Functional features of neutrophils in subclinical hypothyroidism compared to euthyroid status: Functional features of neutrophils in subclinical hypothyroidism

Neutrophil or polymorphonuclear leukocytes are critical to host defense. They act by migrating (chemotaxis) to site of inflammation or infection, phagocytoze the microorganisms to form phagosome. Reactive Oxygen species and hydrolytic enzymes are released (respiratory burst activity) into this phagosome to kill ingested microorganisms (microbicidal activity). Thyroid hormones are essential for proper differentiation, growth and metabolism of an organism. Increasing evidence indicates that thyroid hormones also play an active role in immunity. Subclinical hypothyroidism is associated with normal thyroid hormone levels with increased thyroid stimulating hormone level. While studies indicate elevated TSH to have some effects on immune functions, there is very little evidence regarding its effect on functional features of neutrophils. In this cross-sectional comparative study, we evaluated the phagocytic, chemotactic, candidacidal, and respiratory burst activity of neutrophils in subclinical hypothyroid and euthyroid subjects. Phagocytosis and metabolic function of the neutrophils was assessed using Nitro-blue tetrazolium test. Chemotaxis, directional movement of the PMNs was measured using the N-Formyl methionyl-leucyl-phenylalanine as chemoattractant. Phagocytic activity was evaluated by exposing leukocytes to candida suspension and counting the number of candida ingested and killed. Microbicidal activity of neutrophils was assessed by the ability of leukocytes to kill Candida albicans in both subclinical hypothyroid and euthyroid subjects. Our study demonstrated that chemotactic and mean phagocytic activity was significantly less in those with subclinical hypothyroidism as compared to euthyroid control group (p value= 0.005 and 0.045 respectively). Respiratory burst activities of both unstimulated & stimulated neutrophils were relatively reduced in subclinical hypothyroidism (p value of 0.08 and 0.07). Candidicidal activity was similar in both groups. We conclude that subclinical hypothyroid individuals having excess of thyroid stimulating hormones are associated altered functional characteristics of neutrophils

A study on association between intraocular pressure and myopia

Background: Myopia is one of the commonest ocular disorders and has been recognized as a risk factor for glaucoma. Aim of this study is to find the association between intraocular pressure (IOP) and different grades of myopia from low to high and compare it with emmetropia.Methods: Observational study done from January to May 2014. 178 eyes of 100 patients were divided into four groups according to their refractive status. Group 0 – Emmetropia (+0.5 to -0.5D), Group1- low myopia (-0.75 to -3.00D), Group 2 -moderate myopia (-3.00 to -5.00D) and Group 3 - high Myopia (>-5.00D).A complete ocular examination was done. Intraocular pressure was measured by standard Goldmann applanation tonometer.Results: Mean age of patients was 30.09 (range 11-47 years). The refraction ranged from +0.50D to -9.00D. Group 0 (emmetropia) included 84 eyes and mean IOP was 12.75 (SD: 2.18).Group 1 included 74 eyes with a mean IOP of 12.32 (SD: 2.44),Group 2 had 14 eyes with a mean IOP of 15.00 (SD:2.25)and Group 3 had 6 eyes with a mean I0P 18.5 (SD:0.7).There was no statistically significant difference in IOP between low myopic and emmetropic patients but the IOP in moderate and severe myopia was higher compared to emmetropic patients.                                                                                  Conclusions: There is statistically significant correlation (p<0.05) between IOP and myopia, in moderate and high myopia groups. The IOP was higher in those groups than in emmetropia and low myopia thereby increasing the risk of glaucoma in these patients.

A study of knowledge, attitude and practice in diabetic retinopathy among patients attending a primary health care centre

Background: Diabetic retinopathy is a major cause of preventable blindness. Sufficient knowledge about the disease can prevent sight threatening complications. Aim of this study is to evaluate the knowledge and its influence on attitude and practice in diabetic retinopathy among patients attending a primary health centre.Methods: A knowledge attitude practice questionnaire was prepared and pretested in a sample group of representative population. The response was analyzed as to whether the questions were understood or not. Social workers were trained in administering questionnaire. Diabetic patients were given questionnaires at primary health centre and filled in the presence of social workers.Results: Out of 324 patients 60.8% had no knowledge of diabetic retinopathy compared to 39.19% who had knowledge (p <0.001). Knowledge was more in age <40 years (82.60%) and least in 51-60 years (29.34%) (p<0.001) and more among females (38.59%) than males (61.4%). Knowledge was significantly higher among upper socioeconomic group (77.8%). About 83.46% in knowledge group had right attitude which was significantly higher than non knowledge group (32.48%) (p<0.001).  42.51% in knowledge group had practice of visiting ophthalmologist for eye check-up which was significantly higher than non knowledge group (13.19%) (p<0.001).Conclusions: The attitude and practice of diabetic retinopathy was statistically significant in knowledge group compared to those who had no knowledge of diabetic retinopathy. Improving knowledge about diabetic retinopathy through awareness campaigns can increase attitude and practice. Early detection can help in preventing sight threatening complications of diabetic retinopathy

