LDL levels and ejection fraction in ischemic stroke patients: a hospital based cross-sectional study

Background: Ischemic stroke is a top contributor to mortality amongst non-infectious diseases. Atherosclerosis is a major risk factor. This study aims to assess LDL levels and ejection fraction in ischemic stroke patients. Methods: This descriptive cross-sectional study was conducted in Government Thoothukudi Medical College from November, 2022 to April, 2023. 35 patients admitted in the neuromedicine ward and diagnosed as acute ischemic stroke were included in the study after informed consent and ethical clearance. Patients with acute neurological deficit and evidence of infarct on diffusion-weighted MRI were included. Patients with no evidence of infarct on DWI, those already on lipid lowering therapy, patients with a history of cerebrovascular disease or transient ischemic attacks were excluded. Blood for lipid profile taken after 8 hours of overnight fasting. Echocardiography done for all patients. Results: Of the 35 patients, 26 (74.28%) were men, mean age was 62.4. 57.14%  ischemic stroke patients had their LDL levels elevated, 28.57% had decreased HDL, 28.57% had total cholesterol levels elevated, and in 14.28% triglycerides was elevated. This study also observed the cardiac status of the patients which showed 29% patients had decreased ejection fraction. Conclusions: This study concluded that most patients had elevated LDL levels which is an independent risk factor of ischemic cerebrovascular disease. LDL levels were also associated with decreased ejection fraction in a significant number of patients. Thereby it can be concluded that elevated LDL cholesterol levels can add to the cardiac risk, potentially contributing to stroke morbidity and mortality

The Changing California Coast: The Effect of a Variable Water Budget on Coastal Vegetation Succession

The land-ocean interface along the central coast of California is one of the most diverse biogeographic regions of the state. This area is composed of a species-rich mosaic of coastal grassland, shrubland, and forest vegetation types. An acceleration of conifer encroachment into shrublands and shrub encroachment into grasslands along the coast has been recently documented. These vegetation changes are believed to be driven primarily by fire suppression and changing grazing patterns. Climatic variables such as precipitation, fog, cloud cover, temperature, slope, and elevation also play an important role in vegetation succession. Our study area is located along the central California coast, which is characterized by a precipitation gradient from the relatively wetter and cooler north to the drier and warmer south. Some studies indicate changing fog patterns along this coast, which may greatly impact vegetation. A decrease in water availability could slow succession processes. The primary objective of this project is to determine if vegetation succession rates are changing for the study area and to identify climate and ecosystem variables which contribute to succession, specifically the transition among grassland, shrubland, and forest. To identify vegetation types and rates of succession, we classified two Landsat TM 5 scenes from 1985 to 2010 with a resulting overall accuracy of 82.4%. Vegetation succession was correlated to changes in maximum and minimum temperatures, precipitation, and elevation for each sub-region of the study area. Fog frequency was then compared between the northern and southern regions of the study area for determining the spatial relation between fog frequency and the percent of vegetation change

Long-term Survival of Treated Tuberculosis Patients in Comparison to a General Population In South India: A Matched Cohort Study

Objectives: This study aimed to measure the mortality rate, potential years of life lost, and excess general mortality among individuals treated for pulmonary tuberculosis (TB) in a TB endemic country. Methods: A retrospective analysis was conducted on a population-based cohort study of 4022 TB patients and 12,243 gender-matched and age-matched controls from prevalence surveys conducted between 2000 and 2004 in the Thiruvallur district of Tamil Nadu, South India. Results: The mortality rate among TB patients was 59/1000 person-years. The excess standardized mortality ratio was 2.3 (95% CI: 1.7–3.1). The rate of potential years of life lost was 6.15/1000 (95% CI: 5.97–6.33) in the TB cohort compared to the general population of 1.52/1000 (95% CI: 1.46–1.60). Individuals aged >50 years, those underweight (<40 kg), with treatment failures, or lost to follow-up had higher mortality rates when compared with the rest of the TB cohort. The risk of death was significantly higher in the TB cohort until the end of the fourth year when compared with later years. Conclusion: Mortality in the TB cohort was 2.3 times higher than in the age-matched general population. Most deaths occurred in the first year after completing treatment. Post-treatment follow-ups and interventions for reducing comorbid conditions are necessary to prevent deaths

N-acetyltransferase gene polymorphisms & plasma isoniazid concentrations in patients with tuberculosis

Background & objectives: Variations in the N-acetyltransferase (NAT2) gene among different populations could affect the metabolism and disposition of isoniazid (INH). This study was performed to genotype NAT2 gene polymorphisms in tuberculosis (TB) patients from Chennai, India, and compare plasma INH concentrations among the different genotypes. Methods: Adult patients with TB treated in the Revised National TB Control Programme (RNTCP) in Chennai, Tamil Nadu, were genotyped for NAT2 gene polymorphism, and two-hour post-dosing INH concentrations were compared between the different genotypes. Plasma INH was determined by high-performance liquid chromatography. Genotyping of the NAT2 gene polymorphism was performed by real-time polymerase chain reaction method. Results: Among the 326 patients genotyped, there were 189 (58%), 114 (35%) and 23 (7%) slow, intermediate and fast acetylators, respectively. The median two-hour INH concentrations in slow, intermediate and fast acetylators were 10.2, 8.1 and 4.1 μg/ml, respectively. The differences in INH concentrations among the three genotypes were significant (P<0.001). Interpretation & conclusions: Genotyping of TB patients from south India for NAT2 gene polymorphism revealed that 58 per cent of the study population comprised slow acetylators. Two-hour INH concentrations differed significantly among the three genotypes

Isolation and comparative genomics of Mycobacterium tuberculosis isolates from cattle and their attendants in South India

Funder: UK Medical Research Council, grant Reference number (MR/N501864/1)Abstract: The major human pathogen Mycobacterium tuberculosis is rarely reported to cause disease in other animals. Cases in livestock are thought to occur through contact with infected handlers, but previous studies evaluating putative livestock-human transmission used typing techniques with limited resolution. Here, we undertook cross-sectional surveillance for tuberculosis in 271 livestock handlers and 167 cattle on three farms in Chennai, India and defined the relatedness of cultured isolates using whole genome sequencing. Humans and livestock were screened for active mycobacterial infection, and opportunistic post-mortem examination was performed on comparative intradermal test-positive cattle that died. Four cattle and 6 handlers on two farms were culture-positive for M. tuberculosis; M. bovis was not isolated. All 10 isolates (one from each case) belonged to Lineage 1. Pairwise genome comparisons of single nucleotide polymorphism (SNP) differences ranged from 1 to 600 SNPs, but 3 isolate pairs were less than 5 SNPs different. Two pairs were from handlers and the third pair were from two cattle on the same farm. The minimum pairwise SNP difference between a cattle and human isolate was >250 SNPs. Our study confirms the presence of M. tuberculosis infection in cattle in India, sequencing of which characterised relatedness between human and cattle-derived isolates

Whole-Genome Sequencing of a Mycobacterium orygis Strain Isolated from Cattle in Chennai, India.

Here, we report the isolation of Mycobacterium orygis from dairy cattle in Chennai, India. Spoligotyping assigned the isolate to spoligotype 587 (ST587), which belongs to M. orygis This species was confirmed as M. orygis using whole-genome sequencing