisaema Cum Bile in the prevention and treatment of stroke based on ultra performance liquid chromatography-quadrupole-time-of-flight tandem mass spetrometry （UPLC-QTOF-MS/MS） and Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine （TCMIP） v2.0. MethodUPLC-QTOF-MS/MS was employed with the mobile phase of 0.1% formic acid aqueous solution （A）-0.1% formic acid acetonitrile solution （B） for gradient elution （0-3 min， 0.2%-5%B； 3-5 min， 5%-8%B； 5-8 min， 8%-10%B； 8-14 min， 10%-25%B； 14-18 min， 25%-50%B； 18-20 min， 50%-70%B； 20-21 min， 70%-98%B； 21-23 min， 98%B； 23-24 min， 98%-0.2%B； 24-26 min， 0.2%B）， the flow rate of 0.5 mL·min-1 and electrospray ionization （ESI）. High quality MS/MS data were scanned in positive and negative ion modes with scanning range of m/z 50-1 500. A local database of the chemical constituents in Arisaema Cum Bile was established by UNIFI 1.8. Then the chemical constituents in Arisaema Cum Bile were characterized by matching with the local database and comparing with the reference substances and literature information. TCMIP v2.0 was used to obtain the targets corresponding to the identified components of Arisaema Cum Bile and stroke， and the "disease-formula" correlation analysis was carried out to screen the core targets by topological eigenvalues. DAVID 6.8 was used for enrichment analysis of Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway of core targets. According to the "five principles" of Q-markers and combined with literature reports， the Q-markers of Arisaema Cum Bile in the prevention and treatment of stroke were predicted， and the core components acting on these target genes were obtained. Cytoscape 3.8.0 was employed to draw the network diagram of "medicinal materials-active ingredients-target genes-pathways". Finally， AutoDock Vina 1.2.2 was used to calculate and verify the molecular docking between the candidate components and the key targets. ResultA total of 76 chemical components was identified in positive and negative ion modes， 85 core targets were collected for Arisaema Cum Bile in the prevention and treatment of stroke. A total of 31 stroke-related pathways， 23 target genes and 9 main active components of Arisaema Cum Bile acting on these genes were screened， and then we determined 4 possible Q-markers for Arisaema Cum Bile in the prevention and treatment of stroke according to the "five principles". ConclusionThe possible Q-markers of Arisaema Cum Bile for stroke are gallic acid， apigenin-6，8-di-C-glucoside， apigenin and cholic acid， and the target of these four components may be estrogen receptor alpha （ESR1）.

C-reactive protein (CRP) and Erythrocyte Sedimentation Rate (ESR) Trends following Total Hip and Knee Arthroplasties in an Indian Population – A Prospective Study

@#Introduction: To evaluate the trends of C-reactive protein (CRP) and Erythrocyte sedimentation rate (ESR) in the first three weeks after uncomplicated total hip (THR) and total knee (TKR) arthroplasty/replacement in the Indian population and to compare it with available literature. Material and methods: A total of 90 patients were enrolled for this prospective study, of which 30 were unilateral THR, 30 were unilateral TKR (U/L TKR) and 30 were simultaneous bilateral TKR (B/L TKR). Serum CRP and ESR were measured on the day before surgery and postoperatively on day 1st, 2nd, 3rd, 7th, 12th, and at the end of 3rd week. Results: CRP showed a peak at day 2nd with normalisation to pre-operative value by the end of 3rd week. While ESR showed a peak on day 3rd and continued to remain elevated even at end of 3rd week post-operatively. Both mean CRP and ESR values were higher in THR patients followed by in B/L TKR and then in U/L TKR patients. Conclusion: CRP persists to be the best acute phase reactant in the early post-operative phase with a relatively typical pattern as compared to ESR. CRP values peak at postoperative day 2nd and then show a gradual decline. However, its normalisation to pre-operative baseline values may vary among different groups of population.

