A prospective study of N-acetylcysteine treatment in drug-induced fulminant hepatic failure

Background: Acute liver failure (ALF) is a rare but severe, life-threatening, complex, multisystemic gastroenterological emergency. Its rapid progression and high mortality demand early diagnosis and expert management. Drug-induced ALF (DI-ALF) remains the uncommon cause of ALF in India. To date, there is no established treatment for DI-ALF other than liver transplantation and little is known about the use of N-acetylcysteine (NAC) in DI-ALF. A prospective case-control study was carried with the aim to determine the effect of NAC on mortality of DI-FHF patients and also to evaluate the safety and efficacy of NAC use.Methods: A total of 18 patients with a diagnosis of DI-FHF were included in the study. 10 patients received NAC infusion for 72 hours whereas the control group received placebo. The variables evaluated were demographic, signs and symptoms, biochemical parameters, outcome and length of hospital stay.Results: Out of 18 DI-FHF patients, 13 (72.2%) had anti-tuberculosis therapy (ATT) induced FHF and 5 (27.8%) patients had ayurvedic induced FHF. The two groups were comparable for the various baseline characteristics (age, INR, alanine aminotransferase, creatinine, albumin, grade of encephalopathy, etc.). The mortality decreased to 20% with the use of NAC versus 75% in the control group (P=0.023). Use of NAC was associated with a shorter length of hospital stay of survived patients (P=0.043). Moreover, the overall survival was improved by NAC (P=0.023) in DI-FHF. ATT induced FHF showed better outcome as compared to ayurvedic induced FHF use (P=0.019).Conclusions: Author recommended the use of NAC along with conventional treatments in patients with DI-FHF in non-transplant centers while awaiting referrals. ATT induced FHF showed better outcome as compared to ayurvedic induced FHF with NAC administration and its use was safe

Socio-demographic correlation with overweight and obesity among children of North India

Background: Nutritional and epidemiological evolution over the past 3 decades has resulted in weight changes. The dramatic rise in childhood obesity is one of its adverse outcomes. Objectives: The aim of the study was to assess the prevalence and socio-demographic correlates of overweight and obesity among school children in the age group of 6–14 years in rural and urban Jammu. Methods: This cross-sectional community-based study was conducted in school going children of both sex aged 6–14 years in rural and urban areas of Jammu region. After explaining the purpose of the study, students were interviewed by the investigator and needful information regarding socio-demographic variables collected. Following the anthropometric assessment, body mass index (BMI) percentiles were obtained from the WHO age and gender-specific BMI charts. Among socio-demographic variables age, gender, residential area, type of school, type of family, education of parents, mother’s occupation, family size, and birth order were analyzed for their relationship with overweight and obesity. Results: Of the 230 children surveyed in the age group of 6–14 years, which included 107 from urban and 123 from rural areas, the overall overweight and obesity observed was 8.2%. Conclusion: Sociodemographic and socioeconomic factors affect the nutritional status of children and adolescents. Overnutrition, as one of its adverse outcome, needs to be addressed with priority so as to prevent the pandemic of obesity and its metabolic consequences

The Menace of Aflatoxin: Understanding the Effects of Contamination by <em>Aspergillus Species</em> on Crops and Human Health and Advancements in Managing These Toxic Metabolites

Food security and safety are essential global issues that require collaboration from governments, private industry, and individuals to ensure there is enough safe and nutritious food to meet the needs of a growing population. The three main elements impacting food security and safety are the availability of food, access to safe food, and the utilization of food for a healthy life. Aflatoxins, harmful mycotoxins produced by certain fungi, damage a significant proportion of the world’s food supply, which is a factor in food insecurity. Effective strategies to prevent and manage aflatoxin contamination in crops include promoting sustainable and diversified agricultural practices, improving crop management, post-harvest handling and storage, and strict regulation and monitoring of food quality and safety. To date, there have been 20 different types of aflatoxins identified, with B1, B2, G1, and G2 being the most prevalent and dangerous. To mitigate the impact of aflatoxins, it is important to understand the mechanisms of contamination, the impact of aflatoxins, and the management strategies that can be employed to reduce contamination. An updated review on aflatoxin contamination, its impact and management strategies can provide valuable information for researchers, policymakers, and food safety professionals

Effect of isometric exercise on heart rate variability in prehypertensive young adults

