Old known and possible new biomarkers of ANCA-associated vasculitis.

Antineutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV) comprises a group of multisystem disorders involving severe, systemic, small-vessel vasculitis with short- and long term serious and life-threating complications. Despite the simplification of treatment, fundamental aspects concerning assessment of its efficacy and its adaptation to encountered complications or to the relapsing/remitting/subclinical disease course remain still unknown. The pathogenesis of AAV is complex and unique, and despite the progress achieved in the last years, much has not to be learnt. Foremost, there is still no accurate marker enabling us to monitoring disease and guide therapy. Therefore, the disease management relays often on clinical judgment and follows a" trial and error approach". In the recent years, an increasing number of new molecules s have been explored and used for this purpose including genomics, B- and T-cell subpopulations, complement system factors, cytokines, metabolomics, biospectroscopy and components of our microbiome. The aim of this review is to discuss both the role of known historical and clinically established biomarkers of AAV, as well as to highlight potential new ones, which could be used for timely diagnosis and monitoring of this devastating disease, with the goal to improve the effectiveness and ameliorate the complications of its demanding therapy.

Tandem Detection of Sub-Nano Molar Level CN- and Hg2+ in Aqueous Medium by a Suitable Molecular Sensor: A Viable Solution for Detection of CN- and Development of the RGB-Based Sensory Device.

An inimitable urea-based multichannel chemosensor, DTPH [1,5-bis-(2,6-dichloro-4-(trifluoromethyl)phenyl)carbonohydrazide], was examined to be highly proficient to recognize CN- based on the H-bonding interaction between sensor -NH moiety and CN- in aqueous medium with explicit selectivity. In the absorption spectral titration of DTPH, a new peak at higher wavelength was emerged in titrimetric analytical studies of CN- with the zero-order reaction kinetics affirming the substantial sensor-analyte interaction. The isothermal titration calorimetry (ITC) experiment further affirmed that the sensing process was highly spontaneous with the Gibbs free energy of -26 × 104 cal/mol. The binding approach between DTPH and CN- was also validated by more than a few experimental studies by means of several spectroscopic tools along with the theoretical calculations. A very low detection limit of the chemosensor toward CN- (0.15 ppm) further instigated to design an RGB-based sensory device based on the colorimetric upshots of the chemosensor in order to develop a distinct perception regarding the presence of innocuous or precarious level of the CN- in a contaminated solution. Moreover, the reversibility of the sensor in the presence of CN- and Hg2+ originated a logic gate mimic ensemble. Additionally, the real-field along with the in vitro CN- detection efficiency of the photostable DTPH was also accomplished by using various biological specimens.

Relationship between temperament and fatness in 11-year-old children and 17-year-old adolescents from Wroclaw, Poland.

Childhood obesity is increasing globally, and Poland is no exception. Studies indicate that relationship between obesity and psychological well-being is a complex issue and this needs further research. The objective of the present cross sectional study was to analyze the relationship between some temperament components and fatness among children in two developmental periods, approximately before and after adolescence. Participants included 122 children aged 11 years (57 boys and 65 girls), and 153 adolescents aged 17 years (64 boys and 89 girls) from 6 primary and 4 secondary schools in Wroclaw, Poland. Height, weight, triceps-, subscapular and abdominal skinfold thicknesses were measured. Temperament was assessed by a questionnaire of Buss and Plomin (1984) in two versions: EAS-C for children completed by parents and EAS-D for youth and adults. Physical activity (PAL) was also assessed by a questionnaire. Mean, median and standard deviation (SD) were calculated and Student's t tests were performed to test for significance of differences between groups. Chi squared (χ2) statistic was used to test the significance of differences in frequencies. Analyses of covariance (ANCOVA) were performed to show the effect of the social - psychological factors on fatness. Controlling for socioeconomic status and physical activity level, activity, as a component of temperament had a significant effect on body fatness. The only component of temperament, which significantly influenced level of fatness in girls, was emotionality. These relationships differed according to sex and the two age groups concerned.

Future Research Priorities for Morbidity Control of Lymphedema.

