The Association Between Body Mass Index and Parental History of Hypertension Among Young Indian Adults.

BACKGROUND: Hypertension is a disease of multifactorial etiology. Individuals with parental history of hypertension (PHH) have also been observed to be at an increased risk of developing hypertension in their adult life. However, there is a dearth of studies among youth. Obesity is one of the risk factors, and studies conducted among adults of all age groups have observed that there is a highly significant correlation between hypertension and body mass index (BMI). Hence, the association between the two factors, viz., parental history of hypertension and BMI, among the young Indian male and female population was analyzed in this study. METHOD: This cross-sectional study conducted in Central India comprised 100 young adults between 18 and 25 years of age. On the basis of parental history of hypertension, the subjects were divided into two groups: group 1 comprised youth with parental history of hypertension and group 2 comprised youth without parental history of hypertension, involving 32 and 68 subjects in each of these groups, respectively. Anthropometric measurements were done using standard methods, and BMI was calculated. Statistical analysis was done using Epi Info software. RESULTS: The study subjects in both groups were comparable in age. The mean age of the study participants was 19.32 years and 19.45 years in group 1 and group 2, respectively. The study did not find any association between BMI and parental history of hypertension. CONCLUSION: The association between parental history of hypertension and BMI, the non-modifiable and modifiable independent risk factors, respectively, needs to be further explored in light of the iceberg phenomenon, multifactorial causation, and natural history of disease. It is worth mentioning that parental history of hypertension and other risk factors should be considered even if the BMI is normal as per Asian Indian cutoff levels.

Program management challenges of clinical studies: A qualitative critical assessment.

Background: Organization, coordination, and discipline are required to complete any intricate operation, conducting a clinical experiment is no different. There are usually many moving components, from designing a plan, to conveying changes, to calculating risk, and excellent project management which are necessary to guarantee the study works successfully. Past evidence suggested that roadblock at any level hampers the progress of the clinical research. Understanding program management challenges hence becomes the key for timely and effective completion of clinical research. Methods: A cross-sectional qualitative enquiry involving stakeholders in clinical research program management. We used problem tree-based approach wherein we documented views of various stakeholders to understand the interaction, interdependence, and related interventional needs of bottlenecks for long-term research gains using modern management methods applicable in clinical settings. The best fit approach was also explored to augment maximum benefit in limited resource settings. Results: Non-alignment with state policy aims, a lack of effective coordination and communication among members, challenging logistic management, limited use of technology, a need for training, and an inefficient monitoring mechanism were among the major issues highlighted, and solutions were proposed. Conclusion: Study concludes that an Integrated Process-cum-Timeline-Based Management strategy with multisectoral emphasis is ideal for program management of clinical projects.

COVID19 associated mucormycosis: Is GRP78 a possible link?

This review aimed to study molecular mechanisms for high incidence of life-threatening mucormycosis infection in COVID19 cases during second wave of SARS CoV2 pandemic in India. Hyperglycaemia, impaired immunity, acidosis, raised ferritin, glucocorticoid therapy, and COVID19 specific other factors have been implicated in pathogenesis of COVID19 associated mucormycosis (CAMM). Endoplasmic reticulum chaperone 'Glucose Related Protein 78' (GRP78), also involved in SARS CoV2 entry, is the host receptor for invasion by Mucorales. GRP78 is over-expressed by SARS CoV2, hyperglycaemia and ferritin. Delta variant of SARS CoV2 and indiscriminate use of steroids were distinguishing features of second wave and appear to upregulate GRP78 through intricate interplay between internal and external milieu. Common invasive fungal infections like candidiasis and aspergillosis, not utilizing GRP78 as receptor, were inconspicuous. Further molecular research to unravel mechanisms involved in the pathogenesis of CAMM shall effectively complement existing strategies for its prevention and treatment.

Public Health Threat Assessment of Vehicular Load Index-Induced Urban Air Pollution Indices Near Traffic Intersections In Central India.