Is mean platelet volume the earliest diagnostic marker of neonatal sepsis: a prospective case control study

Background: Neonatal sepsis is the third leading cause of neonatal mortality after prematurity and intrapartum related complications worldwide. The literature regarding the use of Mean platelet volume as a diagnostic tool in neonatal sepsis is scanty.Methods: Prospective case control study in a district hospital. Neonates > 30 weeks gestation admitted to NICU during the study period were included. Neonates who did not have any risk factors for sepsis and did not have a positive blood culture or elevated CRP were categorized as group 1. Neonates who were admitted with risk factors of sepsis but did not have a positive CRP or blood culture positivity were categorized as group 2. Neonates who were admitted as probable sepsis and subsequently developed blood culture or CRP positivity were categorized as group 3.Septic workup was done for all the subjects at admission and at 72 hours after admission. Newborn with congenital anomalies and who were already on antibiotics prior to admission were excluded from the study. Statistical analysis was done using Statistical Package of Social Sciences (SPSS) version 20.0.Results: Total 240 Neonates were included in the study. Elevation of MPV in neonates with sepsis was seen as early as the first sample whereas CRP elevation was seen only on Day 3. Cut off value for Mean Platelet Volume (MPV) was found to be 10.15fl with sensitivity of 84% and specificity of 74%.Conclusions: MPV can be used as a earliest diagnostic marker for prediction of neonatal sepsis and mortality. It can facilitate early initiation of treatment without any additional exposure.

Aetiological Factors and Foetomaternal Outcome in PROM.

Premature rupture of membrane (PROM) refers to the disruption of foetal membranes before the beginning of labour, resulting in spontaneous leakage of amniotic fluid.Homeyr, GJ et al in his study “Amnio infusion for third trimester preterm rupture of membranes”, march 2014 states that premature rupture of membranes (PROM), or pre-labour rupture of membranes, is a condition occurring in pregnancy and defined it as rupture of membranes (breakage of the amniotic sac), commonly called breaking of the mother's water (s), more than one hour before the onset of labour.METHODSThe present study was carried out in the Department of Obstetrics and Gynaecology of Rajendra Institute of Medical Sciences (RIMS), Ranchi, during from April 2017 to October 2018. A total 595 cases were studied. The cases were divided into two groups, Study Group-195 cases and Control Group- 400 cases.RESULTSVarious factors were studied and analysed. Incidence of PROM in the present study was 7.49%. Out of 195 cases 68% were term PROM and 32% were preterm PROM. Mean age in the study group was 23 yrs. Risk factors associated with PROM in most of the cases was unknown (52%). Other causes were anaemia 34%, cervicovaginal infections 16%, malpresentation 10%, multiple gestation 3.5%, prior cervical surgery 1%, history of fall 1% PROM following coitus was 1.5%. In the present study the correlation between CRP and clinical chorioamnionitis was significant. Caesarean section was done was done in 19% cases in study group. There were 3 % cases of chorioamnionitis in study group. Out of 10 patients in the study group, maximum patients had puerperal sepsis (4 patients- 40%) followed by UTI (30%), wound infection (20%) and breast engorgement (10%).CONCLUSIONSPremature infant puts immense burden on the economy and health care resources of the country. Therefore, management of PPROM requires accurate diagnosis and evaluation of the risks and benefits of continued pregnancy or expeditious delivery. Once PROM is diagnosed, it is important to weigh the risk of PROM and prematurity and make the right choice for conservative management or active interventions. Adequate antenatal care should be advocated so that appropriate risk assessment can be done, and intervention provided where applicable. Neonatal units should also be equipped to be able to render necessary care for these preterm neonates thereby reducing the morbidity and mortality associated with PPROM.

Papel de la proteína C reactiva y la velocidad de sedimentación globular en la predicción de colecistectomía laparoscópica dificultosa: su aplicación en un programa de residencia universitario / Role of C-reactive protein and erythrocyte sedimentation rate to predict difficult laproscopic cholecystectomy in a university residency program

Antecedentes: la colecistectomía laparoscópica es uno de los procedimientos quirúrgicos más frecuentemente realizados. Las diferencias en la anatomía y en el grado de inflamación vesicular suelen causar dificultades técnicas intraoperatorias. Objetivo: determinar el valor de la proteína C reactiva (PCR) y la velocidad de sedimentación globular (VSG) como predictores de colecistectomía dificultosa y evaluar su aplicación en la planificación prequirúrgica de un programa de residencia universitario. Material y métodos: se confeccionó un estudio retrospectivo, analítico, en un hospital universitario de tercer nivel. Se incluyeron 104 pacientes adultos operados de colecistectomía laparoscópica por litiasis vesicular sintomática entre enero y julio de 2019. Se categorizó a los pacientes en un grupo de colecistectomías dificultosas y otro de colecistectomías no dificultosas. Resultados: se obtuvieron diferencias estadísticamente significativas al comparar los valores de VSG y PCR de ambos grupos (p < 0,001). La sensibilidad de la VSG fue del 100%, la especificidad del 45%, el VPP del 40% y el VPN de 100%. La sensibilidad de la PCR fue del 87,5%, la especificidad del 86,3%, el VPP del 70% y el VPN de 95%. Ambos parámetros se vieron elevados en 14 de 16 colecistectomías dificultosas y en 2 de 44 colecistectomías no dificultosas. La sensibilidad para ambos parámetros elevados fue del 87,5%, la especificidad del 95%, el VPP del 87,5% y el VPN de 95%. Conclusión: la VSG y la PCR han demostrado ser un método fiable en la predicción de colecistectomías dificultosas por litiasis vesicular sintomática. Esto podría ser aplicado en la programación de cirugías dentro de un programa de residencia universitario.

