Role of yogic practices in individuals with hypertension and low-Peak Expiratory Flow Rate (PEFR) of Ahmedabad city

589-594Hypertension is one of the most important risk factors for various heart related diseases in India, especially in South-Asian region. Nowadays because of very fast life style, breathing pattern and its duration is changed considerably. Breathing duration becomes very short. The main aim of the present study was to assess the therapeutic role of yoga on various cardiovascular parameters, peak expiratory flow rate (PEFR) through pulmonary function test and peripheral capillary oxygen saturation (SpO2), amount of oxygen in the blood in Ahmedabad population. Total 50 individuals with hypertension, low-PEFR and low-SpO2 were selected for the present study. All participants were subjected to yoga therapy (pranayama, yoga postures and meditation) for various time intervals of 0, 3, 6, 9, and 12 months. Heart rate (HR), systolic pressure (SP), diastolic pressure (DP), pulse pressure (PP), mean arterial pressure (MAP), rate pressure product (RPP), double product (DoP), PEFR and SpO2 were measured from all individuals at different intervals. At 0 month, all individuals had very high heart rate (HR), systolic pressure (SP), diastolic pressure (DP), pulse pressure (PP), mean arterial pressure (MAP), rate pressure product (RPP), double product (DoP), but PEFR and SpO2 levels were very low. At the end of 12 month of yoga intervention, significant decrease in all cardiovascular parameters whereas significant elevation of PEFR and SpO2 levels were observed. In conclusion, a comprehensive yoga therapy programme has immense potential to augment the beneficial effects of standard medical management of hypertension, lungs function and total oxygen concentration. Hence it can be used as an effective complementary therapy for heart related diseases

Role of yogic practices in individuals with hypertension and low-Peak Expiratory Flow Rate (PEFR) of Ahmedabad city

Hypertension is one of the most important risk factors for various heart related diseases in India, especially in South-Asian region. Nowadays because of very fast life style, breathing pattern and its duration is changed considerably. Breathing duration becomes very short. The main aim of the present study was to assess the therapeutic role of yoga on various cardiovascular parameters, peak expiratory flow rate (PEFR) through pulmonary function test and peripheral capillary oxygen saturation (SpO2), amount of oxygen in the blood in Ahmedabad population. Total 50 individuals with hypertension, low-PEFR and low-SpO2 were selected for the present study. All participants were subjected to yoga therapy (pranayama, yoga postures and meditation) for various time intervals of 0, 3, 6, 9, and 12 months. Heart rate (HR), systolic pressure (SP), diastolic pressure (DP), pulse pressure (PP), mean arterial pressure (MAP), rate pressure product (RPP), double product (DoP), PEFR and SpO2 were measured from all individuals at different intervals. At 0 month, all individuals had very high heart rate (HR), systolic pressure (SP), diastolic pressure (DP), pulse pressure (PP), mean arterial pressure (MAP), rate pressure product (RPP), double product (DoP), but PEFR and SpO2 levels were very low. At the end of 12 month of yoga intervention, significant decrease in all cardiovascular parameters whereas significant elevation of PEFR and SpO2 levels were observed. In conclusion, a comprehensive yoga therapy programme has immense potential to augment the beneficial effects of standard medical management of hypertension, lungs function and total oxygen concentration. Hence it can be used as an effective complementary therapy for heart related diseases

Protective action of taurine, given as a pretreatment or as a posttreatment, against endotoxin-induced acute lung inflammation in hamsters

To assess the effect of taurine on lipopolysaccharide (LPS)-induced lung inflammation, oxidative stress and apoptosis, female Golden Syrian hamsters were intratracheally instilled with bacterial LPS (0.02 mg in phosphate buffered saline (PBS) pH 7.4), before or after a 3-day intraperitoneal treatment with a single dose of taurine (50 mg/kg/day in PBS pH 7.4), and bronchoalveolar lavage fluid (BALF) and lung tissue samples were collected at 24 hr after the last treatment. In comparison to BALF samples from animals receiving only PBS pH 7.4, and serving as controls, those of LPS-stimulated animals exhibited a higher count of both total leukocytes and neutrophils and increased expression of tumor necrosis factor receptor 1. In comparison to lungs from control animals, those from LPS-treated animals showed increased cellular apoptosis, lipid peroxidation, decreased glutathione levels, altered activities of antioxidant enzymes (catalase, glutathione peroxidase, superoxide dismutase) and focal inflammation confined to the parenchyma. A treatment with taurine was found to significantly attenuate all these alterations, with the protection being, in all instances, greater when given before rather than after LPS. The present results suggest that taurine is endowed with antiinflammatory and antioxidant properties that are protective in the lung against the deleterious actions of Gram negative bacterial endotoxin

