A study of neonatal and maternal outcomes of asthma during pregnancy

Background: Asthma is a common problem all around the world with variable prevalence ranging from 1%–18% in different age and geographical distribution. There are proximately 300 million affected individuals. There are growing prevalence and morbidity, due to asthma associated with pregnancy. The course of asthma in pregnancy is unpredictable.Methods: 2400 consecutive pregnant women attending the antenatal clinic of S.P. Medical College and AG of Hospitals, Bikaner, were screened using asthma questionnaire translated in Hindi based on the questionnaire developed for International Union against Tuberculosis and Lung Disease. 52 patients diagnosed as asthma were subjected for PFT and classified according to clinical severity as per GINA guidelines, 2006. All subjects were followed till delivery and postpartum charts reviewed to see neonate and maternal outcome.Results: The prevalence of asthma during pregnancy was 2.1%, among them, 25 (48.1%) were categorized as having intermittent asthma, 6 (11.5%) with mild persistent asthma, 10 (19.2%) with moderate persistent asthma and 11 (21.2%) having severe persistent asthma. During the course of pregnancy, 36% had no change in the symptomatology, while (32.5%) experienced improvement and (32.5%) of worsening of asthma. 22 (42.31%) women were newly diagnosed during our study. There was no significant adverse maternal and fetal outcome in asthmatic group compared to control.Conclusions: Asthma is an under diagnosed and under treated disorder, especially during pregnancy and overall morbidity of asthma among women & neonates does not change during pregnancy.

The spectrum of mild cognitive impairment in dyslipidemic non-elderly type 1 diabetics

Background: Diabetics often have reduced performance in numerous domains of cognitive function, a process termed as Diabetic encephalopathy. The exact pathophysiology of cognitive dysfunction in diabetes is not completely understood, but it is likely that hyperglycaemia, vascular disease, hypoglycemia, and insulin resistance play significant roles. Although cognitive dysfunction is quite common in elderly, however, its occurrence in non-elderly diabetics is not much investigated. Aim of the study was to identify the correlation among various components of lipid profile with mild cognitive impairment in non-elderly type 1 diabetics.Methods: 98 type 1 diabetics were enrolled justifying relevant inclusion &exclusion criteria. Anthropometric indices, biochemical and clinical parameters were measured. MoCA test was employed for the assessment of cognitive dysfunction. Receiver operating characteristic, partial correlation, and logistic regression analyzes were employed for evaluation.Results: 71.42% of enrolled diabetics had some degree of cognitive dysfunction. Duration of the disease had a significant impact on cognitive functioning (p=0.032).Gender, residential area as well as the age of onset of diabetes appeared to have an insignificant impact on cognitive functioning (p>0.05). Diabetics with poor glycemic control were more prone to develop MCI (p<0.001).On comparison of various component of MoCA test; it was seen that most significant parameter that was affected was attention (p<0.001), followed by delayed recall /memory, naming and abstraction (p<0.05).Conclusions: The results of our study suggest that dyslipidemia chiefly raised total cholesterol, triglycerides and LDL is quite common in non-elderly type 1 diabetics and are associated with poorer cognitive function. Cognitive dysfunction should be listed as one of the many complications of diabetes, along with retinopathy, neuropathy, nephropathy, and cardiovascular disease in the future

Effect of Syzygium cumini (jamun) seed powder on dyslipidemia: a double blind randomized control trial

