Development of novel therapeutic approaches: (I) Targeting allergic responses to peanuts and (II) Inhibition of DPP-IV enzyme involved in diabetes

There is an increase in prevalence of peanut allergy, especially in the western world. The only current treatment for peanut allergy is avoidance of peanut from diet and contact. Additionally, there is currently no specific vaccine that can be taken to decrease peanut allergies. The method of desensitizing a person allergic to peanut allergy is deemed unsafe as the smallest amount of peanut can trigger an anaphylaxis reaction. Thus, various allergoids were created by modifying major peanut protein allergen Ara h2 using various cross-linkers and modification agents in order to disrupt the binding surface epitopes of the antigen to antibody. Diabetes is also a growing problem that affects millions of people globally. Having diabetes is known to lead to various morbidity as well which can be detrimental to the patient and a burden to the economy. Various drugs are available as monotherapy for diabetes; however, we aimed to develop dual acting compounds that would not only control type 2 diabetes but also commonly associated diagnosis of hypertension as well. Thus, we have successfully synthesized and tested compounds in vitro as effective dipeptidyl peptidase-IV (DPP-IV) inhibitors and potentially effective in treating hypertension (future study) associated with diabetes by utilizing cyanopyrrolidines and Beta-amino alcohols scaffolds in the structure, respectively

Predictors of do-not-resuscitate order utilization in decompensated cirrhosis hospitalized patients: A nationwide inpatient cohort study

Introduction and objectives: Decompensated cirrhosis carries high inpatient morbidity and mortality. Consequently, advance care planning is an integral aspect of medical care in this patient population. Our study aims to identify do-not-resuscitate (DNR) order utilization and demographic disparities in decompensated cirrhosis patients. Patients or materials and methods: Nationwide Inpatient Sample was used to extract the cohort of patients from January 1st, 2016 to December 31st, 2017, based on the most comprehensive and recent data. The first cohort included hospitalized patients with decompensated cirrhosis. The second cohort included patients with decompensated cirrhosis with at least one contraindication for liver transplantation. Results: A cohort of 585,859 decompensated cirrhosis patients was utilized. DNR orders were present in 14.2% of hospitalized patients. DNR utilization rate among patients with relative contraindication for liver transplantation was 15.0%. After adjusting for co-morbid conditions, disease severity, and inpatient mortality, African-American and Hispanic patient populations had significantly lower DNR utilization rates. There were regional, and hospital-level differences noted. Moreover, advanced age, advanced stage of decompensated cirrhosis, inpatient mortality, and relative contraindications for liver transplantation (metastatic neoplasms, dementia, alcohol misuse, severe cardiopulmonary disease, medical non-adherence) were independently associated with increased DNR utilization rates. Conclusions: The rate of DNR utilization in patients with relative contraindications for liver transplantation was similar to patients without any relative contraindications. Moreover, there were significant demographic and hospital-level predictors of DNR utilization. This information can guide resource allocation in educating patients and their families regarding prognosis and outcome expectations

Changes in the menstruation pattern after COVID infection: A questionnaire based study

The pandemic of COVID 19  had  tremendous impact on the physical, mental as well as the social well being of the people. It has affected the respiratory, cardiovascular as well as endocrine system. Menstruation which is a regular cyclical phenomenon seem in females of reproductive age group has also been affected because of COVID-19. A study was conducted in Dhiraj hospital to know about the affect of COVID on menstrual patterns of the women who were affected . At the end of the study we observed that the women who recovered from covid infection suffered from altered menstrual pattern in form of scanty menstrual blood flow and, prolonged cycles, few women experienced menorrhagia with excessive amount of blood loss. When followed up for 4 months almost all women regained their normal pattern of menstrual cycle suggesting that the covid 19 infection had  transitory effect on menstrual pattern