Background: laparoscopic cholecystectomy is one of the most common procedures performed in general surgery. The anatomical differences of the gallbladder and the presence of factors related to inflammation can cause technical issues during surgery. Objective: the aim of the present study was to determine the value of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) as predictors of difficult cholecystectomy and to evaluate their application during presurgical planning within a university residency program. Material and methods: we conducted a retrospective and analytical study in a tertiary university hospital. A total of 104 adult patients undergoing laparoscopic cholecystectomy due to symptomatic cholelithiasis between January and July 2019 were included. The patients were categorized into two groups: difficult cholecystectomy and non-difficult cholecystectomy. Results: there were statistically significant differences in ESR and CRP values between both groups (p < 0.001). Sensitivity of ESR was 100%, specificity was 45%, with a PPV of 40% and NPV of 100%. Sensitivity of CRP was 87.5%, specificity was 86.3%, with a PPV of 70% and NPV of 95%. Both parameters were elevated in 14 of 16 difficult cholecystectomies and in 2 of 44 non-difficult cholecystectomies. Sensitivity of CRP was 87.5%, specificity was 86.3%, with a PPV of 70% and NPV of 95%. Conclusion: measuring ESR and CRP has proved to be a reliable method to predict difficult cholecystectomies due to symptomatic cholelithiasis. This could be applied for surgical planning within a university residency program.

A Comparative Evaluation of Macro and Micro Methods for Determination of ESR and PCV in Health and Disease

Background: The erythrocyte sedimentation rate is the rate at which erythrocytes settle down when anticoagulated blood is allowed to stand in a vertical column for a particular period (usually during 1st. hour) and the length of fall of the top of the column of erythrocytes in the given interval of time determines the erythrocytes sedimentation rate. The micro methods of estimation of ESR and PCV have been developed to overcome the drawbacks of macro methods, especially of taking blood sample by venepuncture. Methods: The present study was undertaken to compare ESR and PCV values as estimated by macro and micro methods in diseased and healthy subjects to define the cut off levels of ESR and PCV (Micro method) for the children and adults. When the mean values and the various percentiles obtained by micro method were compared with that of macro method, in healthy and diseased children, healthy and diseased male and female adults, none of them showed any statiscal significant difference. Results: The results of hematocrits by both methods on individual basis were compared. Conclusion: It was noticed that there was a close approximation of the readings in each case in micro and macro methods

Assessment of respiratory morbidity among loading and unloading workers exposed to cement dust

Background: A higher incidence of occupational diseases has been reported recently compared to the past years. One of the industries where workers are remarkably exposed to dust is cement industry. Several studies have been conducted to evaluate pulmonary functions and biochemical parameters of workers exposed to cement dust in factories and construction sites, but few were concentrated among loading and unloading workers of warehouses. Hence the present study was undertaken to find out the effect of cement dust among loading and unloading workers of cement warehouses.Methods: This study was conducted among 82 exposed (cement dust) and 82 non-exposed individuals. Frequency of symptoms, biochemical parameters and spirometric values were taken from all subjects. Spirometric parameters recorded were, forced vital capacity (FVC), Forced expiratory volume (FEV1), FEV1/FVC% and Peak expiratory flow rate (PEFR).Results: Out of exposed group, 51.2% had cough, 46.3% had rhinitis 45.2% had breathlessness. FEV1 and FVC showed significant reduction while FEV1/FVC values were normal. No significant changes were seen in renal function tests or liver function tests. Mean value of erythrocyte sedimentation rate (ESR) was found to be significantly increased.Conclusions: Compared to normal healthy adults the loading and unloading workers in cement warehouses showed restrictive lung disease and an increase in ESR representing a non-specific inflammatory change. A continuous bio monitoring of health status must be initiated for these employees and awareness campaigns regarding the exposure and use of standardized protective devices must be mandated.

