Assessment of executive functions in type II diabetes patients with focus on duration of diabetes: preliminary findings of an analytical cross-sectional study

Background: Executive functions have been defined as one’s ability to plan, initiate, sequence, monitor, and inhibit complex behaviour. Executive functions are purportedly affected significantly in diabetes population; duration of diabetes having particularly negative impact. Present study was undertaken to determine whether executive functions are affected more in diabetic patients as compared to non-diabetics and to further assess the role duration of diabetes. Methods: In this analytical, cross-sectional study being conducted over 18 months period at a tertiary-care private teaching hospital in Central India, 148 participants (74 in diabetic & 74 in non-diabetic group) between the age of 30-60 years are enrolled. Preliminary data of 50 patients is presented here. The executive functions were assessed by using Delis-Kaplan Executive function system and participants was subjected to Trail making test, Design fluency test, Tower test and DKEF sorting test and the scores were compared between the two groups. Results: Statistically significant differences were observed for Trail making test (median value diabetic-7 vs. non-diabetic-10), Design fluency test (median value diabetic-10 vs. non-diabetic-10, the range varied significantly), Tower test (median value diabetic-5 vs. non-diabetic-9), DKEF sorting test (median value diabetic-7 vs. non-diabetic-8) and Sort recognition test (median value- diabetic-6 vs. non-diabetic-8). The duration of diabetes exhibited strong, statistically significant negative correlation with the four studied parameters and had weak, insignificant positive correlation with sort recognition DS. Conclusions: Executive functions are significantly affected in adult diabetes patients as compared to non-diabetic population and duration of diabetes has major contributory role in this affection

Study of efficacy and safety of drug eluting stent versus bare metal stent in ST elevation MI

Background: The present study was conducted with the aim of determining whether drug-elutingstents are superior to uncoated stents in the setting of primaryPCI in terms of occurrence of serious adverse cardiac events.Methods: In this prospective, single blind, randomized study, 20 to 80 years old patients with acute myocardial infarction with ST-segment elevation with >30 minutes of chest pain and at least 1 mm of ST-segment elevation in at least two standard leads or a new LBBB or 2 mm of ST-segment elevation in at least two contiguous leads were included. Patients were randomly assigned to receive either drug eluting stent (DES) (Everolimus Eluting stent, Endevour-Medtronics) or bare metal stent (BMS, Cordis-Dx sonic) in a 1:1 ratio. During follow ups at 30 days and 12 months, all serious adverse cardiac events like death from cardiac or non-cardiac cause, recurrent MI, revascularization of target vessel, coronary artery bypass grafting (CABG) or other intervention to target or non-target vessel etc. were recorded and compared between groups.Results: No significant differences were found between the two treatmentgroups for occurrence of adverse events during first 30 days after the intervention. At one year follow-up, trends were observed in favorof the DES group, none of the differences weresignificant.Conclusions: No significant benefit was observed with the use of Everolimus-eluting stents in primaryPCI for acute myocardial infarction with ST-segment elevation,in comparison with baremetal stents

Anti-RSV Peptide-Loaded Liposomes for the Inhibition of Respiratory Syncytial Virus

Although respiratory syncytial virus (RSV) is one of the leading causes of acute respiratory tract infection in infants and adults, effective treatment options remain limited. To circumvent this issue, there is a novel approach, namely, the development of multifunctional liposomes for the delivery of anti RSV-peptides. While most of the peptides that are used for loading with the particulate delivery systems are the penetrating peptides, an alternative approach is the development of liposome-peptide systems, which are loaded with an RSV fusion peptide (RF-482), which has been designed to inhibit the RSV fusion and block infection. The results of this work have revealed that the liposomes themselves can serve as potential RSV inhibitors, whilst the anti-RSV-peptide with liposomes can significantly increase the RSV inhibition when compared with the anti-RSV peptide alone

