Genomic blueprint of population of Rajasthan based on autosomal STR markers.

Aim: Genetic diversity and forensic efficacy of 20 autosomal STR genetic markers were investigated in a highly diverse population of Rajasthan, a state in north-western India.Subjects and methods: In this study, 317 blood samples from unrelated healthy individuals were directly amplified using the PowerPlex® 21 multiplex system (Promega). Amplified products were separated by capillary electrophoresis using a Genetic Analyser -3500 XL (Thermo Fisher Scientific). The data thus obtained was statistically analysed using population genetic software.Results: The studied population showed genetic affinity with the geographically close populations. The locus Penta-E was found to be the most polymorphic with a value of 0.90 in the studied population. The combined discrimination power (CPD) and combined power of exclusion (CPE) were observed as >0.999999999 and 0.999999997, respectively, for all the studied 20 autosomal STR loci. The combined probability of match (CPm) was 1.39 × 10-25 and combined paternity index (CPI) was 3.66 × 108 for all the studied loci.Conclusion: The results conclusively support the hypothesis that the studied autosomal STR loci are polymorphic in nature and, besides being useful in forensic applications they can also be applied in anthropological and other population genetic studies. This study supports the 'isolation-by-distance' model. Genetic data obtained from this study will enrich the population data bank.

Stronger relationship of serum apolipoprotein A-1 and B with diabetic retinopathy than traditional lipids.

AIM: Diabetic retinopathy (DR) is the most common preventable cause of blindness where early detection and treatment can be sight-saving. Search for biomarkers of the disease has been relentless. We aimed to determine whether lipoproteins apolipoproteins A1 and B1 (Apo-A1 and Apo-B1) have stronger associations with DR in contrast to conventionally measured low-density lipoprotein (LDL) and high-density lipoprotein cholesterol levels. MATERIALS AND METHODS: We performed a cross-sectional study and studied 117 patients. Serum lipid profile was assessed by autoanalyzer. Serum Apo-A1 and Apo-B were measured using immunoturbidimetric kit on an autoanalyzer. Apo-B/A1 ratio was calculated. Retinopathy was graded from the digital retinal photographs, taken with nonmydriatic auto fundus camera and classified according to International Clinical DR Disease Severity Scale. RESULTS: Mean Apo-A1 for mild, moderate, severe retinopathy, and proliferative DR (PDR) shows a significant negative correlation (P = 0.001) with severity of retinopathy. Mean Apo-B for mild, moderate, severe, PDR displayed a significant positive correlation with severity of retinopathy (P = 0.001). Mean Apo-B/A1 for mild, moderate, severe, PDR showed highly significant positive correlation with severity of retinopathy (P < 0.001). In contrast, mean LDL for mild, moderate, severe, PDR showed insignificant association with severity of DR (P = 0.081). CONCLUSION: Apo-A1 and Apo-B have a stronger association with the development of DR than traditional lipids and can thus facilitate early detection and treatment of the disease.

HIV Presenting as Cerebellar Ataxia.

Presenting features of HIV has always been a Pandora's box largely due to multisystem affection by the virus and a large array of opportunistic infections. We hereby report an extremely rare case of 40 yr old patient presenting as symmetric, progressive cerebellar ataxia later found to be HIV positive. Thorough knowledge of rare presentations of HIV and a high index of suspicion are necessary for early diagnosis and efficient treatment of HIV.

Ocular perfusion pressure and choroidal thickness in eyes with polypoidal choroidal vasculopathy, wet-age-related macular degeneration, and normals.

PURPOSE: To measure the choroidal thickness and ocular perfusion pressure in eyes with polypoidal choroidal vasculopathy (PCV), wet-age-related macular degeneration (AMD), and age-matched normal subjects, and look for a possible association between the two. METHODS: This was a prospective study including 22 eyes with PCV, 33 eyes with wet-AMD, and 35 age-matched normal eyes. Choroidal thickness was measured using enhanced depth imaging (EDI) with spectral-domain optical coherence tomography (SD OCT). Mean ocular perfusion pressure (MOPP) was calculated using the mathematical formula 2/3[DBP+1/3{SBP × DBP}]-IOP (DBP-diastolic blood pressure, SBP-systolic blood pressure, IOP-intraocular pressure). Analyses were carried out using SPSS 14 software and comparisons of mean made using't' tests. RESULTS: Eyes with PCV showed increased (285.9 µm; subfoveal) choroidal thickness, whereas eyes with wet-AMD (119.4 µm; subfoveal) showed reduced choroidal thickness in comparison with normal eyes (186.77 µm; subfoveal). MOPP in the PCV group was 57.85 mm Hg (P value 0.00), in the wet-AMD group was 52.1 mm Hg (P-value 0.12), and in the normal group was 49.79 mm Hg. CONCLUSION: It is postulated that higher MOPP in eyes with PCV could have an etiologic implication in disease manifestation and progression. Larger studies with longer follow-up may help validate these findings.