Background: Diabetes is a metabolic syndrome characterized by disturbance in carbohydrate, fat and protein metabolism. Dyslipidemia, commonly associated in diabetes, is major risk factor for macrovascular complications leading to CAD, major contributor to mortality associated with diabetes. Managing DM without side effects is challenge that attracts researchers toward plant based new products. Many studies have found anti-diabetic and anti-hyperlipidemic properties of seeds of Syzygium cumini, attributed to saponins, glycosides and flavonoids. So it should be further explored for its benefits.  The aim was to study the effect of jamun seed powder on dyslipidemia in type 2 DM. Methods: Patients with type 2 DM were randomly divided in two groups- group A was supplemented with 10 gms/day jamun seed powder and group B was given placebo powder. Patients and investigators were blinded about treatment allocated. Lipid profile was noted at baseline and 30th, 60th and 90th day. All the data was collected and analyzed at the end of study.Results: Improvement in dyslipidemia was seen after 60 days of supplementation with S. cumini seed powder. Statistically significant decrease in cholesterol levels by 10.55% and 15.79% in mean triglyceride levels by 8.28% and 13.66%, LDL-c levels by 10.29% and 14.50% was noticed at 60th and 90th day, respectively, reduction in VLDL-c levels by 9.38%, 12.90% and 20.69% was noted at 30th, 60th and 90th day. HDL-c increased significantly by 11.11% and 13.89% in males and 10.81% and 16.21% in females after 60 and 90 days of supplementation with S. cumini seed powder.Conclusions: A significant overall effect of S. cumini supplementation was found in improvement of lipid profile in type 2 diabetes subjects. However, above results are seen in small number subjects, further multicenter studies with larger sample size, supplementation dose and time should be planned and its effects in detail should be explored.

Exploring the impact of salinity on citrus (Citrus spp.) rootstock seed germination and seedling biomass

An experiment was conducted at the screen house of the Department of Horticulture, CCS Haryana Agricultural University, Hisar, Haryana during 2018–19 and 2019–20 to assess the impact of 5 different salinity levels [0.07 (control), 2.5, 4.0, 5.5, and 7.0 dS/m] on the seed germination and biomass of 9 citrus (Citrus spp.) rootstock seedlings (Rough lemon, Pectinifera, Cleopatra mandarin, Rangpur lime, Alemow, Volkamer lemon, NRCC-4, NRCC-3 and CRH-12). Experiment consisted of 45 treatment combinations and 3 replications in a completely randomized design (CRD). Under the influence of soil salinity, the number of days taken for seed germination, seed germination percentage, fresh and dry root and shoot biomass were adversely affected across all rootstocks compared to the control treatment (0.07 dS/m). Among the tested rootstocks, Volkamer lemon exhibited the highest seed germination rate (57%), followed by Rangpur lime (53%) and CRH-12 (50%). Conversely, Pectinifera showed the lowest seed germination percentage (37%), followed by Alemow (43%) at 7 dS/m. The minimum reduction at 7 dS/m over control in fresh shoot and root and dry shoot and root biomass was observed in Rangpur lime (37.7, 16.2, 27.8 and 27.3%, respectively), followed by Volkamer lemon (38.0, 16.2, 28.3 and 28.5%, respectively). On the other hand, Pectinifera exhibited the highest reduction in biomass (51.9, 40.5, 47.0 and 43.9%, respectively), followed by Alemow (45.7, 30.9, 46.5 and 39.9%, respectively). Among all the rootstocks, Rangpur lime, Volkamer lemon and Cleopatra mandarin displayed better tolerance to salinity, exhibiting relatively lower reduction in biomass at the highest salinity level (7 dS/m) compared to the control. Cleopatra mandarin, Rough lemon and NRCC-3 showed a moderate response, while Pectinifera, NRCC-4, and Alemow were found to be less tolerant, exhibiting higher reduction in terms of count of seed germination days, seed germination percentage, fresh and dry root biomass, and shoot biomass at 7 dS/m compared to the control treatment

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

Spontaneous rupture of spleen in malaria: a case report

Malaria is one of the most prevalent infectious diseases in the world, especially in developing world like India. Wide spectrum of complications can happen in malaria. Spontaneous rupture of spleen is one such rare complication. Here we report a case of 17 year old girl with P.Vivax malaria causing spontaneous rupture of spleen which was managed conservatively and was discharged with no complications