Review on Calotropis Gigantea as a Topically used Plant

There have been numerous reports of the Asclepiadaceae plant, Calotropis gigantea R.Br, having medicinal and other uses. Plants have been employed as a source of medicinal substances since ancient times. In the indigenous system of medicine, plants are used extensively to treat disease. Traditional medicine makes use of various plant extracts or bioactive substances. This kind of research offers health at a reasonable price. The findings imply that the stem, leaves, and flower's phytochemical qualities can be used to treat a variety of diseases. The nation that produces the most medicinal herbs is India, which is fittingly known as the world's botanical garden. Calotropis gigantea, a member of the Asclepiadaceae/Apocynaceae family, is also referred to as the Crown Flower and has unique therapeutic properties that can be used alone or in conjunction with other medications to treat common disorders. Herbal medicines have a very wide range of medicinal applications. In ayurveda, the entire dried plant is used as a mucus explusor, parasitic worm expeller, and rejuvenator. Leprosy and asthma are treated with its dried root, while vertigo, baldness, hair loss, and rheumatoid arthritis are all treated with its latex. Calotropis is employed for a variety of conventional and homoeopathic treatments. The plant's many parts can be separated and used as medicine to get a variety of benefits

CAE-driven design methodology for semi-autonomous product development for the next generation light weight vehicle structures

Passenger cell assembly makes up a large percentage of the overall structural weight of the BIW-design, and hence has a high lightweight potential. The structure of the passenger cell not only ensures a “rigid-like” behavior in different crash scenarios, it also contributes to comfort and driving characteristics with a high torsional and flexural stiffness. Applying topology optimization here can facilitate developing novel light-weight floor assembly designs. However, implementing topology optimization as an integral part of the product development process requires a new methodological approach that skillfully combines CAE-tools with analogy methods and data management systems for decision making. For transforming the load paths into a structural concept, a technical evaluation methodology for decision making has been developed. Here the qualitative design parameters, such as geometry and the material grade of e.g. sheet metal profiles and reinforcements, are determined based on packaging requirements and analogy methods. In case of contradictory geometrical and material requirements, decision making is facilitated using preference matrices

Safety and efficacy of nimotuzumab with concurrent chemoradiotherapy in unresectable locally advanced squamous cell carcinoma of head and neck: An Indian rural hospital experience

Context: Nimotuzumab is the only anti-epidermal growth factor receptor monoclonal antibody which can be safely added to concurrent chemoradiotherapy (CRT) to improve efficacy in the management of unresectable, locally advanced squamous cell carcinoma of head and neck (LA-SCCHN). However, the evidence available on this is limited. Aims: We retrospectively investigated efficacy and safety of nimotuzumab when combined with chemoradiation for LA-SCCHN. Settings and Design: Hospital records of 39 patients from January 2012 to December 2016 diagnosed with locally advanced (Stage III-IVb), unresectable SCCHN, and treated with concurrent CRT with weekly nimotuzumab were reviewed retrospectively after fulfilling the inclusion/exclusion criteria. Subjects and Methods: Tumor response was calculated as per response evaluation criteria in solid tumors criteria 1.1. Association of tumor response with independent variables was assessed. Overall survival (OS) and progression-free survival (PFS) were calculated. All patients were assessed for toxicity as per common terminology criteria for adverse events Common Terminology Criteria for Adverse Events v 4.0 (U.S. Department of health and human services, National Institutes of Health, National Cancer Institute). Results: At 6 months after completion of treatment, objective response rate was 97.44% with 26 (66.67%) patients attaining Complete response (CR), 12 (30.77%) patients with Partial response (PR), and one patient (2.56%) had stable disease. Subgroup analysis did not show a significant association of tumor response with independent factors. OS at 1 and 2-year was 100% and 72.9%, while PFS at 1 and 2-year was 87% and 54.40%. The incidence of Grade I, II, III, and IV toxicity was 30%, 18.18%, 41.82%, and 10%, respectively. No grade V toxicity was observed. Common adverse events observed were mucositis (33.64%), skin reaction (24.55%), neutropenia (20.91%), vomiting (18.18%), and diarrhea (2.73%). Conclusions: Nimotuzumab is an efficacious and safe option when added to concurrent CRT in unresectable, LA-SCCHN