Transgene-mediated suppression of dengue viruses in the salivary glands of the yellow fever mosquito, Aedes aegypti.

Controlled sex-, stage- and tissue-specific expression of antipathogen effector molecules is important for genetic engineering strategies to control mosquito-borne diseases. Adult female salivary glands are involved in pathogen transmission to human hosts and are target sites for expression of antipathogen effector molecules. The Aedes aegypti 30K a and 30K b genes are expressed exclusively in adult female salivary glands and are transcribed divergently from start sites separated by 263 nucleotides. The intergenic, 5'- and 3'-end untranslated regions of both genes are sufficient to express simultaneously two different transgene products in the distal-lateral lobes of the female salivary glands. An antidengue effector gene, membranes no protein (Mnp), driven by the 30K b promoter, expresses an inverted-repeat RNA with sequences derived from the premembrane protein-encoding region of the dengue virus serotype 2 genome and reduces significantly the prevalence and mean intensities of viral infection in mosquito salivary glands and saliva.

Is high body mass index associated with increased risk of groin complications using manual compression after diagnostic coronary angiography?

There is a common perception that high body mass index (BMI) is associated with an increased risk of bleeding complications at the site of femoral puncture when manual compression is used for achieving hemostasis. Because of lack of evidence to support or refute this, we conducted a study to assess whether raised BMI is associated with increased risk of groin complications. 15 cases of groin complications after manual compression over 2 years and 40 controls were each divided into 3 groups according to BMI. Baseline characteristics of cases and controls were similar. High BMI was not found to be associated with increased risk of groin complications, suggesting that manual compression is safe and effective in patients with raised BMI.

Role of angiotensin receptor blockers in the prevention and management of ischaemic stroke.

Angiotensin receptor blockers (ARB's) are an important class of antihypertensive agents and appear to have a role in the prevention and management of ischaemic stroke. We present a discussion of the data on ARB's in this important condition.

The role of angiotensin II type 1 receptor blockers in the prevention and management of diabetes mellitus.

Angiotensin II Receptor blockers (ARBs) are an important addition to the current range of medications available for treating a wide spectrum of diseases including cardiovascular diseases. Coronary heart disease (CHD) is the most common cause of death in the United Kingdom and worldwide. More importantly, the presence of the metabolic syndrome and the likelihood of diabetes mellitus taking on epidemic proportions in the years to come all threaten to maintain the mortality rate due to CHD. This review article focuses on the clinical studies that have helped define the trends in the usage of these agents in the prevention and treatment of diabetes mellitus and its complications and also explores possible mechanisms of action and future developments.

Phosphodiester modification by zinc metalated adenine polymer with carboxyl pendants.

This report describes a novel carboxyl pendant containing adenylated polymeric template, its metalation with Zn (II), and manifestation of catalytic activity for the hydrolysis of model phosphodiester, bis(p-nitrophenyl) phosphate (bNPP), and plasmid cleavage. Observation of a bell-shaped pH-K(obs) profile suggested influence of pH variation over hydrolysis rate. This metalated polymer also afforded facile relaxation of pBR322 supercoiled DNA, with an interesting reusability feature intricately associated with heterogeneous catalysis.

Biomimetic synthesis and ultrastructural characterization of a zerovalent gold-hydroxyapatite composite.

This manuscript describes one-pot, in situ synthesis of organoapatite-gold nanoparticle composite and its characterization by XRD, energy dispersive X-ray analysis, atomic force, and scanning electron microscopy. This methodology offers a different approach into the synthesis of zerovalent metal-mineral-phase nanocomposites having potential application as osteointegrative ceramics.

The role of transthoracic echocardiography in excluding left sided infective endocarditis in Staphylococcus aureus bacteraemia.

In all patients with Staphylococcus aureus bacteraemia a transoesophageal echocardiogram is recommended to exclude infective endocarditis. We determined that a finding of normal to trivial valvular regurgitation on transthoracic echocardiogram in these patients significantly reduced the probability of infective endocarditis. Furthermore, in the absence of embolic phenomena the likelihood of infective endocarditis was less than 2%. This probability could be further reduced if the echocardiogram was performed greater than 5 days after the bacteraemia. Therefore, in the assessment of patients with S. aureus bacteraemia a transoesophageal echocardiogram is not always required to exclude infective endocarditis.

Free volume study on calcification process in an intraocular lens after cataract surgery.