AtMND1 is required for homologous pairing during meiosis in Arabidopsis

BACKGROUND: Pairing of homologous chromosomes at meiosis is an important requirement for recombination and balanced chromosome segregation among the products of meiotic division. Recombination is initiated by double strand breaks (DSBs) made by Spo11 followed by interaction of DSB sites with a homologous chromosome. This interaction requires the strand exchange proteins Rad51 and Dmc1 that bind to single stranded regions created by resection of ends at the site of DSBs and promote interactions with uncut DNA on the homologous partner. Recombination is also considered to be dependent on factors that stabilize interactions between homologous chromosomes. In budding yeast Hop2 and Mnd1 act as a complex to promote homologous pairing and recombination in conjunction with Rad51 and Dmc1. RESULTS: We have analyzed the function of the Arabidopsis orthologue of the budding yeast MND1 gene (AtMND1). Loss of AtMND1 did not affect normal vegetative development but caused fragmentation and missegregation of chromosomes in male and female meiosis, formation of inviable gametes, and sterility. Analysis of the Atmnd1 Atspo11-1 double mutant indicated that chromosome fragmentation in Atmnd1 was suppressed by loss of Atspo11-1. Fluorescence in situ hybridization (FISH) analysis showed that homologous pairing failed to occur and homologues remained apart throughout meiosis. AtMND1 showed strong expression in meiocytes as revealed by RNA in situs. CONCLUSION: We conclude that AtMND1 is required for homologous pairing and is likely to play a role in the repair of DNA double strand breaks during meiosis in Arabidopsis, thus showing conservation of function with that of MND1 during meiosis in yeast

Typhoidal Salmonella and Emerging Resistance in Outbreak Proportions

Introduction: Typhoidal Salmonella causes an invasive infection resulting in 200 000 deaths among 20 million patients annually. Typhoid remains a public health problem in Southeast Asia, the Indian subcontinent, Africa, and South America. Traveler’s diarrhea caused by Salmonella is common in Asia. Outbreaks of typhoidal Salmonella resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole in the 1990s pushed therapy to ciprofloxacin which was replaced by ceftriaxone due to fluoroquinolone resistance. Methods: This prospective study characterizes demographical, etiological, and resistance patterns in typhoidal Salmonella at a 1000-bed teaching hospital in New Delhi, India. Two hundred inpatients in pediatrics, obstetrics-gynecology, medicine, intensive care, and OPD in whom Salmonella bacteremia was detected were characterized by routine and automated microbiology techniques. Results: The mean age of patients in this study was 21.4 years. Overall, 71% of patients suffered from Salmonella Typhi followed by 26% from Salmonella Paratyphi A. Four cases of Salmonella resistance to ampicillin, trimethoprim-sulfamethoxazole, and chloramphenicol were encountered. A high degree of partial and complete resistance to fluoroquinolones was seen among Salmonella Typhi, Salmonella Paratyphi A, and Salmonella Paratyphi B cases. Resistance to ciprofloxacin was 48% among Salmonella Typhi and 100% among Salmonella Paratyphi A cases. Only 18% of Salmonella Typhi cases were completely resistant to quinolones, while 79% were partially resistant. A total of 92% of Salmonella Paratyphi A cases were partially resistant to quinolones. Four Salmonella cases were resistant to ceftriaxone. Conclusion: Salmonella Typhi remains the predominant serotype, followed by Salmonella Paratyphi A. The high prevalence of quinolone resistance in Salmonella Typhi and Salmonella Paratyphi A is a serious problem limiting empirical therapy to non-quinolone-based therapy such as ceftriaxone. Multidrug-resistant Salmonella is an emerging problem requiring active surveillance among residents and travelers presenting with tropical fever

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat