Prevalence of subclinical hypothyroidism in North-Indian pregnant women

Background: It is now well established that not only overt but subclinical thyroid dysfunction can also have adverse effects on fetal and maternal outcomes. In recent years several studies show a much larger prevalence of SCH and marked variation between different ethnic groups. The aim of this study was to find out the prevalence of subclinical hypothyroidism during first trimester in a teaching hospital in North India.Methods: A prospective observational study was conducted in all the consecutive first trimester pregnant women attending Santosh Medical College, Hospital, Ghaziabad from June 2014 to April 2015 after institutional ethics approval and consent from the study subjects. Morning samples of serum were tested for TSH. If serum TSH value was more than 2.5mIU/L then Free T4 and TPO Antibody level were estimated.Results: Serum TSH level was normal in 66.2 % women, 32.5 % women had subclinical hypothyroidism and 1.3 % women had overt hypothyroidism using a first trimester normal reference range of 0.1 to 2.5 mU/l suggested by American Thyroid Association or by the American Endocrine Society.Using 5 mIU/L as upper limit of TSH suggested by some Indian studies serum TSH level was normal in 90.6 % women, 8.1 % women had subclinical hypothyroidism and 1.3 % women had overt hypothyroidism.Conclusion: The prevalence of SCH is very high in our study population. We feel that the use of thyroid function reference values based on studies using different populations and different backgrounds can introduce bias in the evaluation of a local population

Utility of fasting plasma glucose test as screening tool for gestational diabetes mellitus based on International Association of the Diabetes and Pregnancy Study Group criteria

Background: The International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria have recently been endorsed by various bodies for screening and diagnosing Gestational Diabetes (GDM). The present study was done to diagnose gestational diabetes (GDM) by the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria in a North Indian Population and to evaluate the performance of fasting plasma glucose (FPG) in screening and diagnosis of GDM.Methods: We conducted a prospective observational study on 417 pregnant women. The women were screened for GDM between 24 weeks and 28 weeks of gestation by 75-g oral glucose tolerance test (OGTT) and GDM diagnosed by the IADPSG criteria.Results: The prevalence of GDM was 17.7% [95% Confidence interval (CI) 21.4 -14.1%] using the IADPSG criteria. Amongst the women diagnosed to have GDM, 64.9% had abnormal fasting plasma glucose (FPG). FPG cut-off value of 92 mg/dL identified 11.5% pregnant women with GDM. FPG cut-off value of 80 mg/dL ruled out GDM in 54.7% women. If 80 mg/dL were made the cut point to decide who should have the 75-g OGTT, then 56.8% (45.3 % with values 5.1 mmol/L) of pregnant women could avoid the 75-g OGTT with the probability that 1.9% of patients with GDM may be missed.Conclusions: FPG at 24-28 weeks’ gestation could be used as a screening test to identify GDM patients. Women with an FPG between ≥ 80 mg/dL and ≤ 92 mg/dL would require a 75-g OGTT to diagnose GDM

Awareness of cervical cancer and its screening methods in Indian women

Background: In spite of effective screening methods, cervical cancer continues to be a major public health problem in India. Therefore, the present study was carried out to assess the knowledge of cervical cancer and its screening among women, it also focuses on the reasons for not undergoing regular screening and the effect of counseling for the same.Method: 400 women were randomly enrolled from the women attending/visiting/working at a tertiary hospital. They were asked questions related to cervical cancer. All answers were obtained verbally and recorded in the questionnaire by the same investigator.Results: Out of 400 women, only 103 were aware of cervical cancer as well as its screening, and only 10 of them were undergoing regular screening. Among those who were aware of cervical cancer, majority (95.14%) were health care workers and most of them got this knowledge form their textbooks. After counseling, all except 6 women were willing for regular screening. The reason for refusal for the same was either they believed they were not at risk or they found pelvic examination uncomfortable.Conclusions: The study found that women had poor knowledge about cervical cancer and its screening. Awareness was higher among the women who had received higher education or were healthcare workers. However, cervical cancer screening rate was low even in these women. Government and health care professionals need to actively promote awareness of the risk factors of cervical cancer and encourage women to undergo regular Pap smear as a cervical cancer screening method

Sustainable dyeing of wool fabric with Talaromyces purpurogenus

Natural dyes had been used by human being since ancient times for colouring of various materials including textiles. These were replaced completely by synthetic dyes, continuous use of which created the problem of pollution and environmental degradation. With the development of green technology and increased awareness of sustainability, the use of non-allergic, non-toxic and eco-friendly natural dyes on textiles has become a matter of significant importance. Among the natural sources of colourants, microorganisms such as bacteria and fungi have gained interest in the field of textile coloration.  In the present study, the pigment solution yielded from growth of Talaromyces purpurogenus sp. on organic waste was used for dyeing of wool fabric. Under the dyeing conditions i.e. 1:30 M:L ratio, pH 5, 80º C temperature and 45 minutes dyeing time, the percent absorption could reach 57 %, 32%, 36% and 49% respectively. The wool fabric samples dyed with the fungal dye exhibited very good to excellent washing and rubbing fastness properties. The colour pigment obtained from fungal thus offered an opportunity to reduce impact on plant resources for dye source exploration. So it can be concluded from the study that a natural fungal dye could help to sustain the environment and to minimize the over exploitation of natural resources

