Osteoartriidi patogenees: immunoloogiline kulg sünoviaalmembraan- sünoviaalvedelik teljel

Väitekirja elektrooniline versioon ei sisalda publikatsiooneOsteoartriit (OA) on kõige levinum liigesehaigus, millel ei ole tänaseni patogeneetilist ravi. Tõhusate ravimeetodite arendamise peamised väljakutsed on OA heterogeensus ja ebaselge patoloogia. OA-d, mida tavapäraselt tuntakse kui „vananemishaigust“, peetakse järjest enam krooniliseks põletikuliseks haiguseks. Käesoleva doktoritöö eesmärk oli hinnata sünoviaalvedelikuga seotud põletikulist mehhanismi, mis on OA patoloogias üks põhilisi põletikukohti. Seda silmas pidades piirdub sünoviaalvedeliku analüüs sageli tema molekulaarse koostise uurimisega, kuid funktsionaalse ulatuse hindamiseks on vaja laiemat tausta. Seetõttu püüti molekulaarse signaali dekodeerimisega uurida sünoviaalvedeliku laiemat kaasatust haiguse patogeneesis. Viidi läbi mitmetasandiline analüüs, kasutades OA-st mõjutatud sünoviaalmembraani ja osteofüütide biopsiaid ning sünoviaalvedeliku proove. Lisaks tehti rakupõhiseid analüüse, kasutades inimese monotsüütide rakuliine (THP1 ja U37) ning inimese vereloome tüvirakke. Bioloogiliste testide tulemuste toetamiseks viidi läbi proteoomi analüüs ja sünoviaalvedeliku immuno-fenotüüpimine. Sünoviaalmembraani rakkude geeniekspressiooni uuring näitas püsivat põletikku OA liigestes. Suurem põletik haiguse varases staadiumis annab vältimatu tõuke kõhrkoe kiiremaks lagunemiseks haiguse hilisemates staadiumites. Kõigi OA staadiumide sünoviaalvedeliku proovid, inkubeerides neid THP1 ja U937 rakkudega, suutsid rakkudes esile kutsuda põletikku. Samas katses näidati, et OA sünoviaalvedelik võib indutseerida immuunrakkude eristumist ja toimida nišina, pakkudes olulist mikrokeskkonda, mis toetab immuunrakkude funktsionaalset aktiivsust ning põhjustab põletiku süvenemist ja kestmist. Sünoviaalvedeliku proteoomianalüüs paljastas mitmeid suures koguses esinevaid valke, mis võivad, nagu täheldati, indutseerida immuunrakkude eristumist. Lõpuks viidi läbi osteofüütide RNA-seq analüüs, et uurida selles toimuvaid molekulaarseid ja rakulisi protsesse, eriti OA patoloogia kontekstis. Geeniekspressiooni mustri funktsionaalne analüüs näitas progresseeruvat aktiivset luu ümberkujunemist ja nuumrakkude tihedat seotust selles protsessis. See teadmine on OA patoloogias uus ja peaks olema arvesse võetud sobivate ravimeetodite kavandamisel.Osteoarthritis (OA) is the most common joint disease, which has no cure to date. The major challenges in developing effective therapies are, heterogenous nature and obscure pathology of OA. Conventionally known as ‘aging disease’, OA is increasingly accepted as a complex disease with an implication of chronic-low-grade inflammation. More illumination is needed on the involved inflammatory mechanism. The present thesis was aimed to evaluate inflammatory mechanism revolving around the synovium-synovial fluid (SF) axis, which are the main inflammation sites in OA pathology. In this regard, particularly SF analysis is limited to understand a molecular make-up of the fluid and there is a wider scope to assess its functional involvement. Therefore, the attempt was to investigate a ‘performance-based involvement’ of SF by decoding the molecular signalling. A multilevel analysis was done using OA affected synovium biopsies, SF and osteophyte samples. Also, cell-based assays were performed using human monocyte cell lines (THP1 and U937) and human hematopoietic stem cells. Proteome analysis and SF immunophenotyping was performed to support the outcomes from the biological assays. Synovium gene expression study showed a persistent nature of inflammation in OA joints. Higher inflammation in early stage provides a necessary impetus for accelerated cartilage-loss at later stages. SF samples of all OA stages, when incubated with THP1 and U937 cells, was able to induce inflammation in the cells. In the same experimental design, we showed that OA SF can induce immune cell differentiation and act as a niche by providing an essential microenvironment, which enable immune cells to be functionally active and for contributing to aggravate and maintain inflammation. Proteome analysis of SF revealed many proteins in abundance, which can induce immune cell differentiation as was observed. Finally, RNA-seq analysis of osteophytes was performed to investigate molecular and cellular events in it, especially in the context of OA pathology. Functional analysis of the gene expression patten, revealed an on-going active bone remodelling and close involvement of mast cells in the process, which is a new dimension of OA pathology and should prove worthy for taking into consideration for designing appropriate therapies.https://www.ester.ee/record=b551832

