Hypertension in the Parsi community of Bombay: a study on prevalence, awareness and compliance to treatment

BACKGROUND: Uncontrolled hypertension (HT) is an established risk factor for the development of vascular diseases. Prevalence varies in different communities and no such study has been conducted in the Parsi community living in Bombay, India. The objectives of this study were to determine the prevalence, awareness, compliance to medication and control of HT in this community. METHOD: We used a 1 in 4 random selection of subjects who were ≥ 20 years of age. A questionnaire was administered and the blood pressure (BP) was measured by a doctor. HT was defined as diastolic blood pressure (DBP) ≥ 90 mm Hg ± systolic pressure (SBP) ≥ 140 mm Hg. Isolated systolic hypertension (ISH) was defined as SBP ≥ 160 mm Hg with DBP < 90 mm Hg. Subsequently, we reanalysed the data using current definition of ISH as SBP ≥ 140 mm Hg with DBP < 90 mm Hg. RESULTS: 2879 subjects ≥ 20 years of age were randomly selected of which 2415 (84%) participated in the study. The overall prevalence of HT in the community was 36.4%, of whom 48.5% were unaware of their hypertensive status. Of those aware of having HT, 36.4% were non-compliant with their anti-hypertensive drugs and only 13.6% had optimally controlled HT. Prevalence of ISH using the present criteria was 19.5% and 73% of hypertensives ≥ 60 years had ISH. CONCLUSION: This study shows that prevalence of HT in the Parsi community is high and nearly half are unaware of their hypertensive status. ISH is the dominant form of HT in the elderly. Compliance to treatment is poor and optimal BP control is achieved in only a small minority. The study highlights the need for regular screening coupled with educational programs to detect and optimally treat HT in the community

Pharmacists' knowledge and attitudes about natural health products: A mixed-methods study

Objectives: To explore knowledge and attitude of pharmacists in Qatar towards natural health products (NHPs). Methods: The quantitative component of this study consisted of an anonymous, online, self-administered questionnaire to assess knowledge about NHPs among pharmacists in Qatar. Descriptive statistics and inferential analysis were conducted using Statistical Package of Social Sciences (SPSS®). Means and standard deviation were used to analyze descriptive data, and statistical significance was expressed as P-value, where P≤0.05 was considered statistically significant. Associations between variables were measured using Pearson correlation. The qualitative component utilized focus group (FG) meetings with a purposive sample of community pharmacists. Meetings were conducted until a point of saturation was reached. FG discussions were audio-taped and transcribed verbatim. Data were analyzed using a framework approach to sort the data according to emerging themes. Results: The majority of participants had average to poor knowledge about NHPs while only around 7% had good knowledge. In the FG meetings, participants considered the media, medical representatives, and old systems of natural health as major source of their knowledge. They criticized undergraduate pharmacy courses (for inadequately preparing pharmacists to deal with NHPs) and the pharmacy regulations (for being irrelevant). A perception of NHPs as being “safe” still exists among pharmacists. Conclusions: Pharmacists’ ability to provide effective services associated with NHPs is limited by poor access to evidence-based information and poor knowledge. A perception of NHPs and CAM as 'safe' still exists among pharmacists, and regulations related to NHPs require addressing to follow best practice and ensure patient safety.Scopu

Pengaruh Intellectual Capital Terhadap Abnormal Return Saham Dan Kinerja Keuangan (Studi Pada Perusahaan Perbankan Di Bursa Efek Indonesia Tahun 2011-2015)

The purpose of this study was to examine the effect of intellectual capital to abnormal stock return and financial perfomance of banking firms. The abnormal stock return was measured by cumulative abnormal return (CAR), and average abnormal return (AAR), the company\u27s financial perfomance measured by return on assets (ROA), assets turn over (ATO) and growth in revenue (GR). Laten variables used in this study was the perfomance of intellectual capital as measured by VAIC™ (VACA, VAHU, STVA). The sample study was using banking company listed in Indonesia Stock Exchange (IDX) for 2011-2015. Research data using purposive sampling method. Data obtained amounted to 75 companies in the period 2011-2015. This study uses PLS version 3.0 to analyze the data. The result showed that significant intellectual capital positive significantly effect the abnormal stock return and financial perfomance that measured by CAR, AAR, ROA and ATO, but no effect on GR. Overall, this research found that structural capital (STVA) gives the most contribution in creating value added of the company

