Semthan: A Hellenistic outpost in Kashmir Himalaya

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Polymorphism in MnSOD Gene and Breast Cancer Risk in Kashmiri Patients: a Case Control Study

Reactive oxygen species (ROS) have been implicated in the etiology of many human diseases. Antioxidant enzymes such as MnSOD protects cells from oxidative stress and generation of ROS. A case control study, with aim to evaluate the relationship between MnSOD Ala-9Val polymorphism and breast cancer was carried out. The study included 522 subjects, including 255 cases and 267 controls, 12 samples were missing or yielded no results. Genotyping of samples were carried out using PCR-RFLP method. We observed that neither of two conditions heterozygous (MnSOD Val/Ala) or Variant/(MnSOD Ala/Ala) was significantly associated with overall breast cancer risk. The frequencies of Val and Ala allele was almost similar in cases, however, a significant association was seen in case of older women (above 45 years of age) (OR =1.98, CI=1.07-3.66, P=0.04). Also ORs were elevated in case of women using oral contraceptives carrying Val/Ala genotype. (OR=2.20; CI=0.54-8.96). In conclusion MnSOD Ala-9Val polymorphism may modify the risk for breast cancer development particularly in presence of age above 45years, oral contraceptives, and urban life style

Training during the COVID-19 lockdown : knowledge, beliefs, and practices of 12,526 athletes from 142 countries and six continents

OBJECTIVE Our objective was to explore the training-related knowledge, beliefs, and practices of athletes and the influence of lockdowns in response to the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS Athletes (n = 12,526, comprising 13% world class, 21% international, 36% national, 24% state, and 6% recreational) completed an online survey that was available from 17 May to 5 July 2020 and explored their training behaviors (training knowledge, beliefs/attitudes, and practices), including specific questions on their training intensity, frequency, and session duration before and during lockdown (March–June 2020). RESULTS Overall, 85% of athletes wanted to “maintain training,” and 79% disagreed with the statement that it is “okay to not train during lockdown,” with a greater prevalence for both in higher-level athletes. In total, 60% of athletes considered “coaching by correspondence (remote coaching)” to be sufficient (highest amongst world-class athletes). During lockdown, < 40% were able to maintain sport-specific training (e.g., long endurance [39%], interval training [35%], weightlifting [33%], most (83%) training for “general fitness and health maintenance” during lockdown. Athletes trained alone (80%) and focused on bodyweight (65%) and cardiovascular (59%) exercise/training during lockdown. Compared with before lockdown, most athletes reported reduced training frequency (from between five and seven sessions per week to four or fewer), shorter training sessions (from ≥ 60 to < 60 min), and lower sport-specific intensity (~ 38% reduction), irrespective of athlete classification. CONCLUSIONS COVID-19-related lockdowns saw marked reductions in athletic training specificity, intensity, frequency, and duration, with notable within-sample differences (by athlete classification). Higher classification athletes had the strongest desire to “maintain” training and the greatest opposition to “not training” during lockdowns. These higher classification athletes retained training specificity to a greater degree than others, probably because of preferential access to limited training resources. More higher classification athletes considered “coaching by correspondence” as sufficient than did lower classification athletes. These lockdown-mediated changes in training were not conducive to maintenance or progression of athletes’ physical capacities and were also likely detrimental to athletes’ mental health. These data can be used by policy makers, athletes, and their multidisciplinary teams to modulate their practice, with a degree of individualization, in the current and continued pandemic-related scenario. Furthermore, the data may drive training-related educational resources for athletes and their multidisciplinary teams. Such upskilling would provide athletes with evidence to inform their training modifications in response to germane situations (e.g., COVID related, injury, and illness).A specific funding was provided by the National Sports Institute of Malaysia for this study.The National Sports Institute of Malaysia.https://www.springer.com/journal/40279am2023Sports Medicin

COVID-19 lockdown : a global study investigating athletes’ sport classification and sex on training practices