BACKGROUND: Innovation in the treatment of lower extremity lymphedema has received low priority from the governments and pharmaceutical industry. Advancing lymphedema is irreversible and initiates fibrosis in the dermis, reactive changes in the epidermis and subcutis. Most medical treatments offered for lymphedema are either too demanding with a less than satisfactory response or patients have low concordance due to complex schedules. A priority setting partnership (PSP) was established to decide on the future priorities in lymphedema research. METHODS: A table of abstracts following a literature search was published in workshop website. Stake holders were requested to upload their priorities. Their questions were listed, randomized, and sent to lymphologists for ranking. High ranked ten research priorities, obtained through median score, were presented in final prioritization work shop attended by invited stake holders. A free medical camp was organized during workshop to understand patients' priorities. RESULTS: One hundred research priorities were selected from priorities uploaded to website. Ten priorities were short listed through a peer review process involving 12 lymphologists, for final discussion. They were related to simplification of integrative treatment for lymphedema, cellular changes in lymphedema and mechanisms of its reversal, eliminating bacterial entry lesions to reduce cellulitis episodes, exploring evidence for therapies in traditional medicine, improving patient concordance to compression therapy, epidemiology of lymphatic filariasis (LF), and economic benefit of integrative treatments of lymphedema. CONCLUSION: A robust research priority setting process, organized as described in James Lind Alliance guidebook, identified seven priority areas to achieve effective morbidity control of lymphedema including LF. All stake holders including Department of Health Research, Government of India, participated in the PSP.

Quantitative evaluation and correlation of serum glycoconjugates: Protein bound hexoses, sialic acid and fucose in leukoplakia, oral sub mucous fibrosis and oral cancer.

BACKGROUND: Cancer is one of the most common causes of mortality and morbidity today, with more than 10 million new cases and more than 6 million deaths each year worldwide. Globally Oral Cancer is the sixth most common cause of cancer related death. India accounts for 86% of the world's oral cancer cases. Often it proceeds by pre cancerous conditions and lesions. In search for biological markers with diagnostic value, we investigated serum glycoconjugates like protein bound hexoses, fucose and sialic acid in these diseases. MATERIALS AND METHODS: For this Study 27 newly diagnosed Oral leukoplakia, 27 OSMF and 26 Oral Cancer patients, 40 healthy controls who are non tobacco users and 40 healthy controls who are tobacco users were selected. In all these groups we estimated serum glycoconjugates. RESULTS: We observed no difference in serum glycoconjugates levels between tobacco and non tobacco controls (P > 0.05), but very high levels in oral cancer, Leukoplakia and oral sub mucous fibrosis (OSMF) patients (P < 0.001) when compared to control groups. Fucose levels were significant (P < 0.05) of all the glycoconjugates between OSMF and Leukoplakia. CONCLUSION: The serum glycoconjugates whose levels were very high in OSMF, Leukoplakia and Oral Cancer, do have a significant diagnostic and prognostic value in these diseases.

Adipocytokine levels in genetically high risk for type 2 diabetes in the Indian population: a cross-sectional study.

INTRODUCTION: In view of the noteworthy role of adipocytokines in the onset of insulin resistance and diabetes in gene-knockout-rat-model-cell-line studies we aimed to study the influence of genetic predisposition for diabetes on adipocytokine levels and their role in building insulin-resistance-like environment well before the onset of diabetes; thus a hypothesis can be drawn on their role in developing diabetes in high risk population. METHODS: Ages between 18 and 22 years were selected and divided into three groups. Group I (n = 81): control group with no family history of diabetes. Group II (n = 157): with one of their parents with history of type 2 diabetes. Group III (n = 47): with both parents having history of type 2 diabetes. In all the groups we estimated fasting plasma glucose, insulin and adipocytokines like adiponectin, leptin, TNF-α, and IL-6. RESULTS: Of all adipocytokines we observed significantly lower levels of adiponectin (8.7 ± 1 µg/mL in group III and 9.5 ± 1.3 µg/mL group II) when compared to control (11.0 ± 1.2 µg/mL; P < 0.01) and it has strong correlation with family history of diabetes with Pearson's coefficient of -0.502. Linear regression analysis showed significant negative association with HOMA-IR (P < 0.01) and logistic regression analysis showed highest association with parental diabetes (P < 0.01; OR .260, 95% CI .260-.468). CONCLUSION: Genetic predisposition for diabetes may influence adiponectin gene expression leading to decrease in its plasma concentration, which might play a key role in developing diabetes in near future.

