Differential Relationship of Grip Strength with Body Composition and Lifestyle Factors Between Indian Urban and Rural Boys and Girls.

OBJECTIVES: To assess grip strength and gender differences in grip strength in 9-18-y-old urban and rural Indian children, to study association of grip strength with body composition, and assess determinants of grip strength. METHODS: This was part of a multicenter, cross-sectional, school-based study (n = 1978, mean age 13.3 ± 2.2 y) from three urban and rural states. Anthropometry, body composition, dietary intake, physical activity, sunlight exposure, and grip strength (in kg) were measured. RESULTS: Mean grip strength increased with age but plateaued in girls after 12 y and was higher in boys (19.6 ± 9.2) than girls (14.3 ± 5.3) (p < 0.05). Mean grip strength was higher in urban (21.05 ± 9.7) than in rural boys (17.8 ± 8.2) (p < 0.05), and comparable in urban (14.9 ± 5.2) and rural girls (13.8 ± 5.5). Grip strength in girls remained lower than boys after adjusting for muscle mass. Difference between boys and girls reduced after body size [body mass index (BMI)] correction, but remained low in girls, plateauing after 15 y. Muscle mass and age were significant determinants of grip strength in all children. On addition of lifestyle factors to the model, grip strength was explained to varied degrees in the children. CONCLUSION: In boys, nutrition through body size and composition was largely responsible for the differences in grip strength, and in girls, additionally, sociocultural factors also possibly impacted grip strength.

Sitting height percentiles in 3-17-year-old Indian children: a multicentre study.

Background: Sitting height (StH) percentiles are not described for the Indian paediatric population.Aim: To generate multicentre StH percentile values for Indian children.Subjects and methods: A total of 7961 apparently healthy children (3-17 years old, Boys: 4328) randomly selected from 10 schools from six states of India were measured for height (ht), StH and weight during July 2016-October 2017.Results: The StH:Ht ratio was 0.52 (0.02) and was similar between boys and girls (p > 0.1). The ratio decreased in boys until the age of 14 years and then slightly increased; the lowest ratio was observed during 13-15 years. In girls, however, the StH:Ht ratio decreased until the age of 9 years and then plateaued until 15 years of age with a slight increase at 16 years; the lowest ratio was observed at the age of 12-13 years. Sitting height percentiles (3rd, 10th, 25th, 50th, 75th, 90th and 97th) were computed using LMS chartmaker.Conclusions: The results indicate that, during the pubertal years, the lower limb growth is more predominant than trunk growth. Further, this study provides smoothened percentile curves for sitting height in Indian children for the first time.

Upper and Lower Body Segment Ratios from Birth to 18 years in Children from Western Maharashtra.

OBJECTIVES: To assess the upper body segment (US), lower body segment (LS) and US:LS ratio for children from birth to 18 y of age and to compare these data with other US:LS ratio norms from previously reported studies. METHODS: A cross-sectional, observational study was conducted in children [birth to 18 y; n = 5454 children (3158 boys)] residing in Pune city, Western India, from December 2015 through June 2017, to evaluate the US, LS and the US:LS ratio. RESULTS: The mean US:LS ratio in boys at birth was 1.45; at one year of age it was 1.35 that decreased to 0.89 at 14 y. The nadir for the US:LS ratio in boys was reached at 14 y of age (0.89). In girls, the mean US:LS ratio at birth was 1.44, at one year of age it was 1.35 that decreased to 0.89 at 12 y. The nadir for the US:LS ratio in girls was reached at 12 y of age (0.89). From 12 to 18 y the US:LS ratio was fairly constant (for girls: 0.89, for boys: 0.9). On plotting the US and LS against the age in present study population, the US and LS curves crossed each other (US:LS = 1) at 7 to 8 y in boys and at 6 to 7 y in girls. CONCLUSIONS: The authors describe data for upper and lower body segments and their ratio in boys and girls from birth to 18 y in children from western Maharashtra. These data may help in the diagnosis of disproportionate short stature in children.

Association of body fat with stress levels and dietary intakes in Indian women.

