Cardio-respiratory Fitness in Medical Students by Queen’s College Step Test: A Cross-sectional Study

Introduction: Cardio-respiratory fitness indicates the ability of circulatory system to supply oxygen toworking muscles during continuous physical activity. Maximum oxygen uptake (VO2max) is a single bestmeasure of cardio-respiratory fitness and is considered gold standard to quantify aerobic capacity. Methods:Eighty students of age group 18-25 years were taken by simple random sampling. VO2max was estimatedindirectly by following the protocol of Queen’s College Step Test (QCST) method. Results: Mean value ofVO2max for male (51.61±6.26 ml/Kg/min) and female (36.02±3.71 ml/Kg/min) was compared, which wasfound significantly higher in males than in females (p<0.001). There was negative correlation of gender(r = -0.838), body mass index (BMI) (r = -0.339), obesity category (r = -0.275), obese vs non-obese (r =-0.264) and basal pulse rate (r = -0.456) with VO2max and positive correlation of height (r = 0.592) and hoursof study(r = 0.309) with VO2max. Conclusion: This study showed that increased BMI is associated withdecreased level of VO2max in young adults. One can improve VO2max by maintaining BMI within normallimits

Hemispheric Brain Preference and Academic Parameters in Medical Students: A Cross-sectional Study

Introduction: Hemispheric brain preference means using one side of the brain over the other to learn. Hemispheric brain preference may influence one’s learning style. This study aimed to investigate hemispheric brain preference and its relation with academic parameters in medical students. Methods: Four hundred participants were included in the study by cluster random sampling. Using self-administered questionnaires, data on personal profile (name, age, sex, handedness, academic score, study method, study hours per day and study pattern) and hemispheric brain dominance was collected. Open Hemispheric Brain Dominance Scale 1.0 (2015) was used to determine the hemispheric brain dominance. Result: Participants having no clear hemispheric brain preference (46.75%) were in majority followed by those with left hemispheric brain preference (29.25%) and then those with right hemispheric brain preference (24%). There was a statistically significant difference in academic score of students with different hemispheric brain preference (p=0.021). Students with left brain preference had the highest academic score (63.85±11.78) and those with no clear preference had the lowest (59.96±11.64). Also, students with left hemispheric brain preference would study more regularly and would spend more time in study per day. Conclusion: In our sample, participants with left hemispheric brain preference were found to have the highest mean academic score but they also spent more time in study and also studied regularly throughout the semester. As this study shows diversity in brain preference among medical students, we recommend a good mix of various teaching learning methods for better learning of the entire class

Stress-induced changes in CARF expression determine growth arrest, apoptosis, or malignant transformation in cultured human cells: Molecular evidence and its application

Background: CARF (Collaborator of ARF)/CDKN2AIP is an essential protein, first cloned as a binding partner of ARF. It was subsequently shown to interact with p53, HDM2 proteins and regulate growth arrest and apoptosis by its multimodal mechanism of action. Over-expression of CARF caused senescence like growth arrest of cells, its knock-down triggered apoptosis. Intriguingly, malignantly transformed cells showed high level of CARF expression. Based on these findings, we hypothesized that level of CARF expression may be a key determinant of cell proliferation fates; where an increase in its levels causes growth arrest/senescence, but beyond a threshold it activates carcinogenesis. Methods: We utilized in vitro cell culture models using retrovirus-driven expression of CARF to achieve over-expression and super-expression of CARF. Analysis of CARF levels was undertaken by biochemical and imaging protocols. Cells exposed to a variety of stresses including physiological, environmental, oxidative, radiation and chemotherapeutics was examined for CARF expression and corresponding cell proliferation fates. Results: Induction of Senescence was seen in cells over-expressing CARF. On the other hand, cells compromised for CARF showed apoptosis, and the ones with super-expression of CARF exhibited malignant transformation. CARF expression analysis in these experimental models endorsed the concept of cell-fate determining role of CARF. Conclusions: We present molecular evidence of the bridging role of CARF in stress-aging-cancer phenotypes and its application in pharmaceuticals and nutraceuticals as a diagnostic and prognostic marker for stress and cancer treatments