Clinical and laboratory predictors to differentiate severe dengue from scrub typhus in children

Background: Objective of study was to compare the clinical features and laboratory parameters at admission and differentiate severe dengue from scrub typhus in children.Methods: Retrospective analysis of case records and comparison of clinical and laboratory parameters at admission of all children with a diagnosis of severe dengue and scrub typhus was done.Results: A total of 72 children were included (severe dengue =40; scrub typhus =32) during the study period. The mean (SD) age of children with severe dengue and scrub typhus was 7.9(3.8) and 11.8(5.8) years, respectively. Majority of children with severe dengue presented with hypotension, 21(52.5%) vs 3(9.4%) in scrub typhus. Children with severe dengue had a relatively low ANC (2.6'1.97x103/mm3 vs 3.9'2.06x103/mm3), low platelet count (50.23'35.55x103/mm3 vs 140'95.0x103/mm3) and low mean ESR at 1hour (8.1'6.82mm vs 33.88'13.79mm) than scrub typhus.Conclusions: Compared to scrub typhus, severe dengue was significantly associated with hypotension, lower ANC, ESR and platelets.

Mean platelet volume (MPV) as a diagnostic marker in neonatal sepsis

Background: Neonatal sepsis is a frequent and important cause of morbidity and mortality which accounts for one quarter of neonatal deaths. There are very few studies done in India to evaluate the role of MPV as diagnostic marker of neonatal sepsis.Methods: Prospective case control study in a tertiary care hospital. Neonates > 30 weeks gestation admitted to neonatal intensive care unit during the study period of 1 year with clinically suspected were included in the study. Neonates with Septic screen positive and culture positive sepsis were included in group A and normal neonates were included in Group B. MPV was done for all the subjects and values more than 10.2fl was considered positive. Newborns with congenital anomalies and who were already on antibiotics prior to admission were excluded from the study. Statistical analysis was done using Statistical Package of Social Sciences (SPSS) version 17.0.Results: 106 neonates were included in the study. MPV showed statistically significant difference between the study groups (mean 12.8'1.52, 10.82'1.20 respectively) at a cut of value of 10.2fl and a sensitivity of 93%, specificity of 84 % with a positive predictive value of 83% and negative predictive value of 94%.Conclusions: MPV can be used as an adjuvant marker along with established septic screen to ensure early diagnosis and treatment of neonatal sepsis with no additional expense.

A Clinical Study Of Peripheral Extra Pulmonary Tubercular Lymphadenopathy

Background & Objectives: Since an ancient time tuberculosis is a widely distributed in all over world more particularly in a country like India. Extra–pulmonary involvement is also common in which Peripheral lymphnode involvement is the commonest form of extra–pulmonary mycobacterial disease and cervical region is the most frequent site nowadays, there is increased incidence of Tuberculous lymphadenitis due to increased prevalence of HIV. Even with the best treatment available, tuberculosis of lymphnode still remains a problem for the clinician, because of late diagnosis, poverty and ignorance of symptoms. Hence this study has been undertaken to evaluate tuberculosis cervical lymphadenitis with special emphasis based on FNAC. Surgical excision biopsy followed by histopathological examination is time consuming, costly, required hospitalization, pre and post procedure complications hence patients compliance is poor. While fine needle aspiration cytology is simple, rapid, cheaper and outpatient department procedure. The success rate of diagnosis from FNAC is around 75–90% in various studies. Methods: A prospective, observational study was conducted among the patients who attended Tuberculosis & Respiratory Diseases Department from June 2011 to March 2013 in a tertiary care hospital with features of Peripheral Extra pulmonary Tubercular Lymphadenopathy. A total of 124 cases of peripheral extra pulmonary tubercular Lymphadenopathy were studied from June 2011 to March 2013. A detailed history, complete physical examination, various laboratory work and radiological studies carried out. Diagnosis of TB made by histopathological & Tuberculin test was done with 10 TU PPD (0.1 ml) on left forearm and reading was taken after 48 hours. Majority patients were sent to pathology department for fine needle aspiration cytology of affected gland. Patients were having private FNAC report suggestive of tuberculous lymphadenitis were also considerd in study. Result: In the present study of 124 patients having Tuberculous Lymphadenopathy, the commonest age group affected is below 40 years (85% patients).Females are affected more than males (M:F ratio 1:1.03). With most of the patients coming from lower socioeconomic status. Majority of patients (72%) were presented with painless swelling in neck and 91% patients had attended health facility within 3 months.Family history positive in 04 (03%) of patients. Most of the time in tuberculous lymphadenopathy patients present with swelling only i.e 106 (86%) and 18 (14%) patients with either cold abscess or pus discharge so simple lymph node enlargement is common. 67 % patients show raised ESR. It may help in supportive diagnosis of tuberculous aetiology.67% patients show tuberculin test positive which also may help in diagnosis of tubercular aetiology. 10(08%) patients of lymphadenopathy had abnormal chest radiogram. Majority of the patients have normal leukocyte count with normal lymphocyte.Only 03 patients are found sputum positive in 124 tubercular lymphadenitis patients.It might be due to direct spread of infection from tonsil to regional lymphnode.Primary infection may occur in lymphoid tissue of tonsil.Only 1 patient is found HIV reactive in this study.This might be due to less HIV prevalence in rural population. Conclusion: It was observed that cervical region lymph node was more commonly involved and fine needle aspiration cytology (FNAC) was found to be a safe, useful, reliable, effective method for early diagnosis of tubercular lymphadenitis and early institution of definitive therapy. It is a comparatively cheap and less time consuming method. Adults are more affected than old people and females are affected more than males. ESR help in supportive diagnosis of Tuberculous etiology and tuberculin test positive also may help in diagnosis of tubercular etiology.