P.Vivax Malaria Causing BOOP: A Rare Complication

India and African countries are said to endemic to malaria. P. Falciparum malaria practically can cause anything as we have read in the articles, but complications with P.vivax are not common. Bronchiolitis obliterans with organizing pneumonia (BOOP) is one of the rare lung diseases. Here we are presenting a case of P.Vivax malaria complicated by BOOP which is a very rare complication

Can Hba1c be a marker for cardiovascular risk in type 2 Diabetes Mellitus

Introduction: One in every five Indians in geriatric age has diabetes. Diabetes is associated with increase in TG and apo B, with decrease in HDL component, so it contributes to atherosclerosis formation. We conducted a study to correlate glycaemic control using glycated haemoglobin with dyslipidaemia. Methods: The study is a cross sectional study with 200 diabetic patients, HbA1c was correlated with lipid profile and atherogenic index of plasma (AIP). AIP is log ratio of plasma triglyceride to HDL. Patients were categorised into good glycaemic control (&lt;7%) and poor glycaemic control (&gt;7%) based on glycaemic control with HbA1C as the marker. Results: Study showed the duration of diabetes directly correlates with HbA1c. None of the patients who had diabetes for more than 10 had HbA1c less than seven. BMI had direct association with HbA1c. HbA1c demonstrated a positive significant correlation with Total Cholesterol, LDL and a negative significant correlation with HDL. Atherogenic index of plasma directly correlates with HbA1c with mean AIP of 0.36+0.24 and 0.58+18 in good glycaemic control (GCC) and poor glycaemic control (PCC) respectively. Patients with HbA1c &gt;7.0% had statistically significantly higher value of total cholesterol, LDL when compared with &lt;7.0%. Conclusion: These findings clearly indicate that HbA1c can provide valuable supplementary information about the extent of dyslipidaemia, AIP. Screening for HbA1c estimation helps in preventing complications by achieving adequate glycaemic control. Thus, HbA1c can be used as a potential biomarker to identify patients with cardiovascular risk in Type 2 Diabetes Mellitus and can used as a guide for aggressive therapeutic approach

The spectrum of mild cognitive impairment in dyslipidemic non-elderly type 1 diabetics

Background: Diabetics often have reduced performance in numerous domains of cognitive function, a process termed as Diabetic encephalopathy. The exact pathophysiology of cognitive dysfunction in diabetes is not completely understood, but it is likely that hyperglycaemia, vascular disease, hypoglycemia, and insulin resistance play significant roles. Although cognitive dysfunction is quite common in elderly, however, its occurrence in non-elderly diabetics is not much investigated. Aim of the study was to identify the correlation among various components of lipid profile with mild cognitive impairment in non-elderly type 1 diabetics. Methods: 98 type 1 diabetics were enrolled justifying relevant inclusion and exclusion criteria. Anthropometric indices, biochemical and clinical parameters were measured. MoCA test was employed for the assessment of cognitive dysfunction. Receiver operating characteristic, partial correlation, and logistic regression analyzes were employed for evaluation. Results: 71.42% of enrolled diabetics had some degree of cognitive dysfunction. Duration of the disease had a significant impact on cognitive functioning (p=0.032).Gender, residential area as well as the age of onset of diabetes appeared to have an insignificant impact on cognitive functioning (p>0.05). Diabetics with poor glycemic control were more prone to develop MCI (p<0.001).On comparison of various component of MoCA test; it was seen that most significant parameter that was affected was attention (p<0.001), followed by delayed recall /memory, naming and abstraction (p<0.05). Conclusions: The results of our study suggest that dyslipidemia chiefly raised total cholesterol, triglycerides and LDL is quite common in non-elderly type 1 diabetics and are associated with poorer cognitive function. Cognitive dysfunction should be listed as one of the many complications of diabetes, along with retinopathy, neuropathy, nephropathy, and cardiovascular disease in the future. [Int J Res Med Sci 2016; 4(6.000): 2246-2251