Study of therapeutic role of yoga (Hathyoga) on lipid profile in dyslipidemic individuals of Ahmedabad city

333-338Abnormal lipid profile is a common problem among hypertensive as well as working individuals. The rate of mortality is increasing day-by-day due to cardiovascular problems which occurs due to dyslipidemia. The aim of the present study was to assess the therapeutic role of yoga on lipid profile in Ahmedabad population. Total 50 normal healthy control and 50 individuals with dyslipidemia aged >20 years were enrolled for the present study. They were divided into two groups. Individuals in Group-1 were normal healthy, whereas individuals in Group-2 were dyslipidemics. All participants were subjected to yoga practices (Hathyogic practices - Pranayama, yoga postures and meditation) for the various intervals of 0, 3, 6, 9, and 12 months. Serum lipid profile was estimated for all individuals at different intervals. Before beginning the yoga intervention i.e., at 0 month the levels of Total Cholesterol, Total Triglycerides, LDL-cholesterol and VLDL-cholesterol were significantly high, whereas HDL-cholesterol levels were significantly low. After completion of 12 months yoga intervention a significant reduction was observed in Total Cholesterol, Total Triglycerides, LDL-cholesterol and VLDL-cholesterol as well as a significant elevation of HDL-cholesterol was observed. Yoga (Hathyoga) can be a new added adjuvant and cost effective therapy for the patients with abnormal lipid profile

C-type natriuretic peptide (CNP) in the paraventricular nucleus-mediated renal sympatho-inhibition

Volume reflex produces sympatho-inhibition that is mediated by the hypothalamic paraventricular nucleus (PVN). However, the mechanisms for the sympatho-inhibitory role of the PVN and the neurochemical factors involved remain to be identified. In this study, we proposed C-type natriuretic peptide (CNP) as a potential mediator of this sympatho-inhibition within the PVN. Microinjection of CNP (1.0 μg) into the PVN significantly decreased renal sympathetic nerve activity (RSNA) (−25.8% ± 1.8% vs. −3.6% ± 1.5%), mean arterial pressure (−15.0 ± 1.9 vs. −0.1 ± 0.9 mmHg) and heart rate (−23.6 ± 3.5 vs. −0.3 ± 0.9 beats/min) compared with microinjection of vehicle. Picoinjection of CNP significantly decreased the basal discharge of extracellular single-unit recordings in 5/6 (83%) rostral ventrolateral medulla (RVLM)-projecting PVN neurons and in 6/13 (46%) of the neurons that were not antidromically activated from the RVLM. We also observed that natriuretic peptide receptor type C (NPR-C) was present on the RVLM projecting PVN neurons detected by dual-labeling with retrograde tracer. Prior NPR-C siRNA microinjection into the PVN significantly blunted the decrease in RSNA to CNP microinjections into the PVN. Volume expansion-mediated reduction in RSNA was significantly blunted by prior administration of NPR-C siRNA into the PVN. These results suggest a potential role for CNP within the PVN in regulating RSNA, specifically under physiological conditions of alterations in fluid balance

Smartphone-based, rapid, wide-field fundus photography for diagnosis of pediatric retinal diseases

PurposeAn important, unmet clinical need is for cost-effective, reliable, easy-to-use, and portable retinal photography to evaluate preventable causes of vision loss in children. This study presents the feasibility of a novel smartphone-based retinal imaging device tailored to imaging the pediatric fundus.MethodsSeveral modifications for children were made to our previous device, including a child-friendly 3D printed housing of animals, attention-grabbing targets, enhanced image stitching, and video-recording capabilities. Retinal photographs were obtained in children undergoing routine dilated eye examination. Experienced masked retina-specialist graders determined photograph quality and made diagnoses based on the images, which were compared to the treating clinician's diagnosis.ResultsDilated fundus photographs were acquired in 43 patients with a mean age of 6.7 years. The diagnoses included retinoblastoma, Coats' disease, commotio retinae, and optic nerve hypoplasia, among others. Mean time to acquire five standard photographs totaling 90-degree field of vision was 2.3 ± 1.1 minutes. Patients rated their experience of image acquisition favorably, with a Likert score of 4.6 ± 0.8 out of 5. There was 96% agreement between image-based diagnosis and the treating clinician's diagnosis.ConclusionsWe report a handheld smartphone-based device with modifications tailored for wide-field fundus photography in pediatric patients that can rapidly acquire fundus photos while being well-tolerated.Translational relevanceAdvances in handheld smartphone-based fundus photography devices decrease the technical barrier for image acquisition in children and may potentially increase access to ophthalmic care in communities with limited resources

Trends of HIV-related cancer mortality between 2001 and 2018: an observational analysis