An opacified intraocular lens explanted from a patient in the postoperative period after phacoemulsification was investigated to find the cause of opacification. From the UV-visible and energy dispersive X-ray spectroscopy (EDS) measurements, the opacification in the present case seems to be due to calcification of the intraocular lens and not due to modification in the UV absorber material of the lens. The average free volume size of the intraocular lens both in unimplanted and explanted state were obtained from positron lifetime spectroscopy (PLS). Further, the combined FTIR and PLS results indicate that calcium gets into the free volume cavities of the intraocular lens matrix as a cationic moiety, may be in the form of Ca(++). The small decrease in glass transition temperature of the calcified lens seems to indicate the plasticizing action of calcium ions. The present results could be of some use in the design of the intraocular lens material in which calcification would be minimum.

WHO's proposed global strategy for infant and young child feeding: a viewpoint.

The Global Strategy for Infant and Young Child Feeding is being developed by the WHO and is likely to be adopted as World Health Assembly Resolution in the month of May, 2002. The global strategy is built on Baby Friendly Hospital Initiative, the International Code of Marketing of Breast Milk Substitutes and the Innocenti Declaration on the Protection, Promotion and Support of Breastfeeding. It emphasises the need for comprehensive national policies on infant and child health feeding including guidelines on ensuring appropriate feeding of infants and young children in exceptionally difficult circumstances and to ensure that all health services protect, promote and support breastfeeding exclusively for first 6 months and then timely and adequate complementary feeding with continued breastfeeding for two years or beyond. Thus the strategy is to improve nutritional status, growth and development, health and survival of infants and young children. It recognises that mothers should have adequate information and support within their families and communities should be free and should be free from commercial influence. The strategy mentions an effective feeding policy with some critical interventions as elaborated in this article.

Training in Baby Friendly Hospital Initiative.

The Baby Friendly Hospital Initiative (BFHI) was initiated in India with focus on large hospitals initially and then spread to many parts of India. 'Ten steps to successful breastfeeding' form the basis of BFHI of which step 2 regarding training is critical for the success of this programme. The duration of training should be at least for 18 hours, including at least 3 hours of clinical practice. Programme managers and policy makers should take training of health care staff rather seriously for achieving the real success in implementing the BFHI policies laid down in steps 3 to 10.

World Health Assembly recommends exclusive breastfeeding for first six months.

Exclusive breastfeeding means that the infant receives only breast milk (from his or her mother or a wet nurse or expressed breast milk) and no other liquids or complementary foods with the exception of undiluted drops or syrups consisting of vitamin and mineral supplements or medicines. During this period water is not permitted. The resolution (WHA 54.2) urges Member States to support exclusive breastfeeding for first six months as a global public health recommendation and to provide safe and appropriate complementary foods, with continued breastfeeding for up to two years or beyond. Breastfeeding Promotion Network of India (BPNI) has issued guidelines for breastfeeding and complementary feeding.

Permanent pacemaker implantation via the femoral vein: an alternative in cases with contraindications to the pectoral approach.

BACKGROUND: This paper presents a consecutive series of permanent pacemakers (PPM) implanted via the femoral vein in patients with contraindications to pacing systems via the superior vena cava (SCV). The femoral vein approach is a less invasive and feasible alternative to epicardial lead placement. METHODS: Twenty-seven patients had femoral pacemakers inserted. Indications for femoral vein pacemaker insertion were: SVC/subclavian obstruction (12 patients, 44.4%), previous infection in SVC leads (four patients, 14.8%), mastectomy and/or radiotherapy to chest (four patients, 14.8%), multiple leads in SVC (two patients, 7.4%), recurrent erosion (two patients, 7.4%), abnormal anatomy (one patient, 3.7%), painful pacemaker pocket (one patient, 3.7%) and burns (one patient, 3.7%). Fifty-one leads, 25 atrial and 26 ventricular, were inserted. The majority of leads were active fixations (96% of atrial leads and 85% ventricular leads). RESULTS: During a mean follow-up of 36.5 months (range 0.9-116.5), six additional unplanned procedures were performed in four patients. Atrial lead displacement occurred in five leads (20%). There were no ventricular lead displacements. In two patients, box revision for pre-erosion was required. One patient had persistent pain at the site of abdominal pacemaker generator. Infection, thromboembolic events, thromophlebitis, evidence of lower limb venous occlusion and lead fracture did not occur. CONCLUSION: Femoral vein PPM are a simple and feasible alternative in patients in whom the SVC approach is contraindicated.

Hydro-chemistry of Udaipur lakes.

The hydro-chemical character of lakes around Udaipur city has been studied for a period of five years. But for the lake Udaisagar, the salinity of water in lakes Badi, Fatehsagar, Pichhola and Swaroopsagar is less than 750 microSiemens per centimeter and fluctuates marginally in dry and wet period. The waters are Ca-Mg-HCO3 type and have calcite saturation. All the lakes have shown dissolved oxygen more than 8.0 mg/L despite of varying level of pollution. The lake Udaisagar is most polluted and exhibits eutrophic character along with the lakes Swaroopsagar and Pichhola.

