Look-Alike Drugs-‘AWonder or a Blunder’?

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Epidemiological study on body mass index distribution and health awareness among women at an urban tertiary care centre of north India

Background: Obesity has become a new worldwide health problem and is gradually moving towards an epidemic. overweight and obesity implies an abnormal excessive fat accumulation that poses health risk. According to National Family Health Survey-4, prevalence of obesity has doubled in country over the last decade. Asian Indians stand at higher risk for development of obesity related non-communicable diseases at lower body mass index levels.Methods: It was an observational interpretive study carried on 1000 randomly selected women over 3 months in a tertiary center of urban northern India. BMI was obtained by dividing weight in kilograms and height in meters squares. Patients were enquired about any menstrual complains, known comorbidities, awareness of obesity in terms of its cause and effects, about weight reduction and benefits of exercise and its practice and details noted in a preformed performa. No prior intervention or health education was given to avoid bias.Results: Out of 1000 women, mean BMI was found to be 31.85±8.85kg/m2. BMI classification (Asian standards) stated that 8.1% were overweight and 78% of patients were pre obese and obese (maximum in age of 21-40 years). Menstrual complaints were present among 39% of overweight and obese groups. Among comorbidities, hypothyroidism was found to be maximum being 9.5% in the obese group, followed by hypertension and diabetes mellitus. Only 26.3% of obese women were aware of the factors causing obesity. Knowledge of exercise benefits was grossly limited, with only one fourth of the pre obese and obese population being aware of it.Conclusions: Rising obesity in Indian women needs measures for prevention. Though there is knowledge of the cure among Indian females but there is limited ability to implement the same. Health education of women regarding obesity related comorbidities along with the benefits of weight loss with exercises should be promoted strongly

Web-Based Educational Seminars Compare Favorably with In-House Seminars for Bariatric Surgery Patients

Background Comprehensive preparative patient education is a key element in bariatric patient success. The primary objective of this study was to compare attrition rates, demographics, and surgery outcomes between patients who participated in the online vs in-house preparative seminars. Methods A retrospective chart review was performed involving patients who chose to participate in online vs in-house educational seminar between July of 2014 and December of 2016. The patients were divided into two groups based on their choice of educational seminar and tracked to see how many made it to an initial visit and to surgery. In those who had bariatric surgery, data was collected on age, type of insurance, length of stay (LOS), longest follow-up, and change in body mass index. Results Total of 1230 patients were included in this study. There was no difference in attrition rate to initial consultation visit (29.1% vs 29.9%), but there was a statistically higher attrition to surgery in the in-house seminar attendees (72.9%) compared to online participants (66.6%, p < 0.05). Between January 2015 and December 2016, 291 patients underwent primary bariatric surgery. The online group was on average 3 years younger which was statistically significant. There were no differences in LOS, longest follow-up, and weight loss at 12 months between the groups. Conclusion When comparing attrition rates and bariatric surgery outcomes, no overall difference was noted between patients who received web- or hospital-based preparative education. Bariatric programs should provide access to online seminars to attract younger population and save resources and cost

Ferrochelatase is a therapeutic target for ocular neovascularization

Ocular neovascularization underlies major blinding eye diseases such as “wet” age-related macular degeneration (AMD). Despite the successes of treatments targeting the vascular endothelial growth factor (VEGF) pathway, resistant and refractory patient populations necessitate discovery of new therapeutic targets. Using a forward chemical genetic approach, we identified the heme synthesis enzyme ferrochelatase (FECH) as necessary for angiogenesis in vitro and in vivo. FECH is overexpressed in wet AMD eyes and murine choroidal neovascularization; siRNA knockdown of Fech or partial loss of enzymatic function in the Fechm1Pas mouse model reduces choroidal neovascularization. FECH depletion modulates endothelial nitric oxide synthase function and VEGF receptor 2 levels. FECH is inhibited by the oral antifungal drug griseofulvin, and this compound ameliorates choroidal neovascularization in mice when delivered intravitreally or orally. Thus, FECH inhibition could be used therapeutically to block ocular neovascularization

Perceptions about hemodialysis and transplantation among African American adults with end-stage renal disease: inferences from focus groups

BACKGROUND: Disparities in access to kidney transplantation (KT) remain inadequately understood and addressed. Detailed descriptions of patient attitudes may provide insight into mechanisms of disparity. The aims of this study were to explore perceptions of dialysis and KT among African American adults undergoing hemodialysis, with particular attention to age- and sex-specific concerns. METHODS: Qualitative data on experiences with hemodialysis and views about KT were collected through four age- and sex-stratified (males <65, males ≥65, females <65, and females ≥65 years) focus group discussions with 36 African American adults recruited from seven urban dialysis centers in Baltimore, Maryland. RESULTS: Four themes emerged from thematic content analysis: 1) current health and perceptions of dialysis, 2) support while undergoing dialysis, 3) interactions with medical professionals, and 4) concerns about KT. Females and older males tended to be more positive about dialysis experiences. Younger males expressed a lack of support from friends and family. All participants shared feelings of being treated poorly by medical professionals and lacking information about renal disease and treatment options. Common concerns about pursuing KT were increased medication burden, fear of surgery, fear of organ rejection, and older age (among older participants). CONCLUSIONS: These perceptions may contribute to disparities in access to KT, motivating granular studies based on the themes identified

Retrospective evaluation of whole exome and genome mutation calls in 746 cancer samples

Funder: NCI U24CA211006Abstract: The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that ~80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAF < 15%) and clonal heterogeneity contribute up to 68% of private WGS mutations and 71% of private WES mutations. We observe that ~30% of private WGS mutations trace to mutations identified by a single variant caller in WES consensus efforts. WGS captures both ~50% more variation in exonic regions and un-observed mutations in loci with variable GC-content. Together, our analysis highlights technological divergences between two reproducible somatic variant detection efforts

Anesthetic considerations for a parturient with pulmonary hypertension

Pulmonary hypertension is defined as persistent rise in mean pulmonary artery pressure of 25 mmHg or more with pulmonary occlusion pressure <15 mmHg. Most of the symptoms encountered in pulmonary hypertension overlap with that of normal pregnancy such as shortness of breath, weakness, fatigue, chest pain, syncope, and abdominal discomfort. Pulmonary hypertension in pregnant patients carries high mortality rates between 30% and 56% and is also the important cause of increased perioperative morbidity and mortality. Basic principles of management include maintaining right ventricular function and reducing pulmonary vascular resistance. Preoperative risk assessment and successful management of patients with pulmonary hypertension undergoing surgery are crucial and important and involve an understanding of the pathophysiology of the disease, analysis of preoperative and operative risk factors, thorough multidisciplinary planning, meticulous intraoperative management, and early recognition and treatment of postoperative complications. We searched PubMed and Google Scholar databases with the following key words: pulmonary hypertension, anesthesia concerns, and parturient female for literature search