Prevalence of gestational diabetes mellitus and its relationship with various risk factors in a tertiary care hospital in West Bengal with special reference to tribal population, India

Background: Gestational diabetes mellitus (GDM) is the most common medical complication and metabolic disorder of pregnancy. The aim and objective of this study was to determine the prevalence of GDM and its relationship with various risk factors with special reference to tribal population.Methods: The study was done in 200 patients between 24 and 28 weeks of gestation, attending antenatal outdoor in a tertiary care hospital of West Bengal.  These patients were given 75gm oral glucose irrespective of the last meal and their plasma glucose was estimated at 2hours. Patients with plasma glucose values ≥140 mg/dl were labelled as GDM. Patients who were diabetic before pregnancy or whose pre pregnancy body mass index was not known or was in labour or had chronic disease, were not included in the study.Results: Prevalence of GDM was 11% in whole population while it was 14.63% and 10.06% in tribal and non-tribal population respectively.  Prevalence of GDM and its correlation with most of risk factors in previous pregnancies was found to be significant in both non-tribal and tribal population. Family history of diabetes mellitus was the most prevalent risk factor in both non-tribal (9.4%) and tribal population (14.63%). There was no single most common risk factor among GDM patients found as there were multiple risk factors present with same frequency in both tribal and non-tribal population.Conclusions: The prevalence of GDM is 14.63% in the tribal population and 10.06% in non-tribal population which is not statically significant (P<0.407). The relation between the prevalence of GDM and risk factors was found to be significant for most of the risk factors

Identification of an N-terminal 27 kDa fragment of Mycoplasma pneumoniae P116 protein as specific immunogen in M. pneumoniae infections

<p>Abstract</p> <p>Background</p> <p><it>Mycoplasma pneumoniae </it>is an important cause of respiratory tract infection and is increasingly being associated with other diseases such as asthma and extra-pulmonary complications. Considerable cross-reactivity is known to exist between the whole cell antigens used in the commercial serological testing assays. Identification of specific antigens is important to eliminate the risk of cross-reactions among different related organisms. Adherence of <it>M. pneumoniae </it>to human epithelial cells is mediated through a well defined apical organelle to which a number of proteins such as P1, P30, P116 and HMW1-3 have been localized, and are being investigated for adhesion, gliding and immunodiagnostic purposes.</p> <p>Methods</p> <p>A 609 bp fragment P116_(N-27),corresponding to the N-terminal region of <it>M. pneumoniae </it>P116 gene was cloned and expressed. A C-terminal fragment P1_(C-40),of P1 protein of <it>M. pneumoniae </it>was also expressed. Three IgM ELISA assays based on P116_(N-27),P1_(C-40)and (P116 _(N-27)+ P1_(C-40)) proteins were optimized and a detailed analysis comparing the reactivity of these proteins with a commercial kit was carried out. Comparative statistical analysis of these assays was performed with the SPSS version 15.0.</p> <p>Results</p> <p>The expressed P116_(N-27)protein was well recognized by the patient sera and was immunogenic in rabbit. P1_(C-40)of <it>M. pneumoniae </it>was also immunogenic in rabbit. In comparison to the reference kit, which is reported to be 100% sensitive and 75% specific, ELISA assay based on purified P116_(N-27),P1_(C-40)and (P116_(N-27)+ P1_(C-40)) proteins showed 90.3%, 87.1% and 96.8% sensitivity and 87.0%, 87.1% and 90.3% specificity respectively. The p value for all the three assays was found to be < 0.001, and there was a good correlation and association between them.</p> <p>Conclusion</p> <p>This study shows that an N-terminal fragment of P116 protein holds a promise for serodiagnosis of <it>M. pneumoniae </it>infection. The IgM ELISA assays based on the recombinant proteins seem to be suitable for the use in serodiagnosis of acute <it>M. pneumoniae </it>infections. The use of short recombinant fragments of P116 and P1 proteins as specific antigens may eliminate the risk of cross-reactions and help to develop a specific and sensitive immunodiagnostic assay for <it>M. pneumoniae </it>detection.</p

A study of clinical, magnetic resonance imaging, and somatosensory-evoked potential in central post-stroke pain