Ga substitution as an effective variation of Mn-Tb coupling in multiferroic TbMnO3

Ga for Mn substitution in multiferroic TbMnO$_{3}$ has been performed in order to study the influence of Mn-magnetic ordering on the Tb-magnetic sublattice. Complete characterization of TbMn$_{1-x}$Ga$_x$O$_{3}$ ($x$ = 0, 0.04, 0.1) samples, including magnetization, impedance spectroscopy, and x-ray resonant scattering and neutron diffraction on powder and single crystals has been carried out. We found that keeping the same crystal structure for all compositions, Ga for Mn substitution leads to the linear decrease of $T_{\rm N}^{\rm Mn}$ and $\tau^{\rm Mn}$, reflecting the reduction of the exchange interactions strength $J_{\rm Mn-Mn}$ and the change of the Mn-O-Mn bond angles. At the same time, a strong suppression of both the induced and the separate Tb-magnetic ordering has been observed. This behavior unambiguously prove that the exchange fields $J_{\rm Mn-Tb}$ have a strong influence on the Tb-magnetic ordering in the full temperature range below $T_{\rm N}^{\rm Mn}$ and actually stabilize the Tb-magnetic ground state.Comment: 9 pages, 8 figure

Genetic and Genomic Analysis of a Fat Mass Trait with Complex Inheritance Reveals Marked Sex Specificity

The integration of expression profiling with linkage analysis has increasingly been used to identify genes underlying complex phenotypes. The effects of gender on the regulation of many physiological traits are well documented; however, “genetical genomic” analyses have not yet addressed the degree to which their conclusions are affected by sex. We constructed and densely genotyped a large F2 intercross derived from the inbred mouse strains C57BL/6J and C3H/HeJ on an apolipoprotein E null (ApoE(−/−)) background. This BXH.ApoE(−/−) population recapitulates several “metabolic syndrome” phenotypes. The cross consists of 334 animals of both sexes, allowing us to specifically test for the dependence of linkage on sex. We detected several thousand liver gene expression quantitative trait loci, a significant proportion of which are sex-biased. We used these analyses to dissect the genetics of gonadal fat mass, a complex trait with sex-specific regulation. We present evidence for a remarkably high degree of sex-dependence on both the cis and trans regulation of gene expression. We demonstrate how these analyses can be applied to the study of the genetics underlying gonadal fat mass, a complex trait showing significantly female-biased heritability. These data have implications on the potential effects of sex on the genetic regulation of other complex traits

Identification of differentially expressed microRNAs during lipotoxic endoplasmic reticulum stress in RAW264.7 macrophages [RAW264.7 makrofajlarında lipotoksik endoplazmik retikulum stres s�recinde ifadesi değişen mikroRNAların tanımlanması]

