THE POTENTIAL IMPACT OF SOCIOECONOMIC STATUS ON MATERNAL HEALTH, TAMIL NADU, INDIA: A PROSPECTIVE OBSERVATIONAL STUDY.

Objectives This study aims to analyze the health challenges experienced by antenatal women and assess the influence of socioeconomic factors, with the goal of informing targeted interventions to enhance global maternal health outcomes.  Methods This prospective observational study, conducted at Sree Balaji Medical College and Hospital’s (SBMCH) Obstetrics and Gynaecology Department over 18 months, enrolled 326 pregnant women without pre-existing conditions. The study focused on the impact of socioeconomic status on diverse pregnancy complications, using randomization as the sampling technique. Comprehensive assessments, including history, examinations, and various blood investigations, were performed, followed by a meticulous follow-up throughout pregnancy.  Results The study identified a predominant age group of 20-34 years among pregnant women, with notable BMI variations. Notably, 61.3% exhibited a normal BMI, 11.7% experienced spontaneous abortion, with 57.9% occurring in the lower socioeconomic class, and 7.4% manifested congenital anomalies, with 83.3% from the lower socioeconomic class. Furthermore, prevalent conditions like anemia (54.3%), GDM (21.8%), cervicovaginal infections (24.8%), and hypertensive disorders (35.9%) showcased substantial associations with socioeconomic factors.  Conclusion The findings of the present investigation underscore the crucial role of socioeconomic factors in maternal health outcomes, emphasizing the need for targeted interventions and awareness programs. This study provides valuable insights for future public health initiatives aiming to address and alleviate health disparities among pregnant women.  Recommendation The study recommends implementing targeted interventions and educational initiatives to address socioeconomic disparities, thereby enhancing maternal health outcomes

MiR193a Modulation and Podocyte Phenotype

Apolipoprotein L1 (APOL1)-miR193a axis has been reported to play a role in the maintenance of podocyte homeostasis. In the present study, we analyzed transcription factors relevant to miR193a in human podocytes and their effects on podocytes\u27 molecular phenotype. The motif scan of the miR193a gene provided information about transcription factors, including YY1, WT1, Sox2, and VDR-RXR heterodimer, which could potentially bind to the miR193a promoter region to regulate miR193a expression. All structure models of these transcription factors and the tertiary structures of the miR193a promoter region were generated and refined using computational tools. The DNA-protein complexes of the miR193a promoter region and transcription factors were created using a docking approach. To determine the modulatory role of miR193a on APOL1 mRNA, the structural components of APOL1 3\u27 UTR and miR193a-5p were studied. Molecular Dynamic (MD) simulations validated interactions between miR193a and YY1/WT1/Sox2/VDR/APOL1 3\u27 UTR region. Undifferentiated podocytes (UPDs) displayed enhanced miR193a, YY1, and Sox2 but attenuated WT1, VDR, and APOL1 expressions, whereas differentiated podocytes (DPDs) exhibited attenuated miR193a, YY1, and Sox2 but increased WT1, VDR, APOL1 expressions. Inhibition of miR193a in UPDs enhanced the expression of APOL1 as well as of podocyte molecular markers; on the other hand, DPD-transfected with miR193a plasmid showed downing of APOL1 as well as podocyte molecular markers suggesting a causal relationship between miR193a and podocyte molecular markers. Silencing of YY1 and Sox2 in UPDs decreased the expression of miR193a but increased the expression of VDR, and CD2AP (a marker of DPDs); in contrast, silencing of WT1 and VDR in DPDs enhanced the expression of miR193a, YY1, and Sox2. Since miR193a-downing by Vitamin D receptor (VDR) agonist not only enhanced the mRNA expression of APOL1 but also of podocyte differentiating markers, suggest that down-regulation of miR193a could be used to enhance the expression of podocyte differentiating markers as a therapeutic strategy

Cultivation of Angelica archangelica Linn.: evaluation for economical viability at two different climatic conditions