Effectiveness and tolerability of nimotuzumab in unresectable, locally advanced/metastatic esophageal cancer: Indian hospital-based retrospective evidence

Context: Epidermal growth factor receptor (EGFR) is overly expressed in esophageal squamous cell carcinoma (ESCC) and is important prognostic and predictive biomarker. Nimotuzumab is a humanized anti-EGFR monoclonal antibody and has documented promising clinical outcomes and survival rates in various solid tumors with high EGFR expression. Aims: Attempt to fill gap on paucity of data in India on the efficacy of Nimotuzumab in the treatment of locally advanced/metastatic ESCC. Settings and Design: Hospital records of 15 patients with unresectable, locally advanced/metastatic esophageal cancers, histologically confirmed squamous cell carcinoma being treated with Nimotuzumab along with standard treatments from October 2006 to November 2016 were retrospectively analyzed. Subjects and Methods: The tumor response rate and overall survival (OS) were analyzed. All patients were assessed for toxicity and adverse events (AEs) as per Common Terminology Criteria for Adverse Events (CTCAE) v4. Results: Majority had lower thoracic esophageal cancer. Tumor response rate observed was as follows 33% had a complete response, 67% had a partial response, and objective response rate was 100%. Survival rate at 1-, 3-, and 5-year was 58.33%, 29.17%, and 29.17%, respectively. Median OS was 26.8 months (95% confidence interval, 2.63–not reached). No Grade III or Grade IV AEs were observed. No added toxicity was observed due to nimotuzumab.Conclusions: Nimotuzumab combined with standard treatment in locally advanced/metastatic ESCC improved the survival rate and achieved a better tumor response rate without accumulation of toxicity and was well tolerated

The J-point phenomenon in aggressive therapy of hypertension: New insights

In the era of aggressive control of cardiovascular risk factors such as hypertension, the mantra of lower is better has taken a strong foothold. Although there is clear epidemiologic evidence that lower blood pressure improves specific organ-related outcomes, this rule does not apply to all patients and definitely not all target organs. The concept of J-curve or adverse outcomes at lower blood pressure has been proposed for more than three decades but has recently come under increasing scrutiny. Specifically, a relationship between adverse cardiovascular outcomes and low diastolic blood pressure has been observed in multiple clinical trials. In this article we review the advances in understanding of the J-curve phenomenon and include a discussion on specific populations that might be at higher risk due to the J-curve relationship. © Springer Science+Business Media, LLC 2012

Retrospective analysis to assess the feasibility of escalated dose of nimotuzumab in patients with locally advanced head and neck cancer

Introduction: Head and neck cancer (HNC) has large worldwide prevalence and accounts for almost 5% among all types of cancers. Nimotuzumab is a humanized anti-epidermal growth factor receptor monoclonal antibody that has shown promising results in patients with HNC. The present retrospective case study aimed at investigating the response rate and adverse events (AEs) of a high dose of nimotuzumab in patients with HNC who are ineligible for platinum-based chemotherapy. Materials and Methods: Patients with locally advanced HNC who refused chemotherapy or were ineligible for platinum-based chemotherapy were analyzed in the study. Patients were given nimotuzumab along with radiotherapy (RT). The duration of each treatment cycle was 6 weeks. About 200 mg nimotuzumab was administered, twice weekly for 6 weeks. The patients who received at least one treatment cycle of targeted therapy and accompanied regular follow-ups were assessed for response rate measurements. Results: A total of six patients were enrolled in the study. A response rate of 100% was observed in the patients who completed the treatment. Complete and partial response was 60% and 40%, respectively, in HNC patients at the end of treatment. Three patients were reported with Grade II mucositis. No Grade III or IV AEs were observed in the patients. Conclusion: High dose of nimotuzumab along with RT enhanced response rate in patients with HNC who are ineligible for platinum-based chemotherapy without producing any additional toxicity