Objective: Increased fatty acids in the circulation and their accumulation in non-adipose tissues play a significant role in the development of obesity related metabolic and inflammatory disorders such as insulin resistance, diabetes and atherosclerosis. While fat tissue has the ability to store excess fatty acids, uptake of excess fatty acids to other tissues burdens intracellular metabolic organelles such as mitochondria and endoplasmic reticulum (ER), leading to stress response and lipotoxic cell death. Unfolded protein response (UPR) is a key adaptation of the ER to stress. It is still not completely clear how lipids engage the UPR and how UPR manages both the adaptive and destructive consequences under its control. Increasing evidence point to the importance of miRNA regulation of the UPR as well as UPR’s role in miRNA biogenesis. In order to understand how lipids engage the UPR, we set forth to identify microRNAs regulated by lipotoxic ER stress in macrophages. Methods: We stressed the mouse macrophage cell line (RAW 264.7) with a saturated fatty acid, 500μM palmitate, reflecting the levels found in the circulation of obese patients. We analyzed the microRNAome profiles of this cell line using QRT-PCR based miScript miRNA PCR array which contained all known mouse microRNAs in miRBase release16 and performed pathway analysis for potential targets. Results: 227 microRNAs showed altered expression levels; 43 microRNAs above 2 fold difference and 13 microRNAs 3-24 fold difference. Pathway analysis enriched the target mRNAs of these lipotoxic ER stress associated miRNAs. Conclusion: When exposed to high concentrations of saturated fatty acids that can induce ER stress, macrophages display a dynamic range of changes in their microRNAome profiles. Our findings reflect the consequences of lipotoxic stress on circulating monocytes and tissue-associated macrophages in obesity. Further studies are needed to deliniate which UPR arm is reponsible for the microRNA changes reported here. � 2016, Turkish Biochemistry Society. All rights reserved

Association of CHA2DS2-VASc score with successful recanalization in acute ischemic stroke patients undergoing endovascular thrombectomy

Introduction: The CHA2DS2-VASc (congestive heart failure, hypertension, age, diabetes mellitus, stroke, vascular disease and sex) score is a simple risk stratification algorithm to estimate stroke/thromboembolic risk in patients with non-valvular atrial fibrillation (AF). Higher pre-stroke CHA2DS2-VASc score is known to be associated with greater stroke severity and poorer outcomes. AF patients generally have higher CHA2DS2-VASc scores than non-AF patients. The Modified Thrombolysis in Cerebral Infarction (mTICI) score is the most widely used grading system to assess the result of recanalizing therapies in acute ischemic stroke (AIS). mTICI 2c and mTICI 3 are conventionally accepted as successful recanalization. Aim: We investigated whether pre-stroke CHA2DS2-VASc score is associated with mTICI recanalization score in AIS patients with and without AF undergoing percutaneous thrombectomy. Material and methods: One hundred fifty-nine patients with the diagnosis of AIS who were admitted within 6 h from symptom onset were included in the study (mean age: 65.7 ±12.9). All subjects underwent endovascular treatment. CHA2DS2-VASc scores of the participants were calculated. Subjects were grouped according to mTICI scores achieved after endovascular treatment. mTICI 2c and mTICI 3 were accepted as successful recanalization. Results: Successful reperfusion was observed in 130 (81.8%) of all patients who underwent endovascular treatment (mTICI flow ≥ 2c) and first-pass reperfusion was observed in 107 (67.3%) patients. When the patients with successful (mTICI flow ≥ 2c) and unsuccessful (mTICI flow ≤ 2b) reperfusion were divided into groups, no significant difference was observed between the patients in terms of comorbidities such as AF, hypertension, hyperlipidemia, coronary artery disease and cerebrovascular accident history. Patients with unsuccessful reperfusion were older than patients with successful reperfusion (71.4 ±11.2 vs. 64.5 ±13.01, p = 0.006), with a higher CHA2DS2-VASc score (4.1 ±1.5 vs. 3.04 ±1.6, p = 0.002). In addition, the duration of the procedure was longer in the unsuccessful reperfusion group (92.4 ±27.2 min vs. 65.0 ±25.1 min, p < 0.001). CHA2DS2-VASc score significantly correlated with successful recanalization (correlation coefficient; 0.243, p = 0.002). Multivariate logistic regression analysis revealed that only CHA2DS2-VASc score (OR = 1.43, 95% CI: 1.09-1.87, p = 0.006) and procedure time (OR = 1.03, 95% CI: 1.01-1.05, p < 0.001) were independent predictors of successful reperfusion. The receiver-operating characteristic (ROC) curve was used to determine the cut-off value for the CHA2DS2-VASc score that best predicts successful reperfusion. The optimal threshold was 3.5, with a sensitivity of 58.6% and specificity of 59.2% (area under the curve (AUC): 0.669, p = 0.005). Conclusions: For the first time in the literature, we investigated and demonstrated that pre-stroke CHA2DS2-VASc score was associated with success of recanalization as assessed with mTICI 2c and mTICI 3 in a cohort of AIS patients regardless of AF presence who underwent endovascular treatment. Our findings deserve to be tested with large scale long term studies