ABSTRACT Cultivation of an important sub alpine-alpine medicinal and aromatic herb, Angelica archangelica Linn. (Apiaceae), was carried out at two different climatic zone at 2200 m asl (Pothivasa, PV) and 3600 m asl (Tungnath, TN) altitudes in Garhwal, North west Himalaya, India. These altitudes represent temperate and alpine region of the Himalaya. Since the species has a very few wild populations, cultivation of the species is recommended for its medicinal use. After the establishment of sufficient quantity of seedlings, they were transplanted in both sites at the age of two, three and four months for the comparative accounts on survival, growth and yield and, to test the appropriate age of seedlings for transplantation and climatic suitability for cultivation of the species. Organic cultivation protocol was adopted by using different farm yard manure (FYM) as treatments. Yield was minimum in youngest seedlings (two months old ) transplanted at TN in ordinary alpine soil (control) and maximum under polyhouse beds at PV after three years of growth. Observations on yield at different climatic zone revealed that it was maximum in PV (temperate site) as compared to alpine site (natural site) in all treatments. Seedlings of different age also had better survival, growth and yield at the temperate site though; two months old seedlings after transplantation had comparatively slow growth and yield than those of three and four months seedlings. These observations clearly suggested that temperate region (2200 m) is suitable for cultivation of A. archangelica. Addition of manure (leaf litter in particular) and polyhouse cultivation further improved the yield. Economical viability of the cultivation was also observed and presented here

Soft Tissue Attenuation Patterns Associated with Upright Acquisition SPECT Myocardial Perfusion Imaging: A Descriptive Study

Abstract: Purpose: Soft-tissue attenuation patterns in SPECT-myocardial perfusion imaging (MPI) of supine acquisition systems are well recognized. Their prevalence and interaction with body-habitus and gender are ill-defined, which we sought to describe in this study. Methods: In a cross-sectional study, we described the prevalence of soft-tissue attenuation patterns in normal SPECT-MPI studies acquired with a supine patient-position SPECT system. Results: In 263 normal, clinically-indicated, supine-acquisition SPECT-MPIs the attenuation patterns observed were: anterior (35.4%), inferior (41.8%) and lateral (13.3%). Anterior attenuation was more prevalent among women (50.7 % vs. 15.7%, P<0.001) and was associated with chest circumference among men. Conversely, inferior attenuation was more prevalent among men (78.3 % vs. 13.5%, P<0.001) and was not affected by body-habitus. Lateral attenuation was more common among women (19.6 % vs. 5.2%, p=0.001) and was associated with obesity (p=0.015). Conclusions: Soft-tissue attenuation artifacts are common in supine-acquisition SPECT-MPI. The recognition of their prevalence and association with body-habitus and gender is critical for the accurate interpretation of SPECT-MPI

A Novel Biclustering Approach to Association Rule Mining for Predicting HIV-1–Human Protein Interactions

Identification of potential viral-host protein interactions is a vital and useful approach towards development of new drugs targeting those interactions. In recent days, computational tools are being utilized for predicting viral-host interactions. Recently a database containing records of experimentally validated interactions between a set of HIV-1 proteins and a set of human proteins has been published. The problem of predicting new interactions based on this database is usually posed as a classification problem. However, posing the problem as a classification one suffers from the lack of biologically validated negative interactions. Therefore it will be beneficial to use the existing database for predicting new viral-host interactions without the need of negative samples. Motivated by this, in this article, the HIV-1–human protein interaction database has been analyzed using association rule mining. The main objective is to identify a set of association rules both among the HIV-1 proteins and among the human proteins, and use these rules for predicting new interactions. In this regard, a novel association rule mining technique based on biclustering has been proposed for discovering frequent closed itemsets followed by the association rules from the adjacency matrix of the HIV-1–human interaction network. Novel HIV-1–human interactions have been predicted based on the discovered association rules and tested for biological significance. For validation of the predicted new interactions, gene ontology-based and pathway-based studies have been performed. These studies show that the human proteins which are predicted to interact with a particular viral protein share many common biological activities. Moreover, literature survey has been used for validation purpose to identify some predicted interactions that are already validated experimentally but not present in the database. Comparison with other prediction methods is also discussed