CO2 Adsorption By Various Catalysts

Global warming arising from the emission of greenhouse gases, especially CO2, has become a biggest issue all over the world in the recent years. Though various CO2 capture technologies have been proposed, chemical absorption and adsorption are currently believed to be the most suitable ones for post-combustion power plants. In this review paper, we will discuss different physical adsorbents; various mesoporous solid adsorbents impregnated with polyamines and grafted with amines are reviewed. The major concern is for CO2 adsorption capacity at different temperature and pressure are compared and discussed. More effective and less energy-consuming regeneration techniques for CO2-loaded adsorbents are also proposed. Keywords: CO2 capture technology, adsorbents, micro or mesoporous materials, post-combustio

Ritucharya w.s.r. to Varsha Ritu and its effect on Health

Ayurveda the science of health suggests various theories and principles towards the achievement of healthy physical and mental status, in this regards Ayurveda advocates concepts of Dinacharya (daily regimen) and Ritucharya. It has highlighted various rules and regimens regarding Ahara (diet), Vihara (regimens), Achara (conduct), Vichara (thoughts) which are mandatory for attaining the desired healthy life, one among such regimens is “Ritucharya”, which plays an important role in acclimatizing the seasonal enforcement easily without altering body homeostasis. In this work an attempt is made to understand the concept of Varsha Ritu, prevention of seasonal disease that may occur in Varsha Ritu, and to understand and follow the regimen of Varsha Ritu which helps to prevent the disease and maintain the health of individual

Role of Abhyanga (oil massage) in daily practice

Ayurveda literally means ‘science of life’. According to Ayurveda the term health does not stand only for the freedom from diseases but it is called as healthy only when a person’s mind, sense organs and the soul are in a perfect state of equilibrium to endow happiness and the body is free from diseases. To promote health certain procedure and methods are followed on daily basis (Dinacharya). Abhyanga (oil massage) is one among the ancient procedure explained in Dinacharya. It is an approach to adopt healing, relaxation and treating various diseases. In Ayurveda it is clearly mentioned that Abhyanga alleviates Vata Dosha and person develops strength both physically and mentally. Here an attempt is made to compile the importance, use and benefits of Abhyanga in daily life

Awareness and Perception of Plastic Surgery among Healthcare Professionals in Pune, India: Do They Really Know What We Do?

Purpose. The aim of this study is to understand the level of awareness and knowledge of plastic surgery in healthcare professionals in a tertiary health care facility in Pune, India. This study also aims to highlight the perception of the medical professionals about plastic surgery and what they think a plastic surgeon does. Materials and Methods. A questionnaire-based survey was done at B.J Medical College and Sassoon Hospital, Pune in 2011. Feedback evaluation forms from hundred resident doctors and faculty were evaluated and analyzed. Results. There is not much awareness about plastic surgery as a specialty amongst health care providers. Plastic surgery is mostly perceived as cosmetic surgery, and the other spectrum of the patients we cater to goes largely unnoticed. Of all the clinical conditions given to the participants, there was not a single clinical condition where the respondents favored unanimously for plastic surgeons. Conclusion. Plastic surgery as a specialty is poorly understood by our medical colleagues, and the onus of creating and improving the awareness and perception of our specialty lies on us. Herculean unified efforts at individual as well as global level will help us achieve this goal

HIV in pregnancy: a study of 30 cases in a tertiary care center in Mumbai, India

Background: HIV/AIDS infection is a significant cause of perinatal morbidity/mortality. Appropriate antiretroviral therapy should be given to all HIV-positive pregnant women to reduce the burden of the infection on mothers and children. The objective of this study was to evaluate the prevalence of HIV infection in pregnant women among age, parity, and mode of delivery and to observe the clinical features, co-existing infections, and various pregnancy outcomes in HIV-positive pregnant women.Methods: It is a type of research article. The present study was conducted in Unit 2, Department of Obstetrics and Gynaecology, Cama and Albless Hospital, Mumbai, Maharashtra, India, from a period of January 2022 to July 2022, 30 HIV-positive ANC mothers were examined.Results: About 30 ANC mothers participated in the study in which most of the subjects belonged to the 23-39 years of age group. Maximum patients are multipara.Conclusions: We found most (66.6%) of the ANC women with HIV-positive status delivered a healthy baby at term.