Intrapartum fever and unexplained seizures in term infants.

OBJECTIVE: Early-onset neonatal seizures are a strong predictor of later morbidity and mortality in term infants. Although an association of noninfectious intrapartum fever with neonatal seizures in term infants has been reported, it was based on only a small number of neonates with seizures. We therefore conducted a case control study to investigate this association further. METHODS: All term infants with neonatal seizures born at Brigham and Women's Hospital between 1989 and 1996 were identified. For this study, cases consisted of all term neonates with a confirmed diagnosis of seizure born after a trial of labor for whom no proximal cause of seizure could be identified. Infants with sepsis or meningitis were excluded. Four controls matched by parity and date of birth were identified for each case. The rate of intrapartum maternal temperature >100.4 degrees F was compared for case infants and controls. Potential confounding was controlled in logistic regression analysis. RESULTS: Cases comprised 38 term infants with unexplained seizures after a trial of labor. We identified 152 controls. Infants with seizures were more likely to be born to mothers who were febrile during labor (31.6% vs 9.2%). In almost all cases, the fever developed during labor (94.7% cases, 97.4% controls). At admission, mothers of infants with seizures were not significantly more likely to have factors associated with concern about infection such as a white blood cell count >15 000/mm(3) (28. 9% vs 19.1%) and premature rupture of the membranes (15.8% vs 17.8%). In a logistic regression analysis controlling for confounding factors, intrapartum fever was associated with a 3.4-fold increase in the risk of unexplained neonatal seizures (odds ratio = 3.4, 95% confidence interval = 1.03-10.9). CONCLUSION: Our data indicate that intrapartum fever, even when unlikely to be caused by infection, is associated with a fourfold increase in the risk of unexplained, early-onset seizures in term infants.

What is the signal for the posttranslational arginylation of proteins?

The N-terminal, posttranslational arginylation of proteins is ubiquitous in eukaryotic cells. Previous experiments, using purified components of the reaction incubated in the presence of exogenous substrates, have shown that only those proteins containing acidic residues at their N-terminals are arginylation substrates. However, data from experiments that used crude extracts of brain and nerve as the source of the arginylating molecules, suggest that the in vivo targets for arginylation are more complex than those demonstrated using purified components. One of the proposed functions for arginylation is as a signal for protein degradation and proteins that have undergone oxidative damage have been shown to be rapidly degraded. In the present experiments we have tested the hypothesis that the presence of an oxidatively damaged residue in a protein is a signal for its arginylation. These experiments have been performed by adding synthetic oxidized peptides to crude extracts of rat brain, incubating them with [3H]Arg and ATP and assaying for arginylated peptides using RP-HPLC. Results showed that while the oxidized A-chain of insulin was arginylated in this system, confirming previous experiments, other peptides containing oxidized residues were not. When a peptide containing Glu in the N-terminus was incubated under the same conditions it too was not a substrate for arginylation. These findings show that neither the presence of an N-terminal acidic residue nor an oxidized residue alone are sufficient to signal arginylation. Thus, another feature of the oxidized A-chain of insulin is required for arginylation. That feature remains to be identified.

Cardioinhibition during tilt testing identifies patients who may benefit from pacing.

UNLABELLED: This study examined whether the various hemodynamic collapse patterns observed during tilt testing in patients with suspected neurocardiogenic syncope are relevant when planning therapy, particularly whether a predominantly cardioinhibitory response predicts a beneficial response from pacing. METHODS: The effects of temporary atrioventricular (A-V) sequential pacing were studied during tilt testing in 34 patients 48.2 +/- 18.5 years of age. The patient population was divided into a cardioinhibitory group (VASIS classes 2A and 2B) or mixed group (VASIS classes 1 and 3) according to their response to baseline tilt testing. The test was then repeated during A-V pacing with rate hysteresis. A positive response to A-V pacing was defined as a > or = 30-second increase between onset of symptoms and syncope, or mitigation of symptoms compared with the baseline tilt test. RESULTS: The study protocol was not successfully completed in three patients. Among the remaining 31 patients, a baseline cardioinhibitory response was observed in 17, and a mixed response in 14 patients. A-V sequential pacing was successful in 13 of 17 patients with a cardioinhibitory response versus 5 of 14 patients with a mixed response (P = 0.024). CONCLUSION: The presence of a predominantly cardioinhibitory collapse pattern (VASIS 2A and 2B) during baseline tilt testing doubled the likelihood of successful temporary A-V sequential pacing, and may identify patients with neurocardiogenic syncope most likely to benefit from permanent dual chamber pacing.