The burden of AIDS-defining cancers has remained relatively steady for the past two decades, whilst the burden of non-AIDS-defining cancer has increased. Here, we conduct a study to describe mortality trends attributed to HIV-associated cancers in 31 countries. We extracted HIV-related cancer mortality data from 2001 to 2018 from the World Health Organization Mortality Database. We computed age-standardized death rates (ASDRs) per 100,000 population using the World Standard Population. Data were visualized using Locally Weighted Scatterplot Smoothing (LOWESS). Data for females were available for 25 countries. Overall, there has been a decrease in mortality attributed to HIV-associated cancers among most of the countries. In total, 18 out of 31 countries (58.0%) and 14 out of 25 countries (56.0%) showed decreases in male and female mortality, respectively. An increasing mortality trend was observed in many developing countries, such as Malaysia and Thailand, and some developed countries, such as the United Kingdom. Malaysia had the greatest increase in male mortality (+495.0%), and Canada had the greatest decrease (-88.5%). Thailand had the greatest increase in female mortality (+540.0%), and Germany had the greatest decrease (-86.0%). At the endpoint year, South Africa had the highest ASDRs for both males (16.8/100,000) and females (19.2/100,000). The lowest was in Japan for males (0.07/100,000) and Egypt for females (0.028/100,000)

Genomic context and TP53 allele frequency define clinical outcomes in TP53-mutated myelodysplastic syndromes

TP53 mutations are associated with adverse outcomes and shorter response to hypomethylating agents (HMAs) in myelodysplastic syndrome (MDS). Limited data have evaluated the impact of the type, number, and patterns of TP53 mutations in response outcomes and prognosis of MDS. We evaluated the clinicopathologic characteristics, outcomes, and response to therapy of 261 patients with MDS and TP53 mutations. Median age was 68 years (range, 18-80 years). A total of 217 patients (83%) had a complex karyotype. TP53 mutations were detected at a median variant allele frequency (VAF) of 0.39 (range, 0.01-0.94). TP53 deletion was associated with lower overall response rate (ORR) (odds ratio, 0.3; P = .021), and lower TP53 VAF correlated with higher ORR to HMAs. Increase in TP53 VAF at the time of transformation was observed in 13 patients (61%), and previously undetectable mutations were observed in 15 patients (65%). TP53 VAF was associated with worse prognosis (hazard ratio, 1.02 per 1% VAF increase; 95% confidence interval, 1.01-1.03; P \u3c .001). Integration of TP53 VAF and karyotypic complexity identified prognostic subgroups within TP53-mutant MDS. We developed a multivariable model for overall survival that included the revised International Prognostic Scoring System (IPSS-R) categories and TP53 VAF. Total score for each patient was calculated as follows: VAF TP53 + 13 × IPSS-R blast score + 16 × IPSS-R cytogenetic score + 28 × IPSS-R hemoglobin score + 46 × IPSS-R platelet score. Use of this model identified 4 prognostic subgroups with median survival times of not reached, 42.2, 21.9, and 9.2 months. These data suggest that outcomes of patients with TP53-mutated MDS are heterogeneous and that transformation may be driven not only by TP53 but also by other factors

Outcomes and genetic dynamics of acute myeloid leukemia at first relapse

Patients with relapsed acute myeloid leukemia (rAML) experience dismal outcomes. We performed a comprehensive analysis of patients with rAML to determine the genetic dynamics and survival predictive factors. We analyzed 875 patients with newly diagnosed AML who received intensive treatment (IT) or low-intensity treatment (LIT). Of these patients, 197 experienced subsequent rAML. Data was available for 164 patients, with a median time from CR/CRi to relapse of 6.5 months. Thirty-five of the 164 patients (21%) experienced relapse after allogeneic hematopoietic stem cell transplantation (alloSCT). At relapse mutations in genes involved in pathway signaling tended to disappear, whereas clonal hematopoiesis-related mutations or TP53 tended to persist. Patients with normal karyotypes tended to acquire cytogenetic abnormalities at relapse. Patients treated with IT had a higher emergence rate of TP53 mutations (16%), compared to patients treated with LIT (1%, P = 0.009). The overall response rates were 38% and 35% for patients treated with salvage IT or LIT, respectively. Seventeen patients (10%) underwent alloSCT after salvage therapy. The median overall survival (OS) duration after relapse was 5.3 months, with a 1-year OS rate of 17.6%. Complex karyotype (hazard ratio [HR] = 2.14, P < 0.001), a KMT2A rearrangement (HR = 3.52, P = 0.011), time in remission < 12 months (HR = 1.71, P = 0.011), and an elevated white blood cell count at relapse (HR = 2.38, P = 0.005) were independent risk factors for OS duration. More effective frontline and maintenance therapies are warranted to prevent rAML