A cross-sectional study of 605 women (aged 18-50 years) conducted from January 2013 to June 2014 in Gujarat, India assessed stress, dietary intakes and body fat percentage (PBF), and the inter-relationship of PBF with stress, dietary fat, and carbohydrates. The population was categorized according to PBF cutoffs for Asians. A generalized linear regression model adjusted for age was performed to assess the relationship of stress, fat, and carbohydrate intakes with PBF. PBF had a significant positive association with stress level (p = .02) and carbohydrate intake (p = .008); fat intake was not significantly associated (p = .8). Women with moderate PBF consumed significantly less carbohydrates (mean = 152.3 ± 13.3 gm/1000 kcal/day, p < .05) and had lower stress scores (mean = 9.7 ± 4.2, p < .05) than women with high PBF (mean carbohydrate intake = 156.2 ± 10.8 gm/1000 kcal/day; mean stress score = 10.9 ± 4.4) and very high PBF (mean carbohydrate intake = 156.8 ± 11.6 gm/1000 kcal/day; mean stress score = 11.2 ± 4.2). We conclude that PBF has a positive association with stress and dietary carbohydrate; women with higher stress and carbohydrate intake are more likely to accumulate higher body fat as compared to women with less stress and low carbohydrate intake.

Reference Centile Curves for Body Fat Percentage, Fat-free Mass, Muscle Mass and Bone Mass Measured by Bioelectrical Impedance in Asian Indian Children and Adolescents.

OBJECTIVE: To create gender-specific percentile curves for percent body fat (%BF) by Bio electrical Impedance Analysis (BIA) for screening adiposity and risk of hypertension in Indian children and generate reference curves for percent fat-free mass (%FFM), muscle mass (%LM) and bone mineral content (BMC) by using bioelectrical impedance. DESIGN: Secondary analysis of data from previous multicenter cross-sectional studies. SETTING: Private schools from five regions of India. PARTICIPANTS: A random sample of 3850 healthy school children (2067 boys) (5-17 yr) from private schools in five major Indian cities. METHODS: Anthropometry, blood pressure (BP) and body composition were measured by bioelectrical impedance. Reference curves were generated by the LMS method. MAIN OUTCOME MEASURES: %BF, %FFM, %LM, BMC and BP. RESULTS: Median %BF increased by 6% from 5 to 13 years of age and declined (around 2%) up to 17 years in boys. In girls, %BF increased by 8% from 5 to 14 years and thereafter declined by 3%. Based upon the risk of hypertension, the new cut-offs of 75th and 85th percentile of %BF were proposed for detecting over fatness and excess fatness in children. Median %FFM was 90% at 5 yrs and decreased till 12 years, and then showed a slight increase to 84% at 17 yrs in boys. In girls, it was 86% at 5 yrs and decreased till 15 yrs, and plateaued at 71.8% at 17 yrs. CONCLUSIONS: Reference curves for percent body fat for Indian children would be useful to screen children for health risk in clinical set up.

Interrelationship between serum 25-hydroxyvitamin D3 concentration and lipid profiles in premenopausal Indian women.