Embelin inhibits TNF-α converting enzyme and cancer cell metastasis: molecular dynamics and experimental evidence

BACKGROUND: Embelin, a quinone derivative, is found in the fruits of Embelia ribes Burm (Myrsinaceae). It has been shown to have a variety of therapeutic potentials including anthelmintic, anti-tumor, anti-diabetic, anti-bacterial and anti-inflammation. Inflammation is an immunological response to external harmful stimuli and is regulated by an endogenous pyrogen and pleiotropic pro-inflammatory cytokine, tumor necrosis factor alpha (TNF-α). TNF-α production has been implicated in a variety of other human pathologies including neurodegeneration and cancer. Several studies have shown that the anti-inflammatory activity of embelin is mediated by reduction in TNF-α. The latter is synthesized as a membrane anchored protein (pro-TNF-α); the soluble component of pro-TNF-α is then released into the extracellular space by the action of a protease called TNF-α converting enzyme (TACE). TACE, hence, has been proposed as a therapeutic target for inflammation and cancer. METHODS: We used molecular docking and experimental approaches to investigate the docking potential and molecular effects of embelin to TACE and human cancer cell characteristics, respectively. RESULTS: We demonstrate that embelin is a potential inhibitor of TACE. Furthermore, in vitro studies revealed that it inhibits malignant properties of cancer cells through inactivation of metastatic signaling molecules including MMPs, VEGF and hnRNP-K in breast cancer cells. CONCLUSION: Based on the molecular dynamics and experimental data, embelin is proposed as a natural anti-inflammatory and anticancer drug

Cancer chemotherapy and beyond: Current status, drug candidates, associated risks and progress in targeted therapeutics

Cancer is an abnormal state of cells where they undergo uncontrolled proliferation and produce aggressive malignancies that cause millions of deaths every year. With the new understanding of the molecular mechanism(s) of disease progression, our knowledge about the disease is snowballing, leading to the evolution of many new therapeutic regimes and their successive trials. In the past few decades, various combinations of therapies have been proposed and are presently employed in the treatment of diverse cancers. Targeted drug therapy, immunotherapy, and personalized medicines are now largely being employed, which were not common a few years back. The field of cancer discoveries and therapeutics are evolving fast as cancer type-specific biomarkers are progressively being identified and several types of cancers are nowadays undergoing systematic therapies, extending patients’ disease-free survival thereafter. Although growing evidence shows that a systematic and targeted approach could be the future of cancer medicine, chemotherapy remains a largely opted therapeutic option despite its known side effects on the patient’s physical and psychological health. Chemotherapeutic agents/pharmaceuticals served a great purpose over the past few decades and have remained the frontline choice for advanced-stage malignancies where surgery and/or radiation therapy cannot be prescribed due to specific reasons. The present report succinctly reviews the existing and contemporary advancements in chemotherapy and assesses the status of the enrolled drugs/pharmaceuticals; it also comprehensively discusses the emerging role of specific/targeted therapeutic strategies that are presently being employed to achieve better clinical success/survival rate in cancer patients.All the authors are highly grateful and acknowledge to the authority of the respective departments and institutions for their support in carrying out this research. The authors also express their sincere gratitude to the unknown referee for critically reviewing the manuscript and suggesting useful changes. This research was funded by "Agencia Canaria de Investigación, Innovación y Sociedad de la Información (ACIISI) del Gobierno de Canarias” (No. ProID2020010134), and o´Caja Canarias (Project No. 2019SP43).Peer reviewe

Studies on the Generation of Biogas from Collagen Hydrolysate obtained from Chrome Shavings by Alkaline Hydrolysis: A Greener Disposal Method

Abstract The leather industry produces a significant amount of chromium bearing hazardous waste. Soli

