Investment-Linked Takaful Plan Patronage: Evidence From Malaysia

Investment-linked Takaful is a recent innovation introduced in Malaysia. This study focuses on Investment-linked takaful plan selection in Malaysia. We have used a self-administered questionnaire to collect data from 143 respondents from the Klang Valley area. Data collected through the survey was analyzed through descriptive statistics, correlation and regression analysis. Results indicate that fee payment and benefits play a significant role in Takaful operator selection while coverage and benefits affect the investment-linked product selection in Malaysia. This study is unique as it provides empirical evidence on the investment-linked takaful investment which is limited in supply. Results provided by this study can be useful for takaful operators in designing the most appropriate investment-linked product for attracting customers

Stability indicating RP-HPLC method development and validation for the simultaneous estimation of ceftriaxone and tazobactum in sterile powder for injection

A simple, rapid, precise and accurate method is developed for the quantitative simultaneous determination of ceftriaxone and tazobactum in bulk and pharmaceutical formulations. Separation of ceftriaxone and tazobactum was successfully achieved by using Inertsil C18 ODS column 250X4.6mm, 5µm in an isocratic mode using water and acetonitrile (80:20) at a flow rate of 1.0 ml/min and was monitored at 254 nm with a retention time of 3.049 minutes and 4.317 minutes for ceftriaxone and tazobactum respectively. The method was validated and the response was found to be linear in the drug concentration range of 20µg/ml to 80 µg/ml for ceftriaxone and 5 µg/ml to 35 µg/ml for tazobactum. The values of the correlation coefficient were found to be 0.999 for ceftriaxone and 0.999 for tazobactum respectively. The LOD and LOQ for ceftriaxone were found to be 0.021 and 0.064 respectively. The LOD and LOQ for tazobactum were found to be 0.030 and 0.091 respectively. The percentage recovery for ceftriaxone and tazobactum were found to be 98-102% respectively which indicates that the proposed method is highly accurate. The specificity of the method shows good correlation between retention times of standard with the sample. The method was extensively validated according to ICH guidelines for Linearity, Accuracy, Precision, Specificity and Robustness.  Stability of the drugs was determined by using acid/base, thermal, oxidative stress testing

Association Between Homocysteine and Vascular Calcification Incidence, Prevalence, and Progression in the MESA Cohort.

Background While elevated homocysteine has been associated with calcification in several studies, its importance as a cardiovascular risk factor remains unclear. This study examines the relationship between homocysteine and vascular and valve calcification in the MESA (Multi-ethnic Study of Atherosclerosis) cohort. Methods and Results MESA participants with baseline homocysteine measurements and cardiac computed tomography scans were included (N=6789). Baseline and follow-up assessment of vascular (coronary artery [CAC], descending thoracic aorta [DTAC]) and valve (aortic valve [AVC], mitral annular [MAC]) calcification was performed. Prevalence ratio/relative risk regression was used to assess the relationship of homocysteine with prevalent and incident calcification, and multivariable logistic regression was used to assess associations between homocysteine and calcification progression. Elevated homocysteine was associated with greater relative risk of prevalent and incident CAC and incident DTAC. We also identified a strong association between elevated homocysteine and CAC and DTAC progression. Elevated homocysteine was found to confer a >2-fold increased risk of severe CAC progression (defined as ΔCAC ≥100/year) and an ≈1.5-fold increased risk for severe DTAC progression (defined as ΔDTAC ≥100/year). Conclusions To our knowledge, this is the first study demonstrating an association between elevated homocysteine and both incidence and progression of coronary and extra-coronary vascular calcification. Our findings suggest a potential role for elevated homocysteine as a risk factor for severe vascular calcification progression. Future studies are warranted to further assess the utility of homocysteine as a biomarker for vascular calcification incidence and progression. Clinical Trial Registration https://www.clinicaltrials.gov/. Unique identifier: NCT00005487

Gestational diabetes mellitus, Vitamin D status and fetomaternal outcome

Background: Diabetes is the most common medical complication of pregnancy. Vitamin D deficiency which was initially considered only to influence bone metabolism, is now known to exert a wide spectrum of extra-skeletal effects. Vitamin D deficiency is closely associated with gestational diabetes mellitus, it also leads to adverse maternal and child outcome. Objective of this study was to compare the vitamin D levels in healthy pregnant women and women with gestational diabetes mellitus and to observe the feto-maternal outcome.Methods: This prospective study was carried out on 160 pregnant women between the age group 20-40 years attending the Obstetrics and Gynaecology department of JNMC, AMU, Aligarh from October 2016 to October 2018. Women were divided into group A- normal pregnant women and group B- women with GDM. Estimation of vitamin D was done in both the groups.Results: Mean vitamin D levels were lower in women with GDM as compared to normal pregnant women.Conclusions: Women with vitamin D deficiency have an increased risk of developing GDM and adverse feto maternal outcome as compared to those who had normal level of vitamin