PURPOSE : To investigate differences in athletes’ knowledge, beliefs, and training practices during COVID-19 lockdowns with reference to sport classification and sex. This work extends an initial descriptive evaluation focusing on athlete classification. METHODS : Athletes (12,526; 66% male; 142 countries) completed an online survey (May–July 2020) assessing knowledge, beliefs, and practices toward training. Sports were classified as team sports (45%), endurance (20%), power/technical (10%), combat (9%), aquatic (6%), recreational (4%), racquet (3%), precision (2%), parasports (1%), and others (1%). Further analysis by sex was performed. RESULTS : During lockdown, athletes practiced body-weight-based exercises routinely (67% females and 64% males), ranging from 50% (precision) to 78% (parasports). More sport-specific technical skills were performed in combat, parasports, and precision (∼50%) than other sports (∼35%). Most athletes (range: 50% [parasports] to 75% [endurance]) performed cardiorespiratory training (trivial sex differences). Compared to prelockdown, perceived training intensity was reduced by 29% to 41%, depending on sport (largest decline: ∼38% in team sports, unaffected by sex). Some athletes (range: 7%–49%) maintained their training intensity for strength, endurance, speed, plyometric, change-of-direction, and technical training. Athletes who previously trained ≥5 sessions per week reduced their volume (range: 18%–28%) during lockdown. The proportion of athletes (81%) training ≥60 min/session reduced by 31% to 43% during lockdown. Males and females had comparable moderate levels of training knowledge (56% vs 58%) and beliefs/attitudes (54% vs 56%). CONCLUSIONS : Changes in athletes’ training practices were sport-specific, with few or no sex differences. Team-based sports were generally more susceptible to changes than individual sports. Policy makers should provide athletes with specific training arrangements and educational resources to facilitate remote and/or home-based training during lockdown-type events.https://journals.humankinetics.com/view/journals/ijspp/ijspp-overview.xmlhj2023Sports Medicin

Assosation of the XRCC1 gene polymorhism with breast cancer risk in Kashmiri patients

X ray repair cross-complementing group 1 (XRCC1) plays an important role in base excision and single-strand break repair, as a scaffold protein that brings together proteins of the DNA repair complex, and appears to be a candidate for cancer risk. A common polymorphism (Arg→Gln) at codon 399 of the XRCC1 gene has been previously linked to functional changes of the gene product and risk of cancers. However, studies on the association between polymorphisms in this protein and cancer have yielded conflicting results. We evaluated the association between XRCC1 Arg399Gln polymorphism and breast cancer risk in the Kashmiri patients. Our study included total of 142 female subjects. In our case control study we genotyped 70 breast cancer (BC) patients and 72 controls for XRCC1 Arg399Gln polymorphisms by PCR RLFP technique.. It was found 22.8%of cases and 37.5%were homozygous for variant genotype with odd ratio OR 0.48 CI (0.18-1.25); P = 0.13 for Gln/Gln and OR=1.01 CI = (0.42-1.49); P= 0.985 for Arg/Gln. However OR was insignificant. It was observed that OR associated with Gln/Gln genotype are not modified for either above or below 45 years age (OR=0.72; CI = 0.18-2.74), (OR=0.28; 95% CI=0.06-1.20), however these results were statistically insignificant. Similar observation was found with respect to menopausal status (postmenopausal women OR=0.85; CI=0.19-3.72), (premenopausal women OR=0.35; CI= 0.09-0.29) as none of association reached statistical significance. Thus we did not find any association between Arg399Gln polymorphism and breast cancer risk among both pre-and post menopausal women

Unusual case of methicillin resistant staphylococcus aureus and acanthamoeba keratitis in a non-contact lens wearer from Kashmir, India

Acanthamoeba species can cause a chronic, progressive, ulcerative keratitis of the eye, which is not responsive to the usual antimicrobial treatment and is frequently mistaken for stromal herpes keratitis. Acanthamoeba keratitis continues to be a burgeoning and unsolved problem. Although soft contact lens wear is reported as the major risk factor in other parts of the world, reports from India suggest that acanthamoeba keratitis is more common among non-contact lens wearers. An unusual case of coinfection with Acanthamoeba and methicillin resistant staphylococcus aureus (MRSA) as causes of corneal keratitis in a contact lens wearer from Kashmir, India, is reported. Recent findings have shown that MRSA uses amoebae to spread, sidestepping hospital and other protection measures. Cysts of the isolated Acanthamoeba tolerated an incubation temperature of 40°C, indicating a pathogenic species. This case highlights the importance of culture methods in the diagnosis of corneal infection and the choice of treatment regimen

Evaluation of acute normovolemic hemodilution and autotransfusion in neurosurgical patients undergoing excision of intracranial meningioma