Background and Objective: Heart rate variability (HRV) is a sensitive and specific non-invasive tool to evaluate the degree of heart rate variation under the balanced influence of sympathetic and parasympathetic components of the cardiac autonomic nervous system. The aim was to study the effect of isometric hand grip exercise on HRV in prehypertensive young adults and to find a correlation of HRV with body mass index (BMI). Materials and Methods: This observational study was done on 60 healthy young adults aged 18–30 years. All the subjects were divided into three groups of 20 each on the level of their BMI and systolic and diastolic blood pressures. Group I were subjects with BMI 25 and prehypertensive. HRV analysis (Chart HRV module, ADInstruments Pty Ltd) was performed with the following parameters calculated: low-frequency power (LF), high-frequency power (HF), and LF/HF ratio. Results: LF/HF ratio was significantly increased (P<0.001) in prehypertensive subjects (groups II and III) when compared with the normotensive subjects (group I), which indicates a heightened sympathetic discharge in prehypertensives. A positive correlation between anthropometric parameters and cardiac autonomic activity parameters and increased sympathetic activity in obese subjects were noted. Conclusion: An increase in anthropometric indices is associated with a change in cardiac autonomic activity, especially toward sympathetic activity. Regular anthropometric assessment can prevent the development of cardiac abnormalities and the incidence of sudden cardiac death

Demography and clinical outcome of pulmonary tuberculosis in Kashmir; 2 year prospective study

Introduction: Tuberculosis (TB) is caused by Mycobacterium tuberculosis, primarily affecting lungs. One-third of the world’s population is currently infected with the TB bacillus. Tuberculosis is one of the three primary diseases of poverty. The risk of developing tuberculosis is higher in immunocompromised persons and is a chronic debilitating disease. Aims and objectives: To study the demographic features and clinical outcome of pulmonary tuberculosis. Materials and methods: A prospective study involving 72 pulmonary tuberculosis patients above 18 years. Results: In our study 45 were below the age of 40 years with a mean age of 47 years ±12.39, with a male to female ratio of 1.4:1.61; patients were from rural areas and 18 were labourers. Two were HIV positive; fever was the main presenting complaint. Mean haemoglobin was 11.2 ± 2.48. Mean ESR was 45.2 ± 12.55. Bronchoscopy was done in 13 patients and 4 had bronchoalveolar lavage positive for AFB. All patients received a daily regimen of ATT. 4 were treated as Cat II, rest were treated as Cat I. 64 patients (88.8%) were cured, 8 (11.1%) are on follow up. No resistance was documented in any of the patients. Treatment related complications were seen in 43 (30.8%). Conclusion: Tuberculosis most commonly occurs in younger patients, especially from rural areas. Due to the low prevalence of HIV in Kashmir association with HIV was low. The Commonest presentation was fever. Most patients had a good response to daily regimen and the most common drug related side effect was hepatitis

Intramuscular Vaccination With the HSV-1(VC2) Live-Attenuated Vaccine Strain Confers Protection Against Viral Ocular Immunopathogenesis Associated With γδT Cell Intracorneal Infiltration

Herpes simplex virus type-1 (HSV-1) ocular infection is one of the leading causes of infectious blindness in developed countries. The resultant herpetic keratitis (HK) is caused by an exacerbated reaction of the adaptive immune response that persists beyond virus clearance causing substantial damage to the cornea. Intramuscular immunization of mice with the HSV-1(VC2) live-attenuated vaccine strain has been shown to protect mice against lethal ocular challenge. Herein, we show that following ocular challenge, VC2 vaccinated animals control ocular immunopathogenesis in the absence of neutralizing antibodies on ocular surfaces. Ocular protection is associated with enhanced intracorneal infiltration of γδ T cells compared to mock-vaccinated animals. The observed γδ T cellular infiltration was inversely proportional to the infiltration of neutrophils, the latter associated with exacerbated tissue damage. Inhibition of T cell migration into ocular tissues by the S1P receptors agonist FTY720 produced significant ocular disease in vaccinated mice and marked increase in neutrophil infiltration. These results indicate that ocular challenge of mice immunized with the VC2 vaccine induce a unique ocular mucosal response that leads into the infiltration of γδ T cells resulting in the amelioration of infection-associated immunopathogenesis