CT imaging and staging of carcinoma oesophagus

Background: Over the past decades, computerized tomography (CT) technology has led to an early detection of cancers and thereby decreasing mortality rate. The objective was to demonstrate usefulness of Toshiba Activion 16 slice multi detector computerized tomography (MDCT) scan in staging of oesophageal cancer.Methods: The study was carried out in the Department of Radio diagnosis, Bapuji Hospital and Chigateri Government Hospital attached to Jagadguru Jayadeva Murugarajendra Medical College, Davangere, Karnataka, India over a period of 24 months. After taking a properly informed written consent, complete history and thorough clinical examination was done and these patients were subjected to CT scan.Results: The total numbers of patients studied in present study were 25. Out of which 10 were males and 15 were females. There were 6 patients upto the age of 54 years and 8 patients equal to or greater than 65 years of age, there were 11 patients between 55-64 years of age. Dysphagia was the most common symptom in patients and was present in all the 25 patients of present study. Other common symptoms were weight loss followed by pain in throat. Two different types of wall thickenings of the involved portion have been reported. The most common asymmetrical wall thickening was observed in maximum number of patients 18 (72%) and circumferential wall thickening was observed only in 7 number (28%) of patients out of 25 total patients showing heterogeneous/homogeneous enhancement. Lower third (40%) and middle third (40%) of the esophagus was the most common site of involvement with regards to location of oesophageal cancer followed by upper third (20%) of the esophagus. Homogeneous wall attenuation was observed in most of the cases accounting for (64%). The other type of wall attenuation noted were heterogeneous (36%).Conclusions: By performing endoscopy uncertainty lies in discrimination of muscular layer from serosal layer in most parts of esophagus. However, by employing MDCT technique separation of 2 layers of esophagus can be better judged.  Therefore, MDCT has been found to be the most valuable and preferential technique for planning operational strategy

Role of bronchoalveolar lavage, transbronchial needle aspiration with bronchial biopsy correlation in lung tumours and immunohistochemistry wherever required

Background: Lung cancer is most frequently diagnosed major cancer in the world and the most common cause of cancer mortality worldwide. It comprises about 17% of the total new cancer cases in males and 23% of the total cancer deaths. The objectives of this study were to compare bronchial biopsy, BAL and TBNA in diagnosing lung malignancies and IHC wherever required.Methods: The study was conducted at Sher-i-Kashmir Institute of Medical Sciences Srinagar, India in the department of Pathology. It was a prospective study over a period of 1½ years from June 2015 to December 2016. All patients clinically/ radiologically suspected of lung malignancies who presented between June 2015 to December 2016 and underwent bronchial biopsy, BAL (washings) and TBNA were included in the study. The study included only those cases where BAL, TBNA and bronchial biopsy were done simultaneously.Results: Out of a total 117 clinically suspected cases of lung cancer, tumor was found in 103 cases (103/117) by biopsy, 51 cases by BAL (51/117) and 64 cases by TBNA (64/117). The total number of false positive cases and false negative cases by BAL were 6 and 58. Sensitivity of BAL was found to be 43.69% and specificity 57.14%. The total number of false positive cases and false negative cases by TBNA were 7 and 46. Sensitivity and specificity of TBNA was found to be 55.34% and 50.0%.Conclusions: Thus, in the present study yield of diagnosis was highest with the bronchoscopic biopsies and in maximum number of cases with a sensitivity of 88.034%, and specific histologic diagnosis was made by biopsies and IHC only. Though BAL and TBNA were inferior to bronchial biopsy in diagnosing lung malignancies but these were effective for peripheral lung malignancies and when the patient was at risk of haemorrhage

Radiographic imaging of metabolic bone disorders and their relative management

Background: Bone is a strong dynamic organ of the endoskeleton playing a vital role in structural integrity envisaging to keep proper shape and maintenance of the body, mineral reservoirs, blood production, coagulation and immunity. Metabolic bone diseases are a heterogeneous group of disorders that interrupt the normal homeostasis of bone formation and resorption. Bone regulates as well as acts as a host for hematopoiesis by providing niche for proliferation and differentiation of hematopoietic cell. Bone is a dynamic tissue but metabolically active as it is being constantly formed (modelling) and reformed (remodelling). Metabolic bone diseases comprise of a broad spectrum of inherited and acquired disorders characterized by abnormalities in calcium metabolism and bone cell physiology- that lead to an altered serum calcium concentration and skeletal failure.Methods: After taking a properly informed written consent and complete history, thorough clinical examination was done and these patients were subjected to radiographic imaging and biochemical analysis.Results: Serum alkaline phosphatase is a good marker in rickets and osteomalacia, ICTP in osteoporosis, pyridinoline, deoxypyridinoline in primary hyperparathyroidism, serum PICP in renal osteodystrophy.Conclusions: In cases of rickets and osteomalacia either decreased or normal values of serum calcium and serum phosphorus were obtained. But the cases pertaining to renal failure with rickets values of serum phosphorous were found to be raised. However, in all cases of rickets and osteomalacia values of serum alkaline phosphatase were also found to be raised

Genopal™: A Novel Hollow Fibre Array for Focused Microarray Analysis

Expression profiling of target genes in patient blood is a powerful tool for RNA diagnosis. Here, we describe Genopal™, a novel platform ideal for efficient focused microarray analysis. Genopal™, which consists of gel-filled fibres, is advantageous for high-quality mass production via large-scale slicing of the Genopal™ block. We prepared two arrays, infectant and autoimmunity, that provided highly reliable data in terms of repetitive scanning of the same and/or distinct microarrays. Moreover, we demonstrated that Genopal™ had sensitivity sufficient to yield signals in short hybridization times (0.5 h). Application of the autoimmunity array to blood samples allowed us to identify an expression pattern specific to Takayasu arteritis based on the Spearman rank correlation by comparing the reference profile with those of several autoimmune diseases and healthy volunteers (HVs). The comparison of these data with those obtained by other methods revealed that they exhibited similar expression profiles of many target genes. Taken together, these data demonstrate that Genopal™ is an advantageous platform for focused microarrays with regard to its low cost, rapid results and reliable quality