Rickettsia conorii infection with fatal complication

Rickettsial diseases (RD) are a group of endotheliotropic infectious diseases caused by different species of genera Rickettsia. RD are not an uncommon disease and may be misdiagnosed during the evaluation of acute febrile illness due to a lack of reliable serological marker and diagnostic culture methods. Clinical manifestation of RD varies from febrile illness with rashes and myalgia to fatal complications such as shock and respiratory failure. We describe a case of a young male who presented initially with acute febrile illness, followed by shock and respiratory failure, and unfortunately succumbed to death. A post-mortem examination showed histological features of endotheliotropic infection, such as interstitial / perivascular edema in various organs and noncardiogenic pulmonary edema (suggesting increased vascular permeability) and evidence of vasculitis in the lung, liver, and intestines. Molecular studies performed from lung, liver, and kidney tissue confirm the diagnosis of spotted fever group rickettsial disease due to Rickettsia conorii

Evaluation of Cardioprotective activity of Asparagus racemosus against Doxorubicin induced cardiotoxicity in albino rats: an experimental study

Background: Cardiotoxicity is one of the most feared side effects of anticancer agents like Doxorubicin. Asparagus racemosus is a widely used medicinal plant in Indian system of medicine known for its antioxidant activity. In certain studies ethanol extract of Asparagus racemosus has shown to possess cardioprotective activity in experimental animals while in some other studies cardioprotective potential of Asparagus racemosus has not been demonstrated. Therefore, due to the controversial action, the present study was designed to explore the cardioprotective effect of aqueous effect of Asparagus racemosus against doxorubicin induced cardiotoxity.Methods: Following approval from Institutional Animal Ethics Committee of L.L.R.M Medical College registered under CPCSEA, India, this study was conducted in which 30 rats were randomized into five groups of six rats each. Group I received 2 ml/kg b.w. normal saline p.o for 21 days, group II apart from receiving pellet diet and normal saline for 21 days were treated with Doxorubicin in a single dose of 20 mg/kg intraperitoneally on the 21st day, group III and group IV received aqueous extract of Asparagus racemosus in doses of 250 mg/kg/day and 500 mg/kg/day respectively p.o. for 21 days followed by administration of Doxorubicin (20 mg/kg i.p.) on the 21st day, Group V received Carvedilol in doses of  30 mg/kg/day p.o. for 21 days followed by administration of Doxorubicin (20mg/kg i.p) on the 21st day. Then they were anaesthetized and blood sample was collected from abdominal aorta for performing blood test i.e. Creatinine kinase MB fraction (CK-MB), Lactate dehydrogenase (LDH), Serum glutamate oxaloacetate transaminase (SGOT), Serum glutamate pyruvate transaminase (SGPT). After blood collection the animals were sacrificed and heart was dissected out for histopathological study. The data obtained was organized and analysed by suitable statistical methods i.e. ANOVA followed by Post Hoc test.Results: CK-MB, LDH, SGOT and SGPT levels were found to be significantly raised (p<0.001) in Doxorubicin treated group. Asparagus racemosus pretreated groups exhibited significant limitation (p<0.001) in rise in levels of CK-MB,LDH,SGOT and SGPT levels in a dose dependent manner following Doxorubicin administration which were comparable to the group treated with the standard cardioprotective drug Carvedilol. Histopathological changes further corroborated cardioprotective potential of Asparagus racemosus.Conclusions: The present study concluded that aqueous extract of Asparagus racemosus possess cardioprotective potential against Doxorubicin induced cardiotoxicity