Background : Several blood conservation strategies have been tried with the purpose of reducing homologons blood transfusion. Patients & Methods : In a prospective randomized study, the potential benefits of acute normovolemic hemodilution (ANH) with autologous transfusion were investigated as a blood conservation technique in surgical excision of intracranial meningioma. Over a period of 2 years, 40 patients undergoing excision of intracranial meningioma were randomly assigned to two groups of 20 patients each. Group I (Control Group) received conventional homologous blood intraoperatively and were not subjected to ANH. In Group II (ANH Group), Acute Normovolemic Hemodilution was initiated to a target hematocrit of 30% after induction of anesthesia. Parameters studied included changes in hemoglobin, hematocrit and hemodynamic parameters. Results : The mean value of blood withdrawn in ANH group was 802.5 ± 208 ml. This was replaced simultaneously with an equal volume of 6% Hydroxyethyl starch to maintain normovolemia. There was no statistically significant variation in mean hemoglobin levels between the two groups at various stages of study. Hematocrit decreased significantly in both the groups at various stages as compared to preoperative values , the decrease being more but insignificant in group II. Changes in heart rate and mean blood pressure were similar and without statistically significant differences in either group at various stages of study. The amount of surgical blood loss in group I was 835.29 ± 684.37 ml, as compared to 865 + 409.78 ml in group II. The difference was statistically insignificant (p>0.05). The mean volume of homologous blood transfused in group I was 864.71 ± 349.89 ml, as compared to 165 ± 299.6 ml in group II which was statistically significant (p<0.05). In group II (ANH Group) only 5 patients (25%) required homologous blood whereas in group I I all patients (100%) needed homologous blood. Conclusion : We conclude that acute normovolemic hemodilution up to a target hematocrit of 30% is safe and effective in reducing the need for homologous blood in neurosurgical patients undergoing excision of intracranial meningioma

Melorheostosis with renal arterio-venous malformation: A case report with review of literature

Melorheostosis, also known as Leri′s disease and flowing periosteal hyperostosis, is a rare cause of pain and stiffness in a limb. The appearance is of "candle greasing" down one side of one or several bones of the body. We describe a case referred to tertiary care center with suspicion of renal cell carcinoma with diffuse bone metastasis. After reassessment, the patient was diagnosed melorheostosis with renal AV malformation. He was reassured about the benign nature of the disease and is asymptomatic

ROLE OF PERCUTANEOUS VERTEBROPLASTY IN VERTEBRAL COMPRESSION FRACTURES: EFFICACY AND SAFETY

Background: Percutaneous Vertebroplasty (PVP) is a minimally invasive interventional procedure performed by injecting bone cement or other therapeutic material into a painful osteoporotic or neoplastic compression fracture for pain or disability improvement. There is conflicting evidence regarding the use of vertebroplasty in osteoporotic vertebral compression fractures (VCFs) in the available literature. Objectives: To evaluate the efficacy and safety of Percutaneous Vertebroplasty in painful vertebral compression fractures in terms of pain alleviation and disability improvement, and thereby, study the profile of complications. Study design: Prospective observational study Study Participants: Patients with clinically symptomatic VCFs, who received various forms of treatment (interventional/conservative) were enrolled for the study. Patients who met the inclusion/exclusion criteria were finally selected. Methodology: Out of the selected patients, two groups were made, one who received the Intervention (PVP) and another group who received conservative management (Bed rest, medications, physiotherapy, etc.). Out of 31 patients selected, 11 were treated by PVP and 20 were treated by conservative management. These patients were followed up at 1-month, 3-month and 6-month intervals to record the Visual analog pain scores (VAS), Ronald Morris disability scores (RDQ) and any complication. Results: VAS scores in the vertebroplasty group decreased from (8.09±0.539) to (3.64 ± 0.674) at 1-month to (3.27±1.009) at 3-month to (3.09±0.831) at 6-month. VAS scores also decreased in the conservative group from (7.6±0.598) to (5.95±0.999) at 1-month to (5.1±1.294) at 3-month to (5.15±1.424) at 6-month. Vertebroplasty group showed the steep fall (-4.45) in VAS values as compared to a gradual decrease in VAS (-1.65) in the conservative group at 1 month follow up, concluding that conservative treatment has a slower effect on pain relief compared with the early response after PVP. Disability scores (RDQ) follow a similar trend with early and better improvement in the vertebroplasty group. RDQ scores: Vertebroplasty group (18.45±1.572 at baseline to 12.27±1.421 at 1-month to 11.82±1.079 at 3-month to 11.82±1.471 at 6-month), Conservative group (17.95±1.146 at baseline to 14.3±1.418 at 1-month to 12.9±1.518 at 3-month to 12.85±2.207 at 6-month). Subgroup analysis showed more benefit in malignant VCFs treated by PVP. The procedure was largely uneventful. An immediate complication was noted in one patient with cement extravasation into the venous channels, however, the patient showed pain and disability improvement without any adverse effects. Furthermore, no additional complication was noted during the follow-up period in any other patient. Conclusion: Percutaneous Vertebroplasty provides early and significant pain and disability improvement in vertebral compression fractures to comparison to conservative management. Implication: Minimal invasive technique for pain relief in osteoporotic and malignant vertebral compression fractures