Plasma non-enzymatic antioxidants-vitamin C, E, beta-carotenes, reduced glutathione levels and total antioxidant activity in oral sub mucous fibrosis.

BACKGROUND: Oral submucous fibrosis (OSMF) is a crippling slowly progressive disease of oral cavity that predominantly affects people habit of consuming areca nut and its commercial preparations which generates high levels of reactive oxygen species (ROS) during their metabolism. OBJECTIVE: The objective of this present study is to evaluate the role of oxidative stress in causation and progression of OSMF by measuring the levels of nonenzymatic antioxidants in OSMF patients. MATERIALS AND METHODS: For this study we selected 27 newly diagnosed OSMF patients of both sex with age group between 23 to 40 years and the same number of age and sex matched healthy individuals were selected as control group. In both the groups we measured plasma non enzymatic antioxidants like vitamin A. E, C and reduced glutathione. Total antioxidant activity was also assessed in both the groups. RESULTS AND CONCLUSIONS: We observed a very low levels of plasma non-enzymatic antioxidants (p < 0.001) and at the same time a very poor antioxidant activity (p < 0.001) in OSMF patients when compared to controls. Therefore, consumption of tobacco or areca quid creates an oxidative stress environment which might plays a major role in the causation of OSMF.

Comparison of body adiposity indices in predicting blood pressure and hypertension among slum-dwelling men in Kolkata, India.

INTRODUCTION: Recent findings show a high incidence of stroke among slum dwellers in Kolkata, India. This cross-sectional study aimed to compare the association of different adiposity indices to blood pressure (BP) and hypertension (HT) among slum-dwelling Bengalee men in Kolkata. METHODS: Measurements of height, weight, waist and hip-circumferences, biceps, triceps, subscapular and suprailiac skinfolds, systolic (SBP) and diastolic (DBP) of 470 men aged 18-60 years were taken. Body mass index (BMI), body adiposity index (BAI), percent body fat, waist-height (WHtR) and waist-hip ratios (WHR) were computed. The effect of adiposity values on HT was estimated by logistic regressions, while partial correlations and linear regressions analyses of SBP and DBP with each index were performed. RESULTS: BMI had the strongest correlation with blood pressure. The newly proposed index, BAI, had significant but considerably lower correlations with both BP compared to BMI and central adiposity. Both BMI and WHtR explained DBP with equal efficacy. Abdominal obesity, measured by WC, showed the strongest association with risk of HT, independent of age and BMI. The predictive effect of abdominal adiposity on blood pressure (SBP and DBP) appeared to be modified by age-BMI interaction. CONCLUSION: BAI showed no advantage over other adiposity measures in the prediction of hypertension among the men in this study. Waist circumference was the best obesity measure to predict hypertension and may be preferred to BMI considering its simplicity of measurement. The simple measure of WC might help in easy screening of hypertension among the poor people in resource constrained settings such as those in urban slums.

Is serum retinol binding protein-4: A predictor for diabetes in genetically high risk population?

BACKGROUND: Retinol binding protein-4 (BP-4) a new adipocytokine, specifically binds to retinol, through experimental studies, reported its link between obesity and insulin resistance (IR). But till date no studies are available on influence of genetic predisposition of diabetes on RBP-4 expression. Hence, we aimed to study the influence of genetic predisposition of diabetes on the serum RBP-4 and its role in development of IR and diabetes in genetically high risk population. MATERIALS AND METHODS: Healthy non diabetic individuals (age 18 to 22) were grouped into Group I: Control (n = 81), whose parents are non diabetic, non hypertensive and does not have any family history of coronary heart diseases. Group II: (n = 157) with one of their parents diabetic and Group III: (n = 47) with both parents diabetic. In all the participants, we estimated fasting serum RBP-4, insulin and glucose. Homeostasis model for assessment-insulin resistance (HOMA-IR) and homeostasis model for assessment-beta cell dysfunction (HOMA-B) were calculated from fasting serum insulin and glucose levels. RESULTS: In this study, we observed significantly higher RBP-4 levels 12.71 ± 2.3 in Group-II and 13.25 ± 2 in Group-III, respectively when compared to Group-I 11.4 ± 1.8 (P < 0.01). RBP-4 showed a significantly strong positive correlation with plasma insulin, glucose and HOMA-IR in genetically high risk population (group II and III) P < 0.01. Linear regression analysis revealed a strong positive association of RBP-4 with parental diabetes even after adjusting for BMI, age and sex (OR 1.53, 95% CI 1.089-1.40). CONCLUSION: Higher serum RBP-4 and its positive correlation with Insulin, glucose, and HOMA-IR in healthy non diabetic participants of genetically high risk population, indicating its role as predictor for the onset of diabetes in coming future.