Active APPL1 sequestration by Plasmodium favors liver-stage development

© 2022 The Authors. This is an open access article under the CC BY-NC-ND license http://creativecommons.org/licenses/by-nc-nd/4.0/).Intracellular pathogens manipulate host cells to survive and thrive. Cellular sensing and signaling pathways are among the key host machineries deregulated to favor infection. In this study, we show that liver-stage Plasmodium parasites compete with the host to sequester a host endosomal-adaptor protein (APPL1) known to regulate signaling in response to endocytosis. The enrichment of APPL1 at the parasitophorous vacuole membrane (PVM) involves an atypical Plasmodium Rab5 isoform (Rab5b). Depletion of host APPL1 alters neither the infection nor parasite development; however, upon overexpression of a GTPase-deficient host Rab5 mutant (hRab5_Q79L), the parasites are smaller and their PVM is stripped of APPL1. Infection with the GTPase-deficient Plasmodium berghei Rab5b mutant (PbRab5b_Q91L) in this case rescues the PVM APPL1 signal and parasite size. In summary, we observe a robust correlation between the level of APPL1 retention at the PVM and parasite size during exoerythrocytic development.This work was supported by grants from the la Caixa Banking Foundation and Fundação para a Ciência e a Tecnologia (HR17-00264 and PTDC/SAU-PAR/30751/2017 respectively, both to M.M.M.). A.L and S.S.B were sponsored by Fundação para a Ciência e a Tecnologia fellowships (PD/BD/114036/2015, SFRH/BD/114464/2016, respectively). V.S acknowledges funding from the Science and Engineering Research Board (SERB) (EMR/2016/006810), Department of Science and Technology (DST), Government of India. V.P. and C.S. were supported by GRK2581 (P6) SPHINGOINF of the Growing Spine Foundation (DFG).info:eu-repo/semantics/publishedVersio

The sea urchin kinome: A first look

AbstractThis paper reports a preliminary in silico analysis of the sea urchin kinome. The predicted protein kinases in the sea urchin genome were identified, annotated and classified, according to both function and kinase domain taxonomy. The results show that the sea urchin kinome, consisting of 353 protein kinases, is closer to the Drosophila kinome (239) than the human kinome (518) with respect to total kinase number. However, the diversity of sea urchin kinases is surprisingly similar to humans, since the urchin kinome is missing only 4 of 186 human subfamilies, while Drosophila lacks 24. Thus, the sea urchin kinome combines the simplicity of a non-duplicated genome with the diversity of function and signaling previously considered to be vertebrate-specific. More than half of the sea urchin kinases are involved with signal transduction, and approximately 88% of the signaling kinases are expressed in the developing embryo. These results support the strength of this nonchordate deuterostome as a pivotal developmental and evolutionary model organism

Focused Cardiac Ultrasound to Guide the Diagnosis of Heart Failure in Pregnant Women in India.

BACKGROUND: Cardiac complications are a leading cause of maternal death. Cardiac imaging with echocardiography is important for prompt diagnosis, but it is not available in many low-resource settings. The aim of this study was to determine whether focused cardiac ultrasound performed by trained obstetricians and interpreted remotely by experts can identify cardiac abnormalities in pregnant women in low-resource settings. METHODS: A cross-sectional study was conducted among 301 pregnant and postpartum women recruited from 10 hospitals across three states in India. Twenty-two obstetricians were trained in image acquisition using a portable cardiac ultrasound device following a simplified protocol adapted from focus-assessed transthoracic echocardiography protocol. It included parasternal long-axis, parasternal short-axis, and apical four-chamber views on two-dimensional and color Doppler. Independent image interpretation was performed remotely by two experts, in the United Kingdom and India, using a standard semiquantitative assessment protocol. Interrater agreement between the experts was examined using Cohen's κ. Diagnostic accuracy of the method was examined in a subsample for whom both focused and conventional scans were available. RESULTS: Cardiac abnormalities identified using the focused method included valvular abnormalities (27%), rheumatic heart disease (6.6%), derangements in left ventricular size (4.7%) and function (22%), atrial dilatation (19.5%), and pericardial effusion (30%). There was substantial agreement on the cardiac parameters between the two experts, ranging from 93.6% (κ = 0.84) for left ventricular ejection fraction to 100% (κ = 1) for valvular disease. Image quality was graded as good in 79% of parasternal long-axis, 77% of parasternal short-axis and 64% of apical four-chamber views. The chance-corrected κ coefficients indicated fair to moderate agreement (κ = 0.28-0.51) for the image quality parameters. There was good agreement on diagnosis between the focused method and standard echocardiography (78% agreement), compared in 36 participants. CONCLUSIONS: The focused method accurately identified cardiac abnormalities in pregnant women and could be used for screening cardiac problems in obstetric settings

Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

BACKGROUND: Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI). METHODS: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE differed from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate. FINDINGS: The highest globally observed HALE at birth for both women and men was in Singapore, at 75·2 years (95% uncertainty interval 71·9-78·6) for females and 72·0 years (68·8-75·1) for males. The lowest for females was in the Central African Republic (45·6 years [42·0-49·5]) and for males was in Lesotho (41·5 years [39·0-44·0]). From 1990 to 2016, global HALE increased by an average of 6·24 years (5·97-6·48) for both sexes combined. Global HALE increased by 6·04 years (5·74-6·27) for males and 6·49 years (6·08-6·77) for females, whereas HALE at age 65 years increased by 1·78 years (1·61-1·93) for males and 1·96 years (1·69-2·13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2·3% [-5·9 to 0·9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the five lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16·1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally. INTERPRETATION: At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs offset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention efforts, and development assistance for health, including financial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support. FUNDING: Bill & Melinda Gates Foundation