Clinical study of cases of intrauterine foetal death in a tertiary centre

Background: Foetal death at any stage of pregnancy is a tragic event and one of the unhappy events in the field of obstetrics. The present study was done to determine the probable etiology for antepartum and intrapartum foetal deaths and to study the role of antenatal care in prevention of intrauterine foetal deaths.Methods: The cases of intrauterine foetal deaths in OBGY department at MGM hospital, Kalamboli and Kamothe with either ultrasound reports proving Intrauterine foetal death  (IUFD) or diagnosed on clinical examination by absence of foetal heart rate with gestational age more than 28 weeks by dating from Naegle’s rule or by ultrasonography were studied. Inclusion criteria includes as following; 1) All cases of IUFD >28 weeks of gestation; 2) Baby weight of 1000 grams or more and exclusion criteria includes molar pregnancy.Results: The foetal death rate was 27.76/1000 births. Major causes of IUFD were PE and eclampsia (34.78%), unexplained (14.49%) and abruptio placentae (7.25%). Majority of the stillbirth were seen in preterm pregnancy between 34 - 36 (18.85%) weeks followed by 28 - 30 weeks (17.39%). Majority of foetuses were preterm and of birth weight between 1 - 1.5 kg (28.26%) followed by 1.5 - 2 kg (26.09%).Conclusions: Present studies showed that majority of IUFDs were preventable. Pre-eclampsia and abruption which are the major causes of IUFD can be reduced by improving education of the patient to avail obstetric care, more frequent visits for high risk pregnancies, timely reference to specialist. Early registration is an important pre-requisite for early detection of risk factors.

Clinical features of endometriosis: a review of literature

Aim: To know the clinical features and prevalence of infertilityin endometriosis.Objectives: 1. to discuss clinical features of endometriosis2. to know the prevalence of infertility in endometriosisMaterial and methods:Background: The study shows the clinical features of endometriosis, common laparoscopic findings of endometriosis, and incidence in a particular age group. Objectives of current study were to discuss the clinical features of endometriosis and to know the prevalence of infertility in endometriosisMethods: Cases of infertility, chronic pelvic pain, dysmenorrhoea, and laparoscopically diagnosed endometriosis were considered for this study.Results: Endometriosis is a disease in which the endometrium (the tissue that lines the inside of the uterus or womb) is present outside the uterus. Endometriosis most commonly occurs in the lower abdomen or pelvis, but it can appear anywhere in the body. Symptoms of endometriosis include lower abdominal pain, dysmenorrhoea, dyspareunia, and infertility.Conclusions: This study show typical clinical features and prevalence of infertility in patients with endometriosis in a tertiary care centre.Cases of infertility, chronic pelvic pain, dysmenorrhoea, and laparoscopically diagnosed endometriosis were considered for this study. Results and conclusion: Endometriosis is a disease in which the endometrium (the tissue that lines the inside of the uterus or womb) is present outside of the uterus. Endometriosis most commonly occurs in the lower abdomen or pelvis, but it can appear anywhere in the body. Symptoms of endometriosis include lower abdominal pain, dysmenorrhoea, dyspareunia, and infertility. This study is to know the common clinical features and prevalence of infertility in patients with endometriosis in a tertiary care centre

Analysis of outcome of vaginal hysterectomy and pelvic floor repair by POPQ system

Background: To assess the relief of symptoms and efficacy of vaginal hysterectomy and pelvic floor repair surgeries in patients with pelvic organ prolapse.Methods: A total of 55 women participated in the study. Vaginal hysterectomy with or without anterior and posterior colporrhaphy and fothergills surgery were done in all cases. Patients were followed postoperatively about symptom relief and the anatomical correction was analyzed at 6 months using Pelvic Organ Prolapse-Quantification (POP-Q) System.Results: The highest incidence of POP was between 41 to 50 years of age and in multiparous women with parity 2 and more than 4. 36.36% had stage III prolapse when measured using the POPQ classification. Something coming out per vaginum was the commonest complaint seen in 100% of the patients. The improvement of all symptoms was significant (p value <0.05).Conclusions: There is significant anatomical restoration and symptom relief after surgery by POPQ

Central giant cell granulomas of the jaws: A review of the literature with its emphasis on differential diagnosis on related lesions

Central giant cell granuloma (CGCG) is an uncommon benign intraosseous lesion that occurs almost exclusively in the jaws that has variable clinical behavior and is difficult to predict. The CGCG of the jaws is usually a non-neoplastic bone lesion accounting for fewer than 7% of all benign tumors of the jaws. Before the early 1950s, central giant cell lesions (GCLs) of the jaws were generally diagnosed as giant cell tumor (GCT) usually found in epiphyseal regions of long bones. Giant cell lesions (GCLs) are mandatorily diagnosed in consideration with clinical and radiological features which predicts its aggressive and non-aggressive behavior. The incidence in the general population is very low and patients are generally younger than 30 years. CGCG belongs together with GCT, brown tumor of hyperparathyroidism and cherubism to the so-called GCLs, which can be difficult to distinguish solely by microscopic examination. GCT of the long bones is practically identical with CGCG of the jaws on histopathologic examination and is considered by some authors as a manifestation of the same disease, where age and local factors are responsible for different clinical characteristics. The aim of this review is to focus on general considerations of CGCG along with its management and to differentiate between various centrally placed GCLs which mimic each other histologically and sometimes clinically