Use of mid-upper arm circumference in determining undernutrition and illness in rural adult Oraon men of Gumla District, Jharkhand, India.

INTRODUCTION: Body mass index (BMI) is widely accepted as one of the best indicators of nutritional status in adults. Mid-upper arm circumference (MUAC) is another anthropometric measure that has also been used to evaluate adult nutritional status. The objective of this study was to evaluate the use of MUAC as a simpler and reliable alternative to BMI. A suitable cut-off value was also proposed for identification of chronic energy deficiency (CED) in relation to self-reported illness among the adult Oraon males of Jharkhand state in India. METHODS: The study was based on a cross-sectional survey involving 205 rural adult men belonging to the Oraon tribal group of Jharkand State in India. Height and weight were measured for each participant. The BMI was calculated as kg/m2. The internationally accepted cut-off points of BMI and MUAC were utilised to determine nutritional status. An episode of illness was recorded for each subject if any working day was lost. Receiver operating characteristic curve analyses were undertaken to discover the most suitable values of MUAC both for CED and illness. RESULTS: The MUAC values of 243 and 239 mm were identified as the best cut offs to identify CED (BMI<18.5) and illness, respectively. There were marked increases in both CED and illness prevalence rates at a MUAC level lower than 240 mm. Therefore, a MUAC value of close to 240 mm seemed appropriate as a simple and efficient cut-off point for the determination of undernutrition and higher rates of illness and loss of working days in adult Oraon males. CONCLUSION: Because MUAC is a much simpler measure than BMI, the use of MUAC 240 mm as a cut-off point is predicted to have considerable public health implications, especially with respect to primary health care related to CED and morbidity.

Effects of a mass media intervention on HIV-related stigma: 'Radio Diaries' program in Malawi.

HIV-related stigma has been recognized as a significant public health issue, yet gaps remain in development and evaluation of mass media interventions to reduce stigma. The Malawi 'Radio Diaries' (RD) program features people with HIV telling stories about their everyday lives. This study evaluates the program's effects on stigma and the additional effects of group discussion. Thirty villages with 10 participants each were randomized to listen to RD only, to the program followed by group discussion or to a control program. Post-intervention surveys assessed four stigma outcomes: fear of casual contact, shame, blame and judgment and willingness to disclose HIV status. Regression analyses indicated that fear of casual contact was reduced by the intervention. Shame was reduced by the radio program, but only for those reporting prior exposure to the radio program and for those who did not have a close friend or relative with HIV. Shame was not reduced when the radio program was followed by discussion. The intervention reduced blame for men and not women and for younger participants but not older participants. Including people with HIV/AIDS in mass media interventions has potential to reduce stigma.

Hypophosphatemic rickets: presenting features of fanconi-bickel syndrome.

Fanconi-Bickel Syndrome (FBS) is a rare variety of glycogen storage disease (GSD). Characterized by massive hepatomegaly due to glycogen accumulation, severe hypophosphatemic rickets, and marked growth retardation due to proximal renal tubular dysfunction. We report a young boy presented as hypophosphatemic rickets with hepatomegaly and subsequently diagnosed as FBS.

The Utility of a New Index for Adiposity among Pre-school Children.

Obesity in children is a cause for concern because it may predict adult obesity and increased risk of coronary heart disease in adult life. Adiposity in preschool children is measured by different conventional indices. The aim of the present study was to measure the indicators of abdominal adiposity - waist circumference (WC), waist-hip ratio (WHR), waist-height ratio (WHTR), conicity index (CI) and a newly proposed body mass abdominal index (BMAI), and to assess the relationship of these with overall adiposity as measured by body mass index (BMI). The study was conducted on 2,016 rural pre-school children (930 boys and 1,086 girls), aged 3-5 years from randomly selected 66 Integrated Child Development Services (ICDS) centres in the Nadia District of West Bengal, India. Results showed significant correlations for all adiposity measures with BMI in both sexes. A noteworthy point was that the correlations were strongest (p< 0.01) with BMAI (boys: r = 0.856, girls: r = 0.868, sex-combined: r = 0.863). Results of linear regression of adiposity measures with BMI revealed that BMAI had the strongest significant impact (t = 76.729) on BMI. Moreover, this new index accounted for 74.5% of variations in BMI. In conclusion, our results provide evidence for the use of body mass abdominal index (BMAI) as a good indicator of overall adiposity (BMI). More studies should be undertaken including its validation with other direct measures of adiposity.