OBJECTIVES: To assess traffic vehicular load, levels of various air pollutants, their correlation at selected traffic intersections of Bhopal city and to suggest suitable public health measures. METHODS: A transverse study was conducted by convenience sampling with equated distribution among vehicular load-based large (Group1:G1: 10 TI), medium (Group2:G2: 5 TI), and small (Group3:G3: 5 TI) traffic-intersections (TI) through a systematic stratified random selection of study sites to assess traffic vehicle load index (VLI). RESULTS: VLI,G1 (cumulative mean: 16.31; day-time (DT): 19.03, DT range 11.68-51.49; night-time (NT): 13.59, NT range 11.7-18.0), VLI,G2 (cumulative mean: 0.965; DT:0.971, DT range 08.56-11.67; NT: 0.960, NT range 07.54-11.39), and VLI,G3 (cumulative mean: 06.17; DT:06.08, DT range 04.12-06.86; NT: 06.27, NT range 03.74-07.53). There is a significant intergroup difference of the mean (G1 vs G2: p=0.03); (G1 vs G3: p=0.002); (G2 vs G3: p=0.003). The range of VLI is found to be wide within G1 (DT; 11.68-51.49; NT 11.7-18.00) as compared to narrow range in G2 (DT; 8.56-11.67; NT7.54-11.39) and G3 (DT; 4.12-6.86; NT 3.74-7.53). CONCLUSION: High air pollution noted at TIs and associated exposure to unprotected commuters pose public-health risks. It has long-term health consequences requiring focused multidisciplinary preventive interventions.

Role of the Backbenchers of the Renin-Angiotensin System ACE2 and AT2 Receptors in COVID-19: Lessons From SARS.

The novel coronaviruses causing severe acute respiratory syndrome (SARS) and coronavirus disease 2019 (COVID-19) have been shown to utilize angiotensin-converting enzyme 2 (ACE2) as the receptor for entry into the host cells. The involvement of the renin-angiotensin system (RAS) in the evolution and pathogenesis of lung diseases has been implicated in recent years. The two enzymes of RAS, angiotensin-converting enzyme (ACE) and ACE2, serve a contrasting function. ACE helps in the formation of angiotensin II (AGII) from angiotensin I (AGI), and ACE2 cleaves AGI and AGII into AG (1-9) and AG (1-7) respectively. The ACE-induced AGII has vasoconstrictor and pro-inflammatory properties via AT1R, whereas ACE2 has been shown to protect against lung injury. The less spoken about AGII receptor, angiotensin receptor type 2 (AT2R), has anti-inflammatory and anti-fibrotic effects in lung tissue and may be of significance in light of the lung pathology presentation in COVID-19. A review of articles searched in PubMed and peer-reviewed journals of importance was done using search terms "ACE2," "AT2," "SARS," and COVID-19." Lung involvement in both SARS and COVID-19 has been very severe and suggestive of severe inflammatory and immune reactions. Animal studies have shown that ACE2 and AT2 receptors counter the pro-inflammatory and other effects mediated by angiotensin II by their vasodilator, anti-inflammatory, anti-fibrotic, and anti-proliferative effects. They have been shown to protect against and revert acute lung injuries. The instrumental role of recombinant ACE2, AT2 receptor agonists, and AT1 receptor blockers may be helpful in the treatment of COVID-19.

Feather hydrolysate from Streptomyces sampsonii GS 1322: A potential low cost soil amendment.