Clinical Observation on Modified Huqianwan in Treatment of Rheumatoid Arthritis Liver-kidney Yin Deficiency Syndrome / 中国实验方剂学杂志

Objective: To explore the clinical efficacy and safety of modified Huqianwan in treatment of rheumatoid arthritis (RA) liver-kidney Yin deficiency syndrome, and investigate its possible mechanism. Method: A total of 184 patients with RA liver-kidney Yin deficiency syndrome were randomly divided into Chinese medicine group (62 cases), western medicine group (57 cases) and integrated Chinese and western medicine group (65 cases) according to the digital table method. The patients in Chinese medicine group were treated with Huqianwan; the patients in western medicine group were treated with methotrexate tablets and leflunomide tablets; and the patients in integrated Chinese and western medicine group received Huqianwan+methotrexate tablets and leflunomide tablets,with a treatment course of 12 weeks in all groups. The pain visual analog scale (VAS), swelling and tenderness scores of 28 joints (DAS28), average hands grip strength, morning stiffness time and liver-kidney Yin deficiency syndrome differentiation of traditional Chinese medicine (TCM) syndrome score were compared between groups before and after treatment. The changes of erythrocyte sedimentation rate (ESR), C reactive protein (CRP), immunoglobulin (Ig) G, tumor necrosis factor-alpha (TNF-α) and rheumatoid factor (RF) were detected in all groups after treatment. Clinical efficacy, and incidence of adverse reactions such as gastrointestinal response, liver injury, leukopenia, serum glutamate oxaloacetic aminotransferase (GOT) and platelet (PLT) level changes were compared between the groups, so as to investigate the efficiency and safety of the different medicines. Result: After 12 weeks of treatment, the total clinical effective rate was 79.0%, 80.7%, and 92.3% respectively in Chinese medicine group, western medicine group, and integrated Chinese and western medicine group; the integrated Chinese and western medicine group was significantly better than the Chinese medicine group and western medicine group (PPPPConclusion: The efficacy in treating RA liver and kidney Yin deficiency syndrome shows no significant difference between modified Huqianwan and methotrexate tablets+leflunomide tablets. In the treatment of RA liver and kidney Yin deficiency syndrome, Huqianwan has fewer adverse reactions. Huqianwan combined with methotrexate tablets+leflunomide tablets is superior to that in methotrexate tablets+leflunomide tablets in treatment of RA liver-kidney Yin deficiency syndrome.