CONTEXT: Vitamin D deficiency is prevalent worldwide, and observational studies have associated it with an atherogenic lipid profile. AIM: To determine the interrelationship between Vitamin D and lipid profile in apparently healthy premenopausal Indian women, considering confounding factors such as lifestyle that independently influence lipids. SETTING AND DESIGN: Cross-sectional study. SUBJECTS AND METHODS: One hundred and twenty healthy premenopausal women (20-45 year) were recruited from Gujarat, India. Data were collected on anthropometry, physical activity, sunlight exposure, and diet. Fasting blood samples were collected for the measurement of serum 25-hydroxyvitamin D3 (25[OH]D), parathyroid hormone, and lipid profile. STATISTICAL ANALYSIS: Pearson's correlation coefficient was used to derive correlation between serum 25[OH]D concentrations and serum lipids. RESULTS: Ninety-three percent women showed Vitamin D deficiency (serum 25[OH]D < 20 ng/ml). Serum 25(OH)D concentrations showed significant inverse correlation with total cholesterol (TC) (r = -0.202, P = 0.027), triglycerides (TG) (r = -0.284, P = 0.002), and low-density lipoprotein-cholesterol (LDL-C) (r = -0.184, P = 0.044) and positive correlation with high-density lipoprotein-cholesterol (HDL-C) (r = 0.250, P = 0.006). On dichotomizing the population according to median 25(OH)D concentration (11.1 ng/dl), no significant differences were observed between the groups for anthropometry, sunlight exposure, and lifestyle. Serum lipid profiles were significantly different, above median serum 25(OH)D concentration group showed favorable serum lipids (TC: 179.3 ± 30 vs. 191.8 ± 31.7 mg/dl; TG: 140 ± 39.1 vs. 165.5 ± 53.4 mg/dl; LDL-C: 100 ± 30.2 vs. 112 ± 32 mg/dl; HDL-C: 53 ± 14 vs. 47.6 ± 9.3 mg/dl)(P < 0.05). CONCLUSIONS: This study demonstrates that association of 25(OH)D concentrations with lipid profile even after considering lifestyle factors which independently influence lipids. Intervention trials would be required to prove this association to be causation.

Association of dental and skeletal fluorosis with calcium intake and serum vitamin D concentration in adolescents from a region endemic for fluorosis.

CONTEXT: Fluorosis is controlled by the duration of fluoride exposure and calcium and Vitamin D nutrition status. AIM: To examine (a) prevalence of dental and skeletal fluorosis in adolescents from upper, middle, and lower socioeconomic strata (SES) and (b) association of fluorosis with calcium intake and Vitamin D status. SETTINGS AND DESIGN: A cross-sectional study conducted in 10-13.9 years apparently healthy adolescents (n = 90), from different SES of Patan (Gujarat, India). MATERIALS AND METHODS: Dental fluorosis was graded as mild, moderate, and severe. Radiographs of the right hand and wrist were examined and graded. Serum 25 hydroxyvitamin D3 (25OHD) and parathyroid hormone concentrations were measured. Diet was recorded (24 h recall) and calcium intake was computed (C-diet V-2.1, 2013, Xenios Technologies Pvt. Ltd). STATISTICAL ANALYSIS: Generalized linear model was used to analyze relationships between fluorosis, SES, serum 25OHD concentration, and calcium intake. RESULTS: Fluorosis was predominant in lower SES (17% had both dental and radiological features whereas 73% had dental fluorosis); no skeletal deformities were observed. Mean 25OHD concentrations and dietary calcium were 26.3 ± 4.9, 23.4 ± 4.7, and 18.6 ± 4 ng/ml and 441.2 ± 227.6, 484.3 ± 160.9, and 749.2 ± 245.4 mg/day, respectively, for lower, middle, and upper SES (P < 0.05). Fluorosis and SES showed a significant association (exponential ß = 2.5, P = 0.01) as compared to upper SES, middle SES adolescents were at 1.3 times while lower SES adolescents were at 2.5 times higher risk. Serum 25OHD concentrations (P = 0.937) and dietary calcium intake (P = 0.825) did not show a significant association with fluorosis. CONCLUSION: Fluorosis was more common in lower SES adolescents, probably due to the lack of access to bottled water. Relatively adequate calcium intake and serum 25OHD concentrations may have increased the efficiency of dietary calcium absorption, thus preventing severe fluorosis.

Impact of occupation on stress and anxiety among Indian women.