Process parameters for obtaining hydrolysate from hen feathers, i.e., initial pH (5.0-9.0) and incubation period (1-6 day), were set and studied, using Streptomyces sampsonii GS 1322 in submerged and solid state conditions. Under submerged conditions, complete hydrolysis of feathers was observed on fifth day [initial pH 8.0, 28 ± 2°C, shaking (150 rpm)] with release of soluble protein (2985 µg ml(-1)) and amino acids (2407 µg ml(-1)). Cell free hydrolysate showed hydrolysis of casein (18 mm), gelatin (26 mm), collagen (31 mm), hemoglobin (23 mm) and Tween 80 (35 mm) while 445 U keratinase activity. Total soluble protein reached 5 mg ml(-1) in solid state conditions. During Pot experimentation using barren agriculture soil the effect of feather hydrolysate on wheat crop were recorded. Significant increase (p<0.01) in wheat seed germination was observed in treated soils as compared to untreated. Treatment significantly increased plant height from 30 to 60 days and 30-90 days (p<0.001). Treated soil showed an increase in total microbial count, proteolytic activity, phosphate solubilizing bacteria and ammonifying bacteria, whereas pathogenic fungi load was reduced. S. sampsonii GS 1322 can be used for bio-processing of poultry wastes yielding feather hydrolysate rich in proteins and amino acids for development of low-cost organic amendment to accelerate wheat crop growth in barren agricultural land.

Weekly iron folate supplementation in adolescent girls--an effective nutritional measure for the management of iron deficiency anaemia.

INTRODUCTION: Nutritional anaemia in India is common morbidity seen in late adolescent and young female population. There are many conflicting opinions regarding dosage of iron folic acid supplementation for managing this simple nutritional deficiency disorder. Hence, this 'Randomized Controlled Trial' was undertaken in adolescent girls suffering from Iron Deficiency Anaemia visiting 'Urban Health and Training Centre' situated in urban slum area. The aim of this study was to assess the (a) Impact of weekly iron folic acid supplementation in comparison with daily iron supplementation for the management of Iron Deficiency Anaemia in adolescent girls visiting 'Urban Health and Training Centre'; (b) Adverse drug reaction profile in 'Weekly Iron Folic Acid Supplementation' and 'Daily Iron Folic Acid Supplementation' regimes; (c) Compliance profile for 'Weekly Iron Folic Acid Supplementation' and 'Daily Iron Folic Acid Supplementation' regimes in adolescent girls. METHODS AND MATERIAL: Randomized controlled trial was conducted in adolescent girls visiting 'Urban Health and Training Centre' during the study period June, 2011 to October, 2012. The 120 anaemic (Haemoglobin < 12 gm%) adolescent girls (10-19 years) were distributed randomly by block randomization in two groups; one receiving daily Iron and Folic Acid supplementation and in other group receiving weekly Iron and Folic Acid supplementation for 3 months. All the study subjects were given de-worming (Albendazole 400 mg) and required health education separately. Both the groups were monitored for Haemoglobin estimation, compliance and adverse drug reactions, if any. Open-Epi Statistical Software was used for data analysis. RESULTS: The mean age of study subjects in 'Daily Iron and Folic Acid Supplementation' and 'Weekly Iron and Folic Acid Supplementation' group was 13.48 and 13.55 years respectively. Their mean pre intervention Haemoglobin was 10.1±1.1 gm/dl and 10.4±1.1 gm/dl respectively. The mean rise in Haemoglobin after lean period of 1 month in respective groups was almost equal i.e. 1.0±0.7 gm/dl and 1.0±0.8 gm/dl. Adverse Drug Reactions were 8.3% in weekly regime as compared to 13.35% in daily regime, abdominal pain being the commonest adverse drug reaction seen .The compliance calculated as mean of unconsumed 'Iron and Folic Acid' tablets was 6.1±10.98 in 'Daily Iron Folic Acid Supplementation' group, while it was 1.3±3.15 in 'Weekly Iron Folic Acid Supplementation' group (p=0.0012), making weekly regime more promising than daily regime with better treatment compliance. CONCLUSIONS: Weekly supplementation of 'Iron and Folic Acid' in 'Iron Deficiency Anaemia' patients is as good as daily supplementation with added benefits of less adverse reactions and better compliance.