Latent coronary artery disease among smokers and smokeless tobacco users: a cross-sectional study

Background: Tobacco related mortality and morbidity and increase in developing country like India. WHO projected till 2020 India will accounts 15% of tobacco related mortality especially preventable causes of death e.g. cardiovascular disease. Active tobacco smoking is undoubtedly major risk factor for cardiovascular disease, but subjects use smokeless tobacco in dependence pattern is not extensively evaluated for cardiovascular risk factor. In India smokeless tobacco especially Khaini is major form of tobacco consumption. Scarcity of data on effects of smokeless tobacco in cardiovascular disease especially coronary artery disease major limiting factor for undermine the detailed evaluation of cardiovascular effects in smokeless tobacco dependence subjects. The aim of the study was to study the risk of coronary artery disease among smokeless tobacco dependence in comparison to tobacco dependence smokers.Methods: Cross-sectional assessments were done on 36 adults (>18 years), treatment-seeking patients with a ICD 10 diagnosis of Mental and behavioral disorders due to use of tobacco. Data was collected on socio-demographic characteristics, and after detailed clinical evaluation treadmill exercise test was done.Results: Mean age of tobacco dependence smokers 51.5±9.6 years vs 53.6±7.5 years. There were male predominant in study subjects and 38% subjects was treadmill test positive. Smokeless tobacco users had 35% positive treadmill test, and among Smokers 42% subjects was positive for treadmill test.Conclusions: Risk for latent coronary artery disease was similarly higher in smokers and smokeless tobacco dependence subjects

Pattern of antidepressant prescription at tertiary (mental hospital vs medical college) care centre of central India

Background: Western literature full of extensively study the antidepressant prescription pattern at different settings. Recently in Indian context multicentre study and individual centers reported pattern of antidepressant uses for management of depression. With the time newer antidepressant approved, with better understanding of evidence based pathogenesis of illness influence the treatment patterns. Mental hospital setting is different that medical college setting at least for stigma related issue. The aim of the research work was to study the pattern of antidepressant prescription at mental hospital and medical college settings.Methods: Cross-sectional assessments were done at mental hospital and medical college centers. Subjects diagnosed as depressive episode as per ICD 10, age >18 year included in study. Total 105 treatment seeking subject included in study from both centers Data was collected on socio-demographic characteristics, Clinical profile and prescribed medication.Results: 49 subjects from mental hospital, 56 subjects from medical college included in study. Mean age of study sample 39.27±12.96 vs 37.49±14.90 years respectively at mental hospital and medical college centers. Escitalopram prescribed 83.7% subjects, 53.3 % subjects receive monotherapy. L methyl folate and atypical antipsychotics was most commonly adjunctive medication with antidepressants.Conclusions: In sociodemographic differences subjects attending mental hospital belong to lower socioeconomic status compare to subject attending mental hospitals. There were no significant differences in prescription pattern of antidepressant medication for treatment of depressive episode. Escitalopram most commonly prescribed antidepressant and L methyl folate and atypical antipsychotics was most commonly used adjuvant with antidepressant medications.

Latent coronary artery disease among smokers and smokeless tobacco users: a cross-sectional study

Background: Tobacco related mortality and morbidity and increase in developing country like India. WHO projected till 2020 India will accounts 15% of tobacco related mortality especially preventable causes of death e.g. cardiovascular disease. Active tobacco smoking is undoubtedly major risk factor for cardiovascular disease, but subjects use smokeless tobacco in dependence pattern is not extensively evaluated for cardiovascular risk factor. In India smokeless tobacco especially Khaini is major form of tobacco consumption. Scarcity of data on effects of smokeless tobacco in cardiovascular disease especially coronary artery disease major limiting factor for undermine the detailed evaluation of cardiovascular effects in smokeless tobacco dependence subjects. The aim of the study was to study the risk of coronary artery disease among smokeless tobacco dependence in comparison to tobacco dependence smokers.Methods: Cross-sectional assessments were done on 36 adults (>18 years), treatment-seeking patients with a ICD 10 diagnosis of Mental and behavioral disorders due to use of tobacco. Data was collected on socio-demographic characteristics, and after detailed clinical evaluation treadmill exercise test was done.Results: Mean age of tobacco dependence smokers 51.5±9.6 years vs 53.6±7.5 years. There were male predominant in study subjects and 38% subjects was treadmill test positive. Smokeless tobacco users had 35% positive treadmill test, and among Smokers 42% subjects was positive for treadmill test.Conclusions: Risk for latent coronary artery disease was similarly higher in smokers and smokeless tobacco dependence subjects

NCoR1: Putting the Brakes on the Dendritic Cell Immune Tolerance

Understanding the mechanisms fine-tuning immunogenic versus tolerogenic balance in dendritic cells (DCs) is of high importance for therapeutic approaches. We found that NCoR1-mediated direct repression of the tolerogenic program in conventional DCs is essential for induction of an optimal immunogenic response. NCoR1 depletion upregulated a wide variety of tolerogenic genes in activated DCs, which consequently resulted in increased frequency of FoxP3 <sup>+</sup> regulatory T cells. Mechanistically, NCoR1 masks the PU.1-bound super-enhancers on major tolerogenic genes after DC activation that are subsequently bound by nuclear factor-κB. NCoR1 knockdown (KD) reduced RelA nuclear translocation and activity, whereas RelB was unaffected, providing activated DCs a tolerogenic advantage. Moreover, NCoR1 <sup>DC-/-</sup> mice depicted enhanced Tregs in draining lymph nodes with increased disease burden upon bacterial and parasitic infections. Besides, adoptive transfer of activated NCoR1 KD DCs in infected animals showed a similar phenotype. Collectively, our results demonstrated NCoR1 as a promising target to control DC-mediated immune tolerance