The objectives of this study were to: (1) assess the prevalence of anxiety and stress in Indian women; and (2) evaluate the relationship of occupation to the prevalence of anxiety and stress. A cross-sectional study was performed from January 2013 to June 2014, on women (aged 18-50 years) randomly selected from different occupations in Gujarat, India. Anxiety was evaluated using Spielberg's State and Trait Anxiety Inventory scale and stress was assessed using the International Stress Management Association questionnaire. Serum cortisol concentration was measured in a sub-sample. The association of occupation with stress and anxiety was analyzed by a generalized linear model adjusted for age. Among all participants, 26% were the most prone and 66% were somewhat more prone to stress; 35% of women showed high anxiety levels. Homemakers had 1.2 times higher anxiety and 1.3 times higher stress than working women (p < .05). Prevalence of stress (37%, p < .001) and anxiety (40%, p = .068) were also higher in homemakers compared to working women and students. Serum cortisol levels did not differ significantly (p > .05) by occupation. This study revealed high prevalence rates of stress and anxiety in Indian women. Involvement in activities outside the home may help women to reduce stress.

Dietary calcium intake influences the relationship between serum 25-hydroxyvitamin D3 (25OHD) concentration and parathyroid hormone (PTH) concentration.

OBJECTIVES: To investigate whether dietary calcium intake will modify the relationship between serum 25-hydroxyvitamin D3 (25OHD) with intact serum parathyroid hormone (PTH) concentrations in apparently healthy Indian adolescents. STUDY DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: Apparently healthy adolescents aged 10-14 years (n=181), from Gujarat, western India. Study conducted from January 2012 to March 2014. METHODS: Serum 25OHD concentrations and intact serum PTH concentrations (both using chemiluminescent microparticle immunoassay) were measured. Diet was recorded through 24 h diet recall and calcium intake was computed (C-diet V.2.1). To assess relationship between 25OHD and PTH, data were dichotomised according to median calcium intakes (520 mg/day) and relationship between serum 25OHD and PTH in the two subgroups was plotted. RESULTS: Subjects with calcium intakes above median (>520 mg/day) had lower intact serum PTH values for given serum 25OHD concentration while those with calcium intakes below median (<520 mg/day) had higher intact serum PTH values for given serum 25OHD concentration. Serum 25OHD concentration was negatively correlated with intact serum PTH concentration at lower as well as higher calcium intakes (r=- 0.606 and -0.483, respectively, p<0.01 for both). Using a regression analysis, predicted values for intact serum PTH concentration for the given serum 25OHD concentrations were plotted. The plot revealed a negative shift with increasing calcium intake. CONCLUSIONS: Dietary calcium intake modifies the relationship between serum 25OHD concentrations and intact serum PTH concentrations. Thus, dietary calcium intake should be taken into account when assessing an individual's vitamin D status.

Inside-out signaling promotes dynamic changes in the carcinoembryonic antigen-related cellular adhesion molecule 1 (CEACAM1) oligomeric state to control its cell adhesion properties.

Cell-cell contacts are fundamental to multicellular organisms and are subject to exquisite levels of control. The carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) can engage in both cis-homophilic (parallel) oligomerization and trans-homophilic (anti-parallel) binding. In this study, we establish that the CEACAM1 transmembrane domain has a propensity to form cis-dimers via the transmembrane-embedded (432)GXXXG(436) motif and that this basal state is overcome when activated calmodulin binds to the CEACAM1 cytoplasmic domain. Although mutation of the (432)GXXXG(436) motif reduced CEACAM1 oligomerization, it did not affect surface localization of the receptor or influence CEACAM1-dependent cellular invasion by the pathogenic Neisseria. The mutation did, however, have a striking effect on CEACAM1-dependent cellular aggregation, increasing both the kinetics of cell-cell association and the size of cellular aggregates formed. CEACAM1 association with tyrosine kinase c-Src and tyrosine phosphatases SHP-1 and SHP-2 was not affected by the (432)GXXXG(436) mutation, consistent with their association with the monomeric form of wild type CEACAM1. Collectively, our results establish that a dynamic oligomer-to-monomer shift in surface-expressed CEACAM1 facilitates trans-homophilic binding and downstream effector signaling.

Chlamydia trachomatis vacuole maturation in infected macrophages.