COST ANALYSIS OF PRIMARY CARE ANAESTHETICS IN INDIAN MARKET: GENERIC VS. BRANDED

Objective: To study the degree of compliance of primary care anaesthesia dispensing companies in following the pricing norms set by Drug Price Control Order 2013(DPCO). Methods: This is an observational analytical study where the dosage, strength and ceiling price of the generic primary care anesthetics was obtained from the National Pharmaceutical Pricing Authority (NPPA) updated price list 2022 and similar data of their various counterpart brands, were obtained from www.medguideindia.com. Thereafter, comparisons of their ceiling price along with the brands cost range, cost ratio and percent cost variation were sought. Results: Our study retrieved 150 brands of total 11 injectable/topical primary care anaesthetics available in India of which 39.33% brands had prices more than DPCO recommended ceiling price.  Maximum price violation (90%) was noticed with brands of Inj. Midazolam 5 mg/ml. The maximum cost variation and cost ratio was seen with brands of Inj. Lignocaine 1-2% (10mg/ml) of 14837% and 149.37 respectively. Conclusion: The adjuvant sedative hypnotic, Midazolam which is often used to supplement the action of primary sedative hypnotics in inducing general anaesthesia, violating price ceiling is a matter of great concern as it would adversely impact the primary patient care; the most basic level of health care which almost whole population needs at some time or the other. Similarly adding to the misery of the common man is the maximum cost ratio and percent cost variation of the local anaesthetic, Inj. Lignocaine 1-2 % as it continues its prominence as the most widely used local anesthetic agent.&nbsp

Isolated cerebellar involvement in posterior reversible encephalopathy syndrome in a child with acute lymphoblastic leukemia

Parieto-occipital region is the most commonly involved site in posterior reversible encephalopathy syndrome (PRES). Cerebellar involvement has been reported with the predominant involvement of posterior cerebral regions, but isolated cerebellar involvement in PRES has been reported only once in English literature. We report here a 7-year-old boy with acute lymphoblastic leukemia who had PRES with isolated cerebellar involvement during induction chemotherapy. He presented with sudden onset headache, vomiting and hypertension followed by seizures, unconsciousness, and involuntary movements. Computed tomography scan revealed bilateral cerebellar hypodensities. He improved within few hours and reversibility of the lesions was documented on magnetic resonance imaging after 2 weeks. Awareness of atypical patterns in distribution of imaging abnormalities is important to recognize PRES more accurately and to avoid unnecessary diagnostic procedures and treatment

Prediction of preeclampsia in primigravida in late first trimester using serum placental growth factor alone and by combination model

We investigated a placental growth factor alone and combined clinical (mean arterial pressure, MAP), biophysical (uterine artery pulsability index, PI) and biochemical (placental growth factor, PLGF) model for predicting preeclampsia in late first trimester. The inclusion criteria was primigravida (<40 years) attending their first hospital visit with singleton pregnancy at 11–14 weeks of gestation. Of the enrolled and followed 291 subjects, 35 (12%) later developed PE (5.8%)/GH (6.2%). An equal number of randomised women with normotensive non-proteinuric course were considered as reference group. For preeclampsia, PLGF alone had detection rate of 40% and 51% with 5% and 10% FPR, respectively. On addition of MAP, the AUC improved to 0.937 for PE. Further, addition of mean PI slightly improved AUC to 0.965. This signifies that a model with all three markers had better prediction of preeclampsia rather than PLGF alone.Impact statement In view of high morbidity and mortality due to hypertensive disorders in pregnancy, there has been extensive research for developing markers to detect/screen the condition in early pregnancy. Several such markers have been tested in their individual capacities and in combination during early pregnancy. Most of these studies have originated from high income countries and focussed mainly on the second trimester of pregnancy. We investigated a placental growth factor alone and combined clinical (mean arterial pressure, MAP), biophysical (uterine artery pulsability index, PI) and biochemical (placental growth factor, PLGF) model for predicting preeclampsia in the first trimester in primigravida (<40 years). A nested case control model was used for our study. For preeclampsia, PLGF alone had detection rate of 40% and 51% with 5% and 10% FPR, respectively. On addition of MAP, the AUC improved to 0.937 for PE. Further, addition of mean PI slightly improved AUC to 0.965. The present study has been done in an Indian subcontinent setting (where maternal mortality related to preeclampsia are even higher) where very limited studies are available for the role of either PLGF or in combinations for prediction of preeclampsia. Our research pointed shows better predictability for PE when a combination of markers is used especially in low-risk nulligravida. These are easy, cheap and non-invasive measurements that can be taken in all women at their first routine antenatal visit