Quercetin elevates p27Kip1 and arrests both primary and HPV16 E6/E7 transformed human keratinocytes in G1

Our previous work with primary bovine fibroblasts demonstrated that quercetin, a potent mutagen found in high levels in bracken fern (Pteridium aquilinum), arrested cells in G1 and G2/M, in correlation with p53 activation. The expression of bovine papillomavirus type 4 (BPV-4) E7 overcame this arrest and lead to the development of tumorigenic cells lines (Beniston et al., 2001). Given the possible link between papillomavirus infection, bracken fern in the diet and cancer of the upper gastrointestinal (GI) tract in humans, we investigated whether a similar situation would occur in human cells transformed by human papillomavirus type 16 (HPV-16) oncoproteins. Quercetin arrested primary human foreskin keratinocytes in G1. Arrest was linked to an elevation of the cyclin-dependent kinase inhibitor (cdki) p27Kip1. Expression of the HPV16 E6 and E7 oncoproteins in transformed cells failed to abrogate cell cycle arrest. G1 arrest in the transformed cells was also linked to an increase of p27Kip1 with a concomitant reduction of cyclin E-associated kinase activity. This elevation of p27Kip1 was due not only to increased protein half-life, but also to increased mRNA transcription

Semiclassical Mechanics of the Wigner 6j-Symbol

The semiclassical mechanics of the Wigner 6j-symbol is examined from the standpoint of WKB theory for multidimensional, integrable systems, to explore the geometrical issues surrounding the Ponzano-Regge formula. The relations among the methods of Roberts and others for deriving the Ponzano-Regge formula are discussed, and a new approach, based on the recoupling of four angular momenta, is presented. A generalization of the Yutsis-type of spin network is developed for this purpose. Special attention is devoted to symplectic reduction, the reduced phase space of the 6j-symbol (the 2-sphere of Kapovich and Millson), and the reduction of Poisson bracket expressions for semiclassical amplitudes. General principles for the semiclassical study of arbitrary spin networks are laid down; some of these were used in our recent derivation of the asymptotic formula for the Wigner 9j-symbol.Comment: 64 pages, 50 figure

Diagnosing Beta Thalassemia trait in a developing country

BackgroundBeta Thalassemia trait (BTT) is diagnosed by detecting hemoglobin A2 (HbA2) >3.8% on either High Performance Liquid Chromatography (HPLC) or cellulose acetate electrophoresis (CAE). HPLC is an accurate and reproducible but costly alternative to more conventional CAE which is labor intensive but easy to interpret and inexpensive.ObjectiveTo determine the sensitivity of CAE and HPLC keeping PCR as gold standard for the diagnosis of BTT.Study DesignCross sectional.Place and Duration of StudyArmed Forces Institute of Pathology Rawalpindi. May 2014 to January 2015.Patient and MethodsFiveml EDTA anti-coagulated blood was collected from 100 PCR proven cases of BTT. HbA2 levels were measured by running samples directly on HPLC. But for CAE, first a hemolysate was prepared which was then applied to cellulose acetate membrane at an alkaline pH (7.9). After elution of HbA2 band in Tris EDTA borate buffer (pH of 8.9), HbA2 concentration was calculated by measuring its absorbance in a photometer at a wavelength of 416nm.ResultsMean age of the patients was 28.8±8.1 year. The most common mutation was Fr 8–9 (35%) followed by IVS1-5 (25%) mutation. Mean HbA2 levels by CAE and HPLC were 4.97±0.42 and 5.54±0.59 respectively. All the patients had HbA2>4% on both CAE and HPLC. None of our patients had false negative result either on CAE or HPLC.ConclusionCAE has comparable sensitivity with HPLC for detection of Beta Thalassemia Trait