Open questions and misconceptions in the diagnosis and management of anemia in patients with gastrointestinal bleeding

Despite high prevalence of iron deficiency anemia (IDA) in patients with acute or chronic gastrointestinal bleeding (GIB), IDA and iron deficiency (ID) are frequently untreated. Reasons may be misconceptions about the impact and diagnosis of IDA and the efficacy of new treatments. Addressing these misconceptions, this article summarizes current evidence for better understanding and management of GIB-associated IDA. Despite only few controlled studies evaluated the efficacy of iron treatment in patients with GIB, there is consistent evidence suggesting that: (a) IDA should be diligently investigated, (b) effective treatment of ID/IDA improves outcomes such as health-related quality of life and can avoid severe cardiovascular consequences, and (c) intravenous iron should be considered as well-tolerated treatment in this setting. Overall, the misconceptions and practices outlined in this article should be replaced with strategies that are more in line with current guidelines and best practice in GIB and other underlying conditions of ID/IDA.A pesar de la alta prevalencia de anemia por déficit de hierro (ADH) en pacientes con hemorragia digestiva (HD) aguda o crónica, la ADH y el déficit de hierro (DH) son frecuentemente infratratados. Diversos conceptos erróneos sobre el impacto, el diagnóstico y la eficacia de los nuevos tratamientos de la ADH probablemente lo justifican. Para abordar estos errores conceptuales, este artículo resume la evidencia actual para una mejor comprensión y manejo de la ADH. A pesar de que existen pocos estudios controlados que hayan evaluado la eficacia del tratamiento con hierro en pacientes con HD, hay evidencia que sugiere que: (a) la ADH debe ser investigada diligentemente; (b) el tratamiento eficaz del DH/ADH mejora la calidad de vida relacionada con la salud y puede evitar relevantes complicaciones cardiovasculares, y (c) el hierro intravenoso debe ser considerado como un tratamiento bien tolerado en este contexto. En general, los conceptos erróneos y las prácticas inadecuadas descritas en este artículo deben ser reemplazados por estrategias que estén más en línea con las directrices actuales y buenas prácticas clínicas en HD y otras condiciones causantes del DH/ADHinfo:eu-repo/semantics/publishedVersio

Update of the ICUD-SIU consultation on upper tract urothelial carcinoma 2016: treatment of low-risk upper tract urothelial carcinoma

Introduction The conservative management of upper tract urothelial carcinoma (UTUC) has historically been offered to patients with imperative indications. The recent International Consultation on Urologic Diseases (ICUD) publication on UTUC stratified treatment allocations based on high- and low-risk groups. This report updates the conservative management of the low-risk group. Methods The ICUD for low-risk UTUC working group performed a thorough review of the literature with an assessment of the level of evidence and grade of recommendation for a variety of published studies in this disease space. We update these publications and provide a summary of that original report. Results There are no prospective randomized controlled studies to support surgical management guidelines. A risk-stratified approach based on clinical, endoscopic, and biopsy assessment allows selection of patients who could benefit from kidney-preserving procedures with oncological outcomes potentially similar to radical nephroureterectomy with bladder cuff excision, with the added benefit of renal function preservation. These treatments are aided by the development of high-definition flexible digital URS, multi-biopsies with the aid of access sheaths and other tools, and promising developments in the use of adjuvant topical therapy. Conclusions Recent developments in imaging, minimally invasive techniques, multimodality approaches, and adjuvant topical regimens and bladder cancer prevention raise the hope for improved risk stratification and may greatly improve the endoscopic treatment for low-risk UTUC