Targeted binding of estradiol with ESR1 promotes proliferation of human chondrocytes by inhibiting activation of ERK signaling pathway / 南方医科大学学报

OBJECTIVE@#To investigate the effect of estradiol (E2)/estrogen receptor 1 (ESR1) on the proliferation of human chondrocytes and explore the molecular mechanism.@*METHODS@#The Ad-Easy adenovirus packaging system was used to construct and package the ESR1-overexpressing adenovirus Ad-ESR1. Western blotting and qPCR were used to detect the expression of ESR1 protein and mRNA in human chondrocyte C28I2 cells. In the cells treated with different adenoviruses, the effects of E2 were tested on the expressions of proteins related with cell autophagy and apoptosis and the phosphorylation of ERK signaling pathway using Western blotting. Immunofluorescence assay was used to observe the intracellular autophagic flow, flow cytometry was performed to analyze the cell apoptosis rate and the cell cycle changes, and qPCR was used to detect the expressions of PCNA, cyclin B1 and cyclin D1 mRNAs. The inhibitory effect of the specific inhibitor of ERK on the expressions of autophagy- and apoptosis-related genes at both the protein and mRNA levels were detected using Western blotting and qPCR.@*RESULTS@#Transfection with the recombinant adenovirus overexpressing ESR1 and E2 treatment of C28I2 cells significantly enhanced the expressions of autophagy-related proteins LC3, ATG7, promoted the colocalization of LC3 and LAMP1 in the cytoplasm, increased the expressions of the proliferation-related marker genes PCNA, cyclin B1 and cyclin D1, and supressed the expressions of cleaved caspase-3, caspase-12 and pERK. RNA interference of ESR1 obviously lowered the expression levels of autophagy-related proteins in C28I2 cells, causing also suppression of the autophagic flow, increments of the expressions of apoptosis-related proteins and pERK, and down-regulated the expressions of the proliferation marker genes. Blocking ERK activation with the ERK inhibitor obviously inhibited the effects of E2/ESR1 on autophagy, proliferationrelated gene expressions and cell apoptosis.@*CONCLUSIONS@#The targeted binding of E2 with ESR1 promotes the proliferation of human chondrocytes possibly by inhibiting the activation of ERK signaling pathway to promote cell autophagy and induce cell apoptosis.

The Effects of Calcium and Vitamin D Supplementation on Blood Glucose and Markers of Inflammation in Non Diabetic Adults

Introduction: Type 2 Diabetes mellitus is associated with considerable morbidity and mortality and its prevalence has been increasing globally. Present study was undertaken to see the effects of calcium and vitamin D supplementation on blood glucose and markers of inflammation in non-diabetic adults. Aim of the study: To compare the effects of combined calcium and vitamin D supplementation versus placebo on blood glucose and markers of inflammation in non-diabetic adults. Material and methods: 120 non-diabetic patients fulfilling the inclusion and exclusion criteria coming to OPD/wards of MGUMST, Jaipur were recruited. They were subjected to two study groups with two treatment arms, one group with normal fasting blood glucose and other group with impaired fasting blood glucose. Results: The effects of calcium and vitamin D supplementation on fasting blood sugar and CRP were statistically significant in impaired fasting blood glucose group. Conclusion: Supplementation with vitamin D and calcium improves blood glucose and markers of inflammation.

Study of Prognostic Significance of Anti Cyclic Citrullinated Peptide Antibodies in Patients with Rheumatoid Arthritis

Background: Rheumatoid arthritis is a chronic autoimmune inflammatory disease with articular and extra-articular manifestation that affects 0.5 to 1 % of total population. Aim and Objectives: To correlate Rheumatoid factor (RF) and Anti-CCP antibody in RA, to evaluate prognostic value of RF and Anti-CCP antibody in RA. Materials and methods: Retrospective study of total 50 patients admitted to our hospital from January 2018 to December 2018 was done. All patients were diagnosed as rheumatoid arthritis as per diagnostic criteria of American College of Rheumatology. All patients had symptom duration of at least one Year. Anti-CCP and lgM-RF were evaluated in all patients. Disease activity score 28 was calculated in all patients. Radiological Damage was assessed by Larsen Score. Results: Anti-CCP and RF were significantly correlated with each other and both were seen as significant independent predictors of radiological outcomes (p value 0.01 and <0.05 respectively). Combination of these two had highest risk for erosive joint damage. Conclusion: RA is more common in female. Anti-CCP antibody and RF both in combination were associated with higher probabilities of erosive disease.

Clinicl Study Of Inflammatory Bowel Disease With Reference To Crp, Esr, Albumin

Inflammatory bowel disease (IBD), which includes Crohn‘s disease and ulcerative colitis (UC), is a relapsing and remitting condition characterized by chronic inflammation at various sites in the GI tract, which results in diarrhea and abdominal pain. Aims of the Study The aim of the study the correlation of CRP, ESR, ALBUMIN in relation to the disease activity of IBD. Material & Methods Patients who come to the outpatient department of general medicine and gastroenterology as well as to the emergency department are taken up for the study. Results A total of 47 cases are studied, Out of 47 cases, 42 (89.36%) are ulcerative colitis 5 (10.63%) are crohn’s disease.