Chlamydia trachomatis is an obligate intracellular bacterium responsible for one of the most common sexually transmitted diseases. In epithelial cells, C. trachomatis resides in a modified membrane-bound vacuole known as an inclusion, which is isolated from the endocytic pathway. However, the maturation process of C. trachomatis within immune cells, such as macrophages, has not been studied extensively. Here, we demonstrated that RAW macrophages effectively suppressed C. trachomatis growth and prevented Golgi stack disruption, a hallmark defect in epithelial cells after C. trachomatis infection. Next, we systematically examined association between C. trachomatis and various endocytic pathway markers. Spinning disk confocal time-lapse studies revealed significant and rapid association between C. trachomatis with Rab7 and LAMP1, markers of late endosomes and lysosomes. Moreover, pretreatment with an inhibitor of lysosome acidification led to significant increases in C. trachomatis growth in macrophages. At later stages of infection, C. trachomatis associated with the autophagy marker LC3. TEM analysis confirmed that a significant portion of C. trachomatis resided within double-membrane-bound compartments, characteristic of autophagosomes. Together, these results suggest that macrophages can suppress C. trachomatis growth by targeting it rapidly to lysosomes; moreover, autophagy is activated at later stages of infection and targets significant numbers of the invading bacteria, which may enhance subsequent chlamydial antigen presentation.

Proteomic analysis of microtubule-associated proteins during macrophage activation.

Classical activation of macrophages induces a wide range of signaling and vesicle trafficking events to produce a more aggressive cellular phenotype. The microtubule (MT) cytoskeleton is crucial for the regulation of immune responses. In the current study, we used a large scale proteomics approach to analyze the change in protein composition of the MT-associated protein (MAP) network by macrophage stimulation with the inflammatory cytokine interferon-gamma and the endotoxin lipopolysaccharide. Overall the analysis identified 409 proteins that bound directly or indirectly to MTs. Of these, 52 were up-regulated 2-fold or greater and 42 were down-regulated 2-fold or greater after interferon-gamma/lipopolysaccharide stimulation. Bioinformatics analysis based on publicly available binary protein interaction data produced a putative interaction network of MAPs in activated macrophages. We confirmed the up-regulation of several MAPs by immunoblotting and immunofluorescence analysis. More detailed analysis of one up-regulated protein revealed a role for HSP90beta in stabilization of the MT cytoskeleton during macrophage activation.

Membrane ruffles capture C3bi-opsonized particles in activated macrophages.

A widespread belief in phagocyte biology is that FcgammaR-mediated phagocytosis utilizes membrane pseudopods, whereas Mac-1-mediated phagocytosis does not involve elaborate plasma membrane extensions. Here we report that dynamic membrane ruffles in activated macrophages promote binding of C3bi-opsonized particles. We identify these ruffles as components of the macropinocytosis machinery in both PMA- and LPS-stimulated macrophages. C3bi-particle capture is facilitated by enrichment of high-affinity Mac-1 and the integrin-regulating protein talin in membrane ruffles. Membrane ruffle formation and C3bi-particle binding are cytoskeleton dependent events, having a strong requirement for F-actin and microtubules (MTs). MT disruption blunts ruffle formation and PMA- and LPS-induced up-regulation of surface Mac-1 expression. Furthermore, the MT motor, kinesin participates in ruffle formation implicating a requirement for intracellular membrane delivery to active membrane regions during Mac-1-mediated phagocytosis. We observed colocalization of Rab11-positive vesicles with CLIP-170, a MT plus-end binding protein, at sites of particle adherence using TIRF imaging. Rab11 has been implicated in recycling endosome dynamics and mutant Rab11 expression inhibits both membrane ruffle formation and C3bi-sRBC adherence to macrophages. Collectively these findings represent a novel membrane ruffle "capture" mechanism for C3bi-particle binding during Mac-1-mediated phagocytosis. Importantly, this work also demonstrates a strong functional link between integrin activation, macropinocytosis and phagocytosis in macrophages.

Evaluation of a fetomaternal-surgical clinic for prenatal counselling of surgical anomalies.