This study evaluates the clinical spectrum of central post-stroke pain (CPSP) and correlates it with magnetic resonance imaging (MRI) and somatosensory-evoked potential (SEP) changes. Thirty-one consecutive CPSP patients whose median age was 51 years were evaluated and subjected to quantitative sensory testing and median and tibial SEPs. Cranial MRI abnormalities were noted and correlated with clinical and SEP abnormalities. The majority of patients (n = 21) developed CPSP within 3 months of stroke, and CPSP was the presenting symptom in 7 patients. Five patients had focal symptoms and 26 had hemibody symptoms with or without facial involvement. Pain threshold was reduced in 12, and 3 did not have pain perception. Allodynia was present in 11, static in 4, dynamic in 5, and cold in 7 patients. Temporal summation was present in 14, punctate hyperalgesia in 11, and cold hyperalgesia in 3 patients. Cranial MRI revealed infarction in 23 and intracerebral hemorrhage in 8 patients; 16 had thalamic and 15 extrathalamic lesions. SEP was abnormal in 15 of 22 (68.2%) patients. There was no difference in symptoms and severity of CPSP, quantitative sensory testing, and SEP abnormalities in thalamic and extrathalamic stroke

Phosphodiesterase 4 D Gene Polymorphism in Relation to Intracranial and Extracranial Atherosclerosis in Ischemic Stroke

In ischemic stroke, extracranial MR angiography (ECMRA) is more frequently abnormal in Caucasians and intracranial (ICMRA) in Asians which may have a genetic basis. We report phosphodiesterase (PDE4D) gene polymorphism and its correlation with MRA findings in patients with ischemic stroke

Profile of autopsied homicidal victims of eastern Nepal: An observational study

Objective: This study was performed to create a profile of the victims of intentional homicide in eastern Nepal. Methods: This is an observational study of homicidal victims autopsied from January 01, 2009 to December 31, 2011 at the Department of Forensic Medicine and Toxicology, a tertiary referral centre in Dharan, Nepal, analyzing: age, sex, educational condition, marital status and occupation of victims, homicidal method employed, motive, season of the year and toxicological study, along with few details on the victims&#146; personal history (alcohol and drug abuse). Results: The homicidal victim profile attained matched that of a man who was a young adult between 25 to 34 years of age, illiterate, unmarried, unemployed, alcoholic and was killed intentionally by sharp weapons or firearms during the September to October period. The most frequent reason for being killed was an argument that led to assault and eventually death. Conclusion: The study of this occurrence should ultimately result in enhanced prevention from these prospective evaluations of the profile. Preventive interventions at the national, social and medical level would be fundamental in saving the lives of potential victims. [Arch Clin Exp Surg 2017; 6(2.000): 58-65

Lactococcus lactis provides an efficient platform for production of disulfide-rich recombinant proteins from Plasmodium falciparum

Abstract Background The production of recombinant proteins with proper conformation, appropriate post-translational modifications in an easily scalable and cost-effective system is challenging. Lactococcus lactis has recently been identified as an efficient Gram positive cell factory for the production of recombinant protein. We and others have used this expression host for the production of selected malaria vaccine candidates. The safety of this production system has been confirmed in multiple clinical trials. Here we have explored L. lactis cell factories for the production of 31 representative Plasmodium falciparum antigens with varying sizes (ranging from 9 to 90 kDa) and varying degree of predicted structural complexities including eleven antigens with multiple predicted structural disulfide bonds, those which are considered difficult-to-produce proteins. Results Of the 31 recombinant constructs attempted in the L. lactis expression system, the initial expression efficiency was 55% with 17 out of 31 recombinant gene constructs producing high levels of secreted recombinant protein. The majority of the constructs which failed to produce a recombinant protein were found to consist of multiple intra-molecular disulfide-bonds. We found that these disulfide-rich constructs could be produced in high yields when genetically fused to an intrinsically disorder protein domain (GLURP-R0). By exploiting the distinct biophysical and structural properties of the intrinsically disordered protein region we developed a simple heat-based strategy for fast purification of the disulfide-rich protein domains in yields ranging from 1 to 40 mg/l. Conclusions A novel procedure for the production and purification of disulfide-rich recombinant proteins in L. lactis is described