Income Level and Food Intake Patterns among Male Bengalee Slum Dwellers in Kolkata, India.

This cross-sectional study explored the relationships between income levels and food intake patterns among slum dwellers in Kolkata, India. A total of 284 male subjects of Bengalee ethnicity participated in the study. The mean (SD) age, monthly family income and monthly per capita income of the subjects were 40.8 years (14.2), Indian Rupees (Rs.) 3259 (1574) and Rs. 700 (416) respectively. Potatoes, fresh vegetables, sweets and eggs were among the most frequently consumed food items on a daily basis. Butter, soft drinks, milk and ghee were least frequently consumed. The frequency of consumption of snacks, sweets and fruits showed strong significant correlations (p < 0.001). Principal component analysis of the frequency of consumption of different foods showed five components that explained a cumulative variance of 56%. Eigen values of components one to five were: 1.49 for fruit, sweets and snacks; 1.36 for fish and soft drinks; 1.16 for ghee and butter; 0.65 for fresh vegetables; and 1.02 for milk. Individually, these components explained 14, 12, 11, 10 and 9% of the variations respectively. Regression analyses showed monthly per capita income to be significantly associated with frequency of consumption of soft drinks (F = 6.79, p < 0.001) and fish (F = 7.90, p< 0.005). Age showed a significantly positive association with butter consumption (F = 9.41, p<0.002), and was negatively associated with intake of soft drinks and fried snacks (F = 10.10, p< 0.002). Using regression equations to predict the impact of increased income on consumption patterns, it was found that a 10% increase in income is associated with 1% increase in consumption of fish, which carries traditional prestige. A similar increase in income would also lead to 10% increase in consumption of soft drinks that has connotations of brand associated prestige.

Prevalence of Thinness among Rural Bengalee Pre-school Children in Chapra, Nadia District, West Bengal, India.

This-cross sectional study investigated the age and sex variations in thinness among 2016 (930 boys and 1086 girls) 3-5 years old rural children of Bengalee ethnicity. The children were randomly recruited from 66 Integrated Child Development Service (ICDS) centres of Chapra Block, Nadia District, West Bengal, India. The area is remote and mostly inhabited by Bengalee Muslims. All preschool children (3-5 years old) living in Chapra Block are enrolled at these centres. Anthropometric measures taken included height and weight using standard techniques and then body mass index (BMI) was computed. Age and sex specific cut-off values of body mass index (BMI) were utilised to identify thinness. Overall prevalence of thinness was 49.68% and 51.57% among boys and girls, respectively. There were significant (p< 0.05) sex differences in height, weight and BMI. In general, the frequency of thinness increased with increasing age in both sexes. The rates of Grade-III and Grade-II thinness were higher among girls (Grade-III = 7.46%, Grade-II = 13.44%) compared with boys (Grade-III = 5.48%, Grade-II = 11.72%). In contrast, Grade-I thinness was higher among boys. The results from this study indicate that the nutritional status of rural Bengalee pre-school children is unsatisfactory. These children are experiencing marked nutritional stress. There is scope for much improvement in the form of enhanced supplementary nutrition.

Leanness among early adolescents in two rural schools of two districts in West Bengal.

This cross-sectional study was conducted in two districts of West Bengal, to report the prevalence of leanness among rural adolescent school children. Leanness was evaluated using age and sex specific cut-off points of triceps skinfold thickness of < 5th percentile of NCHS reference population as recommended by World Health Organization. A total of 2016 students, of these, 51.39% boys and 48.61% girls aged 10-15 years were studied. Overall (age and sex combined) 18.35% children were lean. Moreover, prevalence of leanness was significantly higher in girls (22.04%) as compared to boys (14.86%).