Relative importance of inflammatory markers in deciding infection versus inflammation

Background: Fever is the commonest presentation of pediatric patients attending emergency departments of all children’s hospital. The cause of fever may be acute bacterial infections or primary vasculitic disorders like Kawasaki disease or inflammation due to non-bacterial infections. The objective was to compare the performance of the four biomarkers ESR, CRP, Procalcitonin and IL-6 in predicting a diagnosis of sepsis/infection and find out a definite cut off value for the statistically most significant one.Methods: The authors conducted this prospective observational study at the indoors of a pediatric tertiary care referral center in India to find out a biomarker which can differentiate between infection and inflammation (vasculitis) in children admitted with fever and finally diagnosed as infection or inflammation (vasculitis).Results: Among ESR, CRP, Procalcitonin and Interleukin-6, only IL-6 showed statistical significance in differentiating infection from inflammation (vasculitis) analysed using the Receiver Operating Characteristic (ROC) curve and Mann-Whitney U test, sensitivity and specificity.Conclusions: IL-6 level 27 pg/mL or less at the time of admission indicates an infectious etiology while level more than this indicates towards a vasculitic cause.

Incidence and clinico-immunological assessment of patients of rheumatoid arthritis in Gorakhpur district, Uttar Pradesh, India

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease manifesting itself in various extra-articular signs and progressive articular damage. The present study was designed to find out the incidence and clinico-immunological characteristics of patients with RA.Methods: This one-year observational study involved 150 adult patients attending orthopaedics department at Nehru Hospital, B.R.D. Medical College, 2010. Each patient was subjected to clinical, functional, radiological and laboratorial examination after taking informed consent. SPSS software was used for data analysis.Results: Nearly 36% patients had some radiological changes in the form of surrounding osteopenia articular erosion, joint space narrowing and degenerative changes. All NSAIDs when used alone showed poor fall in values of acute phase reactant i.e. ESR and CRP. Maximum fall in acute phase reactant was obtained by treatment with combination therapy of NSAID + hydroxychloroquine + methotrexate + sulfasalazine. NSAIDs did not prevent radiological progression of disease and in more than 50% radiological progression continued however when NSAIDs used with any DMARDs show radiological regression. Maximum radiological regression was caused by combination therapy of NSAID + hydroxychloroquine + sulfasalazine + methotrexate.Conclusions: All NSAIDs produced poor fall in values of acute phase reactants and radiological progression continued in majority of patients, when a DMARD or combination of DMARDs were used with NSAIDs response was much better and relief was obtained earlier, and remission was sustained for longer duration.

Depression and Routine Biochemical Markers: A Cross Sectional Study

Background: Today, globally up to 6–12% of the adult population suffered mental disorder and recurrent depression. The prevalence of depression in India was reported as 4.5% by WHO. Currently the diagnosis of major depression is carried out through symptom-based assessment process, which has limitation of the development of personalised treatment plans. Objective: To determine the association between various biochemical markers of the inflammation, lipid profile, BMI, thyroid profile and depression among the patients attending department of psychiatry in a tertiary care centre. Methods: A cross-sectional study conducted among 50 patients attending the psychiatry department at S.N. Medical college, Agra and diagnosed as Depression disorder, during April 2012 to December 2012. Hamilton rating scale (HAM-D) was used to assess the severity of depression. The patients were also assessed for their vitals, lipid profile, thyroid profile, ESR, CRP and BMI. Results: 19 (38%) study subjects were in the age group of 18yrs to 30 yrs with mean age as 34.2 ±14.57 years. 36(72%) were of normal weight or under-weight and14 (28%) were pre-obese. Among 14 pre-obese and obese study subjects, 2(15.4%) had mild, 4(18.2%) had moderate and 8(53.3%) had severe type of depression(p=0.03). ESR is more in severe depression as compared to mild and moderate depression. (p=<0.001%). C-reactive protein is statistically more in severe depression (T =2.25; P= < 0.001). Conclusions: There is a positive and significant relationship between the severity of depression and ESR, CRP and BMI among the patients attending department of psychiatry.