With increasing ability to diagnose fetal anomalies, it is imperative that parents receive appropriate counselling to reach their decision. The aim of this study was to evaluate the fetomaternal-surgical clinic held jointly by an obstetrician and a paediatric surgeon. At this monthly clinic the patients are first scanned by the consultant fetomaternal specialist in the presence of a consultant paediatric surgeon and subsequently counselled jointly in an adjacent quiet room. Other specialists such as geneticist and neonatologists provided further counselling where needed. All 43 parents who attended this clinic in the year 2005 were included in this study and were counselled by the same paediatric surgeon. A questionnaire was designed to assess the different aspects of service provided by this clinic. In this study the diagnosis was changed in 3 (7%) babies, 2 (4.6%) parents miscarried and 1 (2.3%) neonatal death occurred, unrelated to the surgical anomaly. The site of delivery was changed in 20 (48%) patients and the mode of delivery in 7 (10%). All 43 (100%) parents were satisfied with the fetal counselling, eight patients (18.6%) felt increased anxiety post-counselling and 95% had a better understanding of their unborn babies condition after counselling. Two (4.6%) parents decided to terminate the pregnancy due to complex fetal abnormalities, and 31 (72%) felt they understood the future pregnancy risks. Fifty-six per cent of parents felt that further counselling from religious person should be offered.

Alveolar capillary dysplasia presenting as pneumothorax: a case report and review of literature.

Alveolar capillary dysplasia, although rare, is a universally fatal form of persistent pulmonary hypertension of the newborn. We report a case of a newborn male baby who developed respiratory distress and pneumothorax 11 h after an uncomplicated delivery. He deteriorated despite full ventilatory support and extracorporeal membrane oxygenation (ECMO). Open lung biopsy provided a diagnosis of alveolar capillary dysplasia and decision was made to withdraw treatment.

Arsenate detoxification in a Pseudomonad hypertolerant to arsenic.

Pseudomonas sp. strain As-1, obtained from an electroplating industrial effluent, was capable of growing aerobically in growth medium supplemented with up to 65 mM arsenate (As (V)), significantly higher concentrations than those tolerated by other reference arsenic resistant bacteria. The majority of the arsenic was detected in culture supernatants as arsenite (As (III)) and X-ray absorbance spectroscopy suggested that 30% of this cell-bound arsenic was As (V), 65% As (III) and 5% of arsenic was associated with sulphur. PCR analysis using primers designed against arsenic resistance genes of other Gram-negative bacteria confirmed the presence of an arsenic resistance operon comprising of three genes, arsR, arsB and arsC in order of predicted transcription, and consistent with a role in intracellular reduction of As (V) and efflux of As (III). In addition to this classical arsenic resistance mechanism, other biochemical responses to arsenic were implicated. Novel arsenic-binding proteins were purified from cellular fractions, while proteomic analysis of arsenic-induced cultures identified the upregulation of additional proteins not normally associated with the metabolism of arsenic. Cross-talk with a network of proteins involved in phosphate metabolism was suggested by these studies, consistent with the similarity between the phosphate and arsenate anions.

Isolation and characterization of nickel uptake by nickel resistant bacterial isolate (NiRBI).

OBJECTIVE: Bioremediation technology has gained importance because microbes could be the convenient source of bio-absorption/bioaccumulation of metals from effluent streams. METHODS: The nickel-resistant bacterial isolates (NiRBI) were selected from various bacterial isolates from industrial effluent and grown in nutrient broth containing different concentrations of nickel sulfate (0.3-3.0 mmol/L) and their capability of accumulating metal from the medium. RESULTS: Well-defined growth of NiRBI was observed in the medium containing up to 2.5 mmol/L of nickel. The isolate was identified using 16S rRNA and closely related to Pseudomonas fragi. Maximum accumulation of nickel (0.59 mg/g dry weight of bacterial cells) was observed when NiRBI was grown in media containing 2 mmol/L of nickel. The protein profile of the NiRBI cellular extract by SDS-PAGE showed two metal stress-induced proteins of molecular weight 48 KD and 18 KD with a simultaneous down regulation of four proteins of 46.7 KD, 42.2 KD, 19.7 KD, and 4.0 KD. CONCLUSION: 48 KD and 18 KD proteins play a role in metal resistance mechanism by NiRBI.